Contributing to A Treatment Trial of Group Therapy: ‘Psychotherapy Supervisor’ or ‘Therapeutic Consultant’?

This paper describes how psychodynamic approaches to understanding therapeutic groups and organizations were applied in a randomized control trial investigating the effectiveness of a group treatment programme for adolescents who had repeatedly attempted suicide. The treatment programme was developed by therapists using a cognitive behavioural framework. The author was invited to contribute specifically as supervisor of the group treatment, although his clinical practice is based in psychoanalytic theory. Despite the differing theoretical foundations a close collaboration developed in relation to the therapeutic work and the process of conducting this within a research project. The psychodynamic perspective simultaneously supported and challenged the author's position, the therapists’ approach and the research process.

A key aspect of the evolution of the author's role related to points of potential conflict between therapeutic and research processes. Exploration of the interrelationship of authority and the ability to fulfil responsibilities within both therapy and research was essential in supporting the therapists in ensuring that the clinical work was paramount. The role was identified as ‘consultation’ as opposed to ‘supervision’. It is suggested that differentiated roles of ‘Research Design Consultant’ and ‘Therapeutic Consultant’ should be part of psychotherapy research trials, with the latter role providing an additional safeguard in relation to ethical issues.