Client Directed Outcome Informed Therapy (CDOI) Analysis

Client Directed Outcome Informed Therapy (CDOI) Analysis Taryn Slaughter Throughout the years, therapies have transitioned through different theories of change, model development and extensive research. For decades evidence based models of therapy were argued to be the best treatment for clients. Whilst therapy programs continued and expanded the rates of success did not. Slowly the perception of traditional models and treatments began to change and therapists began looking for alternatives to best suit the needs of their clients. Gradually the roles of therapist and client have changed and the client now has more involved in their treatment process. The client is no longer just a recipient of treatment; they are a partner in the planning, implementing and the outcomes. This essay will describe client directed outcome informed therapy and how it benefits clients with consistent positive treatment outcomes. The concept of Client Directed Outcome Informed therapy (CDOI) was developed through collaboration between Scott Miller and Barry Duncan (Duncan, Miller Sparks, 2004). After reviewing years of outcomes research, CDOI therapy was created in an attempt to meet the needs of individuals who had not responded to traditional models of therapy (Duncan, Miller Sparks, 2004; Duncan Moynihan, 1994). Through further studies and collaborations other forms of outcome and client directed models emerged. These other forms of therapy have been called Feedback Informed Therapy (FIT) and Partners for Change Outcome Management System (PCOMS) (Miller, Duncan, Sorrell Brown, 2004). All three forms of therapy focus on the same principle of providing treatment for clients that is best suited to their individual needs. CDOI therapy has no fixed treatment, model, practice or intervention. The client directed aspect of CDOI therapy ensures that the differences between individuals are understood (Duncan, Miller Sparks, 2004). Practitioners performing CDOI therapy with clients acknowledge that each individual is different by structuring treatments to meet the needs of each client (Duncan Moynihan, 1994). The process of structuring treatment for each individual requires an understanding of the client’s strengths weaknesses and resources to obtain the best possible outcome (Norcross Wampold, 2010). Once these are understood, the client and therapist are then able to outline the desired goals of the client and implement treatments best suited to the client. The relationship between client and therapist enables the process of establishing goals and treatment options in any therapy. The relationship (or alliance) is built early in the initially stages of therapy (Barber, Connolly, Crits-Christoph, Gladis, Siqueland, 2000). The strength of the alliance is determined on the ability of the client and therapist to work together in a mutually respective, trusting and supportive environment (Klee, Abeles Muller, 1990). A therapist must be able to overcome any early resistance to therapy or formation of alliance to ensure the treatments being provided will meet the needs of the client. Research has shown that the strength of the alliance is a significant indicator to the outcomes of treatment. A meta-analytical review conducted by Martin, Garske and Davis (2000) examined a number of studies which observed alliance and outcomes of treatment. It was found that the alliance formed between therapist and client was the most significant indicator of outcome. These findings are consistent with the other alliance focused research (Klee, Abeles Muller, 1990; Krupnick et al., 1996; Meier, Barrowclough Donmall, 2005) which shows that a strongly built alliance results in more positive outcomes then those client/therapist relationships with inconsistent or weakly formed alliances. The outcome informed aspect of CDOI therapy involves the process of compiling feedback throughout treatment. This process provides indicators on whether the selected treatment is affective for the client and meeting their needs (Duncan, Miller Sparks, 2004). A number of studies have shown the effectiveness of ongoing feedback between counsellor and client and positive outcomes of treatment (Claiborn, Goodyear Horner, 2001; Lambert Shimokawa, 2011). Therapists can use the information gathered through feedback to either continue with current treatments or make adjustments where required to continue to work towards treatment goals (Duncan, Miller Sparks, 2004). The most important aspect of this process is that the client is the one expressing how the treatment is working for them, maintaining to the principle of CDOI therapy. There are many different terms used in professional practise when collecting feedback. There are also a number of different methods used when compiling information transmitted between therapist and client. In CDOI and other client and outcome focused therapies many therapists use the Outcome Ratings Scale (ORS) and Session Rating Scale (SRS) (Miller, Duncan, Sorrell Brown, 2004). Both scales allow the therapist to gain an understanding on the level of alliance formed and the success of the treatment being utilised. Consistent feedback from the client ensures that the alliance is still strong and the treatment is being effective in reaching the clients goals (Shaw, 2014). Other models of treatment and therapies such as Counselling and Medical models have more specific structures and guidelines. These models of therapy use the process of diagnosing a problem and then utilising a specific therapy to treat that problem (Mozdzierz, Peluso Lisieki, 2011). Through evidence based practise, problems and therapies are linked together from previous studies and research in the areas where there have been previous successful outcomes. Therapies such as Cognitive Behaviour Therapy (CBT) are linked with previous results in treating diagnosed disorders such as anxiety and depression (Butler, Chapman, Forman Beck, 2006; Tolin, 2010). These therapies are classified under the medical model of treatment and would be used by therapists after diagnoses of anxiety or depression has been made. The difference between these models and the CDOI therapy model is that there is no distinct diagnoses and treatment structure. Each client is evaluated on their own strengths, weaknesses and ideas about treatment. Goals and treatment options are set by both the client and the therapist to ensure all