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Title: An investigation into the effects of the initial hours of therapy in psychological services
Author: Doorn , Karlijn A. van
ISNI:       0000 0004 5346 4087
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2014
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The systematic review explored the effect of the initial hours of psychological therapy; a critical phase of therapy, which some studies have suggested sets the course of therapy as a whole. The 24 studies included in the review were selected because of their relevance to outpatient adult mental health services. Methodological concerns regarding the nature of the sample, diversity of outcome measures, interventions and timing of follow-up measurement are discussed. Overall, the review suggests that a significant proportion of patients report benefits, including symptom change, following initial hours of therapy and this is especially clear when compared to no-treatment controls. Furthermore, these positive effects appear to be maintained at follow-up. These conclusions are tempered by the methodological concerns outlined in the review and a recommendation is made for more robustly designed research, which could confirm the tentative conclusions of the current review. An empirical study explored whether patients attending secondary care psychology services made early gains following an extended initial 'trial therapy' session of Experiential Dynamic Therapy and what mechanisms of change facilitated these gains. Video-recordings of 31 initial sessions were rated using the Achievement of Therapeutic Objectives Scale, a process scale that assesses patients' degree of absorption and assimilation of therapeutic objectives. Outcome was assessed through comparison of pre- and post scores using the Clinical Outcome Routine Evaluation-Outcome Measure, Brief Symptom Inventory, Inventory of Interpersonal Problems, Self- Compassion Questionnaire and Remoralisation Scale. The patients achieved an initial level of therapeutic objectives, in particular insight into and motivation to relinquish their maladaptive patterns and made significant positive changes in symptoms, remoralisation and self-compassion. Ratings of some achievement of therapeutic objectives were associated with improvement on the outcome measures. The results highlight the potential clinical benefits of extended experiential dynamic therapy sessions in the initial phase of treatment in secondary care NHS psychological therapy services.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available