Download files
Abstract
Evaluation is highly integrated into clinical practice in psychiatry, psychology and social work in the talking therapies . Within these disciplines and the field there has been ongoing interest, but no comprehensive account of evaluation processes, the influences on them, and their relationship to each other and to clinical performance. This knowledge gap is explored here and provides the first comprehensive overview of clinical evaluation and performance in and across the disciplines in the talking therapies.
Although talking therapy is used by a range of health practitioners, this study focuses on the disciplines of psychiatry, psychology and social work, which dominate the field, and to which the subsets of counselling, psychoanalysis and psychotherapy are often linked. The target group comprises a broad range of participants, covering different: levels of experience; systems of employment; profit and not-for-profit practice; geographic location; and training and theoretical orientation. The study uses an inductive qualitative approach, triangulated by subject and data gathering process, with a questionnaire, interview and response validation. Pilot testing of the questionnaire and interview informed the main study. Participants self-selected from a mail out of the questionnaire to all members of the psychiatry and social work professional associations and psychologists in health services.
From a summary comparison across the disciplines emerged six findings. While one extended knowledge on the stages of evaluation and another confirmed the importance of a repertoire of evaluation processes, the findings on hierarchy of value, common purpose and functions, and ten cross-disciplinary themes are unique. The themes include evaluation processes, workforce, pathways, theoretical orientation, personal attributes, knowledge and skill, capacity, sustainability and remediation. From a critical analysis of the ten themes the three concepts scrutiny, connectedness and habituation emerged as the active agents in clinical evaluation and performance. While each active agent has practice implications and theoretical foundations, they are interrelated. When the active agents converge they produce the greatest effect on clinical performance by providing safety and security for clinicians and clients. The convergence of the active agents has implications for clients, clinicians, professional associations and employing agencies through risk, standards, quality, recruitment and retention, learning and teaching.