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On Becoming a Better Therapist

by Barry L. Duncan

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"Outcome research in the last 2 decades has extensively focused on the effects of specific treatments for specific disorders, so-called clinical trials. Researchers employing this methodology typically attend to the individual therapist as an important factor to be controlled before undertaking their primary analysis of treatment effects. Such research uses considerable resources to diminish variability in outcomes that could be attributed to the therapist. This is typically accomplished through careful selection of therapists, extensive training, and supervision of therapists who are using treatment manuals to guide their interventions. The intent of such procedures is to maximize the likelihood of finding effects due to treatments, independent of the therapists who offer them. In a field dedicated to the understanding of human behavior, it is a paradox that half the human element of therapy, the therapist, has largely been relegated to the category of an extraneous variable in clinical trials. This has resulted in an "oddly personless" view of psychotherapy (Norcross, 2002, p. 4). Such designs don't necessarily ignore the importance of the therapist's capacity to both build a relationship with the client and flexibly tailor therapeutic treatment (techniques) to meet the needs of the individual client, but they do reduce variability in these important capacities, which are so central in service delivery in everyday practice. Considering the therapist and the client as central elements in the process of therapy does not detract from psychotherapy itself as having important healing ingredients but expands the possibilities for understanding the human encounter as connected with, rather than incidental to, therapeutic techniques. It makes little practical sense in routine care to ignore or minimize the interpersonal nature of psychotherapy and the therapist's contribution to patient improvement. On Becoming a Better Therapist redirects our attention from specific treatments to our behaviors and attitudes as therapists, offering a refreshing look at improving treatment that operates outside the contemporary solution of providing the "right psychological treatment for the right disorder." This book provides simple but elegant solutions for becoming a more effective therapist"--Foreword. (PsycINFO Database Record (c) 2014 APA, all rights reserved).… (more)
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"Outcome research in the last 2 decades has extensively focused on the effects of specific treatments for specific disorders, so-called clinical trials. Researchers employing this methodology typically attend to the individual therapist as an important factor to be controlled before undertaking their primary analysis of treatment effects. Such research uses considerable resources to diminish variability in outcomes that could be attributed to the therapist. This is typically accomplished through careful selection of therapists, extensive training, and supervision of therapists who are using treatment manuals to guide their interventions. The intent of such procedures is to maximize the likelihood of finding effects due to treatments, independent of the therapists who offer them. In a field dedicated to the understanding of human behavior, it is a paradox that half the human element of therapy, the therapist, has largely been relegated to the category of an extraneous variable in clinical trials. This has resulted in an "oddly personless" view of psychotherapy (Norcross, 2002, p. 4). Such designs don't necessarily ignore the importance of the therapist's capacity to both build a relationship with the client and flexibly tailor therapeutic treatment (techniques) to meet the needs of the individual client, but they do reduce variability in these important capacities, which are so central in service delivery in everyday practice. Considering the therapist and the client as central elements in the process of therapy does not detract from psychotherapy itself as having important healing ingredients but expands the possibilities for understanding the human encounter as connected with, rather than incidental to, therapeutic techniques. It makes little practical sense in routine care to ignore or minimize the interpersonal nature of psychotherapy and the therapist's contribution to patient improvement. On Becoming a Better Therapist redirects our attention from specific treatments to our behaviors and attitudes as therapists, offering a refreshing look at improving treatment that operates outside the contemporary solution of providing the "right psychological treatment for the right disorder." This book provides simple but elegant solutions for becoming a more effective therapist"--Foreword. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

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