Published in TA Journal: Humanistic and Integrative Therapies for Anxiety and Depression

Biljana van Rijn, Ciara Wild (2013) Humanistic and Integrative Therapies for Anxiety and Depression:
Practice-Based Evaluation of Transactional Analysis, Gestalt, and Integrative Psychotherapies and Person-Centered Counseling

Abstract

The research described in this article involved a naturalistic, nonrandomized evaluation of transactional analysis and gestalt psychotherapies, integrative counseling psychology, and person-centered counseling within a medium-term, community-based service. Routine outcome evaluation used standardized measures to assess treatment outcomes and the 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 counseling psychology, and person-centered counseling 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. They were also able to change therapists. Both choices had clinical implications in terms of attrition and outcomes and require further research.

doi: 10.1177/0362153713499545 Transactional Analysis Journal April 2013 vol. 43 no. 2 150-163

Presentation at the 19th BACP Research Conference, May 2013

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.

 

2nd EATA TA Research Conference

Details about this conference can be found at: www.taresearch.org
Upcomming conferences: www.eatanews.org

Paper presentation: Research Clinic, Development, Outcomes and Challenges

Description
The paper will present a year (2010-2011) in the research clinic at Metanoia Institute. This was a naturalistic evaluative study using quantitative, standardised methods of evaluation within a low cost training clinic. Outcomes of evaluation of TA psychotherapy, alongside Integrative Counselling Psychology, Gestalt psychotherapy and Person Centred counselling will be presented and discussed. The presentation will end with recommendations for future research and learning about the development of research clinics.
About the Presenter(s)
Biljana van Rijn is a Head of Clinical and Research Services at Metanoia Institute in London, where she has developed a research clinic and conducts practice based evaluative research projects. She teaches on the MSc programme in Transactional Analysis Psychotherapy and the Doctorate in Counselling Psychology at Metanoia Institute and offers research supervision. Biljana also works as a psychotherapist and supervisor in private practice in West Sussex.
Outcomes for delegates:
Knowledge about current research on effectiveness of Transactional Analysis Psychotherapy.
Understanding of the gains and challenges of evaluation in practice settings.

Research Clinic Approach to the Evaluation of Integrative and Humanistic Psychotherapies

An article by Biljana van Rijn & Ciara Wild, published in The British Journal of Psychotherapy integration. Volume 7, Issue 2 (2010)
http://www.ukapi.com/journal

The co-editors of this issue write in the editorial that

Biljana [van Rijn !] and Ciara Wild provide an example of setting up a research clinic to gather practice-based evidence on the effectiveness of both integrative psychotherapy and transactional analysis. This style of research, we believe, can contribute to the current and very political debate on therapeutic effectiveness by providing information from  these two approaches which hitherto have not received attention in the current public debates.

Article abstract:

This article presents a research project that led to the development of a research clinic within Metanoia Institute. The research is an evaluation of brief Integrative Psychotherapy and Transactional Analysis within primary care using standardised outcome measures, the Working Alliance Inventory and the measure of adherence to the therapeutic model. The research demonstrates effectiveness of these approaches within NHS and suggests a model of evaluation that can be used within different clinical settings.

Article about the research clinic at Metanoia

I’ve published an article in Therapy Today (July 2010, Vol.21/Issue6) about the research clinic at Metanoia. The article is part of the BACP research section in the journal and gives concise background information about the set up of the clinic,  its research aims and outcomes at this stage.

Research clinic at Metanoia

The Metanoia Institute has set up a research clinic using its existing clinical services, which both practitioners and clients are enthusiastic about taking part in.

“Based on this experience we are now planning to expand the research clinic to cover the whole of the service at MCPS [Metanoia Counselling and Psychotherapy Service], which currently numbers 72 practitioners, and all the theoretical orientations practiced here.”