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How Therapy Enhances Psychopharmacology

Frank Anderson On The Process That Gets A Client’s Body On Board

NP0038: Who’s Afraid of Couples Therapy?

Welcome to our “Who’s Afraid of Couples Therapy?” This exciting series, back by popular demand, is based on our November/December 2011 issue on this topic and will explore the challenges of couples work. What are the most effective strategies in working with couples? How can therapists structure therapy—particularly in the early sessions—so that couples leave with a sense of hope, rather than frustration? Can working with individuals who have serious issues in their relationships actually be detrimental to them? Find out the answers to these questions and much more. In this first session with expert couples therapists Ellyn Bader and Peter Pearson, the creators of the Developmental Model of Couples Therapy, you’ll find out why clinicians often avoid working with couples and how you can better prepare yourself for couples therapy work. How can therapists most effectively work with emotion in the consulting room—particularly when it comes to couples therapy? Learn with internationally known couples therapist Hedy Schleifer how to help create a nourishing connection between partners, define a role as therapist-as-guide, and much more. Schleifer, who’s pioneered the training of Imago Relationship therapists internationally, will go into how to use this theory in practice and how to best work with emotions. What happens when partners in couples therapy have two different agendas in mind? Hear from expert William Doherty on this little spoken about topic. Learn how Discernment Counseling, an approach that helps couples clarify their feelings about the next step in their relationship, can help both clients and therapists. Is it possible to rebuild trust and intimacy in a couple’s relationship after a partner has had an affair? How can therapists help? Hear from Esther Perel, author of the international bestseller Mating in Captivity: Unlocking Erotic Intelligence, on how to help couples after an infidelity and the role that cultural perspectives have in this emotional situation. Explore this classic dynamic of couples therapy—an angry woman and a withdrawn man—that’s often confusing for therapists, with couples therapist Jette Simon. Learn more about what’s behind the feelings of anger and the behavior of withdrawing, and how clinicians can more effectively work with shame and fear of disconnection. Hear an unconventional perspective on couples therapy from David Schnarch, who believes that the best way to help couples is to challenge partners to change their individual behaviors and attitudes. Schnarch’s direct, upfront approach to helping clients will illustrate a different viewpoint on effective couples therapy. Join Marty Klein, a marriage and family therapist and certified sex therapist, us for a candid discussion about the assumptions that both clients and therapists often share that can get in the way of improving couples’ sexual relationships. Discover with Kathryn Rheem how to respond effectively when clients express strong feelings in session. Based on Emotionally Focused Therapy, you’ll explore attunement and how to use your own emotions to help clients move beyond attachment injuries. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.

Whole Psychiatry: Alternatives to Conventional Psychopharmacology with Robert Hedaya

Meds: Myths and Realities: NP0035 – Session 4

Is psychopharmacology is a 'go-to' in your practice? Join Robert Hedaya as he discusses how to treat the bodily systems that underlay many mental health issues while avoiding medication. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.

Treating the Mixed-Agenda Couple

Bill Doherty On An Approach For Unaligned Relationships

Tough Customers: Is It Them or Us?

Tough CustomersBy Rich Simon As therapists, many of us practice in two different worlds. In the first, we see polite, well-behaved, articulate clients with solid values. They engage fully in therapy, talk cogently about their problems, listen attentively to our responses, make reasonably good-faith efforts to follow our suggestions, and sooner or later get better. No wonder we genuinely like these people!
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NP0018 Becoming a Smarter Therapist

This blog focuses on discussion regarding the course NP0018 Becoming a Smarter Therapist.
 
 

NP0018, Smarter Therapist, Session 3, Barry Duncan

 

What’s the most important key to improving as a therapist? How can we radically and consistently improve our effectiveness as clinicians? Get the answers to these questions and more in today’s session with Barry Duncan. He’ll go over ways in which we can improve as therapists, including what more than 1,000 studies have taught us about the science of the therapeutic alliance. You’ll learn what “healing involvement” is and how to achieve it with any client and how you’ll come away with a much better understanding of why outcome measurement is essential to improvement.

