Longitudinal Utilization of Mental Health Services: A Timeline Method, Nine Retrospective Accounts, and a Preliminary Conceptualization

McKenna, Patricia A.; Todd, David M.

doi:10.1080/10503309712331332093

Cited by 29 publications

(27 citation statements)

References 11 publications

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“…Terminations due to external events were not associated with more negative ratings of success or helpfulness, but they did receive higher ratings of need for further treatment. It may be that many clients and therapists, as suggested by advocates of short-term therapy (e.g., Budman & Gurman, 1988), are able to evaluate a "piece of work" as successful, despite the fact that additional treatment might be needed in the future (Kupers, 1988;McKenna & Todd, 1997). This again suggests that it may be important to address these issues explicitly in therapies that are ending with the departure (or other environmental event) of the client or therapist.…”

Section: Discussionmentioning

confidence: 98%

Client and therapist reasons for termination: A conceptualization and preliminary validation

2002

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While the comparison of client and therapist reasons for termination might shed light on their respective views of outcome and process, only one published study has examined directly the reasons given by therapist-client pairs. One barrier to such research is the absence of a systematic conceptualization of reasons for termination that incorporates both therapist and client perspectives. This article describes a comprehensive conceptualization, drawn from the existing literature, and applies a coding system based on that conceptualization to naturalistic clinical data from 123 therapist-client pairs in a psychology training clinic. Coders were able to categorize reliably open-ended client data into reasons for termination. For therapist and client data, the relationships between coding categories and participants' outcome ratings, generally were consistent with expectations, providing limited validation. Some support was found for concordance between therapist and client reasons, especially for those related to therapist or client departures, which were prominent in this setting. As expected, however, therapists were more likely than clients to endorse success as a reason for termination. Negative client feelings about therapy, including dissatisfaction, were reported infrequently as reasons for termination, and with little agreement between clients and therapists, but this may be due to methodological limitations.

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Section: Discussionmentioning

confidence: 98%

Client and therapist reasons for termination: A conceptualization and preliminary validation

2002

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“…For example, within the realm of psychotherapy, qualitative methods can provide an insight into change processes (Elliott, 2012;McLeod, 2011) or how people's engagement with services changes across time (McKenna & Todd, 1997) or how theoretical propositions are enacted in therapy (Roy-Chowdhury, 2003). There are some challenges, however.…”

Section: A Pluralistic Approach To Gathering Evidencementioning

confidence: 99%

Beyond Evidence-Based Practice: Rethinking the Relationship between Research, Theory and Practice

Harper¹,

Gannon²,

Robinson³

2003

Applied Psychology: Current Issues and New Directions

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This chapter discusses:• How applied psychologists attempt to ground their practice in research.• The history of the evidence-based practice movement.• Problems with the scientist practitioner model • Alternative conceptualisations of the link between research evidence and practice.• Some of the problems with randomised controlled research trials.• The social context of research.• The need for a different approach, focusing on the views of participants and utilising a broader range of research methods.

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“…Instead they may use silence in response to difficult aspects of the therapy experience (Levitt, 2002), and they sometimes adapt to the therapist to keep the relationship intact (Lietaer, 1992;Rennie, 2002). In research interviews and questionnaires, clients seem slightly more willing to express hindering or unhelpful experiences (Dale, Allen, & Measor, 1998;McKenna & Todd, 1997) but they generally report fewer hindering than helpful factors (e.g. Levy et al, 1996), tend to give fewer comments to questions about unhelpful events and seem often to attribute the experienced difficulties to themselves (Lietaer, 1992).…”

Section: Hindering Factorsmentioning

confidence: 99%

Therapy talk and talk about therapy : Client-identified important events in psychotherapy

Viklund¹

2014

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Capturing and studying the moments in psychotherapy that clients find most important can help us understand more about how psychotherapy works, what the curative ingredients are, and by what processes they are mediated. Qualitative research in this area has, so far, mainly focused on describing, and categorizing clients' experiences of important factors and events. The methods employed to analyse the data have been rather limited in variation and are usually based on a realist epistemology, according to which data are basically treated as reflections of the clients' actual experiences. This entails a risk of overlooking and obscuring other aspects of therapy and the therapy process that are equally important to explore, for example the microprocesses of interaction within important events, or how clients' accounts of their experiences are shaped and limited by the context in which they are produced. The overall aim of this licentiate thesis was to explore client-identified important events in psychotherapy with a focus on studying therapy talk and talk about therapy from a social constructionist point of view, which would allow a closer exploration of the understudied areas mentioned above.In Study I, Conversation Analysis was used to explore the interaction taking place between seven client-therapist dyads in 16 client-identified important events collected from their third sessions. The analysis identified that 12 of the events contained clients' expressions of disagreement. Three different ways that the therapists handled the disagreement were discerned: The first, and most common, way was to orient to the client's cues of disagreement by inviting the client to elaborate on his or her point of view and to establish a shared understanding acceptable to both participants. The second way was to orient to the client's disagreement cues but define the therapist's own point view as more relevant than the client's, and the third way was a single case in which the therapist did not in any way orient to the client's disagreement cues.In Study II, two qualitative methods based on different epistemologies were used to analyse the same set of eight clients' accounts of 18 important events. The aim was to first identify what types of events clients describe as important, and then explore how their accounts of these events were contextually shaped and organized, and the consequences of this. The first analysis, a content analysis, yielded descriptions of five different types of events, which were similar to the ones found in previous research on important events. The second analysis, a discourse analysis, demonstrated how clients' accounts were not only influenced by the participants' ability to accurately remember and report their experience, but also by what was sayable within the context of the research interview. In conclusion, the two studies demonstrate how qualitative methods based on a socialconstructive perspective can contribute to our understanding of clientidentified important events by highlighting and ...

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Longitudinal Utilization of Mental Health Services: A Timeline Method, Nine Retrospective Accounts, and a Preliminary Conceptualization

Cited by 29 publications

References 11 publications

Client and therapist reasons for termination: A conceptualization and preliminary validation

Client and therapist reasons for termination: A conceptualization and preliminary validation

Beyond Evidence-Based Practice: Rethinking the Relationship between Research, Theory and Practice

Therapy talk and talk about therapy : Client-identified important events in psychotherapy

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