Talking Cure

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noreply@blogger.com (Barry) — Sat, 17 Oct 2009 18:01:00 +0000

The Heroic Agency Listserv: http://heartandsoulofchange.com/community/listserv/

The Heart and Soul of Change Conference:
http://heartandsoulofchange.com/training/heart-and-soul-of-change-conference/

Barry’s Blog: http://heartandsoulofchange.com/blog/

Barry’s Schedule: http://www.whatsrightwithyou.com/speakingschedule.htm

Article 2 of the Norway Feedback Trilogy

noreply@blogger.com (Barry) — Sun, 24 May 2009 15:55:00 +0000

I wanted to let you know that we (Morten Anker, Jacqueline Sparks, and Ann Stapnes)
just submitted the second of the Norway Feedback Project trilogy (a lofty title I know, but hey, I have to call it something notable to justify all this work). I can’t tell you much at this point until we get further along in the review and acceptance process. But I wanted to tell you a little about it because it is so interesting.

First, a little about the study: It analyzes 742 written client responses to 2 alliance oriented questions regarding the services received as part of a 6-month follow-up of couples in routine care. Using a qualitative method, 15 categories and 2 domains emerged. In addition, a quantitative analysis of respondents’ statements from the feedback study (Anker, Duncan, & Sparks, in press) compared feedback and non-feedback groups. The study’s mixed method provides a multi-layered view of couple therapy and the alliance, and an interesting finding emerged regarding couples’ experiences of an all but neglected part of the alliance—the nuts and bolts aspects of the agreement on tasks dimension. We generally think of agreement on tasks as being about the agreement of what models and techniques are used in service of the client’s goals. But the tasks dimension also includes routine tasks such as frequency of sessions, payment, scheduling, etc. Clients in the feedback condition had significantly fewer complaints regarding the more mundane aspects of the alliance: frequency of meeting, handling of cancellations and rescheduling, etc. These finding suggest that not only do we need to pay attention to these details, but also that somehow soliciting feedback resulted in more agreement about these mundane but apparently important aspects.

On another note, with Morten's help, I am interviewing the therapist from the Norway Feedback study that became the best therapist when feedback was added to her work. It is really fascinating. Here is the movie trailer version of what she has said so far: Feedback via the measures and graphs brought focus and clarity to the work; engendered a sense of shared responsibility and collaboration; and encouraged her to be more courageous, to step outside of comfort zones knowing that clients would let her know if she went too far. There is much embedded in those words, about the common factors and her development as a therapist, and I look forward to more from her.

The process with her, I believe, would be helpful for about anyone who takes their development as a therapist seriously--to reflect about what feedback has brought to the work, and how it has changed it for the better. That is a project that is just getting under way and I will let you know much more about in the fall.

Barry

The SRS, appreciation, and a call for therapist stories

noreply@blogger.com (Barry) — Sun, 26 Apr 2009 16:44:00 +0000

I have thinking a lot about SRS scores and am very encouraged by what I have been seeing. I believe therapists are getting better and better at soliciting lower scores and feeling more comfortable with alliance feedback from clients. I believe we will see a downward trend of initial SRS scores in the overall data base as time goes on. Keep in mind that the SRS is the first real clinical use of an alliance measure, so as more and more therapists see the benefits, and more and more clients become part of the culture of feedback, the more the SRS will be used to generate alliance discussions. In the Norway study, based on all administrations of the SRS (2294), there was a mean of 34.8. Said another way, 51.8% scored 36 and higher, while 67.67% scored 34 and higher. The mean first session SRS was 33.4 And the SRS scores increased, on average, session by session. We are analyzing the data now and I'll keep you informed of our progress.

While I am talking about the alliance, I wanted to say a few words about "appreciation" because I think it is a very important concept and therapist action. It is essentially an expression of positive regard, another incredible idea that gets too little attention. This therapist quality is characterized as warm acceptance of the client’s experience without conditions. It is understood as a prizing, an affirmation, and a deep nonpossessive caring. Early research (e.g., Truax & Carkhuff, 1967; Orlinsky & Howard, 1978) was very supportive of the association between positive regard and outcome, with about two-thirds of the studies in the positive direction. Recent reviews, however, found that only 49% (27 of 55) of all associations were significant (Farber & Lane, 2002). When outcome and therapist positive regard were both rated by clients, however, the percentage of positive findings jumped to 88% (Farber & Lane, 2002). Let’s face it, that Carl Rogers guy was on to something.

