Recent evidence suggests that psychotherapists may not increase in effectiveness over accrued experience in naturalistic settings, even settings that provide access to patients' outcomes. The current study examined changes in psychotherapists' effectiveness within an agency making a concerted effort to improve outcomes through the use of routine outcome monitoring coupled with ongoing consultation and the planful application of feedback including the use of deliberate practice. Data were available for 7 years of implementation from 5,128 patients seen by 153 psychotherapists. Results indicate that outcomes indeed improved across time within the agency, with increases of d = 0.035 (p = .003) per year. In contrast with previous reports, psychotherapists in the current sample showed improvements within their own caseloads across time (d = 0.034, p = .042). It did not appear that the observed agency-level improvement was due to the agency simply hiring higher-performing psychotherapists or losing lower-performing psychotherapists. Implications of these findings are discussed in relation to routine outcome monitoring, expertise in psychotherapy, and quality improvement within mental health care. (PsycINFO Database Record

Possible reasons for the lack of variability between supervisors are discussed.

Plain English summaryThe Alberta Depression Research Priority Setting Project aimed to meaningfully involve patients, families and clinicians in determining a research agenda aligned to the needs of Albertans who have experienced depression. The project was modeled after a process developed in the UK by the James Lind Alliance and adapted to fit the Alberta, Canada context. This study describes the processes used to ensure the voices of people with lived experience of depression were integrated throughout the project stages. The year long project culminated with a facilitated session to identify the top essential areas of depression research focus. People with lived experience were engaged as part of the project’s Steering Committee, as survey participants and as workshop participants. It is hoped this process will guide future priority setting opportunities and advance depression research in Alberta.Abstract Background The Depression Research Priority Setting (DRPS) project has the clear aim of describing the patient engagement process used to identify depression research priorities and to reflect on the successes of this engagement approach, positive impacts and opportunities for improvement. To help support patient-oriented depression research priority setting in Alberta, the Patient Engagement (PE) Platform of the Alberta Strategy for Patient Oriented Research Support for People and Patient-Oriented Research and Trials (SUPPORT) Unit designed, along with the support of their partners in addictions and mental health, an explit process to engage patients in the design and execution of the DRPS. Methods The UK’s James Lind Alliance (JLA) Priority Setting Partnership (PSP) method was adapted into a six step process to ensure voices of “people with lived experience” (PWLE) with depression were included throughout the project stages. This study uses an explicit and parallel patient engagement process throughout each estage of the PSP designed by the PE Platform. Patient engagement was divided into a five step process: i) Awareness and relationship building; ii) Co-designing and co-developing a shared decision making process; iii) Collaborative communication; iv) Collective sensemaking; and v) Acknowledgement, celebration and recognition. A formative evaluation of the six PE processes was undertaken to explore the success of the parallel patient engagement process. Results This project was successful in engaging people with lived depression experience as partners in research priority setting, incorporating their voices into the discussions and decisions that led to the top 25 depression research questions. Conclusions The DRPS project has positively contributed to depression research in Canada by identifying the priorities of Albertans who have experienced depression for depression research. Dissemination activities to promote further knowledge exchange of prioritized research questions, with emphasis on the importance of process in engaging the voices of PWLE of depression are planned.Electronic supplementary mater...

The present study investigated the impact of motivational interviewing (MI) and stage of change on a self-report measure of global functioning (Outcome Questionnaire [OQ 45.2]). Participants were men mandated to attend the Responsible Choices for Men (RCM) group therapy program following an incident of domestic violence. The study design utilized a quasi-experimental between-groups comparison utilizing data collected at three time points (pregroup, first group session, and final group session). One group of mandated program attendees received two sessions of MI (n = 106), whereas the comparison group did not (n = 106). Stage of change was assessed using the URICA-G and the URICA-DV (University of Rhode Island Change Assessment--Domestic Violence). Multilevel growth modeling indicated that stage of change has a significant relationship to global functioning. Discussion focuses on the potential benefits of MI as a pregroup treatment and the importance of accounting for individual readiness to change.

epression is a major public health issue in Canada. 1 About 8% of adults aged 25-64 years are projected to experience major depression at some time in their lives. 2 Depression is estimated to account for at least $32.3 billion of direct and indirect costs to this nation annually. 3 Continued investment in research that explores prevention and treatment is needed, 4,5 in particular through engaging patients (i.e., people with depression, family members and informal caretakers) in this endeavour to better ensure that research is relevant to their needs. Patient engagement occurs "when patients meaningfully and actively collaborate in the governance, priority setting, and conduct of research, as well as in summarizing, distributing, sharing, and applying its resulting knowledge." 6 However, research findings suggest that medical research topics are selected predominantly by researchers and funding agencies, with little input from patients themselves, 7 and that, even when patients are engaged in setting research priorities, their opinions are sometimes overlooked. 8 Engaging people with lived experience of a health situation in setting research priorities is one structured way of influencing researchers and research funders to consider their opinions.