Complicated grief is ...

More to follow ...

Yesterday I wrote a blog post "Routine Outcome Monitoring can really help therapists clarify where they need to try harder".  Today's post extends this extremely important point.  About twenty years ago Howard and colleagues (Howard, Moras, Brill, Martinovich, & Lutz, 1996) introduced a crucial new approach for improving our outcomes.  They wrote "Treatment-focused research is concerned with the establishment of the comparative efficacy and effectiveness of clinical interventions, aggregated over groups of patients.

I recently wrote a couple of blog posts - "Psychotherapy (and psychotherapist) outcomes are good but largely stagnant" and "Fascinatingly, therapists themselves vary considerably in their effectiveness".  In the second of these posts I commented "A paper published just last month (Green, Barkham et al.

I wrote a post yesterday on the good, but largely stagnant, outcomes currently being achieved in psychotherapy.  In today's post I highlight the fascinating finding that psychotherapists themselves vary considerably in their effectiveness.  If we can help those with poorer outcomes to begin matching those with better, great gains are possible and the log jam in trying to improve psychotherapy's effectiveness can be eased.  In later posts I will argue that this improvement looks eminently achievable.

I have been asked to write a chapter on the importance of obtaining regular feedback on client progress in a book on psychotherapist self-practice & self-reflection.  This initial section (see below) of a draft of the chapter comments on the current state of psychotherapy itself:

(Note the ideas in this blog are explored in more detail in the chapter "Client feedback: an essential input to therapist reflection" in the forthcoming Haarhoff, B. and Thwaites, R. (2016) "Reflection in CBT: Increasing your effectiveness as a therapist, supervisor and trainer." London: SAGE Publications Ltd.)

Should group facilitators & would-be group facilitators have personal experience of the skills they're teaching?  Should swimming or driving instructors be able to swim or drive themselves?  I'm sure it's possible to help someone learn to swim without being a swimmer oneself, but if you're an instructor you're likely to do a better job and be more convincing in your suggestions if you yourself are pretty good at swimming. 

Here are half a dozen recent studies involving cognitive therapy (CBT).  The first by Craigie et al explores the use of mindfulness-based cognitive therapy (MBCT) to treat generalized anxiety disorder (GAD).  Although, as one would expect, MBCT helped GAD sufferers, it was noteworthy that results "fall well short of outcomes achieved by past research".  This adds to my concern that mindfulness training may at times be being over-hyped - see a blog I wrote in September for for more on this.  The next study by Cuijpers et al also suggests limitations to the march of CBT with interpersonal psychotherapy looking a somewhat better candidate for prevention of depression onset.  I guess one could argue that CBT can - and probably more often should - include  behavioural interventions to promote improved relationships.  Click here for tools that can help this approach.   The third piece of research by Grey et al is exciting.  It challenges the Alice in Wonderland dodo bird suggestion that "everyone has won, and all must have prizes"