KEY PROCESSES IN THERAPY
WORKSHOP SERIES
EIGHT DAYS ON BECOMING A MORE EFFECTIVE THERAPIST
It is well known that some therapists are much more effective than others. What are you doing to
make sure that you are helping your clients as much as possible? After 50 years of research on
psychotherapy we can identify with some confidence key processes leading to the best client
outcomes, though this information has not been widely disseminated. This pioneering and unique
course teaches you what scientists have discovered about how therapy works. It goes on to provide
intensive training in five key areas which have been shown to enhance the effectiveness of therapy.
These are 1) setting up a system for receiving structured client feedback to monitor therapy
progress, 2) the use of accurate empathy, 3) knowing how and when to deepen client emotional
experience and when and how to regulate it, 4) identifying and resolving problems in the
therapeutic alliance and 5) working with clients who are ambivalent about changing. The aim
throughout is to give participants an engaging introduction to the research findings followed by clear
description, demonstration and practice of key skills in each area. Learning will be supported with
handouts, references, practical exercises and a reflective log to be completed for each of the key skill
areas. This is a course for ambitious therapists who want to maximise their chances of helping every
client who comes their way.
Tutor: Dr James Macdonald, PhD, DClinPsych, Chartered Clinical Psychologist Specialising in
Psychotherapy (with Senior Practitioner Status)
James is a highly experienced clinician with a particular interest in how psychotherapy research
findings can be used to improve clinical practice. For a number of years, alongside his role as a
clinical psychologist in an NHS secondary care psychological therapies service, James was an
Academic Tutor on the Oxford Doctoral Training in Clinical Psychology where he continues to teach.
Between 2011 and 2014 he was Director of Clinical Training at CORE IMS where he trained clinicians
in the use of feedback informed therapy and developed training materials and workshops on key
clinical skills. James supervises doctoral projects in the area of psychotherapy research and has
completed two doctoral projects of his own. His research interests include the therapeutic alliance,
feedback informed therapy, emotion in psychotherapy and therapist differences. James currently
runs an independent feedback informed psychotherapy service in Oxford
(www.headingtonpsychotherapy.co.uk) and works as a freelance psychotherapy trainer.
Recent articles by James include:James Macdonald (2013). ‘Formal’ feedback in psychotherapy as psychoanalytic technique.
Psychodynamic Practice: Individuals, Groups and Organisations.
http://dx.doi.org/10.1080/14753634.2013.771566.
James Macdonald & John Mellor-Clark (2014). Correcting Psychotherapists’ Blindsidedness: Formal
Feedback as a Means of Overcoming the Natural Limitations of Psychotherapists. Clinical Psychology
and Psychotherapy DOI: 10.1002/cpp.1887.
Aafjes-van Doorn, K., Macdonald, J., Stein, M., Cooper, A., &Tucker, S. (2014). Experiential Dynamic
Therapy: A Preliminary Investigation into the Effectiveness and Process of the Initial Extended
Session. Journal of Clinical Psychology DOI: 10.1002/jclp.22094
Llewelyn, S., Macdonald, J. & Aafjes-van Doorn (in press). Process-Outcome Studies. In J. Norcross,
G. VandenBos & D. Freedheim (eds.) APA Handbook of Clinical Psychology: Volume II. Clinical
Psychology: Theory and Research.
For more information about James and downloads of some of his writing see
www.headingtonpsychotherapy.co.uk
Cost: £980
TIMETABLE
Date
Day
Title
17/04/15
20/05/15
21/05/15
19/06/15
09/07/15
10/09/15
15/10/15
16/10/15
Fri
Wed
Thurs
Fri
Thurs
Thurs
Thurs
Fri
Psychotherapy Research for psychological therapists
Key Processes in Therapy: Feedback (1)
Key Processes in Therapy: Feedback (2)
Key Processes in Therapy: Empathy
Key Processes in Therapy: Working with Emotion
Key Processes in Therapy: Working with Ambivalence
Key Processes in Therapy: Resolving Ruptures in the Therapeutic Relationship
Putting it all together: systematically improving our effectiveness
Day One: Psychotherapy Research for Psychological Therapists
Morning
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The beginnings of psychotherapy research
Establishing that therapy is an effective treatment: an introduction to Randomised
Controlled Trials (RCTs) and related controversies
The greatest psychotherapy RCT: The NIMH Treatment of Depression Collaborative Research
Programme
The ‘Dodo Bird’ controversy
Summarising RCTs: Meta-analyses and evidence based treatments.
The effectiveness of psychotherapy: glass half full or glass half empty?
Afternoon
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Introduction to process-outcome research. How does psychotherapy work?
