Measuring psychotherapy outcomes in routine practice: Examining Slovak versions of three commonly used outcome instruments

This study examined the Slovak mutations of three outcome measures for routine practice i.e. the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM), the Outcome Questionnaire – 45 (OQ-45), the Outcome Rating Scale (ORS), and one control measure the Symptom Checklist 10 Revised (SCL-10R), with regard to their concordance or differences in outcome classification of pre-post change, when used by the same patients and when the criteria used for establishing recovery and improvement status are based on the same sample. Method: Non-clinical (252) and clinical (202) samples were used for the standardisation of all instruments. A portion of the clinical participants (N?=?140) completed all measures at the end of their treatment. Results: The CORE-OM, and the SCL-10R indicated a higher number of recovered and improved clients. With regard to the pre-post differences as expressed in the effect size, the CORE-OM showed the highest pre-post difference (pre-post effect size .98), followed by the ORS (.87), the SCL-10R (.83) and finally with the OQ-45 (.69). Conclusion: Even very similar instruments developed on the basis of similar theoretical conceptualisations and empirical findings may report different pre-post outcomes.     

Offering a ‘therapeutic presence’ in schools and education settings

Abstract

In this essay I present the clinical work with a client that I have been working with for 9 months now. The essay is divided into sections, each one indicative of one phase of the counselling relationship. In each of them I present the therapeutic process (my client's and myself) by highlighting some newly-acquired psychodynamic concepts, sharing some difficulties encountered, the learning gained though supervision and the progress of the client.     

Can voicing conflict within experiential learning groups facilitate connection? building and developing effective multi-disciplinary team-working skills

In the UK, Clinical Psychologists (CPs) work in a variety of settings within the National Health Service (NHS), often within Multi-Disciplinary Teams (MDTs). Problem-Based Learning (PBL) within CP training at the University of Hertfordshire (UH) offers unique opportunities to combine scientist-practitioner and reflective-practitioner models to learn about group dynamics from the personal experience of working within an experiential learning group.

Further, given Trainees work three days per week on placement within MDTs in the NHS, the learning gained within a ‘safer’ PBL context can be utilised within these clinical settings. For two years, Trainees at UH have to work in small PBL groups with five or six members learning to work together to achieve a goal (four assessed presentations) negotiating their own personal and professional journey, as well as a group journey. Consequently, PBL offers trainees opportunities to learn (1) how individuals work within a group; (2) how personal experiences influence this process; (3) how others influence them and are influenced by them; and (4) how a group of diverse individuals conceptualise, understand and convey case vignettes to an audience. Within these groups, many Trainees learn to speak out, reflect, listen attentively, empathise, validate and accept diverse experiences. Further, when differences dominate they often learn to negotiate these, finding a way to maintain effective team working in order to complete the presentation. Focusing on the conflict that can occur within (any) group, this paper explores themes from the reflective narratives of six trainees: parallels and differences between MDTs and PBL groups, striving for and achieving authenticity; and conflict as a ‘swear’ word. We conclude that exploring the role PBL can play in training individuals to work effectively in teams may be of benefit within the training of other professional groups.     

Collaborative helping maps: a tool to guide thinking and action in family-centered services

This article highlights "disciplined improvisation" as a metaphor for community-based work with multi-stressed families. It introduces Collaborative Helping maps as a tool that both helps workers think their way through complex situations with families and provides a structure to support constructive conversations between workers and families about challenging situations. The article illustrates this map through a clinical vignette and uses interviews with workers to highlight ways in which the map can both enhance worker thinking and support constructive conversations between workers and families about problems that could easily divide them and lead to polarization and escalating tension.     

The Score Family Assessment Questionnaire: A Decade of Progress

This paper reviews a decade of research (2006–2016) on a family assessment instrument called the Systemic Clinical Outcome and Routine Evaluation (SCORE). The SCORE was developed in Europe to monitor progress and outcome in systemic therapy and has been adopted by the European Family Therapy Association as the main instrument for assessing the outcome in systemic family and couple therapy. There are currently six main versions of this instrument: SCORE‐40, SCORE‐15, SCORE‐28, SCORE‐29, Child SCORE‐15, and Relational SCORE‐15. It has also been translated into a number of European languages. Fifteen empirical studies of the SCORE “family of measures” have been conducted. Most have aimed to establish psychometric properties of these instruments in English and other languages. Others have used the SCORE to document the level of family adjustment in clinical samples or evaluate outcome in treatment trials. There is now sufficient evidence for the reliability and validity of the SCORE to justify the use of brief versions of this instrument to monitor progress and outcome in the routine practice of systemic therapy.     

Clinical supervisor training in Australia: A review of current problems and possible solutions

Clinical supervision cuts to the heart of professional psychology training. It is the most expensive single investment of staff time in the training of the psychology practitioner, and it appears to be the single most important contributor to training effectiveness, repaying that investment. Now there are changes afoot internationally which may change its pivotal role. For example, the Psychology Board of Australia has recently proposed that supervisors undergo approved supervisor training; in the USA, a competence‐based emphasis is gaining ground; while in the UK, supervisors within the Improving Access to Psychological Therapies initiative are receiving unprecedented training and support. It is therefore timely to clarify the need for such training and to consider promising options for its effective delivery. Following a summary of the changes within Australia, we next address these emergent problems and promising solutions by examining the available scientific evidence and by considering professional consensus statements.     

医院数字化管理在临床决策中的作用

医院数字化建设是管理行为中的重要手段,借助这一工具,医疗决策的制定和执行将更加科学和规范,但同时医院数字化管理在法律和具体操作上对临床决策的管理还有一定的影响。讨论医院数字化在医疗决策中的合法性、安全性及对临床决策基本原则的作用。     

De la question de l’évaluation psychologique et de la psychométrie en douleur chronique

The practice of psychological assessment is an important step in the evaluation of the complex problems presented by patients dealing with chronic pain. We want to discuss here the framework of intervention of the psychologist in the context, but also shed light on the contributions of this practice to the pain clinic. This will include discussing a joint assessment, combining a psychological assessment referred to as classic with a psychological evaluation specific pain.     

Priority setting in health care: on the relation between reasonable choices on the micro-level and the macro-level

There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions that have to be met in order to ensure that individual claims on health care are well aligned with an overall concept of just health care? Drawing upon a distinction between individual and aggregated needs, I argue that even though we assume the legitimacy of macro-level guidelines, this legitimacy is not directly transferable to decisions at micro-level simply by adherence to the guidelines’ recommendation. Further, I argue that individual claims are subject to the formal principle of equality and the demands of vertical and horizontal equity in a way that gives context- and patient-related equity concerns precedence over equity concerns captured at the macro-level. I conclude that if we aim to achieve just health care, we need to develop a complementary framework for legitimising individual judgment of patients’ claims on health care resources. Moreover, I suggest the basic structure of such a framework.