This year marks the 25<sup>th</sup> anniversary of the year that the late Enrico Jones first published his manual for the Psychotherapy Process Q-set (PQS). The manual has since been published in Jones' landmark book, <em>Therapeutic Action</em> (2000), and was recently revised and updated by the Massachusetts General Hospital Psychotherapy Research Program. In this article, we mark the 25<sup>th</sup> anniversary of the PQS by reviewing both the early findings from the measure and more current research driven by those first findings.
This study examined the preliminary results of an integrative, video-assisted training workshop aimed at helping psychotherapists build strong therapeutic relationships with their clients. Participants were 57 clinicians across five community mental health clinics, who were randomly assigned to the brief alliance-training workshop (in which they participated prior to starting treatment with a new client) or to a delayed-training control condition. Outcomes assessed included therapist-reported use of alliance strategies during Session 1, therapist-rated alliance quality after Session 1, and client engagement across the first 4 weeks. In contrast to hypotheses, one-way analyses of variance and chi-square analyses revealed no statistically significant differences between the training and the delayed-training conditions. However, the therapist-reported impact of using the workshop's alliance strategies was positively correlated with therapist-rated alliance quality (r = .30, p = .03) and marginally correlated with number of sessions attended (r = .25, p = .06) across the two conditions. The findings hold promise for the utility of a brief alliance-focused workshop, and for collaborations between researchers and clinicians seeking to bridge science and practice.
In this article, I reflect on the early influences and inspirations that continue to inform my work. I describe my research program on the therapeutic alliance and summarize a study conducted by me and my colleagues examining the efficacy of a brief alliance training for clinicians. I describe additional models of alliance training and end by offering recommendations for future studies of alliance training.
Psychotherapy inherently engages clients' preferences, which have been conceptualized as key elements of evidence-hased clinical practice. Yet, few studies have examined clients' preferences for their psychotherapist's personality characteristics, and even fewer have addressed potential variables that influence such preferences. In a unique study, Greenberg and Zeldow (1980) assessed participants' preferences for an ideal psychotherapist's personality traits, and whether these preferences differed by participant sex. Employing a comparable design, we reexamined in the present study (three decades later) college men and women's ideal psychotherapist preferences. The current participants {N = 258 undergraduates) completed the Adjective Check List (Gough & Heilbrun, 1965) to assess psychotherapist traits. Descriptive statistics are reported for preferred traits across sexes, while t tests and effect size estimates were used to examine differences between sexes. Eindings revealed that the most preferred clinician traits (e.g., personal adjustment, nurturance) were similar for male and female participants. However, Greenberg and Zeldow's primary finding was replicated in the current study: Men indicated a greater preference for a psychotherapist with historically stereotypical feminine sex-role traits, whereas women preferred a psychotherapist with historically stereotypical masculine sex-role traits. There were also several noticeable within-sex differences on stated preferences from the 1980 study to the present study. The fmdings provide psychotherapists with information on client preferences to which they might need to respond, or at least consider, at the level of staffing, client-psychotherapist matching, and/or treatment process.
Mental health care providers have been charged with the task of generating more evidence to support the quality and efficiency of their treatment practices. Health care policies are beginning to enforce the implementation of prescriptive treatment protocols with demonstrated efficacy for specific conditions. Psychotherapy treatment models designed for and evaluated in rigorously controlled experimental settings are frequently considered the hallmark of evidence-based practice. Experimental trials of psychotherapy brands have identified efficacious treatments for a number of specific conditions. However, the current experimental procedures for evaluating a specific treatment model may not be enough to account for the range of patients and challenges found in community practice settings. Clinicians express reservations that many research investigations do not address their most important concerns. Thus, clinical researchers are charged with the task of implementing research protocols of greater clinical utility. Public health practice settings offer numerous opportunities for joining clinical research and practice. However, implementing programmatic psychotherapy research in clinical practice settings presents a number of obstacles. In this article, a case example of implementing a research protocol in a public health safety-net hospital is the lens through which these obstacles are identified and possible solutions investigated. Experience gaps, financial constraints, design flaws, organizational culture, and clinician resistance are barriers to the implementation of practice-based psychotherapy research. With motivated efforts and creative problem solving, these barriers can be removed, opening an avenue for the advancement of practice-informed research and researchinformed practice.
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