Appreciation of clients is therefore a critical relational skill: appreciation of people in general, of their struggles, and of their humanity and innate goodness. I appreciate people and it shows, and I think it helps. In the new Heart and Soul, Norcross (2010, p. xx) concludes:

Clinically, the research results indicate that, first, the provision of positive regard or validation is strongly indicated in practice. Second, similar to empathy and the alliance, it is the client’s perspective of the therapist’s positive regard that has the strongest association with outcome. At the risk of redundancy, supportive therapists will privilege their client’s experience. Third, therapists cannot be merely content with feeling good about their clients, but should ensure that their positive feelings are communicated to them. This does not require a stream of compliments or an outpouring of love. Rather, it speaks to the need for therapists to communicate a caring, respectful attitude, affirming a client’s basic sense of worth (Duncan & Moynihan, 1994; Farber & Lane, 2002).

And finally, I have a project for any of you who fancy an opportunity to write about your therapy experiences. I started a new book that focuses a bit on therapist’s experiences and am looking for 2-3 page (double spaced) therapist stories about the use of feedback and how it has improved your work or developed you as a therapist. This could be about a particular client and how he or she specifically taught you to do good work in ways that you wouldn't have otherwise done, or how feedback over many clients has had a cumulative effect on your outcomes and perceptions about being a therapist. I am looking for evocative stories infused with your personal reflections that will both resonate with therapists and encourage them to take the risk to systematically solicit client feedback. Please change details about clients significantly to ensure confidentiality.

I will select several for inclusion, and the ones not selected will have another shot when Jackie and I do the next edition of Heroic Clients, Heroic Agencies. Thanks very much for your consideration. The deadline is June 15, so get crackin’.

Best,
Barry

The Norway Couple Feedback Study

noreply@blogger.com (Barry) — Tue, 07 Apr 2009 18:48:00 +0000

After a year of contemplating and debating the best possible design and methodology for an RCT in a naturalistic setting, 2 years of intensive data collection, and a year and a half of data analysis, writing, and rewriting, the Norway Couple Feedback Study (Anker, Duncan, & Sparks, in press) has received final acceptance from what I consider to be one of the top (if not the top) psychotherapy research journals on the planet, the Journal of Consulting and Clinical Psychology. Hoorah! I want to publicly thank and congratulate my colleagues and very good friends, Morten Anker and Jackie Sparks not only for their dedicated efforts on the largest RCT ever done with couples, the first feedback study to address couples, and the first RCT published using the ORS and the SRS, but also for their spirit of collaboration and teamwork—that often not experienced stuff that really makes each person bring out their best and propel such a project to fruition.

While we cannot disseminate the article, I can now let you know more about the results.
As most of you know, the study tested the effects of feedback in couples therapy compared with couples receiving treatment as usual (TAU) in a naturalistic setting (n=410). Consistent with our hypothesis, the feedback condition emerged as significantly superior to TAU. A moderate to large ES (0.50) was found for the feedback condition. The predicted score adjusted for severity of an average client in the feedback group was 4.89 points higher than an average client in the TAU group. The difference was, in effect, the difference required for reliable change. Said another way, the average post score for persons in the feedback condition (26.35) was nearly 5 points greater than the average post score for those in the TAU group (21.69). The difference between the groups, in other words, nearly constituted both a reliable change and transcended the clinical cut off. The proportion of clients responding to treatment in the TAU group was 41.7% (both in couple, 22.6%) and in the feedback group was 64.6% (both in couple, 50.5%). The strong effect of feedback seems particularly noteworthy given the relative simplicity of the intervention and in light of the comparison group being an active treatment.

In addition, the significant superiority of feedback over TAU was maintained at follow up. Moreover, the TAU group had a 34.2% separation/divorce rate v. 18.4% rate for the feedback condition. In the feedback group, 40.8% (both in couple) scored 25 or above and 5 or more points in change compared with 10.8% of non-feedback couples, a difference of nearly four times. Six month follow-up revealed that feedback maintained nearly a three-fold advantage in proportion of clinically significant change (35.7% v. 12.5%).

