How can we help our clients more effectively?

How can we help our clients more effectively?

07 November 2013
2.30 pm - 5.30 pm

Dr James Hawkins

£5 booking fee

Counselling & psychotherapy are successful with typically moderate to large effect sizes of 0.4 to 0.8 and reductions in subsequent relapse rates that strongly outperform medication (Lambert, 2013).  Very disappointingly though, after decades of research, the evidence suggests that we are little better at helping our clients than we were as a profession forty years ago (Ost, 2008) or than we were as individuals near the start of our careers (Okiishi et al, 2006).  Happily there are increasingly well documented ways of changing this picture.  One obvious but currently underused approach is to monitor client outcomes session by session and compare their progress with predicted improvement trajectories from thousands of similar cases (Whipple et al, 2011).  Another is a more careful sessional assessment of the therapeutic alliance.  Both these “practice based evidence” strategies allow us to adjust our “evidence based practice” interventions in real time to better fit the specific client that we are currently working with.  A series of research studies have shown that this highly responsive approach significantly improves outcomes (Castonguay et al, 2013).  Further overlapping insights are emerging from a broader understanding of how people attain excellence in other fields ranging from sport, music & chess to management, nursing & medicine (Ericsson, 2009).  Here, particular emphasis is placed on clarifying one’s present level of success, identifying obstacles to better outcomes, and focusing on repeated “deliberate practice” at the growing edge of one’s current abilities.  This more personalised development of psychotherapy gives each of us a very real opportunity to become better therapists who are more effective at helping our clients.

Dr James Hawkins is an Edinburgh-based psychotherapist.  He is a medical doctor who has also trained in CBT and emotion-focused therapy.  He writes a blog – – and produces a digest of emerging research on stress, health & wellbeing that goes out monthly to several thousand therapists around the world.  He has taught cognitive therapy nationally & internationally, served on the Scottish anxiety disorder guideline development committee, trained psychotherapists in group work, practised mindfulness for over forty years, and chaired the clinical advisory group for Scotland’s main depression charity.

PF Counselling Service