NETWORK

Newsletter of the Society for Psychotherapy Research U.K.

Volume 6(3), September 1995

ISSN 1359-3706


Mounted by Chris Evans C.Evans@sghms.ac.uk in October 1995, individual items separated for presentation as individual files to help people with slow connections, slightly altered 15.ii.96

Editor: Chris Evans

Section of Psychotherapy, Dept. of General Psychiatry,
St. George's Hospital Medical School,
Cranmer Terrace, London SW17 0RE
Phone/fax: 0181-725 2540

Feedback greatly appreciated: Email [if your HTML browser doesn't support "mailto:" then use a mail package and send to: C.Evans@sghms.ac.uk]


Inside This Issue


Autumn one day meeting 3rd Nov.radically changed to:"N.H.S. Psychotherapy:Survival of the Fittest? (II)

The one day meeting has changed radically from the idea reported in Network 6(2). Apologies to the two people who submitted things for the advertised meeting. Both should emerge in a more appropriate context at Ravenscar. It became clear that there were very important things going on concerning the very survival of N.H.S. psychotherapy that concern the continuum from research through audit and quality assurance to the whole basis of purchasor/provider bargaining system.

The day that has arisen from the ashes will focus on this issue. That made the title simple as we are clearly following on from the event held at the Uffculme in 1994. The core of the day will be discussion from the floor but this will be focussed by presentations in the morning and a panel in the afternoon.

The three presentations all address the problems of survival at different levels and from different viewpoints but are all critical in the current political scene. The panel discussants are being asked to pick up specific questions or answers that can be used to secure the survival of fit psychotherapy within the N.H.S. At present the panel will include a managerial, a clinical and an audit view. We decided that the researcher view will be well represented from the floor.

The first of the presentations comes from Roy Curtis, Senior Research Fellow at the Royal College of Psychiatrists Research Unit who will be discussing the "Health of the Nation Outcome Scales" (HoNOS) which are figuring in purchasors and managers requests for information in this and other parts of the country.

The second presentation will be from Tony Roth who, with Peter Fonagy, cowrote the review of the "Research on the efficacy and effectiveness of the psychotherapies" commissioned by the D.o.H. as part of their review of psychotherapy services. He wants people to understand that he will be presenting will be his view not a D.o.H. view. The review will be published later in November no doubt couched so as to be readable by mandarins as well as clinicians and researchers). However we will be hearing a condensed version and think this preview and chance to debate with one of its authors will be immensely valuable to anyone wanting to know how best to defend their own services.

The last presentation will be from Michael Rustin who gave an excellent talk earlier this year (to the Tavistock) about the way to put psychodynamic thinking back into the core of the political agenda on health.

A flyer and two application forms are being circulated with Network. Please publicise this as widely as you can.

Chris Evans (on behalf of the conference team of CE, Jo-anne Carlyle and Gill McGauley)

[Page 1 in printed version] [return to index] [More info.] {2kb}


Editorial

Firstly, many congratulations to Mark Aveline on becoming our new U.K. Vice President. S.P.R. (U.K.) will be very safe in his hands as his tremendous achievements for psychotherapy and counselling within the U.K. have shown.

This will be a very small edition of Network as these have been a very hectic few months for me. Please don't let that stop you sending in anything you think should be published for that next issue probably coming out early in 1996 with information about the next Ravenscar meeting.

I have been asked by Michael Barkham to point out that the date on the accompanying voting forms for the international S.P.R. has an incorrect final return date on it of the 1st of October. This arose because the forms were so late being sent to us and we have negotiated an extension to the 1st of November just for the U.K. so don't let your vote be wasted!

All submissions by mail should be sent to:

Section of Psychotherapy,
Dept. of General Psychiatry,
St. George's Hosp. Med. School,
Cranmer Terrace,
London SW17 0RE

Please put submissions on a DOS format 3½" or 5¼"diskette if you can. I can cope with most WP file formats but enclose an ASCII file if your WP is esoteric

The 'phone and 'fax number is:

0181 - 725 2540

If you are 'faxing a submission please double space it, don't use italics and do use a large font: nothing less than 12 point otherwise I have to laboriously retype everything. If your 'fax system won't work with my fax/MODEM or fax detector then use the Departmental 'fax on:

0181-725 3350

and make it clear it's for me and please use big type and double spacing.

