I Was Wrong: The Healing Power of Admitting Mistakes in Psychotherapy
Across modalities, the therapeutic relationship has consistently been found to be a robust predictor of treatment outcome. Most practicing clinicians understand this finding and work hard at establishing and maintaining a collaborative working alliance. Here’s a less well known, but sobering statistic: clients report tensions or actual breakdowns in ...
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The Benefits of Doubt: New Research Sheds Light on Becoming a More Effective Therapist
These are exciting times for clinicians. The pieces of the puzzle are falling into place. Researchers are finally beginning to understand what it takes to improve the effectiveness of psychotherapy. Shifting away from the failed, decades-long focus on methods and diagnosis, attention has now turned to the individual practitioner ...
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Swedish National Audit Office concludes: When all you have is CBT, mental health suffers
"The One-Sided Focus on CBT is Damaging Swedish Mental Health" That's the headline from one of Sweden's largest daily newspapers for Monday, November 9th. Professor Gunnar Bohman, together with colleagues and psychotherapists, Eva Mari Eneroth Säll and Marie-Louise Ögren, were responding to a report released last week by the Swedish National ...
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Do Psychotherapists Improve with Time and Experience?
The practice known as “routine outcome measurement,” or ROM, is resulting in the publication of some of the biggest and most clinically relevant psychotherapy studies in history. Freed from the limits of the randomized clinical trial, and accompanying obsession with manuals and methods, researchers are finally able to examine what ...
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Helping Therapists Help: MyOutcomes Wins Medipex NHS Innovation Award in UK
Documentation and regulation are on the rise. On average, clinicians spend 30% of their day doing paperwork that contributes little if anything to the health and welfare of their clients. What's more, research shows that a high documentation to clinical service ratio leads to higher rates of:
- Burnout and ...
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Recent study documents the effectiveness of psychotherapy has been overstated: An example of an RFTM and PEBKAC problem
Not being a computer nerd, I'd never come across these expressions. My 14-year-old son was the first person I heard use the terms. He was referring to a problem I was having with my desktop computer. To be sure, I'm no Luddite. Still, "computer" will always be a second ...
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The Verdict is “In”: Feedback is NOT enough to Improve Outcome
Nearly three years have passed since I blogged about claims being made about the impact of routine outcome monitoring (ROM) on the quality and outcome of mental health services. While a small number of studies showed promise, others results indicated that therapists did not learn from nor become more effective ...
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Intake: A Mistake
Available evidence leaves little doubt. As I’ve blogged about previously, separating intake from treatment results in: • Higher dropout rates; • Poorer outcomes; • Longer treatment duration; and • Higher costs And yet, in many public behavioral health agencies, the practice is commonplace. What else can we expect? Chronically ...
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What’s happening to CBT? And why all the hoopla misses the point
In May 2012, I blogged about results from a Swedish study examining the impact of psychotherapy's "favorite son"--cognitive behavioral therapy--on the outcome of people disabled by depression and anxiety. Like many other Western countries, the percentage of people in Sweden disabled by mental health problems was growing dramatically. Costs were skyrocketing. Even with treatment, far too many left the workforce permanently ...
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Love, Mercy, & Adverse Events in Psychotherapy
Just over a year ago, I blogged about an article that appeared in one of the U.K.'s largest daily newspapers, The Guardian. Below a picture of an attractive, yet dejected looking woman (reclined on a couch), the caption read, "Major new study reveals incorrect...care can do more harm than good." ...
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Time to Rethink Burnout: Lessons from Supershrinks
The world seems to be in the midst of a pandemic of burnout, spread across all age groups, genders, professions, and cultures. Research specific to mental health providers finds that between 21 and 67 percent may be experiencing high levels. Other related “conditions” have been identified, including compassion fatigue (CF), ...
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Something Fun for Summer: Mindreading, Memory, and Top Performance
Over the last several weeks, I've posted a series of blogs on some pretty serious subjects: (1) new and counterintuitive findings about the therapeutic relationship; (2) data documenting the lack of difference in outcome between mental health professionals, students, paraprofessionals, and a compassionate friend; and (3) cutting edge research on ...
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Room for Improvement: Feedback Informed Treatment and the Therapeutic Relationship
My Scandinavian Grandmother Christina was fond of saying, “The room for improvement…is the biggest one in our house.” Turns out, when it comes to engaging people in physical and mental health services, Grandma was right. We healthcare professionals can do better—and recent research points the way. Stanford psychologists Sims and ...
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What is the difference between a therapist and a compassionate friend?
What’s the difference between a trained therapist and a compassionate friend? Look at outcomes and you are likely to be disappointed. For example, meta-analyses of studies comparing professionals to paraprofessionals (or students) either find that the latter group achieve significantly better results or, at worst, the same! A clearer difference ...
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The Failure Rate of Psychotherapy: What it is and what we can do?
You are not going to believe me when I say it. Fifty percent. It’s true. Even in studies where carefully selected therapists who receive copious amounts of training, support, and supervision, and treat clients with a single diagnosis or problem, between 5 and 10% get worse and 35-40% experience ...
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Becoming a more effective therapist: Three evidence-based clues from research on the field’s most effective practitioners
It’s one of those secrets everyone knows, but few talk openly about: some therapists are more effective than others. Available evidence indicates that clients seen by these practitioners experience 50% more improvement, 50% less drop out, have shorter lengths of stay, and are significantly less likely to deteriorate while ...
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