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Dealing with Scientific Objections to the Outcome and Session Rating Scales: Real and Bogus
The available evidence is clear: seeking formal feedback from consumers of behavioral health services decreases drop out and deterioration while simultanesouly improving effectiveness. When teaching practitioners how to use the ORS and SRS to elicit feedback regarding progress and the therapeutic relationship, three common and important concerns are raised: How can such simple and brief scales provide — read more
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Mental Health Practice in a Global Economy
Did you feel it? The seismic shift that occurred in field of mental health just a little over a month ago? No? Nothing? Well, in truth, it wasn’t so much a rip in the space-time continuum as a run. That "run," however, promises to forever alter the fabric of clinical practice–in particular how clinicians earn… — 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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What’s disturbing Mental Health? Opportunities Lost
In a word, paperwork. Take a look at the book pictured above. That massive tome on the left is the 2011 edition of "Laws and Regulations" governing mental health practice in the state of California. Talk about red tape! Hundreds and hundreds of pages of statutes informing, guiding, restricting, and regulating the "talking cure." Now,… — read more
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Goodbye Freud, Hello Common Factors
Gary Greenberg certainly has a way with words. In his most recent article, The War on Unhappiness, published in the August issue of Harper’s magazine, Greenberg focuses on the "helping profession"–its colorful characters, constantly shifting theoretical landscape, and claims and counterclaims regarding "best practice." He also gives prominence to the most robust and replicated finding in psychotherapy outcome research: the "dodo bird verdict." Simply… — read more
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Ohio Update: Use of CDOI improves outcome, retention, and decreases "board-level" complaints
A few days ago, I received an email from Shirley Galdys, the Associate Director of the Crawford-Marion Alcohol and Drug/Mental Health Services Board in Marion, Ohio. Back in January, I blogged about the steps the group had taken to deal with the cutbacks, shortfalls, and all around tough economic circumstances facing agencies in Ohio. At… — read more
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Outcomes in OZ III
Dateline: November 28, 2009 Brisbane, Australia Crown Plaza Hotel Pelican Waters Golf Resort & Spa As their name implies, LifeLine Australia is the group people call when they need a helping hand. During the last leg of my tour of eastern Australia, I was lucky enough to spend two days working with Lifeline’s dedicated and talented clinicians on improving… — 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
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Practice-Based Evidence Goes Mainstream
For years, my colleagues and I have been using the phrase "practice-based evidence" to refer to clinicians’ use of real-time feedback to develop, guide, and evaluate behavioral health services. Against a tidal wave of support from professional and regulatory bodies, we argued that the "evidence-based practice"–the notion that certain treatments work best for certain diagnosis–was… — read more
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Superior Performance as a Psychotherapist: First Steps
So what is the first step to improving your performance? Simply put, knowing your baseline. Whatever the endeavor, you have to keep score. All great performers do. As a result, the performance in most fields has been improving steadily over the last 100 years. Consider, for instance, the Olympics. Over the last century, the best… — read more
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My New Year’s Resolution: The Study of Expertise
Most of my career has been spent providing and studying psychotherapy. Together with my colleagues at the Institute for the Study of Therapeutic Change, I’ve now published 8 books and too many articles and scholarly papers to count. If you are interested you can read more about and even download many of my publications here.… — read more