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Skills and Expertise
Publications
Publications (283)
Objective: The aim of this study was to investigate a sequence of associations between clients’ pretreatment attachment style, the development of individuated-secure attachment to the therapist (i.e., therapeutic attachment), and the experience of increased comfort with emotional closeness (growing engagement) or independence (growing autonomy) in...
Aimed at understanding and improving psychological therapies as they are conducted in clinical routine, practice-oriented research (POR) is now a well-established approach to the scientific foundations of mental health care services. Resting on the accumulation of a wide range of practice-based evidence related to treatment outcome and process, as...
There has been a growing emphasis on dissemination of empirically supported treatments. Dissemination, however, should not be restricted to treatment. It can and, in the spirit of the scientific-practitioner model, should also involve research. Because it focuses on the investigation of clinical routine as it takes place in local settings and becau...
Objective:
The current study aimed to inform the varied and limited research on clinical variables in the context of teletherapy. Questions remain about the comparative quality of therapeutic alliance and clinical outcome in the context of teletherapy compared to in-person treatment.
Methods:
We utilized a cohort design and a noninferiority stat...
Objective:
Using patient-generated quantitative data in psychotherapy (feedback) appears to enhance treatment outcome, but there is variability in its effect. Different ways and reasons to implement routine outcome measurement might explain such variability. The goal of this review is to address the insufficient knowledge on how these data are use...
Given its interpersonal underpinnings, relational factors may be salient in psychotherapy for generalized anxiety disorder (GAD). Supporting this point, research has indicated a positive total alliance-improvement correlation in cognitive behavioral therapy (CBT) for GAD. However, less research has disaggregated this correlation into within- and be...
Objectives:
This paper presents a randomized controlled trial on assimilative integration, which is aimed at integrating elements from other orientations within one approach to enrich its conceptual and practical repertoire. Elements from Emotion-Focused Therapy (EFT) were integrated into a form of cognitive behavior therapy: Psychological Therapy...
Objective: The literature regarding dropout from psychotherapy has suffered from issues of diverse operationalization of the construct. Some have called for a more uniform definition to aid in generalization across research; this study aimed to assess the viability of such a definition by examining the rate of occurrence for three distinct definiti...
Objective
While agreement between clients and their clinicians on therapy goals has frequently been investigated as a process-level variable (i.e., working alliance), dyadic convergence on presenting concerns is also important for initial case formulation. Transdiagnostic presenting problems, like sleep difficulty, pose a particular challenge for c...
Treatment context may have a unique impact on psychotherapy outcomes, above and beyond client, therapist, and therapy process variables. University counseling centers represent one such treatment context facing increasing treatment demands. This study examined the role of counseling centers and center variables in explaining differences in psychoth...
https://www.guilford.com/excerpts/castonguay_ch2.pdf
It is estimated that 16% of the general population experiences clinically significant depression in a given 12-month period (Kessler, Tat Chiu, Demler, & Walters, 2005). In addition to the impact on affected individuals and their families, depressive disorders place a burden of almost $50 billio...
Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge,...
Purpose: Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming prevalent in mental health services, but there are several challenges to successful implementation. ROM/CFS seem to be helpful for some patients, but not for others. To investigate this, we explored patients’ experiences with ROM/CFS as an interpersonal and p...
Objective:
Although most self-report measures of distress are intended to assess time-varying constructs, they are usually developed using between-person data. They are therefore vulnerable to misspecification due to measurement nonequivalence at the between-person and within-person levels. In recent years, multiple studies have found that self-rep...
Objective: There is a paucity of studies examining the experience of clients who undergo multiple courses of psychotherapy. Conducted within a large practice research network, this study demonstrated that returning therapy clients comprise a considerable portion of the clinical population in university counseling settings, and identified variables...
Purpose: Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming prevalent in mental health services. The field faces several challenges to successful implementation. The purpose of this study is to gain a better understanding of these challenges by exploring the patient perspective. Method: We report the findings from a q...
The early treatment phase appears to be critical in psychotherapy. Even when adequate fidelity has been achieved in controlled trials, the scope of rated interventions is limited and there remains a need to better understand early treatment intervention implementation. Objective: Explore and compare the delivery of diverse intervention strategies i...
