Objectives To investigate the impact of waiting for psychological therapy on client well‐being as measured by the Clinical Outcomes in Routine Evaluation‐Outcome Measure (CORE‐OM) global distress (GD) score. Method Global distress scores were retrieved for all clients referred for psychological therapy in a secondary care mental health service between November 2006 and May 2013 and who had completed a CORE‐OM at assessment and first session. GD scores for a subgroup of 103 clients who had completed a CORE‐OM during the last therapy session were also reviewed. Results The study sample experienced a median wait of 41.14 weeks between assessment and first session. The relationship between wait time from referral acceptance to assessment, and assessment GD score was not significant. During the period between assessment and first session no significant difference in GD score was observed. Nevertheless 29.1% of the sample experienced reliable change; 16.0% of clients reliably improved and 13.1% reliably deteriorated whilst waiting for therapy. Demographic factors were not found to have a significant effect on the change in GD score between assessment and first session. Waiting time was associated with post‐therapy outcomes but not to a degree which was meaningful. The majority of individuals (54.4%), regardless of whether they improved or deteriorated whilst waiting for therapy, showed reliable improvement at end of therapy as measured by the CORE‐OM. Conclusion The majority of GD scores remained stable while waiting for therapy; however, 29.1% of secondary care clients experienced either reliable improvement or deterioration. Irrespective of whether they improved, deteriorated or remained unchanged whilst waiting for therapy, most individuals who had a complete end of therapy assessment showed reliable improvements following therapy. Practitioner points There was no significant difference in GD score between assessment and first session recordings. A proportion of clients (29.1%) showed reliable change, either improvement or deterioration, as measured by the GD score while waiting for therapy. Of the individuals with last session CORE‐OMs (54.4%) showed significant improvement following therapy regardless of whether or not they experienced change while waiting for therapy. Limitations include Problems of data quality, the data were from a routine data set and data were lost at each stage of the analysis. A focus on the CORE‐OM limits exploration of the subjective experience of waiting for psychotherapy and the impact this has on psychological well‐being.
Number of sessions, length of therapy (in weeks), and treatment intensity (the number of sessions per week between the first and last therapy sessions) were not related to therapeutic gains. These results fit with a responsive regulation model of therapy duration, suggesting an individualized approach to therapy cessation as opposed to therapy session limits as the number of sessions a patient experienced was not generally associated with outcome. We found that clients with a diagnosis of a behavioural syndrome (F50-59) had less 'intensive' therapy; they experienced the same number of sessions over a longer time frame. Despite this, there were no associations between diagnosis category and change in score.
The article examines a previously undocumented practice whereby psychotherapy clients support the significance of their experience against the background of how it can otherwise be heard. This practice is the phrase "it sounds X, but Y" (e.g., "which sounds silly now, but was like important then"). We call this an SXB-contrast. We used conversation analysis to examine 21 instances of this phenomenon, identified in 12 audio-recorded individual psychotherapy sessions involving 10 clients and 8 therapists. Clients use SXB-contrasts to mark part of their talk as delicate, specifically by voicing an unsympathetic hearing of that talk whilst supporting its experiential significance. Evidence for our claims comes from clients' use of SXB-contrasts in association with practices of speech delivery (e.g., laughter) and self-repair operations which also establish a part of their talk as delicate. Therapist responses provide additional supporting evidence. The study contributes to understanding how clients can use meta-talk to convey the meaning of their experiences in therapy whilst also making available their own emerging awareness of the multiple meanings of those experiences.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.