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Confirmation from the US Project MATCH alcohol treatment trial that too explicitly imposing structure on therapy risks relatively poor outcomes among patients reluctant to relinquish control and who react against direction – and a further indication that this pattern is not universal, but depends on the context.
Analysis of counselling session recordings from therapists trained in motivational interviewing suggests that the important quality of seeming 'genuine' can suffer if training mandates unnaturally withholding normal responses; however, departing from these tenets is risky unless done by a socially skilled therapist.
From the comprehensive treatment process data collected by a major national US study emerges the important lesson that retention in itself is not an active ingredient in post-treatment outcomes but reflects influences such having one's needs met (especially important for women) and developing a good relationship with the service and your key worker.
STUDY 1981 HTM file
Interpersonal functioning of alcoholism counselors and treatment outcome
Seminal US study which found that the therapy-related social skills of alcohol counsellors were strongly related to how many of their patients relapsed in the two years after leaving inpatient treatment.
DOCUMENT 2013 HTM file
When confrontation was challenged
Focus is on a seminal study from motivational interviewing’s originator which more than any other heightened the profile of the therapist’s interpersonal style in substance use counselling, seeming to confirm that heavy drinkers react best to non-confrontational nudging rather than the more bludgeoning style typical of the time.
DOCUMENT 2013 HTM file
Sometimes best to break the rules
Motivational interviewing’s ‘Do not dos’ like avoiding confrontation were intended to sidestep the traps which provoke clients to dig in their heels or disengage. Imagine then the upset of discovering that in certain circumstances, the opposite is the case; the explanation appeared to lie in coming across as ‘genuine’.
STUDY 1977 HTM file
Effect of counselor expectations on alcoholic recovery
Could negativity about the recovery chances of disadvantaged drinkers become self-fulfilling prophecies? This hidden gem study from the late ’70s suggests they can, and that bolstering counsellors’ expectations promotes commitment to treatment and recovery among the least promising of clients.
REVIEW 2018 HTM file
The real relationship and its role in psychotherapy outcome: a meta-analysis
Findings amalgamated for the American Psychological Association indicate that patient progress and treatment quality are strongly related to the strength of the personal (‘real’) relationship between client and therapist – more strongly than the working relationship focused on the therapy. Showing that you like, value and care for someone may be therapeutic in itself.
COLLECTION 2016 HTM file
The common core of therapy
‘Collections’ are customised Effectiveness Bank searches not available via the standard options in the search pages. Lists entries relating to ‘Dodo bird’ findings that all bona fide therapies tend to have similar effects. Across mental health and behavioural problems, such findings have turned attention to the ‘common factors’ shared by therapies rather than how they differ.
HOT TOPIC 2016 HTM file
Treatment staff matter
One of our hot topics offering background and analysis on important issues which sometimes generate heated debate. By focusing on the intervention as if it were a mechanical lever, research has not just ignored but sought to eliminate what now seems a more important factor – the influence of the practitioner and how they relate to the patient.
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