This study sought to identify predictors of suicidal behavior among college students who are psychotherapy clients, as well as to determine underlying classes of clients with suicidal ideation. Data were gathered from 101,570 clients, 391 of whom engaged in suicide behavior during treatment. Regression analyses revealed that suicide behavior was po...
The integrative approach described in this chapter represents the authors’ efforts to improve the efficacy of cognitive-behavioral therapy (CBT) via a systematic and theoretically cohesive assimilation of treatment procedures typically associated with other psychotherapy orientations. The primary emphasis is on an integrative therapy for generalize...
This chapter presents three cases of social anxiety disorder that served as the basis for the clinician authors to showcase their implementation of empirically based principles of change, as described in subsequent chapters by three therapists. Of the three cases, one displays a co-morbidity of substance abuse, another shows a co-morbid personality...
The goal of this chapter is to generate new conceptual, clinical, and empirical perspectives about principles of change that are relevant to the treatment of depression. It provides an opportunity for the authors of the previous three chapters to present their views about convergences and differences in the implementation of principles, the clinica...
This introductory chapter describes the goals of the book and its structure. It presents the rationale for developing a new list of empirically based principles of change, as well as for inviting expert clinicians to illustrate how such principles can be implemented in their day-to-day practice. The chapter also describes how these clinicians were...
This chapter provides an opportunity for the authors of the previous three chapters on anxiety disorders to present their perspectives about a number of conceptual, clinical, and empirical issues regarding principles of change. These include convergences and differences in the implementation of principles (in terms of how much they are emphasized a...
This chapter presents a list of empirically based principles of therapeutic change that was revised from the one published in this book’s previous volume. The chapter describes the ways in which the original list was modified, and how an extensive review of scientific literature led to the identification of 38 principles clustered into 5 categories...
This chapter presents three cases of depression that served as the basis for the clinician authors to showcase their implementation of empirically based principles of change, as described in subsequent chapters by three therapists. Of the three cases, one displays a co-morbidity of substance abuse, another shows a co-morbid personality disorder, an...
This book aims to create a new venue for evidence-based practice in psychotherapy—a venue that goes beyond the traditional and unidirectional dissemination of research, whereby clinicians are typically viewed as passive recipients of scientific findings. In contrast, this book is the result of an active, intense, and bidirectional collaboration of...
Performance accountability-also frequently referred to as quality improvement in the fields of medicine and public policy-is under growing scrutiny in mental and behavioral health care. As one high-profile example, psychologists and other mental health providers will be deemed "eligible clinicians" under the 2015 Medicare Access and Children's Heal...
This study examined how academic distress changed over the course of counseling and predicted retention. The sample comprised students receiving services at the campus counseling center (n = 404), students from a psychology department subject pool (n = 311), and students from the general campus population (n = 75,748). The analyses performed includ...
This chapter reviews efforts to integrate psychotherapy research and practice through collaboration and information-sharing within naturalistic clinical settings. Specifically, the chapter focuses on three types of practice-oriented research that capitalize on the bidirectional partnership between researchers and practitioners: (1) patient-focused,...
Conducted in naturalistic settings, practice-oriented research (POR) is aimed at building stronger connections between the science and practice of psychotherapy. Promoting the principles of POR, this paper has two aims: (1) Presenting the results of a survey assessing the interests of members of a large practice research network (PRN) in topics tha...
Cet article cherche à décrire trois grandes voies par lesquelles l’impact de la psychothérapie pourrait être amélioré: (a) de façon clinique, en encourageant l’intégration dans la pratique des principes de changement empiriques, (b) de façon empirique, en promouvant la recherche sur le processus et le résultat sur une large palette de facteurs comm...
Background
Psychotherapy can alleviate mental distress and improve quality of life, but little is known about its potential negative effects and how to determine their frequency.
Aims
To present a commentary on the current understanding and future research directions of negative effects in psychotherapy.
Method
An anonymous survey was distributed...
The current study investigated the sensitivity to change of the Counseling Center Assessment of Psychological Symptoms-34 (CCAPS-34), a multidimensional measure designed to assess the mental health problems common in college students across seven domains. The results suggest that the CCAPS-34 is able to capture change taking place during treatment.
In this concluding paper the central subjects that have been elaborated in the 10 works that make up the special issue on Practice Oriented Research are developed. In this direction the topics are presented relation to the current panorama of psychotherapy research field, posing the fundamental challenges that must be overcome to favor a better art...
