Wednesday, May 14, 2008

Research Implications of McLeod et al., Clients’ Criteria for Evaluating Outcome

Entry for 10 May 2008:

At the BACP Research Conference, John McLeod, on behalf of the Tayside research clinic team, presented a lovely paper offering preliminary results from his research on client’s experiences of the outcome of their therapy. The three themes that are currently emerging from the qualitative interviews with clients are:
(a) Getting my life back on track: clients came to therapy because their lives had gotten “off track” and had become “stuck”. John pointed out that this is an example of a Journey metaphor (cf. Lakoff & Johnson). I would add that this is also a metaphor of interrupted agency, given that life projects (following Lakoff & Johnson) are typically expressed in terms of the travel (movement through space) metaphor. This in turn makes therapy all about Agency, as David Rennie has been telling us for lo these many years.
(b) Learning something that helped them get unstuck and back on track. John is particularly struck by the importance of learning as a change process for clients. This opens up interfaces with both psychology (my old life) and education (my new life), and reminds me also of Amadeo Giorgi's classic study in phenomenological psychology: the experience of learning something.
(c) Explanation: developing a coherent story of what happened for them in therapy (that is, of how they got unstuck in their lives). In PE-EFT, we would call this a “meaning perspective”.

Not only are these very pretty and persuasive results, they also had some very interesting implications for therapy research:
1. It would be very good idea to develop a measure of “Life Stuckness” (vs. “Life flow” or some such). This reminds me strongly of American pollsters who ask people if the they the US is “on track” or “off track”.
2. It would be a good idea to ask clients to talk about what they have learned over the course of therapy. This isn’t currently in the Change Interview, but it could easily be added to the question about changes, i.e., “What have you learned about yourself in counselling?” and “How have you applied this learning?”
3. It would be a good idea to ask clients, “What is your understanding of what happened in your counselling/therapy?”
These ideas may be worth following through on, particularly if John’s results hold up over further analyses.

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