Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Research Outcomes. Show all posts
Showing posts with label Research Outcomes. Show all posts

Tuesday, January 19, 2016

Researcher allegiance in psychotherapy outcome research: an overview of reviews

Munder T, Brütsch O, Leonhart R, Gerger H, Barth J.
Clinical Psychology Review
Volume 33, Issue 4, June 2013, Pages 501–511

Abstract

Researcher allegiance (RA) is widely discussed as a risk of bias in psychotherapy outcome research. The relevance attached to RA bias is related to meta-analyses demonstrating an association of RA with treatment effects. However, recent meta-analyses have yielded mixed results. To provide more clarity on the magnitude and robustness of the RA-outcome association this article reports on a meta-meta-analysis summarizing all available meta-analytic estimates of the RA-outcome association. Random-effects methods were used. Primary study overlap was controlled. Thirty meta-analyses were included. The mean RA-outcome association was r = .262 (p = .002, I2 = 28.98%), corresponding to a moderate effect size. The RA-outcome association was robust across several moderating variables including characteristics of treatment, population, and the type of RA assessment. Allegiance towards the RA bias hypothesis moderated the RA-outcome association. The findings of this meta-meta-analysis suggest that the RA-outcome association is substantial and robust. Implications for psychotherapy outcome research are discussed.

The entire article is here.

Friday, September 26, 2014

Did We Interpret the Milgram Study Incorrectly?

Famous Milgram 'electric shocks' experiment drew wrong conclusions about evil, say psychologists

By Adam Sherwin
The Independent
Originally published September 5, 2014

Here are two excerpts:

Now psychologists have found that the study, which showed how ordinary people will inflict extraordinary harm upon others, if someone in authority gives the orders, may have been completely misunderstood.

Instead of a latent capacity for evil, we just want to feel good about ourselves. And it is Professor Stanley Milgram’s skill as a “dramatist” which led us to believe otherwise.

(cut)

Far from being distressed by the experience, the researchers found that most volunteers said they were very happy to have participated.

Professor Haslam said: “It appears from this feedback that the main reason participants weren’t distressed is that they did not think they had done anything wrong.  This was largely due to Milgram’s ability to convince them that they had made an important contribution to science.”

The entire article is here.

Wednesday, September 4, 2013

The Contribution of the Quality of Therapists' Personal Lives to the Development of the Working Alliance

By Helene A. Nissen-Lie, Odd E. Havik, Per A. Hoglend, Jon T. Monsen, and Michael Helge Ronnestad
Journal of Counseling Psychology. 2013 Aug 19

Abstract

Research suggests that the person of the psychotherapist is important for the process and outcome of psychotherapy, but little is known about the relationship between therapists' personal experiences and the quality of their therapeutic work. This study investigates 2 factors (Personal Satisfactions and Personal Burdens) reflecting therapists' quality of life that emerged from the self-reports of a large international sample of psychotherapists (N = 4,828) (Orlinsky & Rønnestad, 2004, 2005) using the Quality of Personal Life scales of the Development of Psychotherapists Common Core Questionnaire (Orlinsky et al., 1999). These factors were investigated as predictors of alliance levels and growth (using the Working Alliance Inventory) rated by both patients and therapists in a large (227 patients and 70 therapists) naturalistic outpatient psychotherapy study (Havik et al., 1995). The Personal Burdens scale was strongly and inversely related to the growth of the alliance as rated by the patients, but was unrelated to therapist-rated alliance. Conversely, the factor scale of therapists' Personal Satisfactions was clearly and positively associated with therapist-rated alliance growth, but was unrelated to the patients' ratings of the alliance. The findings suggest that the working alliance is influenced by therapists' quality of life, but in divergent ways when rated by patients or by therapists. It seems that patients are particularly sensitive to their therapists' private life experience of distress, which presumably is communicated through the therapists' in-session behaviors, whereas the therapists' judgments of alliance quality were positively biased by their own sense of personal well-being.

Introduction

The notion that the psychotherapist as an individual is important for psychotherapeutic outcomes stems in part from the well-known and frequently cited finding of meta-analyses that therapy outcome appears to be less related to the use of different therapy methods associated with established schools of therapy, and significantly related to differences between the individual psychotherapists providing the therapy (Benish, Imel, & Wampold, 2008; Blatt, Zuroff, Quinlan, & Pilkonis, 1996; Huppert et al., 2001; Kim, Wampold, & Bolt, 2006). Moreover, in efforts to identify the characteristics in therapists that promote treatment success or failure, the studies to date suggest that experience level, type of training, theoretical orientation, and so forth have limited value in distinguishing between more or less successful therapists (Beutler et al., 2004; Dunkle & Friedlander, 1996; Sandell et al., 2007; Skovholt & Jennings, 2004; Strupp & Hadley, 1977). Instead, therapists' interpersonal qualities appear to be more relevant, such as their facilitative interpersonal skills (Anderson, Ogles, Pattersen, Lambert, & Vermeersch, 2009); their ability to be affirmative, responsive, and empathic (Bohart, Elliott, Greenberg, & Watson, 2002; Najavits & Strupp, 1994); their ability to resist counteraggression when confronted with devaluation and rejections by patients (von der Lippe, Monsen, Ronnestad, & Eilertsen, 2008); and their interpersonal functioning in their personal lives (Dunkle & Friedlander, 1996; Hersoug, Hoglend, Havik, von der Lippe, & Monsen, 2009b). Hence, although therapists are professional helpers, it may be that their personal characteristics are more important than their professional qualifications in determining their therapeutic capabilities. This suggestion echoes the statements of Rosenzweig (1936), Strupp (1958), and Rogers (1957, 1961), who emphasized that studying the personal characteristics of psychotherapists is necessary in order to understand patient development in psychotherapy.

Thanks to Ken Pope for this information.

Friday, April 19, 2013

Andrew Wakefield: autism inc

Andrew Wakefield's 'dishonest and irresponsible' research into the causes of autism led to his being struck off by the General Medical Council. That would have ended most doctors' careers. Instead, the MMR 'martyr' moved to the US – and into reality TV

By Alex Hannaford
The Guardian
Originally published April 5, 2013

For three days at the end of January, the Renaissance hotel in Washington DC fills up with television executives from around the world. The Realscreen Summit is where the makers of reality TV gather to discuss ideas, negotiate deals and discover the next Apprentice or I'm A Celebrity. Among the estimated 2,200 people who had paid up to $1,600 (£1,050) this year to try to snag face time with an exec from Freemantle, TLC, Discovery or National Geographic was an Englishman in his mid-50s wearing jeans, a crisp, white shirt and loafers, and carrying a MacBook. On his badge were the words "Autism Team".

This man's pitch was a reality TV series about autism, and he had a short trailer on his laptop: an autistic child screams; another bites his mother's hand; another repeatedly and violently slams a book against his head. Then a narrator tells us that "every day across the world, medical symptoms of hundreds of thousands of people with autism are being ignored". Cue piano music and the titles, The Autism Team: Changing Lives.

The premise is that the autism symptoms suffered by the children in the promo (Jon, 14, who is "wasting away"; six-year-old twins "still not potty trained"; and 15-year-old Jack, who is "non-verbal and very self-injurious") have left their parents feeling helpless and alone — until, that is, the Autism Team steps in to save the day.

The entire story is here.