Motivation as a predictor of outcomes in school-based humanistic counselling

Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school-based counselling services. To assess the relationship between young people’s motivation for counselling and its effectiveness within a secondary school setting. Eighty-one young people (12 - 17 years old) who attended school-based humanistic counselling services in Scotland. Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Motivation for counselling was not found to be significantly related to outcomes. The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non-significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects

Practitioner Review: Therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment - a systematic review and meta-analysis

Background: Previous meta-analyses have only found small correlations (r=0.10 to r=0.19) between therapeutic alliance and clinical outcomes in samples of adolescents receiving psychological therapy. Although study-level variables have been found to moderate this, little is known about the impact of therapist variability. The present meta-analysis aimed to address this gap by using patient-therapist ratio as a moderator variable. Methods: Contrary to previous reviews of adolescent alliance, individual effect sizes were extracted using a pre-registered conceptual hierarchy. Controlling for treatment-level confounds, a random effects meta-analysis assessed the moderating effect of patient-therapist ratio on the alliance-outcome relationship in pre-defined single-predictor and multi-predictor meta-regressions.Results: The alliance-outcome relationship was found to be larger than previously thought (k=28, N=2911, r=0.29, 95% Confidence Interval 0.21, 0.37;

B-->pi and B-->K transitions in standard and quenched chiral perturbation theory

We study the effects of chiral logs on the heavy-->light pseudoscalar meson transition form factors by using standard and quenched chiral perturbation theory combined with the static heavy quark limit. The resulting expressions are used to indicate the size of uncertainties due to the use of the quenched approximation in the current lattice studies. They may also be used to assess the size of systematic uncertainties induced by missing chiral log terms in extrapolating toward the physical pion mass. We also provide the coefficient multiplying the quenched chiral log, which may be useful if the quenched lattice studies are performed with very light mesons.Comment: 33 pages, 8 PostScript figures, version to appear in PR

An Application of the Concept of the Therapeutic Alliance To Sadomasochistic Pathology

This paper traces the history of the therapeutic alliance concept, examining how it has been used and misused, at times elevated to a central position and at others rejected altogether. The loss of this concept created a vacuum in classical psychoanalysis that has been filled by rival theories. The continuing usefulness of looking at the treatment process through the lens of the therapeutic alliance, particularly in relation to the manifold difficulties of working with sadomasochistic pathology, is suggested. To this end, revisions of the theory of the therapeutic alliance are suggested to address some of the difficulties that have arisen in conceptualizing this aspect of the therapeutic relationship, and to provide an integrated dynamic model for working with patients at each phase of treatment. This revised model acknowledges the complexity of the domain and encompasses the multiple tasks, functions, partners, and treatment phases involved. The utility of the revised theory is illustrated in application to understanding the sadomasochistic, omnipotent resistances of a female patient through the phases of her analysis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66889/2/10.1177_00030651980460031301.pd