Techniques and outcomes
Therapists and outcomes
The therapeutic alliance and outcomes
The client and outcomes
The challenge of making sense and making use of psychotherapy research
Day will include quizzes, discussion and small group exercises to contextualise learning.
Day Two: Key Processes in Therapy: Feedback (1)
Morning
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Recap from Day One on outcomes in psychotherapy.
Introduction to practice based evidence. Case studies in the use of outcomes in routine
practice to improve effectiveness in medicine
Recap from Day One on processes linked to outcome in psychotherapy
Introduction to systematic use of process monitoring in medicine and elsewhere to improve
outcomes
Afternoon
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Introduction to Mike Lambert’s research on feedback in psychotherapy
Feedback and Clinical Support Tools
The evidence base for feedback
The limits of expertise in psychotherapy
Putting it together: Feedback and process-outcome findings in psychotherapy.
Day will include quizzes, discussion and small group exercises to contextualise learning.
Day Three: Key Processes in Therapy: Feedback (2)
Morning
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Setting the interpersonal scene for the effective use of feedback
A feedback experiment
Feedback tools: finding the right vehicle (from Rolls Royce to Ford Fiesta)
Introducing feedback to clients
Video example
Afternoon
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Frequent barriers to progress in therapy
Evidence based clinical skills linked to common problems in therapy
‘Failing successfully’ in therapy
Using an alliance measure as feedback
Getting started with feedback and making it work in your clinical setting
Day will include quizzes, discussion and small group exercises to contextualise learning.
Day Four: Key Processes in Therapy: Empathy
Morning
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Definitions of empathy
Contemporary perspectives on empathy
Evidence on the relationship between therapist empathy and client outcomes in
psychotherapy
A closer look at empathy in psychotherapy with video examples
Can empathy be learned?
Afternoon
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Strengthening the empathy muscles: Exercises for building our empathic capacity
Empathy and the practice of mindfulness in therapists’ development
Discussion of reflective diary practice on the development of empathy in your clinical work
Day will include quizzes, discussion and small group exercises to contextualise learning.
Day Five: Key Processes in Therapy: Working with Emotion
Morning
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What is an emotion?
The relevance of emotion to psychotherapy
An interpersonal emotion focused model of the development and alleviation of
psychopathology
A simple integrative psychodynamic model for formulating emotional conflicts
Video exercise on formulating emotional conflict in here and now psychotherapy process
Afternoon
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Techniques for helping clients access underlying emotion in psychotherapy
Video exercise from Emotion Focused Therapy
Role play exercises on supporting client emotional awareness and expression
Techniques for helping clients regulate overwhelming emotion
Role play exercises on helping clients regulate overwhelming emotion
Discussion of reflective diary practice on the development of skills in working with emotion.
Day will include quizzes, discussion and small group exercises to contextualise learning.
Day Six: Key Processes in Therapy: Working with Ambivalence
Morning
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Client engagement as the key to change in therapy
What is resistance?
Recognising client resistance and ambivalence
Ambivalence in language – change talk and sustain talk
To be or not to be expert
Video exercise
Afternoon
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Motivating relationships: insights from theory and research
Using empathic reflection to evoke clients’ motivation – video analysis
Using empathic reflection with ambivalent clients – skills practice
Providing useful information without triggering resistance
Research on motivational work in psychological therapy.
Discussion of reflective diary practice on the development of skills in working with client
ambivalence and motivation
Day will include quizzes, discussion and small group exercises to contextualise learning.
Day Seven: Key Processes in Therapy: Resolving Ruptures in the Therapeutic Relationship
Morning
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Reminder of key findings regarding the therapeutic relationship and outcome
Definitions of therapeutic relationship and ruptures
Persecutory therapy and the move towards relational thinking
Codes for trouble: recognising and formulating relational difficulties in therapy
Rupture types
Video exercise
Afternoon
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Video exercise
Typology of rupture repair approaches and principles of rupture repair
Metacommunication
Video exercise
Role Play exercises
Feedback and rupture repair
Discussion of reflective diary practice on the development of skills in rupture repair
Day will include quizzes, discussion and small group exercises to contextualise learning.
Day Eight: Putting it all together: systematically improving our effectiveness
The focus of this final day will be to consolidate learning over the course. The day will consist of
small group and whole group discussion, sharing of extracts from reflective diaries, and thinking
through next steps in learning to become more effective therapists.
If you would like more information on the key clinical skills course please contact James at
james@oxfordpsychologicaltraining.co.uk . James will be very happy to answer any questions and
arrange a call with you if you are thinking of signing up for the course.