My Email address is:

C.Evans@sghms.ac.uk

try using a MIME attachment of a WP file if your mailer does MIME (but still put an ASCII draft in as well!)

Chris Evans [Page 2 in printed version] [return to index]


Vice president's message

Results of the election for UK Vice-President

The results of the election held during July are as follows. A total of 190 voting papers were sent out and 64 were returned: a return rate of 34 per cent. The candidate receiving the most votes was Mark Aveline and I am therefore pleased to announce that Mark is now UK Vice-President Elect. Congratulations to Mark and very many thanks to Chris Evans and Jane Knowles who, by standing, made the election constitutionally possible and also showed the strength of candidates available for this post. Also, many thanks to Debra Kirby-Mayers for managing the election so efficiently.

The strength of candidates, together with a number of other factors, has led Mark and myself to consider a plan to revise the current model in which 2 years are served as VP-Elect, followed by 4 years as VP, and then by 2 years as past-VP acting as an institutional support. This model evolved in the developing years of the UK chapter and it seems appropriate to review it now. The suggestion Mark and I are making is to move from this 2+4+2 model to a 1+3+1 model. We proposed to put this forward at the AGM at Ravenscar next year and, if approved, for it to take immediate effect. This means that I would stand down after the international meeting at Amelia Island (Florida) in 1996 after serving 3 years with Mark having run his 1 year as VP-elect. The next election would therefore be after Mark has served 2 years as VP (summer of 1998) in order to provide the person following him their 1 year tenure as VP-elect.

I thought it would be helpful to set this out now in NETWORK in order to provide the whole membership with the opportunity to comment on this proposal prior to the AGM. If people have strong views they wish to express on this topic, please do contact me.

From the west coast to the south coast - well almost!

One of the major activities of SPR is the international meeting held each year and the decision to hold it in Vancouver did indeed attract the largest number of attendees yet. It also attracted the largest number of presentations with 7 parallel sessions through the meeting. This led to much debate about the impact on the atmosphere of the meeting - too diverse - with the cost that some presenters gave their talks to only a handful of people. However, as always, there were highlights: Clara Hill embarking on some amusing self-reflection in her Presidential Address on dreams; some great 'whoopees' when the meeting were shown slides of the site at Lake Como which will host the 1996 European SPR meeting; some good scenery.....oh, and some good presentations in the areas of change processes! There was a healthy UK contingent present and it would be good to hear an account of the meeting from someone who attended which could appear in NETWORK. If anyone is interested, please contact me or Chris Evans.

Since the York meeting, I've been involved in a small project which has culminated in a special issue of Changes on 'Outcome in psychotherapy' which may be of interest to members, especially as most of the contributors are close to the heart of SPR (surprise, surprise!): Glenys Parry, Peter Fonagy, Irene Elkin, Nigel Beail, John McLeod, John Mellor-Clark & David Shapiro, Hans Strupp, Roberta Russell, and Bill Stiles. It's a bridge between the 'research' world and the 'political' world which is an important interface for SPR members to address. The one-day meeting hosted at St George's on 3 November continues to address this interface and this is why the meeting is important: it provides members with the opportunity to contribute to the wider debate while aiming to keep the research agenda central to the Ravenscar meeting. Chris Evans, Jo-anne Carlyle, and Gill McGauley have done a tremendous job in organising this event: it is our task to be responsive to this opportunity and I very much look forward you there. What this one day meeting also provides is an opportunity to go south without losing our beloved Ravenscar - what a good position to find oneself in.

IMPORTANT: Announcing an increase in SPR(UK) dues

In a past issue of NETWORK, I flagged up the issues of the increase in dues arising from the agreement taken at the York Executive meeting that there should be parity between SPR members and that this would be achieved by UK members increasing their rate as from January 1996. The issue was that UK members were paying substantially less that the $60 paid by all other chapters (including the new South American chapter). I invited any comments from members on this issue. No one contacted me to object. Hence, as of January 1996, all SPR(UK) members need to increase their dues to the equivalent of $60. Taking a rate of £1=$1.50, this results in the dues for UK members being £40. I would be very grateful if all members could act on this over the next 3 months. We should then look at ways of ensuring that we achieve maximum 'value for money' from the international body.

