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Bridging the Gap

A paper by UKCP psychotherapists published in the British Journal of Psychotherapy

The paper reports on a pilot project, set up under the auspices of the UKCP’s Practice Research Network, and led by UKCP psychotherapists. This project had two main objectives: the first was to explore whether the concept of ‘moment of meeting’, developed by the American psychiatrist, psychoanalyst and developmental psychologist Daniel Stern, can help us better understand the psychotherapeutic process and explain outcome; the second was to involve psychotherapists themselves, as participant-researchers, working with their own clients. It might be argued that this latter was the more important objective, since a divide all too often exists between clinical practice and research, with practising psychotherapists wary of research, and researchers failing to involve therapists in a meaningful way. It is this gap that the project hoped to start to bridge.

The first objective addressed the hypothesis that therapies with moments of meeting have better outcomes than those without. Stern believed that psychoanalysts’ reliance on interpretation to bring about change was not enough, and that something more was needed. He suggested that role might be taken by moments of meeting. These involved ‘authentic person-to-person connection with the therapist which altered the relationship with the patient and thereby the patient’s sense of himself’. In order to operationalise this concept, a semi-structured post-therapy face-to-face interview was specially developed for the project. In addition, both participating therapists and their clients were asked over a course of 40 sessions to complete three established research measures (Clinical Outcomes in Routine Evaluation [CORE], Agnew Relationship Measure [ARM] and the Helpful Aspects of Therapy questionnaire [HAT]). Eight therapists, all in private practice, participated throughout the project, together with a total of 23 clients. One set of results, although not conclusive, appeared promising: this very limited sample suggested that those clients who started with a high level of distress (according to CORE scores) and made significant improvement were more likely to report a moment of meeting (using the project group’s extended definition) than clients who showed little improvement. Clearly this is worth further investigation.

The second objective was to involve practising psychotherapists as researchers. Not surprisingly, they initially expressed anxieties about confidentiality, ethics, and the potential negative impact on the therapy, as well as finding the process of involving clients in research quite alien to their practice. The psychotherapists were also concerned about their inadequacies as researchers. Much to the group’s surprise, one fear was unfounded: clients who took part became willing active participants in the research process. In particular, they appeared to find that the reflection involved in the post-therapy interview enhanced their connection with the therapeutic work, and they felt valued as research participants. The main benefit for participating therapists was the stimulation of being part of a group from different modalities and professional affiliations. Although in some ways similar to peer supervision, the focus on specific research tasks gave the group a particular cohesion. Very importantly, psychotherapists who had never previously undertaken psychotherapy research gained confidence and found the process enjoyable and professionally nourishing.

Based on the learning from the project, the final section of the paper includes some ideas for further research activities. If readers would like more detailed information, please contact either Tirril Harris (tirril.harris@kcl.ac.uk) or Brian Cheetham (brian.cheetham@gmail.com).

The paper is the fruition of a number of years’ work. It makes a contribution, albeit small, to two of the UKCP’s strategic objectives for research: practice-informed research, and innovative research investigating the therapeutic process. As a pilot project it shows just a little of what can be achieved, as well as demonstrating how much more there is to be done.

 

Harris, T., Lepper, G., Cheetham, B., Crowther, C., King, D., & Ryde, J. (2020) Bridging the gap between clinical practice and research: findings of a pilot study on Daniel Stern’s ‘moments of meeting’ from the UKCP’s Practitioner Research Network. British Journal of Psychotherapy 36, 2: 180–199. doi: 10.1111/bjp.12541 [596 words]