Deliberate Practice Makes Perfect: Improving Therapist Effectiveness

Psychotherapy works. The results of numerous studies show that those individuals treated are better off than those not treated or on waitlists with an average effect size of .8 (Duncan et al., 2008). To put it in perspective, the effects of psychotherapy are equal to those found for coronary artery bypass surgery and 4 times greater than fluoride in the prevention dental cavities. Yet, three persistent problems plague the psychotherapy field: 1) clients drop out of therapy at alarming rates – almost half of clients decide not to continue and prematurely terminate; 2) not only do therapists not notice when clients are at risk for dropping out, they also do not detect when things are getting worse (approximately 10% of clients get worse after starting therapy); and 3) a small percentage of clients (10%) accounts for the largest amount of expenditures (Minami, 2008). This last finding may be the result of therapists not realizing when things are not working or getting worse and instead of changing course, doing more of what is not working, over and over again. Along these lines, most therapists do not have an accurate sense of their helpfulness and on average, overrate their effectiveness by 65% (Chow, 2014). Given the issues with retention, coupled with the self-assessment bias among therapists, it’s not surprising that psychotherapy outcomes have not appreciably improved over the past 40 years.

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Carotid or Coronary Intervention which is to be done First?

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0038-1656489 ◽

2016 ◽

Vol 01 (04) ◽

pp. 095-097

Author(s):

Ravikiran M. ◽

Jabeen Afshan ◽

Nemani Lalita

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Surgery ◽

Carotid Artery Disease ◽

Artery Bypass ◽

Significant Coronary Artery Disease ◽

Coronary Intervention ◽

Carotid Disease ◽

The Past ◽

Percutaneous Coronary ◽

Artery Disease

AbstractIn carotid artery disease patients with concomitant significant coronary artery disease (CAD - especially left main diseases – LMCA), the risk of perioperative myocardial infarction and early and late death are increased. Conversely, in patients undergoing coronary artery bypass surgery (CABG), uncorrected severe carotid disease increases the risk of adverse neurologic events [1]. The optimal management of these co-existing conditions and the timing and sequence of correcting them remain controversial. Over the past 2 decades, staged carotid revascularisation followed by CABG, staged CABG followed by carotid revascularisation, or combined coronary and carotid revascularisation simultaneously in one operative setting have each been advocated. Our patient presented with both carotid and significant LMCA CAD, first we have done carotid intervention followed one week later by LMCA percutaneous coronary intervention (PCI).

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Dropping out/dropping back in: Matters that make learning matter

Queensland Review ◽

10.1017/qre.2017.9 ◽

2017 ◽

Vol 24 (1) ◽

pp. 57-74 ◽

Cited By ~ 3

Author(s):

Anna Lund ◽

Mats Trondman

Keyword(s):

Young People ◽

Secondary School ◽

School Success ◽

School Achievement ◽

Migration Background ◽

Drop Out ◽

Dropping Out ◽

Relational Capital ◽

The Past ◽

Do So

AbstractNearly one in three students living in the segregated, multicultural city of Malmö, Sweden, fails to finish school with a completed diploma. To remedy this situation, students can attend introductory programs, but only some students who do so end up with a diploma. The aim of this article is to understand why young people from a migration background drop out of secondary school and why some of them drop back in and become school achievers. We explore what makes learning matter among youth who drop back into schooling. In seeking possible answers to this question, we listened to and learned from the students themselves. We hope readers will learn about the elementary forms of an enabling opportunity structure for school achievement, about the significance of relational capital, and about the deeply associated meanings of family and friendship and their importance to school success. The article is framed by the interdependencies of two conditioned temporalities: the temporality of the past — that is, the dropping-out process — and the temporality of the present, that is, the dropping-back-in process. We argue that school failure is not an inevitable phenomenon, and show that young people who are supported to drop back into schooling can discover that they are capable of learning with passion and perseverance.

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