When meta-analysis continues to mislead: A reply to Østergård and Hougaard (2020).

Reply to comments on an article by Duncan and Sparks (see record 2018-10637-001). Østergård and Hougaard (2020) reiterate the flawed conclusions of their meta-analysis of the Partners for Change Outcome Management System (PCOMS) and obfuscate the main point of our critique (Duncan & Sparks, 2020). Despite the lauded statistics and selection criteria, the inclusion of six significantly confounded investigations resulted in a misleading overattribution of meaning to studies of questionable methodology that warranted exclusion.

When meta-analysis misleads: A critical case study of a meta-analysis of client feedback.

Consumers of psychotherapy outcome literature consider meta-analysis the gold standard for assessing the efficacy of interventions across disparate studies. Many assume that findings are valid, especially when published in journals with research credentials. Uncritical acceptance, however, can result in real-world consequences, including whether interventions attain evidence-based status or become marginalized or are considered for implementation in public service arenas.

The Partners for Change Outcome Management System: A Both/And System for Collaborative Practice.

Systematic client feedback (SCF) is increasingly employed in mental health services worldwide. While research supports its efficacy over treatment as usual, clinicians, especially those who highly value relational practices, may be concerned that routine data collection detracts from clinical process. This article describes one SCF system, the Partners for Change Outcome Management System (PCOMS), along a normative (standardized measurement) to communicative (conversational) continuum, highlighting PCOMS' origins in everyday clinical practice.

“Mental Health” Power and Its Effects: A Commentary on Battling Against Inter-Faith Relations in Israel.

Hakak (2016) provides an opportunity to examine how mental health and therapy systems in the United States operate to maintain current social and political structures. This commentary suggests that practitioners, including family therapists, participate in and support practices that do not serve the interests of marginalized social groups, despite our best intentions. Discourse theory offers a lens through which such practices become visible and thus open to revision.

The Norway Couple Project: Lessons Learned.

Couple therapists in routine practice may find it difficult to apply findings from an increasingly expanding and complex body of couple therapy research. Meanwhile, concerns have been raised that competency in evidence-based treatments is insufficient to inform many practice decisions or ensure positive treatment outcomes (American Psychological Association Presidential Task Force on Evidence-Based Practice, American Psychologist, 2006, 271). This article aims to narrow the research/practice gap in couple therapy.

Accounting for therapist variability in couple therapy outcomes: what really matters?

This study examined whether therapist gender, professional discipline, experience conducting couple therapy, and average second-session alliance score would account for the variance in outcomes attributed to the therapist. The authors investigated therapist variability in couple therapy with 158 couples randomly assigned to and treated by 18 therapists in a naturalistic setting. Consistent with previous studies in individual therapy, in this study therapists accounted for 8.

School-based counseling using systematic feedback: a cohort study evaluating outcomes and predictors of change.

The outcomes of school-based counseling incorporating the Partners for Change Outcome Monitoring System (PCOMS) were evaluated using a cohort design, with multilevel modeling to identify predictors of change. Participants were 288 7-11 year olds experiencing social, emotional or behavioral difficulties. The intervention was associated with significant reductions in psychological distress, with a pre-post effect size (d) of 1.

Initial relationship goal and couple therapy outcomes at post and six-month follow-up.

The purpose of this study was to investigate the relationship between client initial goal for couple therapy (i.e., improve the relationship or clarify the viability of the relationship) and the outcomes (including their relationship status, i.

Teaching accountability: using client feedback to train effective family therapists.

The AAMFT Task Force on Core Competencies (Nelson et al., 2007) proposed that marriage and family therapy (MFT) educators teach and provide evidence of trainee competence beyond coursework and accrued clinical hours. This article describes the integration of a systematic client feedback protocol into an MFT-accredited program's curricula to address the call for outcome-based learning.

The alliance in couple therapy: Partner influence, early change, and alliance patterns in a naturalistic sample.

Objective: The purpose of this study was to explore the relationship between the alliance and outcome in couple therapy and examine whether the alliance predicted outcomes over and above early change. The authors also investigated partner influence and gender and sought to identify couple alliance patterns that predicted couple outcomes.

Method: The authors examined the alliances and outcomes at posttreatment and follow-up of 250 couples seeking treatment for marital distress in a naturalistic setting.

Using client feedback to improve couple therapy outcomes: a randomized clinical trial in a naturalistic setting.

Despite the overall efficacy of psychotherapy, dropouts are substantial, many clients do not benefit, therapists vary in effectiveness, and there may be a crisis of confidence among consumers. A research paradigm called patient-focused research--a method of enhancing outcome via continuous progress feedback--holds promise to address these problems. Although feedback has been demonstrated to improve individual psychotherapy outcomes, no studies have examined couple therapy.

The ethics and science of medicating children.

Prescriptions for psychiatric drugs to children and adolescents have skyrocketed in the past 10 years. This article presents evidence that the superior effectiveness of stimulants and antidepressants is largely a presumption based on an empirical house of cards, driven by an industry that has no conscience about the implications of its ever growing, and disturbingly younger, list of consumers. Recognizing that most mental health professionals do not have the time, and sometimes feel ill-equipped to explore the controversy regarding pharmacological treatment of children, this article discusses the four fatal flaws of drug studies to enable critical examination of research addressing the drugging of children.

Taking a stand: an adolescent girl's resistance to medication.

Therapists and clients encounter pressure to seek medication for adolescent depression and dangerous behaviors. A review of current research indicates that medical practitioners prescribe antidepressants for adolescents despite questionable efficacy, side effects, and frequent refusal. Adolescent girls' expressions of distress expose them to systems that promote medication prescription.