Dear Pablo,
And it’s true going the other way also, and frankly I think that’s been one of the problems for some people, because they want the fidelity scale to capture all the nuances and theoretical subtleties in gestalt therapy. They want the GTFS to BE gestalt therapy. It’s not, and it cannot be.
One definition of an operational definition in psychological research (cf. https://onemindtherapy.com/research/operational-definition-psychology-definition-examples-and-how-to-write-one/) :
Definition: An operational definition is the statement of procedures the researcher is going to use in order to measure a specific variable. We need operational definitions in psychology so that we know exactly what researchers are talking about when they refer to something.
Thus, it is exactly what the criticism of the GTFS has been: a description of what therapists DO when they practice GT.
> On Jan 31, 2020, at 9:27 AM, Pablo Herrera Salinas <[log in to unmask]> wrote:
>
> Dear Phil, I’m not so clear about a fidelity scale being always an operational definition of a treatment modality (I cannot give arguments to disagree either…). What I’m sure would be a mistake is reducing a therapy to a set of observable behaviors. I think if any of us wants to understand what psychoanalysis is, we would not start with a fidelity scale (perhaps with the works of Freud and other authors, detailed case studies, etc.). And even if one would analyze a psychoanalytic fidelity scale, I think no rational being would think they understand what psychoanalysis is by only looking at that fidelity scale.
>
> So the main point would be that it’s absurd to reduce GT to a fidelity scale.
>
> Warm regards
>
> Pablo
>
> Pablo Herrera Salinas
> Académico Psicología Universidad de Chile
> Psicoterapeuta Gestalt acreditado
> Psicólogo P.U.C.
> PhD en Investigación en Psicoterapia, P.U.C. & Heidelberg University
> Magíster en Psicoterapia Constructivista U.A.I.
> BLOG: Ceresdesarrollohumano.com
> El 31 de ene. de 2020 13:18 -0300, Philip Brownell <[log in to unmask]>, escribió:
>> Dear Pablo,
>> I am with you hear mostly. However, I think a fidelity scale IS an operational definition of a given modality. One has to ask, “What is an operational definition?” It’s working definition for a given set of circumstances. So, the GTFS is a working definition sufficient to be able to compare recorded sessions of therapy with it so as to claim that something was or was not GT.
>>
>> Phil
>>
>>> On Jan 31, 2020, at 9:03 AM, Pablo Herrera Salinas <[log in to unmask]> wrote:
>>>
>>> Dear Peter and colleagues,
>>>
>>> I would agree that using the GTFS as a competency scale for training and ignoring other key aspects that could not be included on the scale would be a big mistake. It could be used for this purpose but it’s obviously insufficient and needs to be complemented. At the same time, there are trainers who think that the items on the scale represent important aspects of their training and therefore for them it makes sense to use the scale (without reducing GT to what can be measured with the scale).
>>>
>>> And using a fidelity scale as an operational definition or manual of a treatment model would also be a huge mistake. Only someone very ignorant would do this and at least I have never seen this with other treatment modalities. I think in the psychotherapy research field there is a consciousness that treatment fidelity scales are useful instruments but always very narrow and limited because they need to focus on observable behaviors. So they should never be mistaken for a treatment manual or an operational definition of a treatment modality.
>>>
>>> I think one way to orient this discussion would be to think of different appropriate and inappropriate scenarios and uses for the GTFS. In this way, we could prevent the 2 main tragedies that could happen:
>>> • That all the important work done constructing the scale goes to waste and is not used in situations where it would be useful and appropriate (e.g. in outcome studies and perhaps as part of a training for certain GT schools).
>>> • That the scale is used for purposes it’s not adequate, doing more harm than good (e.g. as a treatment manual, as a competency scale that invisibilizes relational and body-related aspects of doing GT, etc.).
>>> Warm regards,
>>>
>>> Pablo
>>>
>>>
>>> Pablo Herrera Salinas
>>> Académico Psicología Universidad de Chile
>>> Psicoterapeuta Gestalt acreditado
>>> Psicólogo P.U.C.
>>> PhD en Investigación en Psicoterapia, P.U.C. & Heidelberg University
>>> Magíster en Psicoterapia Constructivista U.A.I.
>>> BLOG: Ceresdesarrollohumano.com
>>> El 30 de ene. de 2020 18:39 -0300, Peter Philippson <[log in to unmask]>, escribió:
>>>> Thanks Pablo. What you write makes a lot of sense to me. It is possibly better than nothing in those limited spaces. But I'm still worried.