Michael Barkham [Pages 2 to 4 in printed version] [return to index]


Are you planning, doing, writing up or wondering what to do with some interesting research?

... then make sure you get a chance to air it in the congenial setting of Ravenscar next year! We are calling for papers now, and have a deadline for submissions of FRIDAY 13 OCTOBER. Work need not be complete, as long as you will have results to present in March; we want a wide range of different psychotherapy research to think about together. This could be just the stimulus, deadline or persecutory object you need to get you to sit down and sort out that project you always meant to get into shape!

Depending on how much there is in submitted papers, the SPR steering committee decides whether they should be posters (with "just a minute introductions") or verbal presentations (which are mostly between 15 and 30 minutes). We are happy to accept joint presenters.

If you would prefer to develop ideas in a smaller setting, and present and discuss them in more depth, we also have submissions for the workshops. For these, you will get 10-25 participants and two sessions over two consecutive days with a total of about three hours - and then feedback to the whole conference on the last day.

If you have any other interesting ideas for conference activities (academic or otherwise), we would be very interested to hear from you, again by Friday 13 October. This time we have a bonus of two American guest speakers: Jacqueline B. Persons from San Fransisco, and Robert Elliott from Toledo, Ohio. Those of you who know Ravenscar will probably be glad to know that we don't intend to abandon the afternoon free to wander into Whitby, the conference dinner (which we have a few extra plans for this year) or the charades that follow it. From the last conference's feedback, we shall be making the programme a little less packed and give more time for discussion. It will be circulated early in the New Year. The deadline for bookings to attend will be in February.

It helps if anything you submit is on an "abstract form", so we can track you down and get details right on the programme. You should have all been circulated with them, but Sue Robinson will willingly supply further copies

tel.: 01734 561 250

fax.: 01734 561 251

For enquiries about the programme, submissions, abstracts and conference activities, please contact Rex Haigh (same numbers); for information about bookings and general conference enquiries, please contact Debbie Kirby-Mayers

phone or fax.: 0161 442 6291

Rex Haigh [Page 4 in printed version] [return to index]


Report on the Ravenscar Conference 1995

Ravenscar '95 will be remembered by me at least for its unmemorability. That is not to say it was uninteresting - it wasn't ; or that it was less enjoyable - it wasn't ; but that it felt like a year of consolidation rather than change.

Its predecessor Ravenscar '93 was a sudden uncomfortable jolt, a change of direction, new blood, new ideas, controversy, excitement for some, a fall in standards for others. We couldn't be expected to keep up that pace, could we?

Some of the things we tried out reappeared this year: the one minute poster presentations, admirably chaired by Glenys Parry, the panel discussions on a group of papers with a similar theme - and were judged to be sucessful. Other things like the clinical video and brainstorming workshops did not reappear, although may not be dead and buried.

Perhaps the most notable consolidation was in the change of emphasis away from hard quantifiable data towards a methodology for researching the softer areas of psychotherapy - dreams- religious bias - birth stories - therapist abuse of their patients - which more closely reflect the clinical activities and concerns of psychotherapists in practice. This change recieved a mixed reception. I heard animated discussion triggered by these presentations but also critical comments regarding lack of rigour or doubtful methodology.

Perhaps this is the time to invite an exchange of views in Network regarding future directions for the conference. Have we got the balance between clinicians and full time researchers about right? Do you have other suggestions regarding the format of the conference or bright ideas we might try out? Speak now or for ever hold thy peace.

Content-wise there were many interesting presentations with a strongly pragmatic flavour. The keynote address by John Clarkin was a clear and erudite appeal for integration of the biological and psychological in psychiatric practice.

A group of papers on therapeutic communities had more than an eye on their future survival which can no longer be taken for granted. Similarly the referral patterns for C.A.T.,specialist psychotherapy and in primary care settings carry implications which we would do well to note. It was even suggested that psychotherapists could ultimately be replaced by computers although a computer's ability to monitor its own countertransference must be in some doubt!

The conference dinner marked a presentation of the Career Achievement Award to Tony Ryle whose C.A.T. baby continues to flourish and mature within the portals of S.P.R.

