Wednesday, June 27, 2007

Report on SPR-Madison-2007

Entry for 25 June 2007 (returning from the USA):

Memories. The international conference of the Society for Psychotherapy Research has been the high point of my scientific year since I attended my first meeting in 1976. That experience was life-changing: Suddenly, I was confronted with all the people I’d been reading: Hans Strupp, Irene Waskow (later Elkin), Sol Garfield, Ken Howard, David Orlinsky. I also met others whom I later came to know well: Laura Rice, Len Horowitz, Les Greenberg, Mike Lambert. I heard Mary Smith make the first presentation of the now-famous psychotherapy outcome meta-analysis (Smith, Glass & Miller, 1980); Sol Garfield was in the small audience of about 10 people and declared, “I’m not sure I understand all the numbers, but it certainly sounds good!

Experiencing the absence. These and other memories came back to me during this year’s meeting in Madison, Wisconsin, on the shore of Lake Monona. In part, this stemmed from the memorial session held for Hans Strupp at the very end of the conference (after the final plenary in fact), and also because Madison had been the site of my second SPR conference, the one at which I met Clara Hill, Karla Moras, Lorna Benjamin, and others. This conference was notable for me and others for the absence (for various causes) of several key SPR figures, among them Les Greenberg, Irene Elkin, Bruce Wampold, Lorna Benjamin, Larry Beutler, Hartvig Dahl, and Hans Strupp. Psychotherapy research really began to flower during the 1960’s and 1970’s, with the early APA psychotherapy research conferences and then the founding of SPR. Increasingly, the aging process is catching up with many of these founding figures; many are becoming infirm; and, it seems, with every year more of my friends and SPR colleagues are dying. As David Orlinsky noted this year, “There has been so much loss”.

Distinguished Career Award 2007. Another sign of the generational process is the movement of the Distinguished Career Award into my generation: This year’s award went to Clara Hill, who was cited for, among other things, developing Consensual Qualitative Research. Her citation was touchingly read out by two of her former students, an indication of the loyalty and respect with which her students regard her leadership and inspiration. Hers is a gift, I think, of being able to discern promising emerging directions in psychotherapy research and then to attack these with incredible focus, determination, and teamwork. Although I taught her most of what is today known as Consensual Qualitative Research, she has done far more with it than I ever could have, and through her efforts and those of her students has had a huge impact on North American qualitative therapy and counselling research. Congratulations, Clara!

Return of CBT and opportunities for dialogue. One of the most promising signs at this year’s SPR meeting was the return of CBT therapy researchers. In particular, Steve Hollon and Rob DeRubeis featured prominently in the program, but there were others as well. I had a couple of very interesting and enjoyable conversations with Steve and Rob during the conference, and count these contacts as one of the high points of the conference. For years, the SPR leadership has been bemoaning the absence of opportunities for dialog with CBT advocates, but I think it has taken the efforts of Louis Castonguay and others, and in particular the therapy principles project, jointly sponsored by SPR and APA Divisions 12 (Clinical) and 29 (Psychotherapy) (Castonguay & Beutler, 2005), to bring about a change in the field in which dialog has become more possible.

Open Discussion on Models of Change. A good example of this emerging dialog was the set of open discussions hosted by Jacques Barber, in which representatives of different theoretical orientations were asked to make 5-minute presentations of their model of the change process in therapy, including references to research support for particular elements of their theory. A tall order! (Ironically, we have been asking this question – minus the research support – of applicants to our new Counselling Psychology doctoral course. What’s good for the goose is good for the gander…)

This turned out to be a nerve-wracking but ultimately highly informative and stimulating exercise. In the session in which I presented, Chris Muran started things off by presenting the Safran-Muran interpersonal psychodynamic alliance rupture model. Next, I presented a general model of the change process based on the General Task Model of PE-EFT. After I did my brief spiel, Jacques floored me by asking how clients get from stage 4 (newness emerges from dialectical exploration) to stage 5 (awareness, insight or positive transvaluation). This is equivalent to asking how gamma rays cause protons to break into K-mesons when they hit them; in other words, this is a version of one of Zeno’s Paradoxes. I stood there for a moment, transfixed, thinking to myself, “It’s turtles all the way in!” before admitting that I wasn’t really sure and falling back on the cloud chamber analogy of tracking particles coming in and out. (Later, of course, I thought of at least two reasonable things to have said: (a) newness automatically generates these things; (b) the emotion process automatically generates these things. But I’m not particularly happy with these explanations either…)

After me, there was Gary Diamond, who presented a lovely task analytic model of the resolution of communication breakdown between suicidal/depressed adolescents and their parents. So far, I felt we were all basically on the same page, given that I could assimilate both Chris’ and Gary’s models into my generic change model. Then, Steve Hollon and Rob DeRubeis respectively presented behavioral activation and cognitive therapy accounts of change in depression. I found their models to be interesting and reasonably complex and sophisticated, especially in their approach to therapeutic difficulties There was really relatively little to disagree with.

Afterwards, Jeanne Watson and I stuck around for awhile talking to Steve and Rob about what they would do in various clinical situations. What struck us was that they (especially Rob) find it essential to activate client emotions in order to be able to help clients develop either new behaviors or new cognitions. In the end, we all agreed that this had been fun and illuminating … and overdue. Wouldn’t it be great, we wondered, to next look at each other’s actual practice and comment on it? I suggested that we apply our various research tools for describing client processes and therapist responses. An idea for next year in Barcelona?

Other personal highlights:
-Presenting with Jutta Schnellbacher (from KU Leuven) the results of our interpretive discourse analyses of first session Helpful Aspects of Therapy (HAT) data (client postsession descriptions of significant events). It was a joy to see her enjoy her first international SPR conference.
-Presentations on qualitative research on Motivational Interviewing by Henny Westra (York U in Canada) and Allan Zuckoff (Western Psychiatric in Pittsburg). I was so impressed by their research, that I invited them to put together a proposal to do a special issue of Person Centered and Experiential Psychotherapies.
-Program stream on case study research chaired by Dan Fishman. (I was especially struck by a paper by Ron Miller applying the Federal Rules of Evidence to case study research, but the other papers were nice also.) These sessions clearly illustrate the ways in which interpretive case study research is rapidly developing.
-Lovely paper by Ann Doucette on Rasch Analysis of the OQ-30, clearly presenting the basics of the Rasch family of analysis tools and extending the method to reliable clinical change and other topics.
-Great dinners out with Jeanne Watson, Rhonda Goldman, Neil Watson, Chris Muran, Mike Lambert, Louis Castonguay, Michelle Newman, various students and others.
-Being asked by Susan Reynolds of APA Books to put together a proposal for a workbook to go with Learning Emotion-Focused Therapy. (“It’s a good time to do this,” she said.)
-Memorial session for Hans Strupp, with touching presentations by Tim Anderson, Karla Moras and others. I had brought the poem about Hans that I read last October at the North American SPR meeting in Burr Oak (see Poems section of this blog), but hesitated to read it until the end. (Afterwards, Katerine Osatuke, told me it made her cry even though she’d never met Hans, and the nice man who had been running the audio-visual equipment came up and thanked me. Karla later told me that he had told her that the previous day had been the 10th anniversary of his father’s death.)

Reference: Castonguay, L., & Beutler, L. (Eds.) (2005). Principles of therapeutic change that work. Oxford, UK: Oxford University Press.

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