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A project to change long-term interpersonal patterns: post-group reflections

In a recent post - "A project to change long-term interpersonal patterns: at a residential group- I described a fairly classic example of the sort of tangle I can sometimes get into interpersonally (probably especially in group therapy environments), where others may see me as judgemental, a bit condescending, over-dominant and fairly invulnerable. Besides this being territory that I want personally to understand better and change, I hope that this kind of exploration can illuminate the tricky challenge of changing longterm patterns for others who are interested in this kind of work ... either as "general public" or as "psychotherapists".

A project to change long-term interpersonal patterns: background

I have just got back from a rather wonderful two week holiday in Kerala with my wife, Catero.  It was very special ... and one of the interesting spin-offs was the perspective one can get looking back at one's everyday life typically played out over 5,000 miles away.  I'm immensely lucky ... happily married, close to our children & grandchildren, healthy, blessed with precious friends, and committed to work that's a vocation more than a job.  Of course, old age, illness and death lie in wait for me and for those I love.  Of course this sunlit period of our lives is temporary.  And that can make it all the sweeter ... see, for example, Frias's study "Death reflection enhances gratitude".

Recent research: articles from winter journals

I read a lot of research.  When I find an article of particular interest I download it to my bibliographic database - Endnote - which currently contains over 21,600 abstracts.  I also regularly tweet about emerging research, so following me on Twitter, Facebook or Google+ (click on the relevant icon at the top of this web page) will keep you up to speed with what I'm finding interesting.  Additionally you can view this highlighted research by visiting Scoop.it (click on the "it!" icon at the top of this page).  At Scoop.it, I stream publications into five overlapping topic areas: Cognitive & General Psychotherapy, Depression, Compassion & Mindfulness, Positive Psychology and Healthy Living.

A project to change longterm interpersonal patterns: finding a therapist



See too Nissen-Lie et al's "Patient and therapist perspectives on alliance development: Therapists' practice experiences as predictors" with its finding about the toxic effects on client rated therapeutic alliance produced by the "leaking" of unspoken critical therapist. 

"Humble warmth" "Therapist predictors of early patient-rated working alliance: A multilevel approach"

Pre-session 'meditation' on client strengths & resources.  Compassion work.

Work on compassion both for self and for others and its effects on self-esteem ... and note too the benefits of "saying turquoise" and other emotional intelligence aspects.

Practice-based evidence can complement evidence-based practice so very well

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.

Fascinatingly, therapists themselves vary considerably in their effectiveness

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.

Psychotherapy (and psychotherapist) outcomes are good but largely stagnant

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.)