I’ve been a bookstore’s greatest friend this last month. Perhaps it was due to the Black Friday feeling, or it could be that my bookshelf was looking a little bare, but all I can say now is that I am the proud owner of five shiny new books on improving psychotherapeutic delivery (listed below). Each one is demonstrating the important work being undertaken in this field. If you are a service or therapist looking to improve your practice, then there will definitely be something in these books for you. This last month I started reading The Great Psychotherapy Debate by Bruce Wampold and Zac Imel, a 2nd edition update on an already comprehensive overview of research relating to the concepts of therapeutic alliance, therapist effects, client expectations, social context, and mutual empathy. It already sounds fascinating and I look forward to sharing my thoughts with you.

As I begin to delve into these books, one thing that continues to stand out is – and this is true of other emerging work in this area – that although the effectiveness of talking therapies is now generally well-established, many still agree that there is room for improvement. Problems from publication bias to therapy’s unknown long-term effects, as well as poorer outcomes in real-world practice settings, these all serve to highlight the limitations of the field. And yet, further still, if we were to focus earlier in the process and consider the patterns around engagement and process, then there is even more work to be done on top of this. I’m talking of course about premature termination – aka ‘dropout’.

I say of course because if you have been following these blog posts closely you will know that this quarter is all about exploring and reducing unplanned endings. This is an important area of learning as clients who drop out prematurely will attend fewer sessions overall and experience poorer outcomes. What’s more, these clients are less likely to be represented in outcomes research. It could be proposed that if this group is not represented then how can the field be expected to improve as any techniques that are developed will not apply to them.

In exploring techniques for reducing dropout, there are various practical resources available. The best book I have come across so far is Premature Termination in Psychotherapy by Joshua Swift and Roger Greenberg. I can confidently recommend this book it as a great resource, accessibly written and full of useful strategies for engaging and improving client outcomes. At SILC we are particularly interested in hearing about how services implement their own strategies to reduce dropout. If you can think of any other resources, feel free to share them in the comment section below.


-Scott Steen, SILC Research Lead

 Current Reading List

  1. The Great Psychotherapy Debate (Counselling and Psychotherapy), by Bruce Wampold & Zac Imel
  2. Incorporating Progress Monitoring and Outcome Assessment into Counselling and Psychotherapy: A Primer, by Scott Meier
  3. Deliberate Practice for Psychotherapists, by Tony Rousmaniere
  4. The Cycle of Excellence: Using Deliberate Practice to Improve Supervision and Training, edited by Tony Rousmaniere, Rodney Goodyear, Scott Miller and Bruce Wampold
  5. How and Why Are Some Therapists Better Than Others?: Understanding Therapist Effects, edited by Louis Castonguay and Clara Hill

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