Maximising the Benefits of Psychotherapy: A Practice–based Evidence Approach

Within Maximising the Benefits of Psychotherapy , the authors review the evidence for and against Evidence–Based Practice (EBP), viewed as the ‘standard’ approach to how psychotherapy services should best be provided and put this in the context of what we know about why therapy works from over seventy years of research. The book supports the desire to improve therapeutic practice but suggests that to reduce this to advocating one therapy over another may be premature. Other approaches to improving effectiveness are explored, including the use of feedback from clients and the advantages of Practice–Based Evidence (PBE).  This approach offers a more flexible, but compatible, alternative; it allows therapists to draw on a full range of established theoretical models in designing interventions, the effectiveness of which is determined by a continuous flow of feedback from their clients. The treatment thus provided can be characterised as both client–directed and outcome informed (CDOI). This book reviews some of the history behind efforts to determine the effectiveness of psychotherapy, and describes the theoretical rationale and emerging research evidence for the PBE approach in general and the CDOI system in particular. This book includes both an accessible summary of key research findings and a practical introduction to a practice–based evidence approach. It offers a timely alternative – and a significant conceptual challenge – to the prevailing wisdom in the mental health field. The authors include a series of detailed case studies in order to illustrate the method in action.

List of Figures vii About the Authors ix Acknowledgements xi 1 The Equivalence of Psychotherapies 1 2 Research Into Psychotherapy: What Works and How? 23 3 The Conventional Wisdom 45 4 The Real Experimenter 67 5 Practice–based Evidence 87 6 Using Client Feedback in Psychotherapy – The Research 109 7 Using Client Feedback in Psychotherapy – In Practice 129 8 Ideas in Action 151 9 Transforming Training and Supervision 171 10 Conclusions and Some Recommendations 195 Subject Index 211

David Green is a clinical psychologist who has worked therapeutically for more than 30 years with young people and their families. From 1988 to 2010 he was Clinical Director of the Doctor of Clinical Psychology programme at the University of Leeds. He has been particularly interested in the role clinical supervision plays in the education of healthcare professionals. Gary Latchford is a clinical psychologist working in physical health, based at the department of Clinical and Health Psychology at St James’s Hospital in Leeds. Since 1996 he has also been research director for the Doctor of Clinical Psychology programme at the University of Leeds.  His clinical and research interests are mostly around psychological interventions in medical settings, and he has published several papers and book chapters on this topic.