Research can be fun, informative and relatively painless. All you need is a research kit and curiosity! Professor Sue Wheeler University of Leicester IACP Introduction to Research Day Dublin 12 October 2013
Don t run away yet, it may not be too bad! What do we mean by research? Why do research in psychotherapy? Does research affect practice? What can we do, we are not researchers? Practitioner research: Practice Research Networks
Research as a source of knowledge for practice An effective therapist draws on many different sources of knowledge: Personal: self-awareness, how I have dealt with problems in my own life Practical: reflecting on experience with clients Theoretical: concepts and models that make contribute to understanding and planning Social and cultural: the client s social background, values and worldview Research: de-centred knowledge, based on systematic critical inquiry by many researchers around the world
Research as a source of knowledge for practice Just as with any other source of knowledge, it takes time and effort to develop useful research knowledge How do you do this? Read relevant literature actively- looking for evidence Don t shy away from reading research papers Google topics of interest but look for evidence Have an enquiring mind. How might relevant research affect you, your clients and your practice
A pragmatic definition of research A systematic process of critical inquiry leading to valid propositions and conclusions that are communicated to interested others McLeod, J (2013)
Some of the assumptions behind it Critical enquiry A process of enquiry Systematic Products are statements Findings judged according to validity Communicated to interested others
Why do research in counselling and psychotherapy?
Issue date: October 2009 Depression The treatment and management of depression in adults This is a partial update of NICE clinical guideline 23 NICE clinical guideline 90 Developed by the National Collaborating Centre for Mental Health
Why is it important for practitioners? Gaining a wider perspective Accountability Self monitoring Monitoring progress of therapy Gain insight into cases and the process of therapy Developing new ideas and approaches Personal and professional development External credibility for professional work Becoming sensitised to the experience of clients Being part of a research community
Research fulfills needs Modern expression of an innate, universal human need Expression of natural curiosity: The need to understand & master one s environment Pleasure principle of the intellect (C. Levi-Strauss) The growth tendency (C. Rogers)
The psychotherapist learns little or nothing from successes. They mainly confirm in him his mistakes, while his failures on the other hand, are priceless experiences in that they not only open a deeper truth, but force him to change his views & methods. Modern man in search of a soul By Carl Gustav Jung
We are letting knowledge from practice drip through the holes of a colander
Does research affect practice? Probably, but not necessarily for the worse. Some things are routine practice in some models of therapy and in some settings: Video recording and one way mirrors In vivo supervision Audio recordings of sessions Routine outcome monitoring Follow up interviews Systematic discussion of sessions in detail in supervision
Quotes from our clinic It is good to know that this therapy is being monitored in some way. It makes me feel less vulnerable I waited six months for this therapy. I am willing to do anything that might lead to more services being available I found completing the questionnaires helpful. They helped me focus on what I wanted to talk about in the session
more I enjoyed the change interview at 10 weeks. It was good to reflect on how I had changed and what I was doing differently Seeing my scores decrease on the graph was quite motivating I wasn t sure at first but I got used to the tape recorder
What can we do, we are not researchers? Read research reports Become part of a research community Routine outcome monitoring Join a Practice Research Network
Principles of practice oriented research It is bottom up oriented: clients and therapists can be involved in selecting research questions and methods The research is focused: limited to some key elements The methodology is pluralistic: a variety of methods used to catch the complexity of the therapy It is practical: instruments chosen are inexpensive and easy to use It is collaborative: therapists work together in planning the research.
Practice Research Networks Principle of collaboration A common purpose Adoption of a common methodology Co-ordinated research effort rather than fragmented But: Adequate time and resources for data collection and management that is sustainable The sampling frame can be determined Focused attention to achieve quality data
Generating practice-based evidence Re-privileging of practitioner role in research - owned by practitioner Focus on practitioner Integrates process and outcomes Meaningful data (the value of missing data) Adopts common methodology - hub & spoke approach Data collection becomes routine (rooted in practice) and then used to address local practice-based questions Practice becomes evidence-based - commonality and variation
Complementary paradigms and chiasmus Efficacy studies Efficacy studies Randomised Controlled Trials Practice-based evidence Practice-based studies (i.e. effectiveness) Evidence-based Practice as policy Routine Clinical Treatment Practitioners Practitioners Barkham, M. 2009
Some examples of what a Practice Research Network can achieve
Therapist variability (n=211)
Post therapy CORE-OM clinical score CORE NRD (2005): Overall outcomes 40 35 Clinical cut off 30 Reliable deterioration N = 9761 25 20 Reliable and clinically significant deterioration No reliable change Reliable improvement 61.9% recovered 15 10 5 Reliable and clinically significant improvement 0 0 5 10 15 20 25 30 35 40 Pre therapy CORE-OM clinical score
Some reading for starters Counselling and Psychotherapy Research Journal McLeod, J. (2009/13) An introduction to counselling. 5 th edn. Open University Press (chapter on research) McLeod, J. (2013) An introduction to research in counselling and psychotherapy. London: Sage Cooper, M. (2008) Essential research findings in counselling and psychotherapy: the facts are friendly. London: Sage Ladislav Timulak, Research in Psychotherapy and Counselling, London, Sage, 2008 Case study research as a vital source of knowledge for practice: McLeod, J. (2010) Case study research in counselling and psychotherapy. London: Sage Pragmatic Case Studies in Psychotherapy (on-line journal)
Thank you Thanks to: John McLeod Robert Elliott John Mellor Clarke Michael Barkham