Bridging the gap between therapy research and practice in a person-centered/experiential therapy training program : the Leuven systematic case study research protocol

The goal of the Leuven Systematic Case Study Research Protocol project is to stimulate practice-oriented research in order to bridge the gap between research and practice. In this article we give a progress report of the project, in which a set of Dutch-language research instruments was created and tested with postgraduate trainees in person-centered/experiential therapy at the University Leuven (Belgium). We begin by presenting the general framework for the protocol, including the three major domains of therapy process, therapy outcome, and client/therapist characteristics. Then we give an overview of the quantitative and qualitative instruments used. We explain how the project has been implemented in the postgraduate program. To evaluate the success of the project, we analyzed the answers of our trainees on a questionnaire. We give an overview of the clinical cases involved and the variety of research questions that have been formulated in the individual case studies. Finally we discuss the value of this pilot project

Uit de (medische) kleren om de psychotherapie te redden?

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"The first blow is half the battle". Evaluation of a pretherapy training program that prepares clients for psychotherapy

Incorrect or unclear assumptions and expectations about psychotherapy are one of the biggest obstacles of the therapeutic process. When clients are not informed well enough about the underlying rationale of psychotherapy or its specific working methods and when they don’t have an accurate idea of what they are expected to say or do, there is often a premature dropout or stagnation of the psychotherapy process. Poor therapeutic outcome, however, is not always due to a limited cognitive know-how of psychotherapy. Some clients lack the basic ‘therapeutic skills’ to make psychotherapy work. They have difficulties in recognizing or expressing their inner experiences, they are restricted in their relational functioning, they are limited in their introspective capacities and they lack a proper way of relating to their problems (either relating to them as an observing self or coinciding with them). Pretherapy training prepares clients for future psychotherapy by providing accurate information about the therapeutic process and by teaching specific therapeutic skills. In the past decades, a variety of pretherapy programmes was developed, differing in aim, content and method. Some are more cognitive-oriented (providing accurate knowledge about psychotherapy), others are focused on behavioral goals (teaching appropriate client responses), affective goals (reducing excessive arousal or anxiety) or motivational goals (motivating for individual or group psychotherapy). In the Psychotherapeutic Centre for students of the K.U Leuven a multimethod short-term group programme has been developed, combining the goals mentioned above. The programme will be introduced and evaluated by means of a set of research data, both quantitative and qualitative.status: publishe

Dealing with anxiety in a short-term therapy : keeping it company or going beyond

The Leuven Systematic Case-study Protocol was used to analyze the therapeutic trajectory of a young woman suffering from anxiety problems. The LSCS protocol is a broad-spectrum monitoring tool that contains both quantitative and qualitative processes, effects and relational climate measurements. This case-study shows how relational and task-oriented elements can be combined to unlock the client’s structure- bound way of functioning. The therapeutic process was marked by a careful balance between staying with her anxiety (“keeping it company”) and stimulating the client to look beyond it. Outcome/process monitoring helped track the client’s process and correct difficulties. This case is compared to the increasing number of PCE anxiety case-studies and the advantages and pitfalls of monitoring are discussed

Opereren in een mijnenveld van emoties

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Het belang van systematisch case-study onderzoek. Waarom het gouden muiltje Assepoester toebehoort

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Bruggen slaan tussen klinische praktijk en onderzoek

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Early Symptom Change: Relationship with Patient Characteristics and Therapeutic Alliance in Adult Outpatients

OBJECTIVE: This study has three aims: (1) to identify early change trajectories, (2) to examine patient characteristics predicting trajectory classes, and (3) to investigate the moderating effect of trajectory class membership on the working alliance. METHOD: In a sample of 402 outpatients (M age = 38.27, 64.9% women), outcome scores (OQ-45) on three time points (sessions 1, 3, and 5) were analysed by means of Latent Class Growth Curve Analysis. A multinomial logistic regression was used to investigate whether patient's age, gender, initial distress (OQ-45), and personality traits (Dimensional Assessment of Personality Pathology-Short Form) predicted trajectory class membership. A repeated-measures ANOVA examined whether differences in trajectory classes moderated the alliance quality (Working Alliance Inventory-Short version) over time. RESULTS: Four trajectory classes were identified: High distress-no change; moderate/high distress-small improvement, low distress-moderate improvement, and moderate/low distress-strong improvement. Gender, initial distress, and emotion dysregulation significantly predicted patients' trajectory class membership. The Task/Goal alliance component increased linearly over time, whereas the Bond component followed a reversed U-shaped pattern. The alliance was not moderated by trajectory class membership. CONCLUSIONS: Four clinically relevant subgroups could be identified on the basis of the early symptom change trajectories. Gender, initial psychological distress, and emotion dysregulation predicted patient's trajectory class membership. Trajectory class membership did not influence the development of the early working alliance. PRACTITIONER POINTS: As early change in highly distressed patients (Axis I and II) is not characterized by significant symptom change, clinicians should support and facilitate emotion regulation and social skills. Investing in a strong alliance is recommended, although it does not differentiate early responders from non-responders.status: publishe