1. Research Methods in Marriage and Family Therapy University of Guelph, Office of Open Learning and Educational Support

2. Your Host Carlton Brown, MSc, MDiv, RMFT AAMFT Approved Supervisor 3-1216 Upper Wentworth St., Hamilton, ON L9A 4W2 (905) 388-8728 carl@mftsolutions.ca

3. Today RAT results Correlation Ethics Research Questions Common Factors The Research Game Show Hand in your journals please Course Evaluation

4. RAT Results Day Four Scores ranged from 23 – 33 Mean score = 28.44 Standard deviation = 3.13 68.26% of scores between 25.31 and 31.57 95.44% of scores between 22.18 and 34.07

9. Principle V Responsibility to Research Participants Investigators respect the dignity and protect the welfare of research participants, and are aware of applicable laws and regulations and professional standards governing the conduct of research.

10. 5.1 Investigators are responsible for making careful examinations of ethical acceptability in planning studies. To the extent that services to research participants may be compromised by participation in research, investigators seek the ethical advice of qualified professionals not directly involved in the investigation and observe safeguards to protect the rights of research participants.

11. 5. 2 Investigators requesting participant involvement in research inform participants of the aspects of the research that might reasonably be expected to influence willingness to participate. Investigators are especially sensitive to the possibility of diminished consent when participants are also receiving clinical services, or have impairments which limit understanding and/or communication, or when participants are children.

12. 5.3 Investigators respect each participant’s freedom to decline participation in or to withdraw from a research study at any time. This obligation requires special thought and consideration when investigators or other members of the research team are in positions of authority or influence over participants. Marriage and family therapists, therefore, make every effort to avoid multiple relationships with research participants that could impair professional judgment or increase the risk of exploitation.

13. 5.4 Information obtained about a research participant during the course of an investigation is confidential unless there is a waiver previously obtained in writing. When the possibility exists that others, including family members, may obtain access to such information, this possibility, together with the plan for protecting confidentiality, is explained as part of the procedure for obtaining informed consent.

14. Research Questions

15. Common Factors

16. Fred Fiedler 1950a Therapists, regardless of training, have the same concept of an ideal therapeutic relationship

17. Fred E. Fiedler (1950) The concept of an ideal therapeutic relationship. Journal of Consulting Psychology 14(4), 239-245

18. Fielder, continued Clients, when asked, identified the same qualities as what they were most looking for in therapy

19. Fred Fiedler 1950b Therapists right out of school practice according to the model they learned (not the same as the ideal relationship) Experienced therapists practice similarly to one another, not to model The practice of experienced therapists approaches the ideal therapeutic relationship

20. “ Any component which is necessary for successful therapy must not only be present in all types of psychotherapy which lead to successful outcomes, but must also be influential in proportion to the success of the therapy.... This investigation, in other words, supports the theory that relationship is therapy, that the goodness of therapy is a function of the goodness of the therapeutic relationship. ” Fred E. Fiedler (1950) A comparison of therapeutic relationships in psychoanalytic, nondirective and Adlerian therapy. Journal of Consulting Psychology 14(6), 436-445

21. Michael J Lambert Psychotherapy outcome research: implications for integrative and eclectic therapists In: John C. Norcross and Marvin R. Goldfried, eds. Handbook of Psychotherapy Integration. New York: Basic Books (1992) pp. 94-129

22. General Findings A lot of people improve “ spontaneously ” without psychotherapy (median 43%, range 18 - 67%)

23. Psychotherapy is Beneficial Effect size approximately 0.85 (large effect!) Accounts for 10% of the variance Generally as or more effective than medication

24. Little Evidence for Model Specificity No difference in outcome regardless of model used Possible explanations Different methods achieve the same result through different mechanisms Measurements are wrong Common factors

27. Miller, Duncan and Hubble 1997 Escape from Babel All therapy has a mode of one session, average of 6-8 sessions, and equal effectiveness Psychotherapy with “ Impossible ” Cases

28. Duncan and Miller Heroic Client: Doing Client-Directed, Outcome-Informed Therapy Ask about pre-session change Give the relationship priority Engender hope Use a model that the client believes in

29. Sexton, Ridley, and Kleiner Sexton et al. Beyond common factors: multilevel-process models of therapeutic change in marriage and family therapy. Journal of Marital and Family Therapy (2004) vol. 30 (2) pp. 131-149

30. Sexton, Ridley, and Kleiner MFT is effective, as psychotherapy is effective Some argue no difference between models of MFT Others argue that some models work better than others

31. Sexton, Ridley, and Kleiner Reinterpreting Fiedler: the reason that seasoned therapists abandon their “ schools of origin ” is because the theories they learned are inadequate “ traditional theory falls short in providing practitioners the necessary guidance to make systematic clinical decisions in dealing with complex clinical problems ”

32. Sexton, Ridley, and Kleiner Models are weak Present demands of managed care will force the development of “ mature models ”

33. Sexton, Ridley, and Kleiner Common factors based on meta-analysis Meta-analysis is weak and simple Therapy is complex

34. Face Validity When you refer a client to a therapist, which is more important to you: a) the person of the therapist b) the technique that the therapist uses? Blow et al. Is who delivers the treatment more important than the treatment itself? The role of the therapist in common factors. Journal of Marital and Family Therapy (2007) vol. 33 (3), 298-317

35. Is Common Factors anti-theory? One problem with this debate is that it sets up a dichotomy between theory and evidence Science has always been evidence-based, cyclical development of theory based on evidence

36. A Quick Class Survey Which is more important to you in your therapy practice? a) What works? b) How it works? (Model?) (Factors?)

37. Maybe there are other common factors A Competent Therapist

38. The Research Game

39. Log in to play http://www.conferenceservers.com/brand s/GLO/CCPro/default.htm http://www.conferenceservers.com/brand s/GLO/CCPro/default.htm Access code 8417900

40. Please complete the course evaluation

41. Assignments Journal – due today Final papers - due 5:00 pm May 21 st Send to carl@mftsolutions.cacarl@mftsolutions.ca Make sure you get a receipt acknowledgement

42. Goodbye! Thank you for participating in this tele- course! Feedback is appreciated, either to me or to pshaver@uoguelph.capshaver@uoguelph.ca It’s been fun!