The wide divide between research and clinical practice is well documented, and many psychotherapists do not implement empirical findings in their routine clinical work. A proposed evidence-based effort to address this science-practice gap is practice-oriented research, where clinicians are active participants in all aspects of research. The current...
Objective:
Though many studies have shown that psychotherapy can be effective, psychotherapy available in routine practice may not be adequate. Several methods have been proposed to evaluate routine psychological treatments. The aim of this paper is to demonstrate the combined utility of complementary methods, change-based benchmarking, and end-st...
Despite growing evidence that a greater number of students are seeking counseling in college and university counseling centers throughout the United States, there is a dearth of empirical information about (a) the presenting concerns for which students seek treatment and (b) how these concerns differ according to client demographic factors. The pur...
The current state of college student mental health is frequently labeled a “crisis,” as the demand for services and severity of symptomatology have appeared to increase in recent decades. Nationally representative findings are presented from the Center for Collegiate Mental Health, a practice research network based in the United States, composed of...
Objective: Though many studies have shown that psychotherapy can be effective, psychotherapy available in routine practice may not be adequate. Several methods have been proposed to evaluate routine psychological treatments. The aim of this paper is to demonstrate the combined utility of complementary methods, change-based benchmarking and end-stat...
Conducted within a practice-research network in private practice, this exploratory study was aimed at examining whether clinicians can accurately predict and recall profiles of therapeutic interventions they used during an entire treatment for a given client. Based on a small sample (7 clinicians and 30 clients), the results tentatively suggest tha...
Routine outcome monitoring (ROM) and clinical feedback (CF) systems have become important tools for psychological therapies, but there are challenges for their successful implementation. Objective: To overcome these challenges, a greater understanding is needed about how patients experience the use of ROM/CF. Method: We conducted a systematic liter...
Dropout has been a pervasive and costly problem in psychotherapy, particularly for college counseling centers. The present study examined potential predictors of dropout using a large data set (N = 10,147 clients, 481 therapists) that was gathered through a college counseling center practice research network as a replication and extension of recent...
Although dropout from psychotherapy has received substantial attention, the impacts of nonattendance on client outcome across a course of psychotherapy have not been well researched. All in-person psychotherapy treatments require clients to actually attend sessions to generate positive symptomatic results, and missed sessions have at least a time a...
With data gathered from 47 university counseling centers in the United States, this study addresses both inter- and intra-group differences in symptomatology at intake among international students. In Study 1, symptomatology among international students was explored in comparison to US ethnic groups. In Study 2, intra-group differences in symptomat...
El uso sistemático de tareas en la psicoterapia psicodinámica-interpersonal para la depresión: Un enfoque de integración asimilativa
Aunque el uso de actividades entre sesiones, o tareas, ha sido tradicionalmente asociado con la terapia cognitiva conductual (cognitive-behavioral therapy, CBT, por sus siglas en inglés), hay creciente evidencia que t...
The Treatment Outcome Package for children and adolescents (TOP) is a behavioral health and well-being assessment used widely in clinical and child welfare populations. The primary purpose of this study was to examine the concurrent validity of the Child and Adolescent versions of the TOP with the Child Behavior Checklist (CBCL) and the Strengths a...
Objective: The authors attempted to develop and validate a general distress index for a multidimensional psychological symptom/outcome measure used in over 300 college counseling centers with more than 100,000 cases annually: the Counseling Center Assessment of Psychological Symptoms (CCAPS). Method: Four models were compared for fit indices (n = 1...
Objective:
We aimed to study perspectives of clinicians and patients to explore how ROM/CFS can be helpful and acceptable to them.
Method:
We interviewed 55 participants in focus groups and individual interviews and analyzed the data through rigorous team-based qualitative analyses.
Results:
We report 3 overarching domains: (a) Shared needs, (...
The current study explored the reliability and clinical utility of a method designed to identify latent classes of students seeking counseling, based on 8 symptom domains and their interactions. Participants were over 50,000 college students in counseling, assessed with the CCAPS-62 and -34 as part of routine clinical care. Latent profile analysis...
The purposes of this study were to (a) investigate whether psychotherapists differ in their effectiveness with clients, (b) determine whether disparities exist within therapists’ caseloads in their outcomes with White and racial and ethnic minority (REM) clients, (c) explore therapist factors that might contribute to observed therapist effects, and...
