I am frustrated that I cannot find the original article from Acosta et al. (1980) with the detailed description of the video, “Tell It Like It Is.” If anyone finds it, please forward because I think that would be worth our while to read. I have checked every library in town and all over the internet. Nothing. I could not find any other articles other than the ones we had already found earlier in the semester. I did find something about how multimedia projects have enhanced the medical field, but not specific to counseling.
On another note, here are my thoughts about the 2 articles that Dr. Bobele asked us to read:
The Acosta et al. (1983) article was geared more towards what Dr. Slive was saying about preparing clients by 1. informing clients to be more assertive; 2. understand the process; 3. clearly express problems, needs, & expectations; and 4. be more active. I would like to see the 7 types of behavior that are valued, though, that Acosta et al. assert in the video. On the other hand, it seems that their other treatment, the not oriented program, is like our present idea for the video. It is more of an orientation to therapy at our clinic (like their video of the L.A. Med. Ctr.) which describes our process of therapy, including scheduling appts., taking consultation breaks, having 2 co-therapists, etc. According to Acosta, then, our video would not be very effective at providing information about how therapy is effective, and clients would not be any more positive in their attitudes towards therapy.
The other article by Reis and Brown assessed whether it is beneficial to provide a video of this sort and if it’s useful for clients to have the opportunity to estimate how long they will be in therapy. We all know the results of their study, so it seems that they arrived at the same conclusion about the video that the original authors did.
Thus, I am thinking that if we divert from our original script and idea for our video, and focus our video on the goals for our clients (i.e. ask for what they need) then we will be more effective, like Dr. Slive said. If so, then I think the sections we could keep are the goals, homework, and making appointments sections. In addition, we would need to add more about how we expect our clients to act while in therapy (asking questions, clarifying when we say something they do not agree with or understand, stating how they would want to improve, etc.) and even between sessions (carrying out their homework). Therefore, we need to change our rationale for this video to focus more on expectations of clients after watching this video, rather than only making the clients comfortable with the process (we want them to do more than just be comfortable and at ease).
This is it for now.
Karri
March 24, 2008 at 8:26 pm
Thanks for the summaries, Karri. I have put in an email to Acosta to see how we can get a copy of the video. I think it may be difficult to get a copy of the original article.
I am hoping that the class will use these articles as a jump start to begin a professional literature review on the content and topics that need to be included in the video.
One thing to keep in mind is that some of this research is about preventing drop-outs and early termination. So the purpose of some of this work has been to keep people in treatment. One of the purposes of our video is to help people get the most out of their treatment as soon as possible.
March 26, 2008 at 8:33 am
I have been looking for the original 1980 article as well and cannot find it. I was thinking that if we are going to focus on what to do in therapy maybe we should look at how we want clients to be. I am thinking about what Dr. Bobele is always telling us in terms of clients not knowing what they are supposed to say or do.
I’m not suggesting we coach them in terms if we ask you this then you say that but maybe talking about what it is we need clients to tell us. For example telling clients we will often focus on how they want their lives to be in the future. So maybe getting clients prepared to be present and future focused rather than focusing on the past which I think is a common misconception from clients.
So maybe if we look at breaking down misconceptions about what we want from clients it will help them be more clear about what they want. Just some thoughts….
March 27, 2008 at 8:52 am
Oh Frank Acosta – if he only knew that we needed the original article with the details!!! What I found most important in this article that we do have is that expectations are important, to also agree with and emphasize Karri’s point above. the Acosta et. al., (1983) article pointed out that patients are disstisifed due to unmet expectations. It would be interesting to study what client expectations are and what roles clients think therapists should fulfill — and I will do a lit review to see what work is out there on this topic as of now. Keeping this in mind, we can incorporate Dr. Slive’s ideas and make this video a client prep video (logistics: map, appointment scheduling, payment, etc.) and also cover what happens in ‘goal setting’ and the like as he suggested.
Something else I considered while reviewing this article is that they asserted that the coul dnot conve what patients need to know in the span of 12 minutes. I know this might be re-hashing the subject, but we need to consider how to best use the time we have in this video (time and budget) and create something we can complete soon.