needs of the client are being met, not just the symptoms of a disorder that may be present resulting in a diagnoses (Duncan, Miller Sparks, 2004). Other models of therapy are more restricted in the types of treatments provided and do not allow for individual characteristics of each client. When adopting the CDOI method there is no need to completely discard other models such as the Counselling Model of treatment. CDOI therapy can draw from these different models and modify the structure to suit the client, instead of following the guidelines that may not be appropriate in every case (Duncan Moynihan, 1994). There have been many cases of successful outcomes for clients using evidence based therapies in the past (Butler, Chapman, Forman Beck, 2006; Tolin, 2010). However CDOI therapy is an alternative to these therapies that can be structured to meet the needs of any client by minimising the risk of negative outcomes. There are a number of strategies that can be used by a professional counsellor to improve their outcomes when using CDOI therapy. The importance of alliance between client and therapist has been proven to be a significant indicator of outcome. To build an alliance a professional needs to build a strong, safe and trusting relationship with the client (Norcross Wampold, 2010). A professional counsellor needs to understand the processes involved to build and maintain a strong alliance throughout treatment. Building strong interpersonal skills is one way a professional can achieve a strong alliance. To assess interpersonal skills, a professional can use the Social Skills Inventory (SSI) and the Facilitative Interpersonal Skills (FIS) Performance task questionnaires (Anderson, Ogles, Patterson, Lambert Vermeersch, 2009). These questionnaires measure social and emotional aspects of individual’s interpersonal skills. These aspects are important in building a successful alliance between professional and client which has shown to be a strong indicator of positive outcome. Building on interpersonal skills can be achieved through continuing regular training and education. By continuing education, a professional counsellor can remain current with ongoing research, therapies and treatments and build on existing skills (Norcross Wampold, 2011). By utilising further education a professional can use new ideas to improve outcomes in future cases. One other strategy relates to the feedback process between therapist and client. A successful indicator of outcome, the feedback process is important (Claiborn, Goodyear Horner, 2001). A professional counsellor needs to use a simple and quick system of collecting feedback so that the process doesn’t become overwhelming for the client (Lambert Shimokawa, 2011). This process can only lead to positive outcomes for the professional and client. Conclusion- No one model has proven superiority over another References Anderson, T., Ogles, B M., Patterson, C. L., Lambert, M. J., Vermeersch, D. A. (2009). Therapist Effects: Facilitative Interpersonal Skills as a Predictor of Therapist Success. Journal of Clinical Psychology, 65(7), 755-768. Barber, J. P., Connolly, M. B., Crits-Christoph, P., Gladis, L., Siqueland, L. (2000). Alliance Predicts Patients’ Outcome Beyond In-Treatment Change in Symptoms. Journal of Consulting and Clinical Psychology, 68(6), 1027-1032. doi: 10.1037/0022-006X.68.6.1027. Butler, A. C., Chapman, J. E., Forman, E. M., Beck, A. T. (2006). The empirical status of cognitive-behavioural therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31. doi:10.1016/j.cpr.2005.07.003. Claiborn, C. D., Goodyear, R. K., Horner, P. A. (2001). Feedback. Psychotherapy:Theroy, Research. Practise, Training, 38(4), 401-405. doi:10.1037/0033-3204.38.4.401. Duncan, B. L., Miller, S. D., Sparks, J. A. (2004). The Heroic Client. A revolutionary way to improve effectiveness through client-directed, outcome informed therapy. Sanfrancisco, California: John Wiley Sons. Duncan, B. L., Moynihan, D. W. (1994). Applying Outcome Research: Intentional Utilization Of The Clients Frame Of Reference. Psychotherapy, 31(2), 294-301. doi: 10.1037/h0090215. Johnson, L., Brown, J., Anker, M. Becoming Outcome Informed. In Duncan, B. L., Miller, S. D., Sparks, J. A. (2004). The Heroic Client. A revolutionary way to improve effectiveness through client-directed, outcome informed therapy (pp. 81-118). Sanfrancisco, California: John Wiley Sons. Klee, M. R., Abeles, N., Muller, R. T. (1990). Therapeutic Alliance: Early Indicators, Course and Outcome. Psychotherapy: Theory, Research, Practise, Training, 27(2), 166-174. doi: 10.1037/0033-3204.27.2.166. Krupnick, J. L., Sotcky, S. M., Simmens, S., Moyer, J., Elkin, I., Watkins, J., Pilkonis, P. A. (1996). The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal Of Consulting And Clinical Psychology,64(3), 532-539. doi: 10.1037/0022-006X.64.3.532. Lambert, M. J., Shimokawa, K. (2011). Collecting client feedback. Psychotherapy, 48(1), 72-79. doi:10.1037/a0022238. Martin, D. J., Garske, J. P., Davis, M. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytical review. Journal of Consulting and Clinical Psychology, 68(3), 438-450. doi: 10.1037/0022-006X.68.3.438. Meier, P. S., Barrowclough, C., Donmall, M. C. (2005). The role of the therapeutic alliance in the treatment of substance misuse: a critical review of the literature. Addiction, 100(3), 304-316. doi: 10.1111/j.1360-0443.2004.00935.x Miller, S. D., Duncan, B. L., Sorrell, R., Brown, G. S. (2004). The Partners for Change Outcome Management System. Journal of Clinical Psychology, 61(2), 199-208. doi: 10.1002/jclp.20111. Mozdzierz, G. J., Peluso, P. R., Lisieki, J. (2011). Evidence-Based Psychological Practices and Therapist Training: At the Crossroads. Journal of Humanistic Psychology, 51(4), 439-464. doi:10.1177/0022167810386959. Norcross, J. C., Wampold, B. E. (2010). What Works for Whom: Tailoring Psychotherapy to the Person. Journal of Clinical Psychology, 67(2), 127-132. doi. 10.1002/jclp.20764. Norcross, J. C., Wampold, B. E. (2011). Evidence based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 48(1), 98-102. doi: 1037/a0022161. Shaw, S. W. (2014). Monitoring Alliance and Outcome with Client Feedback Measures. Journal of Mental Health Counselling,36(1), 43-57. Tollin, D. F. (2010). Is cognitive-behavioural therapy more effective than other therapies? A meta-analytic review. Clinical Psychology Review, 30(6), 710-720. doi:10.1016/j.cpr.2010.05.003.