Objective: Differences between therapists (therapist effect) are often larger than differences between treatments (treatment effect) in explaining client outcomes, and thus should be considered relevant to providing optimal treatment to clients. However, research on therapist effectiveness has focused largely on global measures of distress as oppos...
This book attempts to foster collaboration between clinicians and researchers by presenting the experiences of 11 groups of contributors who have conducted practice-oriented research (POR) in various countries and naturalistic settings. Each of these groups was asked to describe the context in which their collaborative initiatives took place, as we...
The Treatment Outcome Package (TOP; D. R. Kraus, Seligman, & Jordan, 2005) is a multidimensional routine progress and outcome measure developed for use in diverse naturalistic practice settings. In this article, we (a) provide a brief review and summary of the extant psychometric and research support for the TOP, (b) provide examples of the TOP's u...
The goal of this article is to present information about a standardized multidimensional measure of psychological symptoms, the Counseling Center Assessment of Psychological Symptoms (CCAPS; Locke et al., 2011; Locke, McAleavey, et al., 2012; McAleavey, Nordberg, Hayes, et al., 2012), developed to assess difficulties specific to college students' m...
As a field, psychotherapy has long been dominated by the different types (or orientations) of psychological therapies in practice. Though there are hundreds if not thousands of different kinds of psychotherapy, in many ways some are quite similar—they share some common factors. In other ways, each orientation may possess some unique elements, or co...
Aim: Although psychotherapy is effective for a majority of people, there is a subset of people who fail to improve over the course of therapy. Prior research has shown that clients whose actual rate of change in therapy deviates significantly from the expected rate of change are much more likely to have a negative outcome. This expected trajectory...
To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP).
Eighty-three participan...
The role of the alliance in predicting treatment outcome is robust and long established. However, much less attention has been paid to mechanisms of change, including moderators, particularly for youth. This study examined the moderating role of pretreatment adolescent-caregiver attachment and its impact on the working alliance-treatment outcome re...
Integration has become an important and influential movement within psychotherapy practice, reflected
by the fact that many treatment providers now identify as integrative. However, integration has not had
as great an influence on psychotherapy research. The goal of this paper is to highlight the growing body
of research on psychotherapy integratio...
Practice research networks (PRNs) are infrastructures that allow for the collaboration of researchers and clinicians in conducting clinically meaningful and scientifically rigorous research. Despite the variety of PRNs, they can be broadly grouped into three clusters: (a) PRNs sponsored by professional organizations, such as American Psychiatric As...
2015) Building clinicians-researchers partnerships: Lessons from diverse natural settings and practice-oriented initiatives, makes every effort to ensure the accuracy of all the information (the "Content") contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties wh...
Objective: To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive–behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). Method: Eigh...
We argue that the evidence-based practice (EBP) model represents an evolution in integrating science and practice and synchronizes well with broader trends in health care. Because the curriculum for EBP training involves explicit emphasis on the best empirical evidence within Clinical Psychology, it can be utilized by all programs, irrespective of...
Abstract This paper is an introduction to a special series that attempts to foster collaboration between clinicians and researchers by presenting the experiences of 11 groups of contributors who have conducted practice-oriented research (POR) in various countries and naturalistic settings. Each of these groups was asked to describe the context in w...
Objective
The present study was a replication and extension of prior work (Stulz, Lutz, Leach, Lucock, & Barkham, ) that identified multiple groups of clients in treatment with high-symptom severity and markedly different recovery trajectories (rapid/early response vs. little or no response).Method
Using data collected through repeated administrati...
Abstract This paper describes the experience of clinicians in conducting research and collaborating with academic researchers. As part of clinical routine of a residential program for adolescent substance abusers, empirical data have been collected to assess client's needs before and after treatment, improve clinical practice, and identify barriers...
Abstract The goal of this paper is to describe the authors' experience conducting research in and for private practice. Based on two distinct research programs (one guided by a scientist practitioner leading various groups of clinicians and another from a network of practitioners and researchers), a number of practice-oriented studies are presented...
Background: Theoretical orientation is a multifaceted construct that is integral to the process of psychotherapy and psychotherapy training. While some research has been conducted on personal identification with particular schools of psychotherapy, techniques used in psychotherapy sessions, and match between trainees and supervisors in training, th...