No Change? A Grounded Theory Analysis of Depressed Patients Perspectives on Non-improvement in Psychotherapy
This course is based upon material published in the Frontiers in Psychology and is available as an open-access article.
Understanding the effects of psychotherapy is a crucial concern for both research and clinical practice, especially when the outcome tends to be negative. Yet, while the outcome is predominantly evaluated by means of quantitative pre-post outcome questionnaires, it remains unclear what this actually means for patients in their daily lives. To explore this meaning, it is imperative to combine treatment evaluation with quantitative and qualitative outcome measures. This study investigates the phenomenon of non-improvement in psychotherapy, by complementing quantitative pre-post outcome scores that indicate no reliable change in depression symptoms with a qualitative inquiry of patients’ perspectives. The study took place in the context of a Randomized Controlled Trial evaluating time-limited psychodynamic and cognitive behavioral therapy for major depression. A mixed-methods study was conducted including patients’ pre-post outcome scores on the BDI-II-NL and post-treatment Client Change Interviews. Nineteen patients whose data showed no reliable change in depression symptoms were selected. A grounded theory analysis was conducted on the transcripts of patients’ interviews. From the patients’ perspective, non-improvement can be understood as being stuck between knowing versus doing, resulting in a stalemate. Positive changes (mental stability, personal strength, and insight) were stimulated by therapy offering moments of self-reflection and guidance, the benevolent therapist approach, and the context as important motivations. Remaining issues (ambition to change but the inability to do so) were attributed to the therapy hitting its limits, patients’ resistance, and impossibility and the context as a source of distress. “No change” in outcome scores therefore seems to involve a “partial change” when considering the patients’ perspectives. The study shows the value of integrating qualitative first-person analyses into standard quantitative outcome evaluation and particularly for understanding the phenomenon of non-improvement. It argues for more multi-method and multi-perspective research to gain a better understanding of (negative) outcome and treatment effects. Implications for both research and practice are discussed.
This course on the grounded theory analysis of non-improving depressed patients is designed for social workers, professional counselors, psychologists, nurses, and substance abuse counselors, who do clinical work. This course is appropriate for intermediate and advanced level practitioners who wish to develop enhance their knowledge of grounded theory and patients with serious depression. The course material is based upon a research study, limitations of the study are included. It may also be useful for licensed clinicians who require clinical continuing education courses for license renewal.
The course is based on a journal article that includes research. It contains statistical analysis and data that some clinicians enjoy reading and others do not. A major benefit of reading research-based articles for continuing education is they provide practitioners with the latest findings in their field.
Authors: De Smet, Meganck, Van Nieuwenhove, Truijens, Desmet
Learning Objectives: This course will provide the practitioner with detailed information regarding the non-improving depressed patients and some of the reasons they are non-improving. Specifically, a professional will:
- Identify why analyzing a patients failure to improve is necessary
- Describe from a patients perspective why there is often a failure to improve their depressed state
- Recognize the unique contributions of both qualitative and quantitative data for analysis of patient outcomes
Citation: De Smet, M. M., Meganck, R., Van Nieuwenhove, K., Desmet, M., & Truijens, F. L. (2019). No Change? A Grounded Theory Analysis of Depressed Patients’ Perspectives on Non-improvement in Psychotherapy. Frontiers in Psychology, 10, 588.
This Ce-Classes.com course is approved for CE credit by:
- The American Psychological Association (APA) Ce-Classes.com is approved by the American Psychological Association to sponsor continuing education for psychologists. Ce-Classes.com maintains responsibility for this program and its content.
- Association of Social Work Boards (ASWB) Ce-Classes.com, Provider #1142, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Ce-Classes.com maintains responsibility for this course. ASWB Approval Period: 1/5/2020-1/5/2023 Social workers participating in this course will receive 2 Clinical continuing education clock hours.
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This course is Non Interactive .