Barack Obama: The Audacity of Hope

The words â€Å"The Audacity of Hope† comes from Obama’s 2004 Democratic Convention keynote address. Much of the book deal with Obama’s policy positions on a number of issues, from health care to the occupation of Iraq. In this book, Obama criticizes the existing policy positions of the Bush government, and tries to reconcile political differences based on the twin principles of respect and statesmanship. There are several issues that Obama discussed in the book. The first issue is about racial discrimination. Obama rejects the notion that the United States is divided into politically racial spheres.Obama argues that the so-called ‘racial divide’ is a social construction – hence, cannot be immersed in policy-making. The personal attributes of people, according to Obama, should not become a hindrance to their own development. The second issue is rather unusual for the common reader. Obama rejects the ‘either – or formulationsâ€⠄¢ as a matter of policy. Here, he is referring to George W. Bush absolutists’ foreign policy that does not take into consideration alternatives. Obama provides a general background of such policy in the 60’s.According to Obama, the admission of African-Americans, minorities, and women to full citizenship had greatly undermined the power of the racial majority. What had developed was a system of grudge that, even today, manifests itself in government, business, education, and defense. The unity of the American nation had been greatly undermined. Obama argues that the only means to restore that unity is towards reconciling political differences. Although this is difficult to achieve, the price of success far outweighs the short-run costs.Obama’s idea of national unity transcends race, creed, and political differences. His idea of unity resembles that of Martin Luther King. Much of Obama’s thoughts on foreign, military, and domestic policies are a general t riangulation of liberal and conservative ideas – probably a way to appease both liberals and conservatives in society as Tony Blair did. In any case, his ideas about national security are much more enlightened than that of Bush. Obama’s argues that war in Iraq was a misguided war on the basis that it increased the associated risks to the United States.It did not put an end to terrorism, rather magnified it threefold. Tolerance, according to Obama must be observed in domestic and foreign policies. This is the only way to achieve an everlasting peace. The thesis of the book is: Unity of the American nation transcends race, creed, and politics, and the way to achieve peace is tolerance. For an intelligent reader, this thesis is something more of a vague statement. It does not attempt to give specific solutions to specific problems. There is no evaluation of alternatives.It is even possible to argue that Obama’s thesis is a coagulation of his political motives †“ a desire for higher political office. In any case, unlike his predecessors, Obama’s attempts to give a general view of American policies are generally unbiased and to some extent open-ended. Much of his enthusiasm of a possible end of conflict in Iraq is generally based on the hopes of a policy-shift – whether a Republican or Democrat is elected to the White House. Here, one can see that Obama’s audacity in intellectual leadership in his party exceeded that of George W. Bush.One can therefore argue that even if Obama’s thesis is a motherhood statement, it is in fact a radical alternative of the conservative-either-or policies of the Bush administration. Here, one sees the views of both a rising politician and a ‘dreamer of the 1960s. ’ Again, the specification of Obama’s thesis is still problematic, even though it carries a very meaningful radical policy-shift. In any case, there is no end to the question, â€Å"Is unity a long-ru n possibility? † Reference Obama, Barack. 2006. The Audacity of Hope: Thoughts on Reclaiming the American Dream. New York: Crown.

