Norcross J.C., Krebs P.M., Prochaska J.O.
Journal of Clinical Psychology: 2011, 67(2), p. 127–132.
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Based on commissioned meta-analytic reviews, a US task force judged that adapting psychotherapy to the patient's reactance/resistance, preferences, culture, and religion/spirituality demonstrably improved effectiveness.
Summary This article introduces a special issue of the Journal of Clinical Psychology devoted to evidence-based means of adapting psychotherapy to the patient's characteristics across patients with different diagnoses including those with substance use problems. Practitioners have long realised that treatment should be tailored to the individuality of the patient and the singularity of his or her context, but only recently has sufficient empirical research emerged to reliably guide practice. This article reviews the work of a task force and its dual aims of identifying elements of effective therapy relationships (what works in general) and identifying effective methods of adapting treatment to the individual patient (what works in particular). The task force judged that adapting psychotherapy to four patient characteristics (preferences, reactance/resistance, Resistance was originally seen as an inherent striving to avoid, repress, or control conflicted thoughts and feelings. Reactance is now usually the preferred term and has been defined as a "state of mind aroused by a threat to one's perceived legitimate freedom, motivating the individual to restore the thwarted freedom". culture, religion/spirituality) demonstrably improved effectiveness. Adapting to another two – stages of change Often known by its originators' names, Prochaska and DiClemente or as the cycle of change model. The model conceptualises behaviour change as a process which unfolds over time and involves progression through a series of five stages: precontemplation, contemplation, preparation, action, and maintenance. and coping style Recurrent patterns of behaviour that characterise the individual when confronting new or problematic situations. – was judged probably effective. Two more patient facets (expectations, attachment style) were related to psychotherapy outcome, but there was insufficient research on adapting psychotherapy to these facets. This special issue provides research-supported methods of individualising psychotherapy to the person, in addition to his or her diagnosis.
commentary This article was in a special issue of the Journal of Clinical Psychology devoted to adapting psychotherapy to the individual patient. For other Findings entries from this issue see:
Adapting psychotherapy to the individual patient: Stages of change
Adapting psychotherapy to the individual patient: Preferences
Adapting psychotherapy to the individual patient: Culture
Adapting psychotherapy to the individual patient: Coping style
Adapting psychotherapy to the individual patient: Expectations
Adapting psychotherapy to the individual patient: Attachment style
Adapting psychotherapy to the individual patient: Resistance/reactance level
Adapting psychotherapy to the individual patient: Religion and spirituality
Last revised 09 March 2011