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Practice-based Evdience (Michael Barkham, 2014)

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Presentation by Dr. Michael Barkham about practice-based evidence being used to establish an evidence-base for the practice of psychotherapy.

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Practice-based Evdience (Michael Barkham, 2014)

  1. 1. Michael Barkham Centre for Psychological Services Research University of Sheffield UK m.barkham@sheffield.ac.uk Calgary Counselling Centre Conference: December 2014
  2. 2.  Worth the effort commi,ng research 1me to inves1gate phenomena/experiences you believe are theore1cally or prac1cally important  Devising, adap1ng, & adop1ng innova1ve research methods  Science needs to adopt a shared frame of reference that has prac11oners as equal partners  Strive towards a level playing field  No single research method can develop or deliver a comprehensive science of the psychological therapies © University of Sheffield 12/10/14
  3. 3. © University of Sheffield 12/10/14
  4. 4. © University of Sheffield 12/10/14
  5. 5. • Adop1ng a boGom-­‐up approach • Measurement system at its heart using common data methods • Willingness to collect & share data with other prac1ce communi1es  Use data to improve prac1ce  Use data to enhance evidence and complement trials methodology © University of Sheffield 12/10/14
  6. 6. © University of Sheffield 12/10/14
  7. 7. © Centre for Psychological Services Research © University of Sheffield 12/10/14
  8. 8. © Centre for Psychological Services Research © University of Sheffield 12/10/14
  9. 9. © University of Sheffield 12/10/14
  10. 10. © University of Sheffield 12/10/14
  11. 11.  Map of the CORE measures © University of Sheffield 12/10/14
  12. 12. © University of Sheffield 12/10/14
  13. 13. © University of Sheffield 12/10/14
  14. 14. © University of Sheffield 12/10/14
  15. 15. © University of Sheffield 12/10/14
  16. 16. © University of Sheffield 12/10/14
  17. 17.  Outcomes as numbers at the group level N = 9761 61.9% recovered 81.4% improved © University of Sheffield 12/10/14
  18. 18.  Same data as 9761 individuals © University of Sheffield 12/10/14
  19. 19. © University of Sheffield 12/10/14
  20. 20. © University of Sheffield 12/10/14
  21. 21. © University of Sheffield 12/10/14
  22. 22. © University of Sheffield 12/10/14
  23. 23.  Caterpillar plots & therapist variability  Dave Saxon: d.saxon@shefffield.ac.uk © University of Sheffield 12/10/14
  24. 24. © University of Sheffield 12/10/14
  25. 25.  Therapist effects increase as a func1on of pa1ent ini1al severity © University of Sheffield 12/10/14
  26. 26.  Jo-­‐Ann Pereira: jopereira150@gmail.com  Prac11oners’ descrip1ons:  Empathy is key component for prac11oners -­‐ they value the importance in having a capacity to understand pa1ents’ personal emo1onal experiences © University of Sheffield 12/10/14  Personal aspects (quali1es) prac11oners bring to their prac1ce as people  Inves1ga1ng the role of prac11oner resilience, empathy, and mindfulness
  27. 27.  Less effec1ve prac1ce rate empathy as a personal aspect higher than more effec1ve prac1ce  But more effec1ve prac1ce rate resilience and mindfulness higher than less effec1ve prac1ce  Personal aspects are differen1ally responsive to pa1ent severity  Combined resilient & mindful pracLce © University of Sheffield 12/10/14  Inves1ga1ng the role of prac11oner resilience, empathy, and mindfulness  Self-­‐report measures of Resilience, Empathy, & Mindfulness
  28. 28. A case study: Counselling & pa1ent choice © University of Sheffield 12/10/14
  29. 29.  Evidence for the efficacy of counselling © University of Sheffield 12/10/14
  30. 30.  Comprehensive cohort design: Trial nested within a rou1ne service Sheffield IAPT service © University of Sheffield 12/10/14
  31. 31.  Counselling for depression vs. CBT  Funder: BACP Research Founda1on Caveats:  Repe11ve/symptom focus  Value of missing data  Poten1al mismatch between sta1s1cal recovery and reports of pa1ents’ lives as lived © University of Sheffield 12/10/14 Trial pre-­‐ measures Trial post-­‐ measures Sessional measures (PHQ-­‐9, GAD-­‐7, WSAS mandated)
  32. 32.  Prac1ce-­‐based methods are central for improving prac1ce  Place prac11oners as central in integra1ng prac1ce and science  Prac1ce-­‐based evidence yields good enough science that is cost efficient – but there is an argument to be won about its acceptance  Argument for combining both prac1ce-­‐based evidence and trials methodology in comprehensive cohort designs  Inves1ga1on of prac11oner variability will help inform us about what best prac1ce is – from which we can all learn  Improving access is good but need to engage and retain pa1ents in treatment – dropout is the key issue to address © University of Sheffield 12/10/14
  • Tpombeiro

    Dec. 16, 2015
  • merakhuang

    Dec. 13, 2014

Presentation by Dr. Michael Barkham about practice-based evidence being used to establish an evidence-base for the practice of psychotherapy.

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