ABSTRACT
This study examined the preliminary results of an integrative, video-assisted training workshop aimed at helping psychotherapists build strong therapeutic relationships with their clients. Participants were 57 clinicians across five community mental health clinics, who were randomly assigned to the brief alliance-training workshop (in which they participated prior to starting treatment with a new client) or to a delayed-training control condition. Outcomes assessed included therapist-reported use of alliance strategies during Session 1, therapist-rated alliance quality after Session 1, and client engagement across the first 4 weeks. In contrast to hypotheses, one-way analyses of variance and chi-square analyses revealed no statistically significant differences between the training and the delayed-training conditions. However, the therapist-reported impact of using the workshop's alliance strategies was positively correlated with therapist-rated alliance quality (r = .30, p = .03) and marginally correlated with number of sessions attended (r = .25, p = .06) across the two conditions. The findings hold promise for the utility of a brief alliance-focused workshop, and for collaborations between researchers and clinicians seeking to bridge science and practice.
Subject(s)
Family Therapy/education , Inservice Training , Marital Therapy/education , Professional-Patient Relations , Psychotherapy/education , Video Recording , Curriculum , Humans , Mentors , Outcome and Process Assessment, Health Care , ResearchABSTRACT
The present study used Consensual Qualitative Research methodology to explore how experienced therapists understand and learn from impactful cases of premature termination. Eleven board certified psychologists were interviewed regarding a former client who left treatment prematurely. Participants were asked to reflect on client and therapist factors that may have contributed to premature termination, and on how the termination affected their work and professional development. Results indicated that therapist reactions and mistakes may contribute to the risk of premature termination, and that therapists may experience complex and lasting personal reactions to such outcomes. While they may face considerable uncertainty, therapists can learn valuable lessons by reflecting on departed clients. Implications for research and practice are discussed.
Subject(s)
Professional-Patient Relations , Psychotherapy , Treatment Refusal/psychology , Humans , Interviews as Topic , Mental Disorders/psychology , Mental Disorders/therapyABSTRACT
Reasons for premature termination of outpatient substance user treatment were evaluated from client and clinician perspectives using qualitative (focus groups) and quantitative (survey) methods in a pilot study (N = 44). The sample consisted of clients (n = 22), the majority of whom were male (73%) and African American (50%) or Caucasian (41%). The sample of clinicians (n = 22) were predominantly female (64%), and Caucasian (52%) or African American (24%). The most frequently endorsed reasons for leaving treatment were related to individual rather than program characteristics with heavy drug or alcohol use, transportation or financial problems, and ambivalence about abstinence being highly rated by both clinicians and clients. Survey results indicated that clinicians more frequently attributed treatment dropout to individual- or client-level factors than did clients. Focus group ratings indicated that clinicians felt client motivation and staff connection issues were primary reasons for dropout, whereas clients indicated social support and staff connection issues. The findings suggest that the development of early therapeutic alliance and active problem solving of potential barriers to treatment attendance may influence treatment retention.
Subject(s)
Attitude of Health Personnel , Patient Dropouts/psychology , Substance-Related Disorders/psychology , Adult , Aged , Female , Focus Groups , Health Care Surveys , Humans , Male , Middle Aged , Pilot Projects , Substance-Related Disorders/therapy , Time FactorsABSTRACT
The RIFE Grants Program offers funding to individuals in recovery from mental health and substance abuse problems for innovative projects to help them take steps toward achieving their life aspirations. Twenty-one people who received awards participated in an evaluation using the MDS and EPQ with significant increases in items related to empowerment from the beginning to mid study and a decrease in the empowerment factor from mid to end study. Ninety-one percent of participants reported improvements in daily life, 82% in thoughts of self, 80% in belief in capabilities, 60% in social roles, 80% in socializing, and 50% in values.