Another finding really blew us away—about therapist effects and feedback. The effect of feedback varied significantly across therapists, and was not due to outliers (extreme scores). The correlation between the variability in the effectiveness of a therapist with no feedback and variability in the effect of feedback was unusually high, r = -.99. Although the small number of therapists significantly limits any conclusions that can be drawn, it does suggest that the less effective therapists (those who had the worst outcomes without feedback) benefited more from feedback that the most effective therapists. Feedback, therefore, seems to act as a “leveler” among therapists, raising the effectiveness of lower or average therapists to that of their more successful colleagues. In fact, check this out: the therapist with the WORST results without feedback became the therapist with the BEST results with feedback! These preliminary findings based on but ten therapists warrant further investigation and replication. Nine of ten therapists benefited from the effects of feedback.

With this study in the bank, Jackie is writing a grant for replication with kids and families, and with Barry W. in Louisville, we are hoping to replicate in an inpatient setting.

Bottom Line: Add feedback to your work and watch your effectiveness soar!

Barry

Heart and Soul 2010

noreply@blogger.com (Barry) — Tue, 10 Mar 2009 11:50:00 +0000

The next Heart and Soul of Change conference is set: Heart and Soul 2010 will be in New Orleans, in the French Quarter, June 17-19, 2010. The conference will be held at the InterContinental Hotel
(http://www.ichotelsgroup.com/intercontinental/en/gb/locations/neworleans) and I am very happy to say that the room rate was negotiated to be a very reasonable $119 per night.
June 17 will be a pre-institute that covers the basics—I will do the morning, the client directed part while Scott will do the afternoon, the outcome informed part. That way, people should be starting off well grounded for the rest of the conference. You veteran CDOI’ers could skip the pre-institute, unless you are the kind of person who likes some repetition. I will be using new video but will be covering the common factors side of CDOI.

The rest of the conference boasts new material. The actual conference will run June 18-19, and as I said before will include the themes of “Recovery” and “Social Justice” with keynotes from speakers outside of CDOI, followed by a plenary of how these themes fit and complement CDOI. In the afternoons, the conference will include 3 separate tracks: Beginning/Intermediate (I will do the first day of this and Scott will do the second, so people just getting going can catch how to get started—we are offering it both days because with all the choices, it will allow folks to not miss a thing); Special Applications (this will include 3 breakout sessions covering a variety of special applications—these will be very pragmatic “how to” workshops, short on theory or repetition of CDOI concepts, except as they apply to the issue at hand, and long on practical considerations; and Implementation/Supervision/Administration, which will address agency implementation and training issues the first day and how to guide both supervision and overall management with the data on the second. Although we are in the early stages of planning, it is already shaping up to be an exciting three days. We are leaving ample time for lunch so that you may explore the amazing culinary experiences awaiting you in the French Quarter.

The Louisiana Counseling Association is our co-sponsor and they draw big numbers for their conferences. I did a keynote for them last year and was absolutely shocked to walk into a room with 800 people! That keynote led to this conference so there is already a lot of interest. This could bring a lot of new folks to CDOI so it is a great opportunity to spread the word. I hope you will consider coming. New Orleans is an incredible place to eat, drink, and be merry. Scott and I hope to see you there.

Barry

Heart and Soul 5

noreply@blogger.com (Barry) — Tue, 10 Feb 2009 02:14:00 +0000

Heart and Soul 5 will be unlike any of the previous four in several respects. Scott and I felt that the conference needed to evolve. So in addtion to providing the latest and greatest information about the common factors and the power of feedback, we are integrating two themes, including keynote speakers from outside of the CDOI fold, into the conference: Recovery and Social Justice. Both themes connect well to CDOI work and the conference will highlight those connections. The recovery movement, as Bob B describes in his chapter in the Heart and Soul of Change 2nd ed, fits very closely with the values and practices of CDOI. We have always advocated for client privilege and just services, and see the ORS/SRS as a means to insure that social justice is more than a lofty idea. Using the ORS and SRS transcends notions of stereotypical cultural competence and promotes egalitarian practice--one that "levels" the therapeutic process, as Jackie has been writing about of late. Finally, for the first time we will offer a beginning/intermediate track for folks just getting acquaited with the ideas, a special population track looking at the broad applicability of CDOI practices, and a management/supervisor/implementation track for more advanced folks and those itching to implement on a large scale.

