Table 2.
Summary of the clinical advisory team’s comments and recommendations regarding the acceptability and delivery of the specific intervention techniques
The technique | Comments about acceptability and delivery |
---|---|
Goal specified AND |
Having specific goals for therapists (as opposed to therapy goals for patients) is likely to range from contentious to highly unacceptable. |
contract | |
Having goals for a team is likely to require persuasion, and success is likely to depend on the goals. Supportive and encouraging, rather than normative, team goals are likely to be more acceptable. | |
Goals that allow measurement of progress or comparison between individual therapists are likely to be highly unacceptable. | |
“Targets” are likely to be associated with “sales” and thus likely to be strongly opposed to therapists’ professional identity. | |
Self-monitoring AND feedback |
In general, any monitoring or feedback, and especially external monitoring/feedback, about individual therapists’ practice is likely to be highly unacceptable. |
Low levels of self-monitoring might be acceptable if combined with use of social processes of encouragement and support. | |
Rewards |
Social support and encouragement is valued very highly. |
Graded tasks AND |
Highly desirable, especially for the target behaviours of formulating goals and agreeing goals—for as long as the tasks were presented in a way that was relevant to practice. |
Rehearsal of relevant skills | |
Could involve grading the target behaviours in terms of the other people involved (e.g., whether goals are formulated with parent or with the child) and context. | |
Coping skills |
Current method of coping with emotional aspects of practice is to draw on professional community for support; this is effective and preferable to therapists. |
Social processes of encouragement and support |
Emphasis should be on mutual support, positive interactions, and sharing. |
Changing practice as part of a team is likely to be more acceptable than changing practice individually. | |
This technique should be included in all aspects of the intervention as far as possible and in high dose and frequency. | |
Social processes of pressure |
It might be acceptable to establish some team norms, but these would need to be carefully negotiated if therapists’ motivation to comply with the norms is hoped to be gained. |
Explicit social pressure from colleagues or manager is likely to be highly unacceptable, and the intervention should be designed so that it cannot be used to exert pressure. | |
It might be acceptable to include expectations from parents, but acceptability of this is likely to be contingent on therapists’ holding a professional norm about the importance of client-centred practice. | |
Any technique that is not, or appears not to be, in line with being an autonomous practitioner is likely to be rejected. | |
Modeling/ demonstration of the behaviour | Examples by others, as part of the social processes of support, would be desirable. |