What Therapists Want/Opening the Path (original) (raw)

2010

Most therapists aspire to become better at what they do. However, research has shown that personal therapy has nothing to do with outcome; there are no therapeutic approaches, strategies or interventions shown to be better than any other; professional training and discipline do not matter much to outcome; there is no evidence to show that continuing professional education will improve effectiveness; and, although it defies common sense, experience does not improve outcomes either. So what does 'professional development' mean and how do we accomplish it? In this edited extract from his recent book, On Becoming a Better Therapist, BARRY DUNCAN explores how we can remember our original aspirations, continue to develop as therapists, and achieve better results more often with a wider variety of clients.

The Journey of the Counselor and Therapist: Research Findings and Perspectives on Professional Development

Journal of Career Development, 2003

This article summarizes a reformulation of the main findings and perspectives from a cross-sectional and longitudinal qualitative study of the development of 100 counselors and therapists. The results are presented as a phase model and as a formulation of 14 themes of counselor/therapist development. The following six phases are described: The phases of the lay helper, the beginning student, the advanced student, the novice professional, the experienced professional, and the senior professional. The themes describe central processes of counselor/therapist development. The themes are addressing different issues such as shifts in attentional focus and emotional functioning, the importance of continuous reflection for professional growth, and a life-long personal/profession integration process. Sources of influence for professional functioning and development are described. The results show consistently that interpersonal experiences in the personal life domain (early family life

The Evolving Professional Self: Stages and Themes in Therapist and Counselor Development

Therapist predictors of early patient-rated working alliance: A multilevel approach

Psychotherapy Research, 2010

The present study investigated whether and how various therapists' (N 0 68) self-reported characteristics relating to their therapeutic work predicted patients' (N 0 335) early ratings of the working alliance in a naturalistic psychotherapy study. Results from multilevel modeling demonstrated that certain self-reports accounted well for the therapist effect in the early alliance. The effect of therapists' experiences of difficulties in practice was particularly strong: a negative influence of difficulties termed negative personal reaction (NPR) and a surprising positive influence of another factor, professional selfdoubt (PSD), were found. The latter was interpreted as reflecting an attitude of therapist humbleness and sensitivity, which seems to facilitate alliance development. A negative impact of self-reported skills in using one's own and the patients' emotional reactions in the therapeutic relationship (advanced relational skills) was found when controlling for a warm interpersonal style. The negative effect of advanced relational skills depended on the level of NPR difficulties. The findings suggest that therapists should be cautious in using this kind of relational skill unless they experience relating to patients in a warm manner and report low levels of NPR in their practice.

The Person of the Therapist: One Therapist's Journey to Relationship

In K. J. Schneider, J.F. Pierson, & J.F.T. Bugental (Eds.) The Handbook of Humanistic Psychology (2nd Ed.), Sage Publishing Co.

This chapter reviews the clients who most impacted Barry Duncan's career and journey to a relational model of psychotherapy and away from a medical model. This chapter appeared in In K. J. Schneider, J.F. Pierson, & J.F.T. Bugental (Eds.) The Handbook of Humanistic Psychology (2nd Ed.), Sage Publishing Co.

Accounting for Therapist Variability in Couple Therapy Outcomes: What Really Matters?

Journal of Sex & Marital Therapy, 2013

This study examined whether therapist gender, professional discipline, experience conducting couple therapy, and average second-session alliance score would account for the variance in outcomes attributed to the therapist. The authors investigated therapist variability in couple therapy with 158 couples randomly assigned to and treated by 18 therapists in a naturalistic setting. Consistent with previous studies in individual therapy, in this study therapists accounted for 8.0% of the variance in client outcomes and 10% of the variance in client alliance scores. Therapist average alliance score and experience conducting couple therapy were salient predictors of client outcomes attributed to therapist. In contrast, therapist gender and discipline did not significantly account for the variance in client outcomes attributed to therapists. Tests of incremental validity demonstrated that therapist average alliance score and therapist experience uniquely accounted for the variance in outcomes attributed to the therapist. Emphasis on improving therapist alliance quality and specificity of therapist experience in couple therapy are discussed.

Stressful involvement in psychotherapeutic work: Therapist, client and process correlates

Psychotherapy Research, 2012

We examined potential predictors of therapists' ''Stressful Involvement'' (SI) among variables reflecting the psychotherapy process, therapist characteristics, patients' symptom severity or context variables (treatment setting). Ninety-eight sequences from individual psychodynamic treatments conducted by 26 therapists were studied. Data were analyzed using mixed regression models. Between-therapist and within-therapist variance accounted for most of the difference in SI. SI was strongly associated with negative feelings of the therapist about patient and therapy in the time between sessions. Therapists with more 'unassertive' and 'vindictive' interpersonal styles were also more prone to experiencing SI. The strong association of SI with therapist rather than patient characteristics and process ratings indicates the importance of further study of the therapist as a person and participant in psychotherapy.

The Partners for Change Outcome Management System (PCOMS): The Heart and Soul of Change Project

Two continuous monitoring and feedback models have demonstrated gains in randomized clinical trials (RCTs): Lambert's Outcome Questionnaire (OQ) System and the Partners for Change Outcome Management System (PCOMS). This article chronicles the evolution of PCOMS from a simple way to discuss the benefit of services with clients to its emergence as an evidenced based practice to improve outcomes. Although based in Lambert's model, several differences are described: PCOMS is integrated into the ongoing psychotherapy process and includes a transparent discussion of the feedback with the client; PCOMS assesses the alliance every session; and the Outcome Rating Scale, rather than a list of symptoms rated on a Likert Scale, is a clinical tool as well as an outcome instrument that requires collaboration with clients. The research supporting the psychometrics of the measures and the PCOMS intervention is presented and the clinical process summarised. Examples of successful transportation to public behav-ioural health are offered and an implementation process that values consumer involvement, recovery, social justice, and the needs of the front-line clinician is discussed. With now nine RCTs and American Psychological Association endorsements to support it, it is argued that client-based outcome feedback offers a pragmatic way to transport research to practice.

What Therapists Want/Opening the Path (original) (raw)

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