jermey mcgrath Essay - 992 Words

Wide Open Jeremy McGrath nbsp;nbsp;nbsp;nbsp;nbsp; A man named Jeremy McGrath a Supercross legend finds himself to be the best of the best. He has won Seven 250 Supercross championships, two 125’s, one outdoor, and two FIM World Supercross championships. He is now dominating all of Motorcross and is becoming a legend. â€Å"Jeremy McGrath is an unlikely champion who became a legend in Supercross, and helped bring the sport out of the backyard and into your living room†. Wining 12 major championships is not the easiest thing ever. Having almost 3 perfect seasons is even harder. But Jeremy McGrath has accomplished almost all of these. He wants us to understand that the life of a professional rider is not all it is worked up to be, but†¦show more content†¦So at age 6 Jack surprised him with a dirt bike. He would stay out and ride figure eight’s in their backyard all day. But after a while the mini bike had gotten old and as soon as age 11 rolled around and he found himself racing his first BMX race. He continued racing BMX for most of his childhood. He had a couple used dirt bikes here and there but nothing special. He competed in BMX for about 3 years. He had won several championships and was good enough to hold a sponsor and race for a race team. This was where his whole car eer was starting and he didn’t even know it. In 1985, age fourteen Jack bought him a brand new YZ80. Soon as that 80 came into view Jeremy through the BMX bikes into the back of the garage. He started racing at the local track right around the corner. Racing was great for him because he got to meet a lot of riders that would push to win, and that’s who you want to ride with. He was winning all the 80 races and was now traveling around California beating all his competitors. Life was hard not having any sponsors and winning almost every race you entered. Jeremy soon moved up to the 125class and still couldn’t get a factory ride. He started racing all around the country and won most of his races. Loretta Lins, this is like the super bowl of amateur Motorcross was where he finally got noticed and was asked to ride for Honda. Jeremy signed the three-year contract with Honda almost right away. Soon after signing with Honda Jeremy turned pro.

Major Phases Of A Product Life Cycle Stages - 2397 Words

Chapter 8 7. Is a well-known brand valuable only to the owner of the brand? A well-known brand it not only valuable to the owner of the brand. Some consumers may derive satisfaction by using the product, thus making the brand valuable to them. Also, wholesalers and retailers who handle the product may find it more profitable because of the demand for the product, thus making it valuable to them. Chapter 9 2. Cite two examples of products that you think are currently in each of the product life-cycle stages. Consider services as well as physical goods. Products pass through four phases of life. The four phases of a products life cycle are: 1. Introduction stage -This is the stage where products are designed, developed and introduced to the market. 2. Growth stage - In this stage, sales and profits start to grow as company gains economic scale of production and marketing. 3. Maturity stage - in this stage the market for company’s product saturate and company reaches the threshold level of profit and sales. 4. Decline stage – in this stage the company’s market for products begin to shrink. Companies experience a decline in sales and profit. One example of a company in each of the stages would be Samsung mobile. 1. Introduction stage – in this stage Samsung designs, develops and introduces a new series of their mobile phone. 2. Growth stage – in this stage Samsung incorporates and modifies their basic model with better features, thus launching the touch screen model phones.Show MoreRelatedThe Software Development Life Cycle1202 Words   |  5 PagesThe software development life cycle is utilized by the software industry to design, develop, and test software. The objective of the SDLC is to provide high quality software that exceeds customer expectations and meets timeframes and cost expectations. 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