Week 1 DQ:

#2:

The Practice of EBPP

In order to complete this discussion, you will need to watch Miller's Client-Directed Interaction:
Adjusting the Therapy, Not the Person.

The video you watched demonstrates an evidence-based psychotherapy intervention technique that
focuses on the interaction between client and therapist. In your discussion essay:

 What did you notice about how the therapist attended to the client? What kinds of client
behavior or statements did the therapist respond to?

 What did you notice about how the client responded to the therapist? What did you notice that
indicated that the client was feeling understood and was developing trust in the therapist?

In the video, “Brief Therapy Inside Out, 5, Client-Directed Interaction: Adjusting the Therapy, Not the
Person” (Carlson, Kjos, & Miller, 2011), the therapist acknowledges the client’s feelings and thoughts in
a supportive way. He also tends to paraphrase quite often in order to substantiate what the client is
saying and ensure they are both on the same page. Each time the client talks about his feelings or
thoughts, the therapist acknowledges this by mirroring the tone of the phrase back with different; but
like, statements. For example, in reference to the client’s mother telling him that he can’t do what he
had been doing when he was younger, the client states, “it’s finally starting to sink in.” The therapist
responds with, “So with age, comes some maturity.” The client agrees with the statement, which
increases the rapport between the two, and facilitates the positive flow of conversation between the
two. It was also nice to see how the therapist doubled back to ask questions about specific topics that
the client brings up to gauge their relevancy.

The non-verbal attending skills included head-nodding when the client spoke. This allows the client to
see that they are on the same page and the therapist is in congruence with what is being said. His hand
gestures also are vibrant and are used in conjunction with affirmations into how the client feels. The
therapist also utilizes the verbal mutterings of “mmhmm” for validation purposes. He will also pause the
discussion at times to paraphrase with the client and draw the client into the interaction by asking, “am I
getting this right?” The therapist also touches upon the strengths and weaknesses of the client;
addressing that he is a “people-person, out-going, but likes to build relationships slowly.” This can only
be established if the therapist genuinely listening and is empathetic with the client. He also helped the
client to draw up a greater distinction between how he has improved in communication style from shy
adolescence. This links back to his earlier discussion about helping the client create a better story about
themselves.

The client responded very favorably to the therapist. He appears happy to have someone that is
genuinely listening to his issues and acknowledging his thoughts and feelings. The warmth of exchange
allows him to feel comfortable in the session to open-up about his feelings toward himself, his girlfriend,
family, deaths in the family, and Jerry. It is also interesting to note that the session itself is not entirely
client-directed, as the therapist seems to gently guide the client into specific directions of topics by
simply asking the right question. For example, one specific question posed was, “you not only take time
to take a break and say I got to get away, but there’s always times where you discuss it? How do you
make the decision between the two?” Laughter also strengthens the communication between the two
and facilitates the flow of conversation.

After the break, he validates the client’s thoughts and feelings, continues to paraphrase after thanking
him for sharing. Positive reinforcing the rapport further by addressing the favorable facets of
conversation and exchange; promoting conviviality between them both. He continues to highlight the
strengths and weaknesses in what had been shared before offering a suggestion for change. What’s
interesting is that after this stage within the session, the client seems to feel so comfortable and trusting
of the therapist, he discloses further information pertaining to his experience with depression and lack
of foresight to his feelings. The therapist continues to offer suggestions to self-monitor and take notice
of when the depression occurs. This would be crucial to help understand the underlying causes for the
depression episodes that can also be brought up in future sessions with the client. He continues to
ensure that they are in congruence with one another when he asks, “does that make sense?”

Carlson, J., Kjos, D., & Miller, S. (2011). Brief Therapy Inside Out, 5, Client-Directed Interaction: Adjusting
the Therapy, Not the Person [Video file]. Retrieved from Alexander Street a ProQuest Company website:
https://search-alexanderstreet-
com.library.capella.edu/view/work/bibliographic_entity%7Cvideo_work%7C1779307

#3:

APA Policy on Evidence-Based Practice in Psychology

The APA policy on evidence-based practice (EBPP) addresses psychology's fundamental commitment to
the partnership of science and practice in establishing efficacious and effective psychological practices.
Yet the implementation of EBPP by professional psychologists has been marked by difficulties
integrating research and practice.

In your discussion essay:

Define evidence-based practice in psychology.

Identify and briefly describe the three major components of evidence-based practice.

Integrate EBPP into your practice: Summarize steps in the process of implementing evidence-based
practice as identified by Frueh et al. in the assigned reading from your Handbook of Evidence-Based
Practice in Clinical Psychology text. Of these steps, which seem most challenging to you? What can you
do to gain knowledge and skills to improve your proficiency in these areas?

Evidence-based practice pertains to the attempt in making the best decision with the best evidence
(Sturmey & Hersen, 2012). Individuals utilized evidence-based practice in every facet of life; for example,
when shopping for a car or deciding what to make for dinner with the ingredients left in the refrigerator.
However, in the case of psychology, making the best decision with the best evidence refers to the
client/patient.

The three fundamental components of evidence-based practice include best available research
evidence, clinical expertise, and patient values and expectations. Best available research evidence refers
to the various clinical trials and studies conducted utilizing control and treatment groups,
randomization, and reliable psychometric assessment tools to obtain information that is both valid and
reliable. While not all effective treatment options and interventions are valid and reliable, the
effectiveness depends upon the efficaciousness of client attitudes and positive prognosis. The second
component is the clinical expertise; which is the ability of the professional to successfully integrate
“knowledge, experience, critical thinking, prediction, decision making, self-assessment, and technical
and relational skills” (p. 4) with the specific mental condition. For example, therapists who specialize,
have experience, and training in treating clients with panic disorders may produce greater and superior
results than a therapist who does not. The last component is dependent upon the client’s perspective,
culture, value, and personal preference. Clients who feel that they can connect with a specific therapist
often have greater prognosis than those who do not. This also means that the therapist must be open
and cognizant to client characteristics, culture, and core values. For example, taking extra personal time
to learn about the culture of a Native American client may be a requirement for success in evidence-
based practice (Yates, 2012).

Knowledge of the first two components are offered and practiced through the educational curriculum,
however, the third component appears to be the most extensive, as it may require the clinician to take
personal time to learn and study about the culture and values of the client in order to bring a
substantive level of multicultural awareness into the session; thus it is the most challenging. However,
obtaining proficiency in this specific area is invaluable and may instill a type of specialized knowledge for
the clinician. For example, a therapist working with a Native American client lacks prior knowledge
about the culture, value system, and gender roles. While taking the time out of sessions to procure
information about these components, the clinician seeks consultation from Native American leaders,
obtains resources, and researches to enrich their understanding of the culture. This knowledge will help
the current client but will also help the clinician to work and become specialize in working with others of
Native American decent.

Sturmey, P., & Hersen, M. (2012). Handbook of Evidence-Based Practice in Clinical Psychology (Volume
2). Hoboken, N.J.: John Wiley & Sons, Inc.

Yates, C. (2012). Evidence-Based Practice: The Components, History, and Process. Counseling Outcome
Research and Evaluation, p. 1-14.