It is imperative that we ask
ourselves questions:
What counts and what can we count?
What information do we want to collect?
What are our hypotheses?
What sorts of conclusions can we validly draw?
How can information be collected reasonably?
What is the timeline for collecting information?
What resources are available for this process?
It appears that we have two separate and
complementary goals:
Program evaluation and outcome
measurement – we would like to be able to look
at gains and changes in our patients during or after
they are in treatment at the SFPRG clinic. In other
words, we want to verify that we, as a clinic, are
doing what we think we are doing when we provide
clinical services.
We believe that the benefits associated
with evaluating the outcome are many. They include:
Telling us if we are helpful to our patients
Giving us information to promote the program to
potential participants and referral sources
Enhance the public image of the program
Help us identify partners for collaboration
Retain and increase funding
Attract potential interns
Help us identify training needs
Clinical research – we would like to
continue to examine core concepts of Control
Mastery and provide empirical support for the
usefulness of this approach in the work with
patients. We would want to provide evidence to the
unique contributions that control mastery offers to
theory and practice of psychotherapy.
The brilliance of the previous research done
by the San Francisco Psychotherapy Research Group
is in its ability to challenge notions about what can
and cannot be counted, daring to make sure to
measure what counts.
Complex clinical concepts have rarely been
formally assessed in empirical research to sustain
clear conclusions as to their validity. This previous of
SFPRG research has been able to establish the
reliability of concepts such as Tests, Case
Formulation and the validity of hypotheses on healing
elements in therapy.
Our ultimate goal is to continue this tradition of
creativity in research and establish Control Mastery
among the treatments that are empirically validated.
Presently, we utilize the following research and
evaluation procedures in the clinic: New patients are
asked to fill a series of questionnaires in addition to
an extensive personal data form. The personal data
form includes open ended items such as:
- What qualities would you like your therapist to
have?
- What are the most important things for your
therapist to know about you?
- What are your most pleasant and most
unpleasant childhood memories?
We also ask patients to fill standardized outcome
questionnaires (OQ-45; Beck Depression Inventory
(BDI); Beck Anxiety Inventory (BAI)). Those
questionnaires are sensitive to changes that occur in
psychotherapy and thus can give us important
information about the progress that patients are
making. We will administer these standardized
questionnaires once every 3 months.
An additional outcome study run by Dr. Marshall
Bush is underway. Former patients, who no longer
receive treatment in the clinic, are asked to report
on their experience in therapy. Some of the
questions are close-ended, such as ratings of the
personality fit between the therapist and the patient
on a scale of “very poor” to “excellent”, while others
are open-ended, allowing the patient to freely
describe their experience. Such a question
was “what was the least helpful thing your therapist
did or said”.
Finally, patients are asked to rate their therapists
on a scale of “Never” to “Always” on such questions
as “my therapist recognized and took responsibility
for his/her mistakes” or “my therapist gave me helpful
advice”.
In addition to the important feedback that
we receive, we will also be able to look at the
correlations between those responses and patient’s
characteristics and outcome.
We are working to create a systematic way of
collecting and managing this rich data and hope that
within the next year we will be able to utilize it to
answer some of the questions that we raised.
I will be happy to receive feedback from any of
you who have ideas or comments about the issues
discussed here at zoharin@sbcglobal.net
In writing this essay, I used the following
resources:
Carter McNamara. Basic Guide to Program
Evaluation.
http://www.managementhelp.org/evaluatn/fnl_eval.ht
m#anchor1577333
United Way.
http://national.unitedway.org/outcomes/resources/
