3) What is the relationship between the empirically-based methods for assessment and the traditional practice of assessment? Each of the studies in this special issue explored psychotherapy practice in usual care using measures of clinical skill, such as session-by-session ratings of treatment fidelity. Assessment of practice in usual care has been the subject of systematic reviews since the 1960s (Fonagy et al. 2010). In some cases, these have focused on how to measure aspects of usual care practice, such as treatment contacts (Hackett et al. 2010), working alliance (Boros et al. 2008), patient-centered care (Haynes et al. 2006), and the fidelity of brief interventions (Barnett et al. 2002). This special issue also contains studies that suggest that measures of clinical skill are associated with psychotherapy outcomes. There is some evidence to suggest that the association may be stronger for therapist-reported than for patient-reported measures of clinical skill (Witte et al. 2009), and this may be because the measurement of patient-perceived treatment-related changes is influenced by the clinicians perception of the patients progress (Witte et al. 2009). The fact that evidence on clinical skill is often mixed is not surprising given that most psychotherapy outcome studies have used measures of patient-perceived change, which is a complex construct influenced by clinician-perceived changes in the quality of care (Armour et al. 2009).
In this activity students use a familys pedigrees to make a claim based on evidence about mode of inheritance of a lactose intolerance trait, determine the most likely inheritance pattern of a trait, and analyze variations in DNA to make a claim about which variants are associated with specific traits. This activity serves as a supplement to the film Got Lactose? The Co-evolution of Genes and Culture ( -fittest-got-lactase-co-evolution-genes-and-culture). The film shows a scientist as he tracks down the genetic changes associated with the ability to digest lactose as adults. A detailed teachers guide that includes curriculum connections, teaching tips, time requirements, answer key and a student guide can be downloaded at -and-inheritance-lactose-intolerance. Six supporting resource and two click and learn activities are also found on the link.
We hope that the papers in this special issue of Acta Paediatrica stimulate further research in psychotherapy research and encourage researchers to seek answers to the questions raised by these papers. We also hope that the papers will stimulate the discussion of questions raised by the research and lead to the development of a research agenda to guide future studies of psychotherapy practice and outcomes in the field. We offer these ideas here as a call to action. We encourage questions and feedback that will help us to address the challenges of assessment of psychotherapy. Please contact us at M.H.Garland@monash.edu .
3) What specific aspects of psychotherapy processes and outcomes are most likely to predict treatment outcomes? In this issue, we find that individuals who demonstrate better process components of the intervention are more likely to benefit from the treatment (Kiesler et al. 2009; Kuyken et al. 2009). This finding is consistent with studies in other areas of health care that show that the quality of process as measured by observational tools is a better predictor of patient outcomes than the quantity of visits to the provider (Brown et al. 2002; Peterson et al. 2002). In the mental health field, the use of observational methods to assess psychological treatment is still in its infancy. As more evidence is gathered, it seems likely that the qualities of the therapeutic work and the therapeutic relationship will emerge as important predictors of treatment outcome. 827ec27edc