The role of the therapeutic alliance in internet-delivered cognitive-behaviour therapy

My research tested the importance of the client–practitioner relationship to therapeutic outcomes, utilising an Internet-based treatment for panic disorder. Results indicate that, while the relationship remains important when shared online, it matters less than in face-to-face settings. This calls into question conventional models of what makes psychological treatments effective.

Cleaner wrasse prefer client mucus: support for partner control mechanisms in cleaning interactions

Recent studies on cleaning behaviour suggest that there are conflicts between cleaners and their clients over what cleaners eat. The diet of cleaners usually contains ectoparasites and some client tissue. It is unclear, however, whether cleaners prefer client tissue over ectoparasites or whether they include client tissue in their diet only when searching for parasites alone is not profitable. To distinguish between these two hypotheses, we trained cleaner fish Labroides dimidiatus to feed from plates and offered them client mucus from the parrotfish Chlorurus sordidus, parasitic monogenean flat-worms, parasitic gnathiid isopods and boiled flour glue as a control. We found that cleaners ate more mucus and monogeneans than gnathiids, with gnathiids eaten slightly more often than the control substance. Because gnathiids are the most abundant ectoparasites, our results suggest a potential for conflict between cleaners and clients over what the cleaner should eat, and support studies emphasizing the importance of partner control in keeping cleaning interactions mutualistic.

Does client size affect cleaner fish choice of client? An empirical test using client fish models

To determine whether the choice of client fishes in the cleaner fish Labroides dimidiatus was influenced by client size, cleaner fish were given a choice of equal amount of food spread on large and small client redfin butterflyfish Chaetodon trifasciatus models. All large models received bites from cleaners compared to 27% for small models. Seventy-nine per cent of cleaners took their first bite from the large fish model. The results suggest that client size may affect cleaner fish choice.

Controlled study into the effectiveness of individual client-centred counselling for young offenders in residential care

This study is toe first documented account in the British Isles of an evaluation of the effectiveness of client-centred counselling with young offenders in secure residential care. It is a test of Rogers' (1957) position on the 'necessary and sufficient' conditions of therapeutic personality change within a counselling relationship. Forty teenage male offenders, the subjects of Training School Orders, were randomly allocated in equal numbers to either an experimental or control group. Boys in the experimental group received weekly individual sessions of client-centred counselling over a seven month period. Boys in the control group received no formal counselling but were shown to have similar intellectual, personality, socio-economic and criminal backgrounds to those in the experimental group. It was hypothesised that counselled subjects would show more positive outcomes than control subjects over a range of measures relating to criminal behaviour and self-conception. The results indicated that the counselled subjects had a significantly lower rate of offending and a srnaller range of offences over a mean follow-up period of 2.5 years. They were also licensed from the institution significantly earlier and spent less time in custody during a one year follow-up after counselling was completed. Self-conception measures gave less clear-cut results. The direction of change towards better adjustment favoured the counselled subjects but the magnitude was often small. Those counselled subjects with most positive behaviour change tended to have significantly improved self-evaluation, less self/ideal self discrepancy and more variation on 'actual' self concept compared to pre-counselling. The results are discussed in the context of client-centred theory, methodological adequacy of the experimental design, and their application to the future treatment of young offenders in secure residential care.

Outcomes of a randomised controlled trial of the application of cognitive and behaviour therapies for problematic gambling : implications for the Statewide Gambling Therapy Service treatment model

Through an ongoing research programme, the Statewide Gambling Therapy Service (SGTS) in South Australia has been systematically developing approaches to treatment and relapse prevention in order to include a wider range of clients in the treatment programme, help them recover from their gambling problems and support them to avoid relapse to problematic gambling post treatment.In a recent randomised controlled trial exploring the efficacy of cognitive versus behavioural therapy in the treatment of problematic gambling disorders in SGTS, no significant differences were found between clinical outcomes of the two treatment modalities. Both purely cognitive and purely bahavioural approaches to therapy had similar outcomes in terms of improvements in measures of health and wellbeing (Work and Social Adjustment Scale: WSAS), general depressioni (Kessler 10: K10) and problematic gambling (Victorian Gambling Screen: VGS). Further studies are planned to test more precisely whether both approaches are indeed equivalent in terms of outcomes achieved for clients. In the mean time, the fact that behavioural therapy (BT) tends to required less treatment sessions to achieve the same outcomes as cognitive therapy (CT) suggests that working to retaining clients in treatment using BT may be a more effective and parsimonious treatment option for people with gambling disorders . This current paper provides an overview of SGTS client engagement and management strategies following the completion of our recent RCT.