As always, we encourage you to take a few minutes after the session to comment—what was new, or most interesting to you about this session? What questions do you have or relevant experiences to share? And as always, if you ever have any technical questions, just email support@psychnetworker.org!


05.03.2012   Posted In: NP0018 Becoming a Smarter Therapist   By Psychotherapy Networker
8
Comments
 

  • 0 avatar Ruth Gordon 05.03.2012 12:58
    I have ALWAYS felt the cure was in the alliance -- what a pleasure to hear that point of view from one of the most respected therapists in out field. Thank You
    Reply
    • Not available avatar Barry Duncan 05.14.2012 04:53
      Hi Ruth,
      Sorry for the delay in response. Thanks very much for you kind comment. For too long, the field has given the alliance short shrift when it is far more important than model and technique--and far more difficult to achieve than many think. It is the main thing that separates the great therapist from the average one. I wish we all could say outloud that psychotherapy is a relational endeavor, not a medical one!
      Reply
  • Not available avatar art miron 05.05.2012 16:55
    If I'm correct, Lambert indicated that his use of outcome measures had significant impact on the treatment outcomes for the therapists working with the most acute clients, but had little impact for clinicians working with the 80% of clients falling within moderate acuity levels. This suggests that use of an outcome measure may not be as helpful for most clinician experiences. We tested an outcome measure at our large private practice and found that clinicians experienced benefit from its use less than 25% of the time. What are your thoughts about this. Thanks.
    Reply
    • Not available avatar Barry Duncan 05.14.2012 05:21
      Hi Art,
      Sorry for the delay in response. Thanks for your question. I am pretty familiar with Lambert's studies but I don't recall seeing anything that suggests that the feedback effect is limited to those of any particular acuity level but I could have missed that. I was just looking at Baldwin's (et al., 2009) analysis of OQ data and it doesn't reflect any differences in outcomes based on acuity if you are defining acuity as severity of distress at intake. Lambert's studies have typically found that the clients at risk are more likely to benefit from feedback while our studies have found a feedback effect across clients. In addition, our studies have found that 8-9 therapists out of 10 do benefit from adding feedback to their work. Lambert's use of the OQ is very different than our use of the ORS/SRS. We integrate the measures into the ongoing psychotherapy process and include a transparent discussion of the feedback with the client; We assess the alliance every session; and the Outcome Rating Scale, rather than a list of symptoms rated on a Likert Scale, is a clinical tool as well as an outcome instrument that requires collaboration with clients and clinical nuance in application.

      Regarding why your practice found outcome measurement only of benefit 25% of the time, I really can't comment given that I don't know what measure you used or how it was used.
      I am very confident in saying that using the ORS and SRS to include client feedback into the psychotherapy process does improve the outcomes of most therapists who give it a try.

      I hope you give a try. You can find lots of free stuff about using the measures at www.heartandsoulofchange.com.
      Reply
  • Not available avatar Graham Hocking 05.07.2012 19:12
    Thank you for continuing to promote your very sound advice. I am interested in following up a study you mentioned which was the re analysis of the NIMH depression study which showed with the top third of psychiatrists placebo was better than medication. Could you provide the reference for this study?
    Graham Hocking Australia
    Reply
    • Not available avatar Barry Duncan 05.14.2012 05:39
      Hi Graham,
      Thanks for yoru comment. The top third psychiatrists got better results with placebo than the bottom third psychiatrist got with antidepressants. The reference:
      Kim, D. M., Wampold, B. E., & Bolt, D. M. (2006). Therapist effects in psychotherapy: A random effects modeling of the NIMH TDCRP data. Psychotherapy Research, 16, 161-172
      Reply
  • Not available avatar Anne Fowler 06.04.2012 15:48
    Hi, I\'d appreciate any recommendations for books, accessible to lay people, on the therapeutic alliance. Thanks so much. Anne
    Reply
    • Not available avatar Barry Duncan 06.05.2012 22:49
      Hi Anne,
      My book, What's Rigtht With You, discusses the alliance and the importance of relaltionship to making changes. It covers many things but there is a chapter devoted to the power of relationship in the change process.
      Reply
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