I am excited already.

Barry

Heart and Soul 5

noreply@blogger.com (Barry) — Tue, 10 Feb 2009 00:48:00 +0000

Just a brief update about Heart and Soul 2010: It will be in New Orleans—right in the French Quarter! Lousianna Counseling Association is the co-sponsor. I was there to look at the venues for the conference and it is such an historical, festive, musical, culinary, cultural place that you have to experience first hand to appreciate it. We are still negotiating with the hotels, but we will have a specific date this week some time (mid June 2010), which I will announce when I know. And good news, we are going to get a great deal so this will be, unbelievably, the most economical Heart and Soul to date. My experience last night on Bourbon Street only highlighted the fact that this is indeed a very fun place to visit.

More details to come.

Barry

Barry in Portland on April 10

noreply@blogger.com (Barry) — Thu, 05 Feb 2009 12:44:00 +0000

Given I haven't been keeping my schedule up to date (I promise I'll do better), the good people at Spring Harbor asked me to announce that I will be in Portland, Maine on April 10 presenting: Becoming Outcome Informed: A Revolutionary Way to Improve Effectiveness

For more information visit www.springharbor.org/conference or call 207-761-2239.

Barry

New Updates to Site

noreply@blogger.com (Talking Cure) — Mon, 02 Feb 2009 02:07:00 +0000

We've added 2 new webinars free to the public. Please check them out on the member site at: Free Webinar.

Also, Dr. Duncan has uploaded a Frequently Asked Questions (FAQ) for CDOI - Certified trainer, Cynthia Maeschalck, helped author thos FAQ - you can check it out at: Frequently Asked Questions.

Finally, we're going to be posting new updates to the site via this blog instead of the "Whats New" section, so please visit the Blog often to find out what has been added to the site.

Thank you!
TalkingCure.com Webmaster

Psychotherapy Networker Symposium

noreply@blogger.com (Barry) — Fri, 23 Jan 2009 15:35:00 +0000

Scott and I will both be presenting at the Networker Symposium, "Seizing the Day: Therapy and the Art of Engagement." Scott is presenting the morning of March 27, "How to Be a Supershrink," and I am presenting the afternoon of the 27th, "On Becoming A Better Therapist," based on a new book I am working on. Just visit: http://www.psychotherapynetworker.org/symposium-2009 to register. Hope to see you there.

Barry

Heart and Soul Conference Announcements

noreply@blogger.com (Barry) — Wed, 16 Apr 2008 13:25:00 +0000

Speaker Change: We are sorry to report that Wolfgang Lutz has sustained a broken leg from a sporting accident and will not be able to travel to the Heart and Soul Conference. We wish him a speedy recovery. Coming through at the last minute for us, Michael Lambert, noted client feedback pioneer, will present the keynote on the second day of the conference. Thanks Dr. Lambert! Please join us for this exciting conference. Register at:
www.ti-sbh.org/displayconvention.cfm

The ISTC Research Award: Thanks to all who submitted proposals for the research award. There were so many great proposals that it was too difficult to choose just one. So, we are dividing the award. The winners are:
R. Jeff Reese for his study entitled: Does a Popular Feedback Model Improve Psychotherapy Outcome?
Donald L. Schuman for his study entitled: Measuring the Impact and Relevance of Feedback on the Treatment Experience. Come see their poster presentations at the Heart and Soul Conference.

Also at the Heart and Soul of Change Conference in Phoenix: Day 3, June 7, 2008
Achieving Excellence in Practice and Supervision with Scott Miller, Barry Duncan, Bob Bohanske, Mike Franczak, Bill Andrews, & Jim Walt

Excellence in clinical practice has traditionally been expected to emerge from training in specific content areas combined with supervised experience over time. Unfortunately, these methods have not been shown to matter much in terms of effectiveness, let alone clinical excellence. Thanks to several recent studies, it's possible to identify who the highly effective clinicians are and incorporate their practice secrets. In this workshop, you’ll learn the surprising facts about what distinguishes the “supershrinks” from the “pseudoshrinks.” You'll find out how you can develop a profile of your own and your supervisee’s most and least effective moments in therapy—based in an easily replicable feedback system—and translate that data into effective strategies for supervision and improved outcomes. You’ll come away with concrete tools that'll immediately boost your supervisee’s clinical abilities (and your own) as well as the power of your supervision. Four coherent modules (including all the presenters) will hasten your journey to clinical excellence in practice and supervision.

