| The APA Presidential Task Force on Evidence-Based Practice (2006) called for more research on the practices of expert clinicians as an important component of promoting effective psychotherapy practice. Research that identifies areas of agreement among therapists can complement findings from randomized controlled trials by highlighting common practices as well as clinical innovations. The present study attempted to access consensus among expert psychologists and social workers by drawing on the behavior-alanalytic model developed by Goldfried and D'Zurilla (1969) and the methodology of the Expert Consensus Guideline Series developed by Frances and colleagues (Frances, Kahn, Carpenter, Ross, & Docherty, 1996) with a sample of peer-nominated clinicians. This initial investigation was focused on interpersonal problems between young adults and their parents. In the first phase of the study, 54 therapists provided examples of situations that they had encountered in their practices involving young adults experiencing difficulties with their parents. In the second phase, six representative situations were selected and presented to a sample of 171 therapists, who provided therapeutic responses that they would recommend for use during the session and in future sessions. Based on these responses, clinical strategies underlying the responses were identified. In the third phase, 113 therapists (a mean of 18.83 therapists per situation), who were nominated by their peers as therapists to whom they would refer their own friends and family, rated the effectiveness of these clinical strategies. Results indicated that peer-nominated therapists reached consensus on the effectiveness of a number of strategies; in particular, they agreed on the importance of providing empathy and validation during the session. However, the low response rate and the lack of objective criteria for determining the clinical skills of the peer-nominated clinicians raise concerns about whether these participants were expert therapists. Additional limitations and future directions are discussed. |
