Evidence-Based Psychotherapy Means Evidence-Informed,Not Evidence-Driven

Some advocates of empirically-supported treatments (ESTs) argue that practitioners who do not use them are practicing unethically. I argue that it is unethical to try to impose EST criteria on the field of psychotherapy practice when (a) there is considerable controversy over these criteria, (b) there are alternative ways to construe evidence-based practice, and (c) by other criteria many approaches are evidence-based. I consider views of the relationship of science to practice, and other bases for practice such as practical knowledge and ethics. I conclude with a case history of client-centered therapy.     

Evidence-Based Psychotherapy and Counselling in the UK: Critique and Alternatives

Developments in empirically supported therapy or evidence-based practice in the UK are outlined and critically examined. Perceived advantages and disadvantages are set out, with a commentary. It is asserted that the evidence-based ethos is seriously flawed and that psychotherapy is essentially a faith-based craft, not a thoroughly researchable scientific enterprise. Some alternatives to evidence-based practice are briefly outlined, before turning to an exploration of the wider context of anthropathology in which therapy takes place and against which it must acknowledge its limitations. Broad-brush conclusions are drawn.     

A Multi-Theoretical,Evidence-Based Approach for Understanding and Managing Adolescent Resistance to Psychotherapy

Adolescents are often labeled as “resistant” to psychotherapy. Rather than blaming adolescent clients or psychotherapists, this article conceptualizes adolescent resistance as normal behavior emanating from a challenging situation. Based on a developmentally sensitive foundation and drawing from person-centered, motivational, solution-focused, choice theory, cognitive-behavioral, and multicultural perspectives, several practical and evidence-based strategies for managing, reducing, or eliminating resistance are provided. Case vignettes are used to illustrate specific strategies. Successful psychotherapy with adolescents requires flexibility and openness, integration of diverse theoretical perspectives with contemporary empirical knowledge, and an attitude of respect for adolescent autonomy.     

Psychotherapy Supervision in the New Millennium: Competency-Based, Evidence-Based, Particularized, and Energized

Psychotherapy supervision has increasingly become or is on the fast track to becoming competency-based, evidence-based, particularized, and accountable. In this paper, I explore how that appears to be so by: (1) briefly considering the concepts of ??competencies?? and ??evidence-based practice?? as preeminent guides for psychotherapy supervision practice and training; and (2) briefly reviewing the current status, pressing needs, and future possibilities of psychoanalytic, cognitive-behavioral, humanistic-existential, and integrative psychotherapy supervision. Based on my examination, the following conclusions are proposed: (1) the supervision relationship, individualization, developmental differentiation, and self-reflection (for supervisee and supervisor) appear to be crucial cornerstones for the conceptualization and actuation of supervision process and practice across psychotherapy-based supervision approaches; (2) all indications suggest that three emphases??competency-based supervision, evidence-based practice, and accountability??will continue to substantially influence, affect, and inform psychotherapy supervision practice for its near and distant future; (3) psychotherapy-based supervision approaches will need to be and indeed appear to now be in the process of becoming increasingly particularized in how each of their respective approach-specific competencies are defined and explicated; and (4) psychotherapy supervision has come to be increasingly viewed as an educational process and practice that is best facilitated by: (a) a rich and enriching supervision training environment that vigorously addresses and attempts to meaningfully integrate declarative, procedural, and reflective knowledge bases throughout the supervisory endeavor; and (b) the considered and deliberate utilization of facilitative technology that has the potential to substantially enhance and expand the value of the supervisee??s training/supervision experiences. Some discussion is provided about those four conclusions, and a retrofitted psychotherapy supervision for the new millennium is considered.     

Have Phobias,Will Travel: Addressing One Barrier to the Delivery of an Evidence-Based Treatment

Although a host of evidence-based treatments exist for youth with anxiety disorders, less than 30% of youth and their families receive these treatments. One of the main barriers to receiving these treatments is the lack of access to care, due largely to the absence of mental health professionals who have expertise in the delivery of these treatments in certain geographic locales. The current study examined whether a brief intensive treatment for specific phobias (SPs), Augmented One-Session Treatment (OST-A), would result in comparable treatment gains for families who traveled a considerable distance to receive this treatment when compared to families who resided in our local community. Participants included 76 youth with a clinically confirmed diagnosis of SP (38 local families and an age- and sex-matched sample of 38 nonlocal families). Although SP severity at pretreatment was significantly greater for the nonlocal youth than the local youth, both nonlocal and local youth showed commensurate improvement and maintenance of treatment gains over a 6-month period across several clinical outcome measures. Findings from this study show that OST-A is effective when families choose to travel for treatment, addressing at least one of the barriers to use of this evidence-based treatment.     

