CEU Course Details


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No Change? A Grounded Theory Analysis of Depressed Patients Perspectives on Non-improvement in Psychotherapy

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Course Description:

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 Psychology10, 588.

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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.
  • The National Board for Certified Counselors (NBCC) Ce-Classes.com has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6320. Programs that do not qualify for NBCC credit are clearly identified. Ce-Classes.com is solely responsible for all aspects of the programs.
  • Florida Certification Board

  • The Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling Provider #852 BAP-Expires 3/31/2023
  • The California Board of Behavioral Sciences. The California Board of Behavioral Sciences, BBS, recognizes relevant course work/training that has been approved by nationally recognized certifying bodies, such as APA, to satisfy renewal requirements.
  • California Consortium of Addiction Programs and Professionals (CCAPP) Provider Number OS-12-147-0223 Expires 2-2023
  • The Texas Board of Social Work Examiners – CE-Classes.com meets the requirements for acceptable continuing education
  • The Texas Board of Professional Counselors – CE-Classes.com meets the requirements for acceptable continuing education
  • Massachusetts Authorization Number: 2288
  • Ohio Counselor, Social Worker and Marriage and Family Therapist Board – Provider # RCST031201 Expires 5/31/2021
  • New York Social Work Board – Ce-Classes.com is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0120.

  • The Florida Board of Nursing (CE Provider #: 50-4896) Expires 10/31/2022 Do not send certificates to the Florida Board of Nursing. You must keep this certificate for 4 years.
  • The California Board of Registered Nursing. CEP 15647 Expires 11/30/2022.

This course is Non Interactive .

If you would like to take this course for your CE program, it is recommended that you:

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  9. Complete the course evaluation, (all items must be completed)
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