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The Importance of "Whoops" in Improving Treatment Outcome
“Ring the bells that still can ring, Forget your perfect offering There is a crack in everything, That’s how the light gets in.” Leonard Cohen, Anthem Making mistakes. We all do it, in both our personal and professional lives. “To err is human…,” the old saying goes. And most of us say, if asked, that we agree — read more
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Looking for Results in All the Wrong Places: What Makes Feedback Work?
As anyone knows who reads this blog or has been to one of my workshops, I am a fan of feedback. Back in the mid-1990’s, I began using Lynn Johnson’s 10-item Session Rating Scale in my clinical work. His book, Psychotherapy in the Age of Accountability, and our long relationship, convinced me that I… — read more
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A Lotta Help from One’s Friends: The Role of Community in the Pursuit of Excellence
Dateline: Chicago, IL USA Hard not to be impressed with the USA Women’s Gymnastic team. What skill, percision, expertise, and excellence. By now, I’m sure you’ve seen the interviews. In all instances, each and every one has focused on the team. Despite some in the media attempting to make stars out of the individual members,… — read more
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The DSM 5: Mental Health’s "Disappointingly Sorry Manual" (Fifth Edition)
Have you seen the results from the field trials for the fifth edition of the Diagnostic and Statistical Manual? The purpose of the research was to test the reliability of the diagnoses contained in the new edition. Reliable (ri-lahy-uh-buhl), meaning "trustworthy, dependable, consistent." Before looking at the data, consider the following question: what are the… — read more
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The International Center for Clinical Excellence: Using Social Networks for "Real Time" Research
The International Center for Clinical Excellence was officially lauched at the Evolution of Psychotherapy Conference in December 2009. Since that time, membership has grown steadily. With over 3800 members, the ICCE is the largest, web-based community of behavioral health professionals dedicated to improving the quality and outcome of service delivery. The site features nearly… — read more
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More from Sweden
Three short weeks ago, I was in Stockholm, Sweden talking about "what works" in clinical practice. As I announced at the time, my visit coincided with an announcement by the organization governing mental health practice in the country. For the better part of a decade, CBT enjoyed near exclusive status as "evidence-based." Indeed, payment for… — read more
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Is the "Summer of Love" Over? Positive Publication Bias Plagues Pharmaceutical Research
Evidence-based practice is only as good as the available "evidence"–and on this subject, research points to a continuing problem with both the methodology and type of studies that make it into the professional literature. Last week, PloS Medicine, a peer-reviewed, open access journal of the Public Library of Science, published a study showing a positive… — read more
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A Progress Report on the Science (and Art ) of Psychotherapy: The Psychotherapy Networker 30th Anniversary Edition
The 30th Anniversary Edition of the Psychotherapy Networker has hit newsstands. In it, is an article by Diane Cole taking the measure of psychotherapy. Her question? Has the field gotten any better over the last three decades? The entire issue is a "must read," starting with editor Rich Simon’s lengthy and thought provoking editorial, "Still… — read more
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Feedback-Informed Treatment as Evidence-based Practice: APA, SAMSHA, and NREPP
What is evidence-based practice? Visit the UK-based NICE website, or talk to proponents of particular theoretical schools or therapeutic models, and they will tell you that being "evidence-based" means using the approach research has deemed effective for a particular diagnosis (e.g., CBT for depression, EMDR for trauma). Over the last two decades, numerous organizations and… — read more
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Psychologist Alan Kazdin Needs Help: Please Give
Look at this picture. This man needs help. He is psychologist, Alan Kazdin, former president of the American Psychological Association, and current Professor of Psychology at Yale University. A little over a week ago, to the surprise and shock of many in the field, he disclosed a problem in his professional life. In an interview… — read more
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Getting FIT in the New Year: The Latest Evidence
John Norcross, Ph.D. is without a doubt the researcher that has done the most to highlight the evidence-base supporting the importance of the relationship between clinician and consumer in successful behavioral healthcare. The second edition of his book, Psychotherapy Relationships that Work, is about to be released. Like the last edition, this volume is a virtual… — read more
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Pushing the Research Envelope: Getting Researchers to Conduct Clinically Meaningful Research
At the recent ACE conference, I had the pleasure of learning from the world’s leading experts on expertise and top performance. Equally stimulating were conversations in the hallways between presentations with clinicians, policy makers, and researchers attending the event. One of those was Bill Andrews, the director of the HGI Practice Research Network in the UK who… — read more
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Clinician Beware: Ignoring Research Can be Hazardous to Your Professional (and Economic) Health
“Studies show…” “Available data indicate…” “This method is evidence-based…” My how things have changed. Twenty years ago when I entered the field, professional training, continuing education events, and books rarely referred to research or evidence. Now, everyone refers to the “data.” The equation is simple: no research = no money. Having “an evidence-base” increasingly determines book sales, attendance at… — read more
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What Works in the Treatment of Post Traumatic Stress Disorder? The Definitive Study
What works in the treatment of people with post-traumatic stress? The influential Cochrane Collaboration–an "independent network of people" whose self-professed mission is to help "healthcare providers, policy makers, patients, their advocates and carers, make well-informed decisions, concludes that, "non trauma-focused psychological treatments [do] not reduce PTSD symptoms as significantly…as individual trauma focused cognitive-behavioral therapy (TFCBT), eye… — read more
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Feedback, Friends, and Outcome in Behavioral Health
My first year in college, my declared major was accounting. What can I say? My family didn’t have much money and my mother–who chose my major for me–thought that the next best thing to wealth was being close to money. Much to her disappointment I switched from accounting to psychology in my softmore year. That’s when I first met Dr. Michael Lambert.… — read more
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Eruptions in Europe and in Research
Dateline: 11:20 am, April 18th, 2010 Today I was supposed to fly from Stockholm, Sweden to the far northern town of Skelleftea–a flight that takes a little over an hour. Instead, I’m sitting on a train headed for Sundsvall, the first leg of a 12 hour trip that will include a 6 hour bus ride… — read more
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Are all treatments approaches equally effective?
Bruce Wampold, Ph.D. Late yesterday, I blogged about a soon-to-be published article in Clinical Psychology Review in which the authors argue that the finding by Benish, Imel, & Wampold (2008) of equivalence in outcomes among treatments for PTSD was due to, "bias, overgeneralization, lack of transparency, and poor judgement." Which interpretation of the evidence is correct? Are there… — read more
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The Crown Jewel of Research on CDOI: Professor Jan Blomqvist receives 2.9 million crown grant for RCT on feedback in Sweden
If you’ve been following me on Twitter, then you know that last week I was touring and teaching in different spots around Europe. First, I presented two days in Copenhagen. Then I keynoted the British Association of Counseling and Psychotherapy Conference in Newcastle, England. Early Saturday morning, I flew from London to Stockholm. My long time friend… — read more
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History doesn’t repeat itself,
Image via Wikipedia "History doesn’t repeat itself," the celebrated American author, Mark Twain once observed, "but it does rhyme." No better example of Twain’s wry comment than recurring claims about specifc therapeutic approaches. As any clinician knows, every year witnesses the introduction of new treatment models. Invariably, the developers and proponents claim superior effectivess of… — read more