How usual is treatment as usual? Experienced therapists’ reflections on participation in practice-based research

Halvorsen, Margrethe Seeger; Benum, Kirsten; Oddli, Hanne Weie; Stänicke, Erik; McLeod, John

doi:10.1080/09515070.2017.1397502

Cited by 7 publications

(5 citation statements)

References 46 publications

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“…In doing so, we address the need to examine the effectiveness of psychodynamic treatment beyond the efficacy evidence offered by randomized clinical trials (RCTs; Fonagy, ), and we respond to calls for theory‐driven research on psychoanalytic therapies by testing a theoretical premise of CRP (Luyten, Blatt, & Mayes, ). Practice‐based research findings complement evidence from RCTs, offering a different perspective of change and greater external and ecological validity (Barkham, Stiles, Lambert, & Mellor‐Clark, ; Halvorson, Benum, Oddli, Stänicke, & McLeod, ). Identifying trajectories of change extends previous empirical findings documenting that (a) change varies among subgroups of clients over time (Owen et al, ) and (b) not every client experiences improvement (e.g., Frankfurt, Frazier, Syed, & Jung, ).…”

Section: Introductionmentioning

confidence: 80%

Latent trajectories of change for clients at a psychodynamic training clinic

et al. 2019

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Objective Employing practice‐based research methods, we addressed the need to examine the effectiveness of psychodynamic treatment as a supplement to the efficacy evidence offered by randomized clinical trials. Method We used person‐centered analyses to generate latent subgroups of clients (N = 118; M age = 40.92; 53.4% female; 81.4% Caucasian; 80.5% heterosexual) receiving contemporary relational psychotherapy (CRP) at a psychodynamic community mental health training clinic. Results Subgroups of clients reported a change in depression, social conflict, and anxiety symptomatology, and overall life satisfaction, depicted by significant quadratic growth curves. Findings also offered exploratory support for a theoretical proposition from CRP that improved relational functioning would correspond to improved affect dysregulation and overall life satisfaction. Conclusion Clinical and training implications highlight the need to distinguish subgroups of “responders” and “nonresponders” to inform treatment.

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Section: Introductionmentioning

confidence: 80%

Latent trajectories of change for clients at a psychodynamic training clinic

et al. 2019

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“…We used a practice-based research design, a supplement to efficacy research (e.g. randomised controlled trials), which offered the opportunity to examine the effectiveness of psychotherapy to promote growth in virtuousness in a real-world treatment context, with greater ecological and external validity (Halvorson et al, 2020;Henton, 2012). Specifically, we tested the theoretical premise that growth in the virtue of humility could facilitate changes in mental health symptoms and social well-being through decreased affect dysregulation.…”

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confidence: 99%

Exploring virtue ethics in psychodynamic psychotherapy: latent changes in humility, affect regulation, symptoms and well‐being

Jankowski

Captari

Sandage

2021

Couns and Psychother Res

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A virtue ethics premise is that flourishing cannot be achieved solely through symptom reduction, but, rather, is inextricably connected with the development of 'qualities of human character and excellence which enhance the capacity to live well' (Sandage & Hill, 2001, p. 243). Sometimes also described as character strengths, virtues are grounded in motivational, affective, cognitive, relational, behavioural and contextual dimensions of human functioning, and thus hold important implications for therapists' clinical formulation and treatment approaches. Virtues orient clients to reflect on who they are and are becoming in relation to others (McMinn et al., 2016). While numerous virtue-based interventions exist (e.g. keeping a gratitude journal), considerably less attention has been given to understanding the complex and often implicit psychotherapeutic processes that promote or impede virtue development (Jankowski et al., 2020). Rowden and colleagues (2014) described a shift from 'focusing exclusively on what people do in relationships (action oriented or skills training approaches) to addressing who people are (character, affective, and motivational domains)' (p. 380). It is this focus on who people are in relation to others that is consistent with a psychodynamic understanding of virtue development (Akhtar, 2019; Summers & Barber, 2010), and frames our current study.Recent psychotherapy research suggests the importance of dual-factor models that attend to both mental health symptoms

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“…Giants Kraus, Miller, & Lambert, 2014;Shedler, 2006). Each group may consequently find it difficult to mentalize the assumptions and exigencies of the other (e.g., Halvorsen, Benum, Oddli, Stänicke, & McLeod, 2017;McWilliams, 2017). In the current research literature, some scholars have bemoaned "empirical imperialism" (Castonguay et al, 2015), in which academic researchers expect deference from clinicians but fail themselves to listen to their clinical colleagues.…”

Section: Feminist Ethicsmentioning

confidence: 99%

“…In this vein, both Wachtel (2016) and Orange (2003) emphasize the limitations of randomized-controlled studies, suggesting that the assumptions of their authors about the real-world clinical implementation of RCTs can be naïvely narrow; specifically, these investigators fail to appreciate the struggles and efforts of ordinary therapists with naturalistic samples of complex patients (see Shedler, 2018, for an even harsher critique). Halvorsen, et al (2017) note that "Several studies have suggested that research participation increased therapist interest in research and willingness to use research findings to inform their practice" (p. 4). Attention to research by clinicians is assumed to be valuable for practice.…”

Section: Feminist Ethicsmentioning

confidence: 99%

Collaborative reading of medical records in psychotherapy: A feminist psychoanalytic proposal about narrative and empowerment.

Fors

McWilliams

2016

Psychoanalytic Psychology

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Trust of Norway, for supporting this project from its inception-not only morally but also financially. A special thanks to Mette Kjaer, Head of Research at Finnmark Hospital Trust, and to Torben Wisborg, Head of the Research Board there, for helping me navigate Norwegian health law, Regional Ethical Committee requirements, and other practical issues. Much gratitude to the people I work under, Bryndis Rogde, Robert Kechter, Ragnhild Hanne Nilsen and Inger Lise Balandin, for supporting my work in the most generous ways. Thanks to my lovely colleagues for always backing my intellectual ambitions and enduring my absence from the clinic. Thanks to professor emerita Hanne Haavind for very valuable comments in the process of editing. Thanks to Joyce Slochower, Joel Weinberger, and Simone Drichel for theoretical discussions. I owe my deepest gratitude to my mentor and friend, Nancy McWilliams. My most poetic efforts cannot really express how important you have been, not just for this project but also for my professional and personal growth."Thanks" feels like a platitude. Finally, heartful appreciation to my beloved wife, Erica, not just for reliably supporting my career in the most unselfish and generous ways but also for enduring my endless, preoccupied self-absorption in this writing. Your vital ideas, generous heart, sharp mind, and critical reflections are deeply important to me. Thanks for love and wisdom. Finally, and centrally, I want to honor the people I cannot name: my patients, supervisees, and students. A special thanks to the brave Isabel and the thoughtful Sonja.Thank you all. Any mistakes in my work are my own.

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How usual is treatment as usual? Experienced therapists’ reflections on participation in practice-based research

Cited by 7 publications

References 46 publications

Latent trajectories of change for clients at a psychodynamic training clinic

Latent trajectories of change for clients at a psychodynamic training clinic

Exploring virtue ethics in psychodynamic psychotherapy: latent changes in humility, affect regulation, symptoms and well‐being

Collaborative reading of medical records in psychotherapy: A feminist psychoanalytic proposal about narrative and empowerment.

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