>>>>
>>>> I have already seen instances where people are speaking of the GTFS as a competency scale for training, when it doesn't require any emphasis on exploring the relational space, or of the body process of the therapist, only the client. This has the potential to skew training programmes.
>>>>
>>>> Further, it will be taken as an operational definition, a manual, for what GT is by those outside. Then we are back to the 1960s where people are putting mothers on cushions and hitting them with bats and calling it GT, taking some caricature of something they had seen someone do.
>>>>
>>>> Best wishes,
>>>>
>>>> Peter
>>>>
>>>> On Thu, 30 Jan 2020 at 21:25, Pablo Herrera Salinas <[log in to unmask]> wrote:
>>>> Dear Peter, I’m glad we can discuss the specific criticisms of the instrument in a constructive way. As I understand it, you mentioned 3: it represents the “lowest common denominator” of GT; it probably wouldn’t differentiate between GT and person-centered, and probably could not identify a relational Gestalt practitioner as GT. I guess there are other criticisms in the different BGJ papers, but I don’t remember them.
>>>>
>>>> I would like to argue that any methodology can only be judged or evaluated regarding a specific research question or aim. It doesn’t make sense to state that a method is good or bad without referring to the use we plan to give it in a research project, for a concrete objective. So we can discuss the merits and limitations of the GTFS regarding different research aims.
>>>>
>>>> As I understand (and have spoken to Madeleine about it explicitly), the main aim of the GTFS is to be used for outcome studies (like our Single Case studies, future RCTs, the CORE study, etc.) as a measure of treatment fidelity. In these studies, if we don’t use the GTFS we need to assume that the therapists are doing GT because they are trained and supervised by gestalt therapists. This is acceptable but decreases the methodological rigor of our study. If the GTFS represents the “lowest common denominator”, then it’s not a problem for this research aim. Peter’s criticism could pose a problem if the outcome study is full of more relational Gestalt therapists whose practice registers as “non-gestaltic” in the GTFS. If this happens, then it would be very interesting input for potential discussions about the varieties of GT “schools”. And if this happens, of course the researchers would not use the GTFS as it would not be useful for their specific study.
>>>>
>>>> There are several situations where Peter’s criticisms would be relevant and therefore the GTFS should not be used or at least used with caution: a comparative study between GT and person-centered therapy; the use of the GTFS as a competency scale for training (probably it could be useful for basic GT competencies but should be complemented with other indicators).
>>>>
>>>> So I think these criticisms are useful to think of limitations for specific studies and research questions. However, I still think that for its original aim (to improve the methodological rigor of outcome studies) the GTFS is a good enough instrument. Of course, even for this aim it could be improved but I think our community has very limited research resources and it wouldn’t be strategic to improve a good enough instrument because of the immense cost in time and money required to do so. It would only make sense to develop an improved fidelity scale if we have the need or desire to start research projects that stretch the limitations of the GTFS (if the instrument is not useful for specific projects we are starting). One of the main lessons from my PhD in psychotherapy research was that first we define the research question and only then we look at the methods.
>>>>
>>>> Warm regards
>>>>
>>>> Pablo
>>>>
>>>> Pablo Herrera Salinas
>>>> Académico Psicología Universidad de Chile
>>>> Psicoterapeuta Gestalt acreditado
>>>> Psicólogo P.U.C.
>>>> PhD en Investigación en Psicoterapia, P.U.C. & Heidelberg University
>>>> Magíster en Psicoterapia Constructivista U.A.I.
>>>> BLOG: Ceresdesarrollohumano.com
>>>> El ene. 29, 2020 11:23 -0300, Peter Philippson <[log in to unmask]>, escribió:
>>>>> Dear Pablo,
>>>>>
>>>>> I agree with you, with one or two provisos.
>>>>>
>>>>> The first is that the criticised research authors need to be willing to engage constructively with the criticism, rather than attacking the critics. This is clearly not happening here.
>>>>>
>>>>> The second is that the original research project, while not needing to be perfect, is done in a transparent and reasonably well-supported way, so that we don't have a situation where research based, in this case on the GTFS, potentially falls when there is shown to be a problem with how it was put together.
