‘Learning from research’: Therapist perspectives on the benefits and challenges of participating in a longitudinal,systematic case‐study

Objectives: In psychotherapy research we have often neglected to examine the impact of research procedures on therapy process and outcome. Such information is extremely important in helping us evaluate the validity of our findings, increase relevance of research for practice, and choose appropriate methods for future projects. The aim of this paper is to share the experience of six person‐centered therapists, who participated in a longitudinal, systematic study, and present their reflections about the impact of research on therapy process, therapeutic engagement and professional development. Methods: The findings have emerged from semi‐structured interviews that took place after the first, sixth (middle) and last therapy session. In total 18 interviews were conducted. These data were part of a much larger research protocol that included a number of outcome and process measures. Results & Conclusions: The analysis of therapist narratives revealed important benefits for those participating in systematic case study research. The use of Brief Structured Recall methods and qualitative interviewing was an important factor in promoting therapist reflexivity and professional development. The importance of a strong research alliance and the active involvement of the client in the research process is discussed.     

Online Cognitive Behavioural Therapy Training for Therapists: Outcomes,Acceptability, and Impact of Support

The objectives of the present study were to assess the effects of online cognitive behavioural therapy (CBT) training for therapists on measures of CBT knowledge, skills, confidence, and utilisation; to determine what differences might exist between a group supported by regular telephone contact and an independent group who undertook online training without additional support; and to determine the acceptability of CBT online training among rural and remote mental health professionals. Mental health practitioners were randomly allocated to a supported training group (six sessions of 15‐min support) or an independent group. They undertook a 12‐week online CBT training program. The two groups showed similar gains on an objective test of knowledge of CBT, and on self‐report measures of knowledge, skills, confidence levels, and utilisation of skills. However, the supported training group had a significantly higher program completion rate than the independent group. Participants evaluated the program favourably. The results suggest that online CBT training represents a promising and cost‐effective approach to training the mental health workforce, and may be particularly attractive for those who live in regional, rural, and remote communities. A challenge is to determine the most cost‐effective ways to enhance program completion rates and trainee skills.     

自身抗体检测新技术及其临床应用

自身抗体的检测在自身免疫性疾病（A ID ）的诊断,判断疾病的严重程度及评价疗效方面拥有十分重要的临床意义。随着免疫检测技术的进步,新的自身抗体特异性靶抗原被发现,自身抗体的检测技术也越来越多,出现如何评估自身抗体检测方法及诊断价值的新问题。本文介绍自身抗体检测的新技术及自身抗体检测技术的发展趋势,评估自身抗体检测方法应用现状,分析了临床自身抗体检测技术的优缺点,让临床实验室更加合理有效选择自身抗体检测技术。     

治疗感染性骨不连伴大段骨缺损的探讨与思考

感染性骨不连伴大段骨缺损是目前临床骨科较为常见、多发、治疗极为棘手的病种之一,治疗方法多种多样,但疗效却不理想,且缺乏统一的诊治与疗效判断标准,总结、分析几种临床上主要治疗方法的利弊,为该病探寻一条微创、安全、并发症少及疗效确切的可靠治疗方法.随着对Ilizarov技术的基础与临床研究的不断深入,该技术在治疗传统方法难以治愈的疾病如四肢关节严重畸形、感染性骨不连或伴有骨缺损、皮肤软组织缺损等方面显示出自身的优势,为治疗疑难骨科疾病开辟了一条新的有效途径.     

The pregnant therapist and the psychotic client: A phenomenological understanding of the impact of the therapist’s pregnancy on the therapeutic process

This original paper examines the underresearched area of therapist pregnancy. It explores the impact of psychosis as an additional complicating factor to the therapeutic process and the experience of one British counselling psychologist working in the National Health Service whilst pregnant. Five brief client summaries/clinical examples are presented to explore the common themes of anger, rejection, abandonment and envy that often emerge following the disclosure of a therapist’s pregnancy or the opposite reactions of over-protectiveness and an unwillingness to engage in therapy for fear of harming the therapist. Recommendations are made for further research within this neglected area and the need to incorporate the themes within training for therapists and training for supervisors.     

Client self-image,therapist acting,and the establishment of the therapeutic alliance in a training context

This study examined how clients’ self-image and perception of therapist’s behavior are related to the therapeutic alliance, as well as how these variables change in the psychotherapy process in trainee-led psychotherapy. A total of 164 participants (M = 28.9 years) who attended two semesters of treatment at the Psychology Clinic of Umeå University completed the Working Alliance Inventory (WAI) to evaluate their perception of their alliance with the therapist. They also completed two questionnaires based on the Structural Analysis of Social Behavior (SASB) model to give insight into their self-image patterns and to analyze their perceptions of the therapist’s behavior. The results show that a positive self-image and positive perceptions of the therapist’s actions increased significantly over the course of the therapy, with a corresponding decrease in negative patterns. The alliance scores show that the therapeutic alliance gains significance over time and that it is influenced more by the perception of the therapist’s behavior than by the self-image. The self-image becomes relevant after the mid part of therapy, underlining the role of the therapist in co-creating the treatment relationship. The implications of these results are discussed, and so are directions for future research in other trainee-led settings and samples.     

Cancer Patients' Illness Experiences During a Group Intervention

The study used secondary data analysis to explore cancer patients' illness experiences during a listening group intervention. Participants were 12 patients (age range 22 to 62 years in age; males = 4; females = 8). Data were analysed using qualitative content analysis. Analysis of the data yielded twelve prevalent themes namely, support, perspectives and experiences in medical context, perspectives on life and death, emotional experiences, religiosity, role of knowledge and information pertaining to cancer, finances, concern for others, loss, desire for survival, humour, and physical symptoms. A framework suggesting possible moderating factors that could influence cancer patients' illness experiences and outcomes are proposed. The results of the study emphasise how stressful and complex living with cancer can be. However, many cancer patients developed alternative perspectives on life which also seem to bring about personal growth. It is suggested that further research regarding the development of a survivorship care programme within the South African context be undertaken.     

Response to “Turning Words and Twisting Truths”

SUMMARY

Too often, in discussions of psychotherapy, the techniques are given undue emphasis. Research suggests that the same techniques are differentially effective when used by equally trained and supervised therapists. Not only are some therapists more effective, irrespective of the type of therapy they practice, but some, because of their personal qualities, may actually harm those with whom they work. This research reflects the vast importance of the ubiquitous element in therapy, that of the “person” of the therapist. The question, then, follows, how may personhood be developed? This question is explored as it relates to both breadth and depth of life experience.