Dr. Biljana van Rijn

19th Annual BACP Research Conference, 10 & 11 May 2013;
Conference title ‘Synergy in counselling & psychotherapy research’

Presenter: Dr Biljana van Rijn and other author: Ciara Wild

ABSTRACT: Research Clinic: Routine Outcome Evaluation of Humanistic and Integrative Therapy

Keywords (give 5): research clinic, Humanistic and Integrative psychotherapy/counselling; routine outcome evaluation

Aim/Purpose:

The research was a naturalistic, non randomised, evaluation of Transactional Analysis (TA) and Gestalt psychotherapies, Integrative Counselling Psychology and Person Centred counselling within a community based service. Routine outcome evaluation used standardised measures to assess treatment outcomes and working alliance. Adherence to the model was evaluated in clinical supervision. The outcomes showed that clients who engaged in treatment made statistically significant improvements and that Transactional Analysis and Gestalt psychotherapies, Integrative Counselling psychology and Person Centred counselling can be used effectively in treatment of anxiety and depression within a community setting. Clients had a choice about the duration of therapy and used different numbers of sessions within the framework of the service. The presentation will offer a reflection on how a choice of therapist and a length of therapy impacted on outcomes.

To evaluate the outcomes of humanistic and integrative psychotherapies (Transactional Analysis, Gestalt, Integrative Counselling Psychology) and Person Centred counselling in routine practice by:

• Evaluating whether these therapies achieved a  significant reduction in scores on  standardises measures
• Comparing the effectiveness of different theoretical orientations

Design/Methodology:

The project was a naturalistic, non-randomised, evaluation of routine outcomes of Transactional Analysis and Gestalt psychotherapies, Integrative Counselling Psychology and Gestalt and Person Centred counselling. Differences between the approaches have not been evaluated due to the sample size.

Therapy was evaluated using sessional standardised measures  (GAD7;PHQ9;Core 10), pre and post measures (BDI-II;CORE 34). Adherence to the theoretical model was evaluated using Adherence questionnaires.

Results/Findings:

67 herapists and 321 clients took part in the evaluation. There was a high percentage of completed data sets (over 90% for sessional measures). The outcomes show that:

• Clients who continued in therapy after the assessment period, achieved a significant improvement and large effect size on sessional measures for depression, anxiety and general outcomes measured by CORE 10.

• There were no differences in effectiveness between theoretical orientations

Additional Analysis:

• Analysis of the high level of attrition and requests to change therapists during the assessment period. It showed that once the clients changed therapists they achieved the same levels of change as those who made a good working relationship with their initial therapist.
• Length of therapy. The number of sessions varied between individual clients, but was not directly related to the outcomes.

Research Limitations relevant to naturalistic research:

• No randomisation
• No control group
• Limited monitoring of  therapist techniques in sessions
• Evaluation of therapies in routine practice, rather than efficacy.

Conclusions:

• Humanistic (Transactional Analysis; Gestalt Psychotherapy; Person Centred Counselling) and Integrative therapies achieved a significant improvement in anxiety, depression and general wellbeing in routine practice, within a community setting.
• There was no difference in effectiveness between these approaches
• Length of therapy varied but a number of sessions was not directly linked to outcomes
• A large proportion of clients stop therapy prematurely within a community setting. Offering a different therapist to those clients enabled them to engage in therapy and gain from it.