An Exceptional, Efficient, and Resilient Therapist: A Case Study in Practice-Based Evidence
Keywords:practice-based research, therapist effects, sudden gains and losses, resilience, alliance, case studies, clinical case studies
AbstractHansen, Lambert, and Vlass (2015) offer a timely and insightful research study into the delivery of exceptional psychotherapy practice by a private practitioner name Eri. At the conceptual level, we raise points about terminology ("supershrink") and the operationalization of sudden loss, while in terms of research we draw links with models of very brief interventions and set the account within the paradigm of practice-based research. We argue that the report is an exemplar of practice-based research at the level of the individual practitioner. In relation to clinical practice, we comment on how Eri demonstrates resilience in her routine practice by maintaining a high degree of personal competence, not only towards herself (e.g., in her deliberate use of patient outcome measures) but also in the application of her clinical skills and the development of a working alliance bond with clients, evidenced particularly with patients achieving sudden gains. Consideration is given to the salient client factors that may or may not facilitate change and additional comment is made on how service-level designs could impact on the delivery of sufficient treatment depending on clients' needs.
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