Relationship between expectation management and client retention in online Cognitive Behavioural Therapy

Background Engaging clients from the outset of psychotherapy is important for therapeutic success. However, there is little research evaluating therapists’ initial attempts to engage clients. This article reports retrospective analysis of data from a trial of online Cognitive Behavioural Therapy (CBT) for depression. Qualitative and quantitative methods were used to evaluate how therapists manage clients’ expectations at the outset of therapy and its relationship with client retention in the therapeutic intervention. Aims To develop a system to codify expectation management in initial sessions of online CBT and evaluate its relationship with retention. Method Initial qualitative research using conversation analysis identified three different communication practices used by therapists at the start of first sessions: no expectation management, some expectation management, and comprehensive expectation management. These findings were developed into a coding scheme that enabled substantial inter-rater agreement (weighted Kappa = 0.78; 95% CI: 0.52 to 0.94) and was applied to all trial data. Results Adjusting for a range of client variables, primary analysis of data from 147 clients found comprehensive expectation management was associated with clients remaining in therapy for 1.4 sessions longer than those who received no expectation management (95% CI: -0.2 to 3.0). This finding was supported by a sensitivity analysis including an additional 21 clients (1.6 sessions, 95% CI: 0.2 to 3.1). Conclusions Using a combination of qualitative and quantitative methods, this study suggests a relationship between expectation management and client retention in online CBT for depression, which has implications for professional practice. A larger prospective study would enable a more precise estimate of retention.

Managing clients’ expectations at the outset of online Cognitive Behavioural Therapy (CBT) for depression

Background Engaging clients in psychotherapy by managing their expectations is important for therapeutic success. Initial moments in first sessions of therapy are thought to afford an opportunity to establish a shared understanding of how therapy will proceed. However there is little evidence from analysis of actual sessions of therapy to support this. Objective This study utilised recordings to examine how therapists manage clients’ expectations during the first two sessions of online Cognitive Behavioural Therapy (CBT). Methods Expectation management was investigated through conversation analysis of sessions from 176 client-therapist dyads involved in online CBT. The primary focus of analysis was expectation management during the initial moments of first sessions, with a secondary focus on expectations at subsequent points. Analysis Clients’ expectations for therapy were most commonly managed during the initial moments of first sessions of therapy. At this point, most therapists either outlined the tasks of the first and subsequent sessions (n=36), or the first session only (n=108). On other occasions (n = 32), no attempt was made to manage clients’ expectations by outlining what would happen in therapy. Observations of the interactional consequences of such an absence suggest clients may struggle to engage with the therapeutic process in the absence of appropriate expectation management by therapists. Conclusion Clients may more readily engage from the outset of therapy when provided with an explanation that manages their expectation of what is involved. Therapists can accomplish this by projecting how therapy will proceed, particularly beyond the initial session.

The World Cup that was : a look back through social media

On Sunday, Germany held the World Cup aloft after scoring a goal in extra time. Somewhat surprisingly, the final wasn’t the most tweeted event of the 2014 tournament: that title went to Germany’s demolition of Brazil in its semi-final four days earlier, which ended up being the most tweeted sporting event in history. Let’s take a look back at some of the bigger stories of the World Cup from social media, as well as the prominence of the event in Europe...

Feeling a little Blue? : Boofheads, bodies, and beaches

Pat Grant’s graphic novel Blue (2012) tells two stories about the impact of a newly migrant group on a small coastal Australian town. The wider story explores the wholesale effects of a previously unknown population joining an existing, culturally homogenous community. These broad social images are used to contextualise the more immediate story of three youths who are disenfranchised within the pre-existing community, but who can claim social enfranchisement by alienating the new members of the community. That the migrant population is depicted literally as aliens emphasises Blue’s participation in a wider conversation about citizenship and empathy. However, Blue does not necessarily seek to provoke a particular emotional response in its readers. Rather, in following three characters who lack what Nussbaum calls “narrative imagination” in their pursuit of good surfing or visceral entertainment—of beaches or bodies—Blue explores the means and consequences of refusing intersubjective affect. This is most powerfully rendered by the main characters’ ultimate avoidance of, and fictions about, a dead body they have wagged school to see. At the very moment of a person becoming a true object—a corpse—the meaning of objectifying people is revealed; the young protagonists seem to recognise this fact, and thus retreat from the affective scene which nonetheless informs Blue as a whole.

Cut here : reshaping the ABC

Monday’s announcement that the ABC will make 80 positions redundant is just the latest move in an enforced process of change to the public service broadcaster. It has a long way yet to run. The announcement finally put the lie to Tony Abbott’s election eve pledge, live on national television, that there would be “no cuts to the ABC or SBS”. In concert with other recent announcements, it seems clear that public broadcasting – and in particular the ABC – is squarely in the government’s sights.