Training Individuals to Implement Applied Behavior Analytic Procedures via Telehealth: A Systematic Review of the Literature

The purpose of this article is to summarize literature relating to training individuals to implement applied behavior analytic procedures via telehealth and identify any gaps in the evidence base for this type of support. A systematic literature search revealed 20 articles focusing on training individuals to implement specific ABA techniques via telehealth. The Evaluative Method (Reichow et al. in J Austism Dev Disord 38:1311–1319, 2008; Reichow, in: Reichow, Doehring, Cicchetti, Volkmar (eds) Evidence-based practices and treatments for children with autism, Springer, New York, Reichow 2011) was used to assess the methodological quality of included articles. Results indicated that individuals were trained to implement a range of techniques, including assessments, targeted interventions, and specific teaching techniques. Socially significant outcomes were reported for clients in the form of reduced challenging behavior and increased skills. Trainee fidelity following training via telehealth was variable, and barriers related to the use of telehealth were highlighted. Where evaluated, cost and travel burdens were considerably lower than support provided in-person. The emerging literature is promising and suggests that telehealth may be an effective means of training individuals in ABA techniques; however, wider issues and practical implications related to the use of telehealth should be considered and are discussed as it relates to ABA providers.     

Development and Implementation of a Transdiagnostic,Stepped-Care Approach to Treating Emotional Disorders in Children via Telehealth

Stepped-care interventions may increase the accessibility of evidence-based treatments but remain relatively underexplored in the child mental health literature. Further, while the feasibility and efficacy of stepped-care interventions have been examined for specific diagnoses or classes or disorders, transdiagnostic stepped-care interventions have not yet been developed. We discuss the development and initial implementation of a transdiagnostic approach to emotional disorders using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C; Ehrenreich-May et al., 2018). A case series is presented to illustrate the delivery of UP-C stepped care (UPC-SC) via telehealth, using a collaborative decision-making process to inform step-up/step-down decisions. Lessons learned are discussed to guide refinements of UPC-SC and inform a larger trial.     

传统心理治疗的困境与释义学对心理治疗的影响

传统心理治疗追求自然科学模式,接受经验主义科学观,方法论上表现出本质主义、个体主义、普适主义、量化方法和还原论等特征.但是心理治疗更多的是一种人文关怀领域,因而传统心理治疗面临着种种困境.释义学强调了人文社会科学同自然科学的不同.释义学是一种意义的追寻,而不是一种因果关系的说明.它强调的是理解及其理解的文化背景.这些特征使得释义学与心理治疗具有明显的契合性,给心理治疗提供了一种新的理论基础.     

The Relation of Psychotherapy Integration to the Established Systems of Psychotherapy

That individuals (and groups) have vested interests is part of the nature of the human condition and is captured in the cognitive theoretical concept “personal domain” (Beck, 1976, p. 56). Of relevance to psychotherapy integration (and consistent with this concept), there are some apparent philosophical differences between advocates of psychotherapy integration and those of the major systems of psychotherapy. In the same manner that the various schools of integrative and eclectic psychotherapy compete with one another (Lazarus & Messer, 1991, p. 144), so too do they contend with the established systems. In this article, we present several issues about which the systems of psychotherapy and the integration movement may differ, and we respond to criticisms of cognitive therapy that have been the focus of previous articles in this journal. Finally, we give examples of how those who research and apply the contemporary systems of psychotherapy can, within those systems, explore possibilities for psychotherapy integration. We conclude that there is probably much that the integration movement and the established systems of psychotherapy can offer each other.     

Dynamic Logics of Evidence-Based Beliefs

This paper adds evidence structure to standard models of belief, in the form of families of sets of worlds. We show how these more fine-grained models support natural actions of ??evidence management??, ranging from update with external new information to internal rearrangement. We show how this perspective leads to new richer languages for existing neighborhood semantics for modal logic. Our main results are relative completeness theorems for the resulting dynamic logic of evidence.     

Practicum of Group Psychotherapy

Abstract

Many studies on therapeutic factors in group psychotherapy were done during the 1970s and 1980s, primarily with Western samples. The present study was carried out in a psychiatric inpatient clinic in Turkey. Using Yalom’s (1975) therapeutic factor questionnaire administered at discharge, patients rated existential factor, instillation of hope and self–understanding as the most helpful factors and identification as the least helpful. There were significant differences among patients with regard to gender, age, education, and comorbid personality disorder, but not with Axis I diagnosis or number of attended sessions. Patients’ and psychiatrist’s ratings showed significant differences. Differences between this Turkish sample and those reported in common Western literature are discussed under the light of relatedness psychology, which is an important concept of cross–cultural psychology.     

The art of Psychotherapy

Anthony Storr (1979) The Art of Psychotherapy, Oxford: Oxford University Press; originally published by Secker & Warburg/Heinemann     

Behavior Therapy for Tics via Videoconference Delivery: An Initial Pilot Test in Children

Habit reversal training (HRT) has been proven effective for reducing tics in children with Tourette's syndrome (TS). However, the availability of the intervention is limited. Videoconference technology represents a promising mode through which HRT may be disseminated to underserved areas. Using a multiple-baseline across participants design, the current study tested the effectiveness of videoconference-delivered HRT for 3 children with TS. Similar to results from randomized controlled trials studying face-to-face delivered HRT, videoconference-delivered HRT was effective for reducing tics. All three children demonstrated significant tic reduction following videoconference HRT delivery. All participants and their families rated the delivery modality as acceptable and the therapeutic relationship as strong. These results suggest that videoconference delivery may be a promising method for disseminating behavior therapy for tics.