The hotel complained that we had not drunk suficient malt whisky since they had bought in stocks specially. This was in marked contrast to '93 when we drunk them dry of both malts and bitter! Whether this reflects a more sober atmosphere, I'm not sure but the charades on Tuesday evening lacked the inebriated spontaneity of previous years.

I am sure we can look forward to many more years of rewarding meetings in what remains a uniquely friendly informal event, distinguished by the ability of psychotherapists from a wide variety of backgrounds to find areas of common ground and shared interest.

Rex Haigh and Debbie Kirby-Myers are due our grateful thanks for another sucessful and enjoyable event, with record numbers of participants.

Ian Macilwain [Pages 3 and 4 in the printed version] [return to index]


Annual prize for Ethics in Psychotherapy

What is the basis of ethics? What does it mean psychologically to break a boundary? Could an in-depth view of ethics help you in your therapeutic/research work? etc?

As reported in July Network (6(2)), the offer at the A.G.M. of an potentially annual prize relating to this topic led to the formation of a discussion group to make proposals to the next S.P.R. Committee Meeting on November 3rd.

The discussion group is in favour of such a prize. We agree that ethical issues, widely defined, are interwoven with both psychotherapy theory and practice. Research funds are normally directed at other issues and our understanding of both ethics and psychotherapy could be enriched by the broader intellectual approach to ethics (potentially arising from research) rather than a view of ethics as a series of proscriptions.

Four themes were identified:

  1. processes of ethical decision malking
  2. psychodynamic basis and confounding factors in ethics
  3. empirical surveys of guidelines and practice
  4. impressive insights into ethics arising from research on other focal issues.

A prize would encourage attention to the ethical perspective on psychotherapy not only within S.P.R. but would signal to a wider professional and lay audience that its relevance is taken seriously - thus also potentially good public relations for psychotherapy and psychotherapy research. A small committee of researchers and laymen with special knowledge or interest in ethics could jointly evaluate submissions for the prize. The aim is not to be implicitly critical of psychotherapy but to enrich understanding of both ethics and psychotherapy in this difficult interpersonal domain.

S.P.R. (U.K.) was felt to be the most suitable sponsoring body and that there would be mutual benefits in such a prize. SPR has funds which could be used, as mentioned at the A.G.M.

The members of the discussion group wish to propose a session on this topic at the next Ravenscar meeting and cordially invite the following:

(a) outlines of 10 or 20 minute contributions on
ethics in psychotherapy, or
psychotherapy research, or on
a prize,

to us and to Rex Haigh, the Conference Programme Coordinator before Friday 13 October, so that we could organise an agenda for the session.

(b) comments favouring the idea are welcome: especially also comments unfavourable to the idea that it would be helpful to consider before recommendations to the SPR Committee are made.

(c) advice based on experience of members in the administration of comparable prizes

(d) suggestions for fine tuning the criteria for such a prize, which might vary according to submissions received, in terms of "the substantive issues, novelty of insight, clarity of expression, value to particular audiences" etc.

Discussion group members. Gwen Adshead, Erica Brostoff, Chris Evans, Chris Mace, Hilde Rapp. All communications welcome to coordinator

Erica Brostoff,
Cavendish, New Road,
Bathford, Bath,
Avon, BA1 7TR
Tel: 01225 858495
Fax: 01225 859601
E-mail: erica_brostoff@iconex.mactel.org

Erica Brostoff [Page 5 in printed version][return to index]


Campaign Corner

Again no submissions and no cuttings for this section, are we all just to embroiled in local defence of our N.H.S. or other base that we have no energy left over for campaigning? If so I fear we're in real trouble as a community of psychotherapists and psychotherapy researchers. I believe psychotherapy was on the list of services that Berkshire Health Commission (I may have that title slightly wrong but a purchasing authority for Berkshire) put up for discussion as services that the N.H.S. could no longer afford to fund. There are many obvious counterattacks but I think we should be coordinating making them!

Chris Evans [Page 6 in printed version] [return to index]


I.T. Corner

Network on the Internet is now averaging two accesses a day (I don't know how many people read how much of what's there nor whether this is a few people coming back and back or different people each time). I'm about to mount this and the last issue and to push the Internet publicity much further. They can be reached by those with the necessary connection and software at:

http://sghms.ac.uk/intro.htm

That's our Psychotherapy Section "home page" and it's getting about 50 accesses a day and the rate is still rising steadily. Only about 18% are from the U.K. as far as it is possible to work out routes of access from site locations. If you have things that are psychotherapy or psychotherapy research related and you want them to be hung off those home pages then send them to me on diskette and I'll mount them within three weeks if they don't seem likely to land me in court!

