Georgios K. Lampropoulos

The Meta-Analysis of Clinical Judgment Project: Fifty-Six Years of Accumulated Research on Clinical Versus Statistical Prediction:

Clinical predictions made by mental health practitioners are compared with those using statistical approaches. Sixty-seven studies were identified from a comprehensive search of 56 years of research; 92 effect sizes were derived from these studies. The overall effect of clinical versus statistical prediction showed a somewhat greater accuracy for statistical methods. The most stringent sample of studies, from which 48 effect sizes were extracted, indicated a 13% increase in accuracy using statistical versus clinical methods. Several variables influenced this overall effect. Clinical and statistical prediction accuracy varied by type of prediction, the setting in which predictor data were gathered, the type of statistical formula used, and the amount of information available to the clinicians and the formulas. Recommendations are provided about when and under what conditions counseling psychologists might use statistical formulas as well as when they can rely on clinical methods. Implications for clinical judgment research and training are discussed.

Bridging Technical Eclecticism and Theoretical Integration: Assimilative Integration

Assimilative integration is a new type of psychotherapy integration introduced by Messer in 1992. This paper explains the “where, what, when, and how” of this integrative route, outlines its advantages and weaknesses, and discusses areas for potential assimilative practice in various models of therapy. Following a brief review of the current status of psychotherapy integration and its practices, assimilative integration is conceptualized as a “mini theoretical integration” and as “theoretical eclecticism” it is offered as a bridge between theoretical integration and technical eclecticism. Assimilative integration is proposed as the best theoretically and empirically based integrative approach available at this time, particularly for therapists who have been trained in a single mode of therapy before they became integrationists.

Evolving psychotherapy integration: Eclectic selection and prescriptive applications of common factors in therapy.

Since its inception 65 years ago, the psychotherapy integration movement has undergone much development along its major thrusts: technical eclecticism, common factors, and theoretical integration. Based on findings from decades of exploration of psychotherapy integration, this article attempts to advance the movement one step further by (a) reviewing the pros and cons of eclecticism and common factors, and (b) integrating the two approaches into a new conceptual scheme. The new integrative scheme aspires to improve treatment selection and application, as well as facilitate integrative training and research.

Definitional and Research Issues in the Common Factors Approach to Psychotherapy Integration: Misconceptions, Clarifications, and Proposals

This paper focuses on two common misconceptions of common factors in therapy. The first misconception entails the confusion between common factors and therapeutic factors, and thus the inappropriate and misleading use of the term “therapeutic common factors” in various situations. The second misconception is the mixing of commonalities of different kinds and levels in proposed lists and studies of common factors. These areas are discussed and clarified, and recommendations designed to facilitate conceptual and methodological improvements relative to each misconception are offered. The selection of best levels and kinds of common factors to be studied are further explored (i.e., the study of client change events and antecedent therapist behaviors across different therapies), and specific proposals for their research are outlined.

The Use of between Session Assignments in ADHD Coaching with College Students.

Objective: To provide an analysis of the use of between session assignments (BSA) in ADHD coaching with college students. The article provides a description of the structure and process of using BSA in an academic setting. Method: A brief survey of ADHD coaches is used to evaluate 13 coaching clients engaged in an 8-week structured program. A case study illustrates the process of using BSA with college students. Results: Overall progress in the ADHD coaching sessions was significantly correlated with coach’s rating of the client’s quality of BSA during treatment, the client’s positive attitude to BSA, and the usefulness of BSA. Treatment gain scores were significantly related to the client’s being motivated by a desire to please their parents. Conclusions: BSAs can be useful in the context of ADHD coaching with college students.

A Common Factors View of Counseling Supervision Process

Abstract This paper offers a common factors view of counseling supervision process. This approach is based on (a) a common factors conceptualization of counseling supervision parallel to those which exist in counseling, and (b) an eclectic approach to supervision methods selection similar to those which exist in counseling. Such an approach not only allows a view of supervision in the broader context of change-inducing interactions, but also the incorporation of theoretical and empirical findings from the related fields of counseling and education.

Integrating Psychopathology, Positive Psychology, and Psychotherapy

Reading the special issue of the American Psychologist (January 2000) on the contemporary, data-based movement of positive psychology was an uplifting experience in itself. Positive psychology seems to emerge as a renewed humanistic approach to the individual and collective potential for happiness, but this time it is strengthened by empirical data and adequate research methodologies. Seligman and Csikszentmihalyis (January 2000) call for a shift from a disease-oriented science to a science of optimal functioning, well-being, and happiness provides psychology and related disciplines with a noble goal to pursue in the beginning of the new century. Indeed, what can be more positive, rewarding, and fulfilling than studying and facilitating peoples happiness? However, transforming therapeutic psychology from a science based on the medical model to a science that emphasizes positive experience and prevention is easier said than done. Although Seligman and Csikszentmihalyi (2000) recognized the domination of the disease model in mental health, they suggested that because psychologists have now found treatments for the majority of psychological problems, they should start studying how to make peoples lives even better. They proposed that psychologists could use the same research methods and even the same laboratories that have developed psychology and psychiatry as healing sciences during the past half century to focus on the study of positive psychology, with only a slight shift of emphasis and funding. Although certainly feasible, how easy or likely is that to happen? How can a long tradition of conceptualizing and treating people in psychopathological terms shift to the study of positive functioning? How do psychologists change not only their mind-set of focusing on the negative but also the pathology-based therapeutic practices that are currently empirically supported and embraced by third-party payers? How can psychologists convince the scientific and professional mental health establishment to make scarce monetary and human resources available to positive psychology research and practice? To achieve a major scientific shift to positive psychology (which could complement the dominant disease-oriented focus in mental health), psychologists should reconcile and merge the two foci; this could be best done by gradually infusing positive psychology into current models of psychopathology and treatment. To ease the integration and transition from a psychopathology-focused to a strength-focused approach in therapeutic psychology, programmatic research might be necessary; here are three possible areas of attention:

Type of counseling termination and trainee therapist–client agreement about change

Research on client–therapist agreement about change has shown mixed results within an overall pattern of limited agreement. However, relatively little research has been conducted in counseling training clinics. This archival study sheds light on this inconsistency by examining trainee therapist–client agreement on outcome in different types of counseling termination. Treatment gains were found for both counseling completers and dropouts, with findings somewhat favoring the former group. Moderate trainee therapist–client agreement about change was found. Larger agreement was obtained for clients who completed treatment (r =.53) compared to clients who withdrew unilaterally from treatment (r =.30). However, this difference was not statistically significant.

Common Processes of Change in Psychotherapy and Seven Other Social Interactions.

This paper argues that change processes in psychotherapy can be understood more clearly by comparing them with other change-inducing social relationships. In showing how this may be done, different social interactions (e.g. religion, parenting, education, politics, coaching, and sales) are described and discussed in terms of a parsimonious set of common factors in change. The importance of the cross-fertilisation of psychotherapy and other fields is stressed, and research recommendations are offered.

Failure in psychotherapy: an introduction

This article introduces an issue of the Journal of Clinical Psychology:In Session devoted to treatment failures in psychotherapy. In contrast to recent attention from the research perspective and cognitive-behavioral orientation, this issue focuses on clinical material from multiple theoretical perspectives. This article provides an overview of some of the empirical and definitional issues on treatment failure and then outlines the five subsequent articles, each of which offers an interesting case illustration. The article concludes with several transtheoretical recommendations for reducing the incidence of therapeutic failures.