The Marrakesh Treaty could bring the world’s books to the blind

An estimated 285 million people worldwide are visually impaired. Some 90% of those live in developing nations, where less than 1% of the world’s books are available in a form they can read. In developed countries, the situation is only marginally better: only around 7% of the world’s books are accessible to print-disabled people. The right to read is part of our basic human rights. Access to the written word is crucial to allow people to fully participate in society. It’s important for education, political involvement, success in the workplace, scientific progress and, not least, creative play and leisure. Equal access to books and other cultural goods is also required by international law. The technology now exists to deliver books in accessible electronic forms to people much more cheaply than printing and shipping bulky braille copies or books on tape. Electronic books can be read with screen readers and refreshable braille devices, or printed into large print or braille if needed. Now that we have this technology, what’s been referred to as the global “book famine” is a preventable tragedy.

Large arrays and networks of carbon nanotubes : morphology control by process parameters

Large arrays and networks of carbon nanotubes, both single- and multi-walled, feature many superior properties which offer excellent opportunities for various modern applications ranging from nanoelectronics, supercapacitors, photovoltaic cells, energy storage and conversation devices, to gas- and biosensors, nanomechanical and biomedical devices etc. At present, arrays and networks of carbon nanotubes are mainly fabricated from the pre-fabricated separated nanotubes by solution-based techniques. However, the intrinsic structure of the nanotubes (mainly, the level of the structural defects) which are required for the best performance in the nanotube-based applications, are often damaged during the array/network fabrication by surfactants, chemicals, and sonication involved in the process. As a result, the performance of the functional devices may be significantly degraded. In contrast, directly synthesized nanotube arrays/networks can preclude the adverse effects of the solution-based process and largely preserve the excellent properties of the pristine nanotubes. Owing to its advantages of scale-up production and precise positioning of the grown nanotubes, catalytic and catalyst-free chemical vapor depositions (CVD), as well as plasma-enhanced chemical vapor deposition (PECVD) are the methods most promising for the direct synthesis of the nanotubes.

Exploring Bodies in Time and Space

While the body, time and space are fundamental to human experience, comparatively little attention has been given to the connections between them. Here scholars from a wide range of disciplines explore important themes of embodied life in time and space across cultures, activities and bodymind states. Motivated by a common desire to deepen and extend our comprehension of these phenomena and the connections and conversations between them, this book emerged from intense inter-disciplinary dialogue during the 1st Global Conferences on Time, Space and the Body and Body Horror. A plenitude of theoretical approaches and media are deployed to investigate assumptions and pose problems, to creatively deconstruct and reconstruct the terms through which experience is rendered meaningful, pleasurable, and functional. These investigations, pursued through various research methods in fields of the arts, social and psychological sciences and humanities, invite readers into a genuinely pluralistic conversation around the most basic and profound aspects of being.

Troubling dissemination : experimentations with the salon as conference event

Salons became popular in Europe in 17th Century as sites of philosophic and literary conversation. A group of female academics interested in Deleuzian theories experimented with the salon to challenge presentation and dissemination norms that hierarchize and centralize the human. For Deleuze and Guattari (1987), assemblages are shifting and decentering, so how might assemblages of chairs, tables, bodies, lights, space, help to trouble thinking about the methodological conventions around academic disseminations? The authors discuss the salon as a critical-cultural site: Cumming presents Deleuze and play-dough, an exploration of how the playful dissemination format of the salon prompted a re-reading of a methodological vignette from earlier research. Knight, an arts-based researcher, uses video art as a creative methodology to examine conceptualizations of rhizomes and assemblages at the salon as a dissemination site. The authors conclude that the salon, as a critical, cultural site disrupts hierarchized ways of approaching and presenting research.

Think of the children! The decline of the big day out and mega-festivals

What does the future look like for music festivals in Australia? This article examines the decline of the large festivals that have grown to dominate the scene in Australia in the last twenty years, and the rise of small, specialized festivals that offer a boutique experience.

Lose yourself in books no more - interactive maps show the way

This article explores the use of digital technology such as interactive maps to enhance books.

Information Experience : Contemporary Perspectives

The purpose of this book is to open a conversation on the idea of information experience, which we understand to be a complex, multidimensional engagement with information. In developing the book we invited colleagues to propose a chapter on any aspect of information experience, for example conceptual, methodological or empirical. We invited them to express their interpretation of information experience, to contribute to the development of this concept. The book has thus become a vehicle for interested researchers and practitioners to explore their thinking around information experience, including relationships between information experience, learning experience, user experience and similar constructs. It represents a collective awareness of information experience in contemporary research and practice. Through this sharing of multiple perspectives, our insights into possible ways of interpreting information experience, and its relationship to other concepts in information research and practice, is enhanced. In this chapter, we introduce the idea of information experience. We also outline the book and its chapters, and bring together some emerging alternative views and approaches to this important idea.

The story of the men’s white shirt

The classic white dress shirt is familiar and omnipresent in men’s fashion. As a result, we tend to be unaware that for more than 200 years this singular item of apparel, which is essentially unadulterated in form from the late 19th century, has been able to define and represent status, wealth and fashion norms. The history underlying this garment is rich and, in the main part, untold.