Network in its paper incarnation is created using Microsoft Publisher 2.0a and the latter is proving capricious. Anyone got the money to buy me PageMaker 6.0 or anything guaranteed to work reliably? Bill Gates are you listening?!

Chris Evans [Page 6 in the printed version] [return to index]


Watercolour Exhibition

As noted in Network 6(2), Mary Burton is holding her first exhibition of paintings at St. Botolph's Church, Aldgate (adjacent to the Aldgate Tube Station). Mary has asked me to alert people that the times have changed slightly from those given in 6(2). The private view is on Sunday afternoon, the 29th of October from 14.00 to 18.00. Members of SPR are especially invited to attend at that time, although the exhibition will remain open until Thursday the 16th of November. It you are visiting London during that three-week period, you are warmly invited to call in. The church is open on weekdays, 10.00 to 15.30 on Sundays from 11.30 to 12.30.

Mary Burton, Ph.D.,
Chartered Clinical Psychologist
& Psychotherapist,
Flat 1, 40 Belsize Park, London NW3 4EE
Tel.: 0171-586 9708

[Page 6 in the printed version] [return to index]


Books for review

I am accumulating books sent by publishers for review. I'm also (when I can find time) passing on specific requests from readers to publishers. Publishers won't provide books published more than two years ago and British based publishers are generally easier than American but if you have requests, pass them on. For the remainder, listed below, my system hasn't changed. Send me a cheque for the cost of the book made out to:

S.G.H.M.S. MHGP RNFB account

That's my research account. When you do the review, I pay you back and you have the kudos of a publication! Write to the address shown in the editorial. Please, no matter how eminent you are, don't just write saying you'll do one of the books on the list without a cheque. When you've got a track record of delivering I may start sending books out without the cheque, until then, no go! All this is done in my free time so if you ask me to chase a book and don't hear from me, that's because I haven't been sent it by the publishers.

O.K. now who wants to do:

[HTML readers. I can only offer books for review to SPR(UK) members (though I might bend on that for books that have been around my office for say eighteen months!). If you are an SPR(UK) member then go ahead and contact me: C.Evans@sghms.ac.uk

Chris Evans [Pages 6 to 7 in the printed version][return to index]


Doing Counselling Research

McLeod, John (1994) Doing Counselling Research London:Sage. Pp. 196(?), ISBN 0-8039-7804-9, £10.95 pbk.

This book is a wonderfully comprehensive guide to thinking about and conducting research specifically into psychotherapy. It follows the whole research process, beginning with reading and reviewing the literature through deciding on a research question to writing the final project. It covers quantitative and qualitative approaches with constant attention to ethical and practical considerations, and the philosophical underpinnings of each approach. It is written with great clarity and encourages critical thought about what is being researched and why as well as how.

The first chapter addresses the importance and use of counselling research, giving common sense explanations of the point of research into counselling and psychotherapy. This chapter also contains a brilliantly down-to-earth discussion of what research is and incorporates a very understandable history of the seminal thoughts in the philosophy of science as they relate to considerations of research into counselling.

This clarity continues throughout the rest of the book. The style is very readable and discussions are easily comprehensible without being oversimplified. Each chapter contains boxes summarising the main elements of the discussion, and references to sources of more specific information follow each point. The daunting task of research is broken into digestible and less intimidating parts in a reassuring and methodical way.

It is very difficult to single out the parts of the book that I particularly enjoyed above others as I learned from all of it. However, the chapter devoted to the research process, which has practical suggestions of how to anticipate and ease the difficulties of research helped make light of some of my fears as well as confirming them! I was also very grateful for the chapters on qualitative research, which outline different ways to approach the collection of qualitative data and explain the underlying theories. These chapters address, amongst other techniques, qualitative questionnaires, participant observation, co-operative inquiry groups, as well as data analysis. Other chapters address process research and evaluations of outcome. A whole chapter discusses ethical considerations in counselling research with practical suggestions for approaching issues.

