The UKCP Conference on ‘Effectiveness in Psychotherapy’
“I shall never forget those images of an emotionally frozen baby and his mother starting to smile and come alive again...”
The conference included national and international speakers and provided an opportunity for participants to take part in debates about psychotherapy research and to share work being carried out by UKCP members and students. The keynote speakers were:
Professor John Norcross - Professor of Psychology and Distinguished University Fellow at the University of Scranton
Psychotherapy relationships that work: evidence-based responsiveness .
Dr Roxane Agnew-Davis - Clinical Psychologist and Director of Domestic Violence Training Ltd.
Walking gently through the minefield: managing vicarious trauma
Amanda Jones - Consultant Perinatal Psychotherapist, Head of Perinatal/Parent-Infant Mental Health Service - North East London NHS Foundation Trust
An exploration of the process of change in psychoanalytic parent-infant psychotherapy.
Professor Norcross was impressive with his command of statistics and his analysis of how psychotherapy actually works and how effectiveness can be measured experimentally. Although by the end of his presentation I sensed that some members of the audience were finding it difficult to keep up with his quantitative approach to the subject (myself included), some of his findings did come through loud and clear.
These were the consistent research findings showing once again that the relationship between therapist and client is highly significant. But also, and more interesting for me, were his findings on the importance of carrying out really thorough assessments of the client’s history, issues and personality For example, some clients work better in a highly directive and goal oriented approach and others respond better to an approach that is more exploratory and open ended. Clients that have suffered histories of abuse and neglect require much more emphasis on the creation of clear boundaries of working and safe practice than those clients who have had a fairly supportive and positive life experience preceding a major trauma. Norcross made the point that it is vital to shape the therapy to fit the client’s personality and coping style.
Norcross also emphasised that ‘Research evidence’ includes reports from clinical sessions, case studies and experiential reports as well as more quantitative approaches like randomised controlled trials, but that bodies such as NICE ( The National Institute for Clinical Excellence) tends to focus only on the quantitative research methods, thus missing important research evidence that can alter the whole research picture.
For my money the highlight of the day was the presentation by Amanda Jones on parent-infant psychotherapy. Amanda Jones is a highly respected psychoanalytic psychotherapist and she showed her film of therapy with a teenage single mum and her baby. The film proved once again how a picture is worth a thousand words.
At the beginning of the therapy the severely depressed young woman spoke in a monotone and seemed to be trying to ‘do the right thing’ by her baby but it felt robotic and she was not able to notice how her baby kept trying to avoid her eyes, was unnaturally quiet and still and even tried to arch his body away from her.
Throughout the presentation, Amanda Jones showed how, by holding her patient in mind and reflecting back to her imaginatively what it must feel like to be a young mother in her situation, she was able to model warmth and sensitivity and kindness to her young patient. The woman had experienced domestic violence and years of neglect and was unable to connect with her own body and needs let alone those of her baby. Through the films of sessions and over a period of about 18 months, one witnessed the change in the woman’s bodily posture, facial expressions and relationship with her baby who , in the last film was laughing and gurgling, reaching out to his mother and snuggling up to her lovingly. Apparently this young mum left her violent partner, and entered a loving relationship with someone who was much safer and kinder towards her and her child. Many years later they are still together and have other children who are apparently thriving. By experiencing ‘being held in mind’ in psychotherapy, this woman was able to think about herself and then her baby.
Apart from leaving her audience emotionally wrung out by these films, with not a dry eye in the house, Amanda Jones also described how she had used this very film to show how psychotherapy can change lives in a presentation to GP Commissioners of services. They had apparently been threatening to cut funding for the mother and baby psychotherapy unit and this film was the only evidence that convinced them not to.
There were many opportunities in the day to enjoy other presentations which were all interesting and covered many different areas (see the list below). My own presentation was the last one in the day by which I had managed to feel completely overawed, inadequate and just wanted to ‘get my coat’ and make a run for the nearest exit....I was not allowed to though and sure enough found myself standing in front of the conference audience holding the mike and trying to work my power point presentation. My challenge had been to distil my 30.000 word dissertation into a 20 minute presentation...
Well, I survived, it was not great but I think I got my point across which was that psychotherapy is being changed by the socioeconomic forces that require funders to offer shorter and shorter periods of treatment, even in some areas, 30 minute sessions and that in such circumstances, the nature of psychotherapy itself can become changed from what it should be, a place of exploration and healing to one of expedience. I made some recommendations for how UKCP could lobby to maintain good standards and these points were noted.
As I negotiated the London Underground on my way back home I felt relieved that I had survived the experience of presenting. I felt I had learnt alot and would be willing to have another go, but mainly felt very proud to work in a field that does such important and needed work. I shall never forget those images of an emotionally frozen baby and his mother starting to smile and come alive again.
Please see below the list of presenters at the Conference.
Presentation of papers
Can psychotherapy penetrate beyond skin colour? - MJ Maher
Equivalence of working alliance and an understanding of the patient's experience of the therapeutic presence - Henry Adeane
The therapeutic effect of alignment: a transpersonal view - Emma Therese Lewis
Plato's Sun and Plato's Cave: Philosophically based research into relational process - Heward Wilkinson
Attachment to the clinical team and its association with therapeutic relationships, social networks and clinical wellbeing - Jocelyn Catty et al
Freedom and oppression in therapeutic space: how do trauma therapists protect the therapeutic milieu? A heuristic study. - Jessica Woolliscroft
Psycho-quackery: discredited mental health treatments and tests - John Norcross
Research ethics: exploring some knots and entanglements - Liz McDonnell and Angela Cotter
Domestic violence - Dr Roxane Agnew-Davies
Collaborating across organisations on research programmes: what are the possibilities? Open discussion. - Liz McDonnell and Sheila Butler