Come join us!

Barry Duncan and Scott Miller

Anyone for Controversy?

noreply@blogger.com (Barry) — Sun, 13 Apr 2008 16:08:00 +0000

Let's face it. Sometimes conferences are boring! But not this one, and that's why I am calling your attention to the CAMFT's May 1-4 2008 Annual Conference: Controversy: Current Debates Within a Changing Profession
http://www.camft.org/Conf_Workshops/2008Con/Greeting.htm This conference is really taking on the big ones: evidence based practice (EBP) and kids and psychiatric drugs. I am debating Thomas Sexton of Functional Family Therapy fame (he came down with a bad back and was unable to attend our scheduled debate at the Networker a couple of years back) who will be arguing for EBP while I will be highlighting the pitfalls of EBP and the benefits of practice based evidence.

I will also be presenting a keynote about the risks and benefits of psychiatric drugs based on the thorough review of the APA Working Group on Psychoactive Drugs for Children and Adolescents as well as the risk/benefit analysis conducted by Jacqueline Sparks and I that will soon be available on this website. If my recent experience in Colorado Springs is in any indication, sparks will likely fly!

I think this conference is a cut above most. So if you live in the Los Angeles area, check it out and look me up and say hi.

And don't forget to register now for the Heart and Soul of Change conference in Phoenix, June 5-7. Both of the above topics are covered as well as many others of note. For example, Noted school psychologist John Murphy will address how schools can become outcome informed by using the Child Outcome Rating Scale and the Child Session Rating Scale. Register at:
www.ti-sbh.org/displayconvention.cfm

Hope to see you at one or both of these events.

Barry

University of Colorado fails to act

noreply@blogger.com (Barry) — Tue, 08 Apr 2008 02:35:00 +0000

Many of you are aware of, and participated in, our efforts to bring the behavior of the researcher who made outlandish, unsubstantiated comments in Newsweek regarding the connection between a rise in youth suicides and the drop in prescriptions for SSRIs. Because his study in NO way supported his over-the-top assertions, we filed a formal complaint with the University of Colorado. We just heard back from the University of Colorado Committee on Research Ethics (CRE), specifically, John E. Repine, M.D. who informed us that the CRE did not find sufficient evidence to warrant an inquiry. I invite you to judge for yourself. Here is our complaint:

I am filing this complaint in behalf of a group of scholars at the Institute for the Study of Therapeutic Change in response to Dr. Valuck's comments in the July 16 Newsweek article “Trouble in a Black Box.” Here are excerpts from that article and his comments:

"According to a new study in The Journal of American Psychiatry, the number of SSRI prescriptions for pediatric depression (ages 5 to 18) tumbled more than 50 percent between 2003 and 2005. In a troubling parallel development, the number of teen suicides jumped a record 18 percent between 2003 and 2004, the most recent year for which data exist. Are the two trends connected? Many experts say yes…

'You may induce two suicides by treatment, but by stopping treatment you're going to lose dozens to hundreds of kids. You're losing more than you're saving. That's the calculus,' says Dr. Robert Valuck, of the University of Colorado Heath Sciences Center, coauthor of the new paper.’"

The problem is that an examination of the study revealed that the "parallel" development was not parallel at all. An inspection of Figure 3 in the study clearly shows that the precipitous drop in prescriptions occurred AFTER the increase in suicides. Lifting the black box warning could put many children at risk. It is an egregious ethical violation for a researcher to respond to the findings as a "parallel development" while understanding full well that the precipitous drop in his study occurred after the increase in suicides. In addition, examination of the suicide data from the CDC reveals that the "jump" in suicides from 2003 to 2004 was in fact a return to normal levels after an unexplained temporary decline for the years 2002 and 2003. Again, this shows no relationship to prescribing patterns whatsoever reported in his study referenced in the Newsweek article.