In fact "Doing Counselling Research" is written about research into psychotherapy in general rather than counselling in particular, and is intended for people at all professional levels who aim to conduct research or read research papers critically. As a new researcher hoping to evaluate therapeutic community treatments using qualitative methods for a post graduate degree, I found this book very readable, informative, and reassuring. It is even more valuable because it explains research into psychotherapy specifically, which fills in the gap between many research textbooks, which approach particular research strategies, and the subject that one wants to research. I would highly recommend it to anybody who was looking for an introductory textbook to researching psychological therapies and a source of references for further information on any element of research in this area.

Fiona Warren. Assistant Psychologist, Henderson Hospital, Surrey.

[Page 7 in the printed version][return to index]


Submissions for Psychotherapy Research

As a member of the SPR Email list, I've received a request for submissions for special sections of Psychotherapy Research. The deadline for the first has fallen between two issues of Network but the second, which feels very topical is still one you can make.

Date: Mon, 17 Jul 95 21:18:38+010
Reply-to: FAC0029@UOFT01.BITNET
Sender: spr-l@sip.medizin.uni-ulm.de
From: Robert Elliott <FAC0029@UOFT01.BITNET>
To: Multiple recipients of list <spr-l@sip.medizin.uni-ulm.de>
Subject: Call for Papers, Two Special Sections of Psychotherapy Research

Dear SPR Colleague:

Please consider writing something for one of the following:

Psychotherapy Research and the Demands of the Present Moment: A Call for Papers for Two Special Sections of Psychotherapy Research

Psychotherapy research is facing critical demands stemming from political, economic, scientific and practical developments. These developments have raised a number of key debates in the field. We believe that SPR members have the expertise to take part in these debates and that SPR's journal, Psychotherapy Research, can provide an important forum for these debates. For this reason, we are issuing a Call for Papers for two special sections to be published in Psychotherapy Research. We are seeking 10-20 page papers on two topics of importance to SPR members:

(1) The Empirically Validated Treatment Controversy. In the past two years, North America and Europe have seen an organized movement toward the official designation of specific psychotherapies as "empirically-validated" for insurance and training purposes. In the USA, this movement is centered around the APA Division 12 Guidelines for Empirically Validated Treatments, while in Germany, Meyer et al.'s "expert statement" endorsing specific treatments and Grawe et al.'s (1994) Psychotherapie im Wandel are both attracting considerable attention. For this special section, we are looking for papers supporting and criticizing this movement. Deadline: 1 Oct. 1995. [This was extended to Nov. 1st immediately after Network went to press -- see the advantages of reading it on the WWW!]

(2) Health Services Research: Opportunities and Pitfalls for Psychotherapy Researchers. Research on real-world utilization of psychotherapeutic services is another hot topic in Europe and North America. The managed care industry has discovered "Outcomes" research and some psychotherapy researchers are moving into the field of Health Services Research, including utilization patterns, large-scale outcome, medical cost offset and burden of illness, doseeffect, cost-effectiveness analyses, and related approaches. However, some have argued that traditional psychotherapy research methods are largely irrelevant for conducting useful research of this type. Thus, Health Services Research offers both opportunities and pitfalls for psychotherapy researchers. We are looking for papers which point to the opportunities or warn of the pitfalls, or both. Deadline: 1 Jan. 1996.

North American manuscripts should be submitted to Robert Elliott, Department of Psychology, University of Toledo, Toledo, OH 43606 USA.

European manuscripts to Bernhard Strauss: Klinik fuer Psychotherapie, Universitaet Kiel, Niemannsweg 147, D24105 Kiel, Germany.

All others to Hans Strupp: Department of Psychology, Wilson Hall, Vanderbilt University, Nashville, TN 37240.

Direct inquiries to Robert Elliott (fax: 419-537-8479; e-mail: fac0029@uoft01.utoledo.edu).


If you live in Britain and you're interested in joining SPR(UK)

Please pick up the 'phone now and ring:

01734 561250

or write to:

S.P.R. (U.K.) membership dept!
53-55 Argyle Road,
Reading RG1 7YL
Fax.: 01734 561251

Sue Clarke or Sue Robinson will give you the details and send you an application form. Then write to me and tell me what you think of Network, or better still, write an article, a book review or a response to anything in this edition and send that to me [contact details]. [Page 14 in printed version] [return to index]