Research can be fun, informative and relatively painless. All you - PowerPoint PPT Presentation

Research can be fun, informative and relatively painless. All you need is a research kit and curiosity! Professor Sue Wheeler University of Leicester IACP Introduction to Research Day Dublin 12 October 2013

Don’t run away yet, it may not be too bad! • What do we mean by research? • Why do research in psychotherapy? • Does research affect practice? • What can we do, we are not researchers? • Practitioner research: Practice Research Networks

Research as a source of knowledge for practice • An effective therapist draws on many different sources of knowledge: – Personal: self-awareness, how I have dealt with problems in my own life – Practical: reflecting on experience with clients – Theoretical: concepts and models that make contribute to understanding and planning – Social and cultural: the client’s social background, values and worldview – Research: “de - centred” knowledge, based on systematic critical inquiry by many researchers around the world

Research as a source of knowledge for practice • Just as with any other source of knowledge, it takes time and effort to develop useful research knowledge • How do you do this? • Read relevant literature actively- looking for evidence • Don’t shy away from reading research papers • Google topics of interest but look for evidence • Have an enquiring mind. How might relevant research affect you, your clients and your practice

A pragmatic definition of research • A systematic process of critical inquiry leading to valid propositions and conclusions that are communicated to interested others McLeod, J (2013)

Some of the assumptions behind it • Critical enquiry • A process of enquiry • Systematic • Products are statements • Findings judged according to validity • Communicated to interested others

• Why do research in counselling and psychotherapy?

Issue date: October 2009 Depression The treatment and management of depression in adults This is a partial update of NICE clinical guideline 23 NICE clinical guideline 90 Developed by the National Collaborating Centre for Mental Health

Why is it important for practitioners? • Gaining a wider perspective • Accountability • Self monitoring • Monitoring progress of therapy • Gain insight into cases and the process of therapy • Developing new ideas and approaches • Personal and professional development • External credibility for professional work • Becoming sensitised to the experience of clients • Being part of a research community

Research fulfills needs • Modern expression of an innate, universal human need • Expression of natural curiosity: – The need to understand & master one’s environment – “Pleasure principle of the intellect” (C. Levi -Strauss) – The growth tendency (C. Rogers)

“The psychotherapist learns little or nothing from successes. They mainly confirm in him his mistakes, while his failures on the other hand, are priceless experiences in that they not only open a deeper truth, but force him to change his views & methods.” Modern man in search of a soul By Carl Gustav Jung

We are letting knowledge from practice drip through the holes of a colander

Does research affect practice? • Probably, but not necessarily for the worse. • Some things are routine practice in some models of therapy and in some settings: – Video recording and one way mirrors – In vivo supervision – Audio recordings of sessions – Routine outcome monitoring – Follow up interviews – Systematic discussion of sessions in detail in supervision

Quotes from our clinic • ‘It is good to know that this therapy is being monitored in some way. It makes me feel less vulnerable’ • ‘I waited six months for this therapy. I am willing to do anything that might lead to more services being available’ • I found completing the questionnaires helpful. They helped me focus on what I wanted to talk about in the session

more • ‘I enjoyed the change interview at 10 weeks. It was good to reflect on how I had changed and what I was doing differently’ • ‘Seeing my scores decrease on the graph was quite motivating’ • ‘I wasn’t sure at first but I got used to the tape recorder

What can we do, we are not researchers? • Read research reports • Become part of a research community • Routine outcome monitoring • Join a Practice Research Network

Principles of practice oriented research • It is bottom up oriented : clients and therapists can be involved in selecting research questions and methods • The research is focused : limited to some key elements • The methodology is pluralistic : a variety of methods used to catch the complexity of the therapy • It is practical : instruments chosen are inexpensive and easy to use • It is collaborative : therapists work together in planning the research.

Practice Research Networks • Principle of collaboration • A common purpose • Adoption of a common methodology • Co-ordinated research effort rather than fragmented But: • Adequate time and resources for data collection and management that is sustainable • The sampling frame can be determined • Focused attention to achieve quality data

Generating practice-based evidence • Re-privileging of practitioner role in research - owned by practitioner • Focus on practitioner • Integrates process and outcomes • Meaningful data (the value of missing data) • Adopts common methodology - hub & spoke approach • Data collection becomes routine (rooted in practice) and then used to address local practice-based questions • Practice becomes evidence-based - commonality and variation

Complementary paradigms and chiasmus Practice-based Efficacy studies evidence Efficacy studies Randomised Controlled Trials Practice-based studies (i.e. effectiveness) Routine Evidence-based Clinical Practice as policy Treatment Practitioners Practitioners Barkham, M. 2009

Some examples of what a Practice Research Network can achieve

Therapist variability (n=211)

CORE NRD (2005): Overall outcomes 40 Post therapy CORE-OM clinical score 35 Clinical cut off Reliable deterioration N = 9761 30 25 No reliable change Reliable and clinically 61.9% significant deterioration 20 recovered Reliable improvement 15 10 Reliable and clinically significant improvement 5 0 0 5 10 15 20 25 30 35 40 Pre therapy CORE-OM clinical score

Some reading for starters Counselling and Psychotherapy Research Journal McLeod, J. (2009/13) An introduction to counselling . 5 th edn. Open University Press (chapter on research) McLeod, J. (2013) An introduction to research in counselling and psychotherapy . London: Sage Cooper, M. (2008) Essential research findings in counselling and psychotherapy: the facts are friendly . London: Sage Ladislav Timulak, Research in Psychotherapy and Counselling , London, Sage, 2008 Case study research as a vital source of knowledge for practice: McLeod, J. (2010) Case study research in counselling and psychotherapy . London: Sage Pragmatic Case Studies in Psychotherapy (on-line journal)

Thank you • Thanks to: • John McLeod • Robert Elliott • John Mellor Clarke • Michael Barkham