While sloppy journalism and lack of fact checking is expected from the media, the bold and even outrageous comments that Dr. Valuck made went well beyond just an unfortunate misrepresentation of the data. His comments bordered on hysteria and fear mongering, far removed from an objective interpretation of the facts and offered a conclusion from the data that he must have known, as a study co-author, to be false. This is a serious ethical violation because it created unjustified fear and could potentially influence the repeal of a warning label implemented, after extensive scientific debate, to protect children. This was neither balanced nor ethical science especially as it involves a life-and-death issue impacting our nation’s youth. A New York Times article has since appeared raising this issue and questioning the conclusions of "experts" like Dr. Valuck.

Researchers, especially those funded by corporate interests have to be held accountable.
Thank you for your consideration.

If you disagree with the University of Colorado’s decision that there was not sufficient evidence to warrant an inquiry, please contact John E. Repine, M.D. at john.repine@uchsc.edu

FYI: The National Center For Health Statistics (a branch of the CDC) released preliminary death data for 2005. The suicide rate dropped from 10.9 per 100,000 in 2004 to 10.6 per 100,000 in 2005, a decrease of about 3 percent. 2005 was the first full year of the black box warning of possible suicides and suicidal ideation. The new data won't be broken out by age groups, genders and race until next summer, so for now it isn't possible to say how the 2004 and 2005 suicide data compared. But it appears to be a fly in the ointment to the increase in suicides caused by the Black Box Warning argument.

And finally, even if the two events (rise in suicide and decrease in SSRI prescriptions) did occur (but they didn’t), one should be cautious before reading much into a correlation, especially at such a large population level. Many other factors are involved. Following their logic, it could be argued that the dramatic increase in antipsychotic prescriptions to youth is causative to increased suicides.
Barry

Prescriptive Authority for Psychologists

noreply@blogger.com (Barry) — Mon, 10 Mar 2008 01:42:00 +0000

Many of you know the American Psychological Association is hell-bent for leather to gain prescriptive authority for psychologists. An oft-mentioned tagline for prescriptive authority—the ability to prescribe carries with it the ability NOT to prescribe—seems satirical. Psychiatrists, at one time, were trained as psychotherapists. Despite the underwhelming data supporting drug efficacy, and under the intoxicating influence of massive marketing and increased personal income, psychiatrists regressed into the pill pushers they are today. The current fervor for prescriptive authority combined with a disturbing lack of awareness of the data does not inspire confidence in psychologist’s abilities to swim upstream against the strong rapids of corporate influence and personal financial success.

Discovering a psychiatrist who doesn’t prescribe occurs with about the same frequency as a discussion of the evidence or a dissenting opinion on the pages of the APA Monitor on Psychology (hereafter Monitor). Drug efficacy is portrayed as a foregone conclusion and prescriptive authority as a necessary step to expand the practice of psychologists. For example, a column (“Neuroscience and Prescriptive Authority”) by APA President Sharon Stephens Brehm (2007) lamented the rift between science and practice and asserted that the rising interest in biology among scientists (neuroscience) and practitioners (prescriptive authority) might bridge the divide. Brehm called for the unity of science and practice “to serve psychology’s common self-interests” (p. 5). And the tale is told: The push for prescriptive authority seems more about self-interest than science, and is far removed from our consumer base. A never cited finding from a 2004 APA survey is that 91% preferred a helper who would emphasize talk therapy as a first course of action, not drugs. A letter challenging the assumptions of the column was sent but not published.

Returning to the tagline, consider a special feature on psychopharmacology that appeared in the February issue of Monitor. Prescriptive authority was lauded as providing “one-stop shopping for patients” and the following example provided:
"Thinking about how being able to prescribe has improved patient care, he mentions a patient diagnosed with bipolar disorder. Fain put him on a combination of medications no one had tried with him before. The medication brought relief from his manic symptoms for the first time. Fain says, “He tells me every time, he pats me on the shoulder and says, ‘You saved me.’”

The ability NOT to prescribe? The psychologist put the client on a combination of medications never tried before. No combination of medications is FDA approved so all combinations are guinea pig experimentations. So much for NOT prescribing—sounds exactly like the whatever comes to mind multiple medication concoctions that psychiatrists regularly inflict on clients! And what about the “You saved me” part! Holy cow! Talk about a God complex and doctor wanna be. And we are supposed to believe that psychologists won’t wind up under the sway of corporate influence and personal financial success pushing unsupported and unapproved poly-pharmaceutical solutions just like psychiatrists. Yeah, right!

Another letter and more

noreply@blogger.com (Barry) — Mon, 18 Feb 2008 15:54:00 +0000

Those of you who follow our exploits know we like to write letters when drug issues are misrepresented. Here is one I wrote to the Networker after yet another positive spin by a drug company spokesperson. They chose not to publish it...

I write again in response to the Clinician’s Digest report of psychotropics with children, in this case the MTA and stimulants—and I am asking the Networker to set a higher standard of journalism. The expert cited, Peter Jensen, is extensively linked to Novartis, the makers of Ritalin, the drug investigated in the MTA, perhaps explaining his decided pro-drug spin and glaring lack of mention of adverse effects. Contrast Jensen’s comments with another MTA investigator, William Pelham, who said on a recent BBC documentary, "There's no indication that medication's better than nothing in the long run." Pelham also added that the impact (of Ritalin) was seemingly negative.

The original MTA study found that 64% of children had adverse drug reactions. The 36 month follow-up reported that decreases in growth in medicated children averaged 2.0 cm and 2.7 kg less than not medicated groups, without evidence of growth rebound at 3 years. The lack of differences in effectiveness among the groups in the MTA (and other studies) combined with notable as well as largely unknown long-term side effects led the American Psychological Association Working Group on Children and Psychotropics to conclude: “With regard to use over a period of 2 to 3 years, the risk–benefit analysis of stimulant medication does not appear to be favorable because beneficial effects appear to dissipate while side effects (e.g., growth) do not.”

I respectfully request that articles addressing medication rely on primary sources or include experts without ties to drug companies to provide counterbalance to pharmaceutical spins.

Oh well. You can't win them all! Come to the Heart and Soul of Change 4 in Phoenix (June 5-7)and hear the real story about kids and drugs from Jacqueline Sparks. Also learn the latest about client directed outcome informed clinical work with substance abusing clients from Cynthia Maeschalck and Rob Axsen. Hope to see you there.

Barry

Check It Out

noreply@blogger.com (Barry) — Sat, 26 Jan 2008 14:48:00 +0000

Barry is presenting “Lessons of the ‘Supershrinks’” at the upcoming Psychotherapy Networker Symposium on March 14 at the historic Omni Shoreham Hotel in Washington, D.C.

The new subscription service is in the works and we are looking at a May 1 start up. Get the inside scoop on the latest happenings of client directed outcome informed work (CDOI) as well as regular trainings from Scott and Barry.

And don’t forget to register for our biannual international conference, “The Heart and Soul of Change 4: Delivering What Works” coming up June 5-7 in Phoenix Arizona. Learn the latest and greatest research as well as the nuts and bolts about implementing CDOI in whatever setting you may work. Register now at http://www.ti-sbh.org/displayconvention.cfm.

For example, Morten Anker, (who I like to call the outcome prince of Norway) will be presenting the incredible results of his 600 couple feedback study. He is presenting with ISTC Associate and CDOI partner in crime, Jacqueline Sparks about using client feedback to tailor services with couples and families. Hope to see you there.

noreply@blogger.com (Barry) — Wed, 28 Nov 2007 12:57:00 +0000

Coming soon: the long awaited "members only" subscription service--get the latest from Barry and Scott's research projects before they are published; one hour personal Q & A or training from Scott and Barry per month; interviews with CDOI movers and shakers; and more...stay tuned for details.

Morten Anker's (with Barry and Jacqueline) feedback study with 600 couples in Norway is coming to a close and the results are incredible. The feedback group achieved well over double the effectiveness of the non-feedback group--with therapists serving as their own control.

Welcome

noreply@blogger.com (Talking Cure) — Tue, 13 Nov 2007 05:20:00 +0000

Welcome to the TalkingCure Blog. Barry and Scott will be posting their latest findings here soon. Meanwhile, checkout the new issue of the Psychotherapy Networker magazine for a feature article by Scott Miller, Mark Hubble and Barry Duncan - Supershrinks - What's the secret of their success?