>>>>>
>>>>> The time-line here was that Gianni Francesetti persuaded me to go to Paris and participate on a panel with Madeleine and himself chairing it. I was completely open at that time to sharing my concerns with Madeleine and hearing her response. One of my criticisms at the time was that any good Person Centred therapist would pass the scale, while those working in a strongly intersubjective, relational way would not. The panel was quite friendly. After the panel, people came to me who were involved in the 'validation' process, who told me that they had raised similar concerns during the process. This shocked me, because in normal research, if negative responses came out of a validation process, but it was published without mentioning those responses but only the success, the author or journal would have to make a retraction, and maybe will have difficulty publishing in that research journal in future.
>>>>>
>>>>> So it was at that point that I got considerably less friendly, because this kind of thing can put into jeopardy all our efforts to show GT research in a good light. I have been portrayed since then as anti-research, though I have participated in both Phil's books, participated fully in the British CORE research project, and attended the Paris conference. It looks like putting all the Gestalt research eggs into one insecure basket.
>>>>>
>>>>> My primary concern about the original Delphi process, as I said in this latest BGJ letter, is that if a modality has a large common core, then a Delphi process shows that core of practice in a way that is recognisable as the modality. If the modality has a very disparate way of being practised, then a Delphi process produces a lowest common denominator, that does not equate to the modality (in this case it would not distinguish between Gestalt and Person Centred work). So I would say that the original Delphi process, which was a good initiative, and in which I participated, essentially showed this lowest common denominator, which is a meaningful result about our community. The same would be likely to be true in producing a fidelity scale for psychoanalysis, with many different schools and approaches. There is a fidelity scale to differentiate CBT from short-term psychoanalytic psychotherapy <https://www.ncbi.nlm.nih.gov/books/NBK425411/>, and the analogy to the GTFS would be to use that scale as a general scale for psychoanalysis.
>>>>>
>>>>> I hope this makes sense.
>>>>>
>>>>> Best wishes,
>>>>>
>>>>> Peter
>>>>>
>>>>> On Wed, 29 Jan 2020 at 13:17, Pablo Herrera Salinas <[log in to unmask]> wrote:
>>>>> I wanted to share my little experience in the world of Psychotherapy Research.
>>>>> In Chile we have a very strong program and tradition of psychotherapy research, compared to other latin american countries. The main researcher and leader has been Mariane Krause (past president of the International Society for Psychotherapy Research, who was a keynote speaker at our latest Gestalt Research Conference). I worked in her research team for several years and she was one of the tutors of my doctoral dissertation.
>>>>>
>>>>> She is widely respected in Chile and other countries, and at the same time me and other students-colleagues openly criticized her work and the work of our research team. This criticism didn’t stop her work from spreading and being used widely. At the contrary, those criticisms encouraged me and other colleagues to develop new instruments and methods to improve the perceived limitations of her research, and use her work as the basis of newer studies.
>>>>>
>>>>> What I want to say is that in my little experience in psychotherapy research it’s OK to do something, to have strong (valid and not valid) criticism and then continue to use the criticized work and at the same time improve it and do newer work. It’s what happens when we produce something and it gathers enough attention for other people to see its shortcomings. Absolutely all the most important psychotherapy research work I know has very important limitations and has received criticism.
>>>>>
>>>>> It’s an illusion to produce something that will not have limitations and will not be criticized. The only option is to do something so irrelevant that no one takes the time to criticize it. The criticized work keeps being used (hopefully acknowledging its limitations), and the critics continue to criticize (and hopefully produce their own improved work, or inspire others to do so).
>>>>>
>>>>> Warm regards
>>>>>
>>>>> Pablo
>>>>>
>>>>> Pablo Herrera Salinas
>>>>> Académico Psicología Universidad de Chile
>>>>> Psicoterapeuta Gestalt acreditado
>>>>> Psicólogo P.U.C.
>>>>> PhD en Investigación en Psicoterapia, P.U.C. & Heidelberg University
>>>>> Magíster en Psicoterapia Constructivista U.A.I.
>>>>> BLOG: Ceresdesarrollohumano.com
>>>>> El 29 de ene. de 2020 9:39 -0300, Philip Brownell <[log in to unmask]>, escribió:
>>>>>> That is bullshit Peter. My reputation is what is. Whatever it is. I don’t need the GTFS and I doubt that Madeleine does either but I’ll let her speak for herself.
>>>>>>
>>>>>> Sent from my iPhone
>>>>>>
>>>>>>> On Jan 29, 2020, at 3:44 AM, Peter Philippson <[log in to unmask]> wrote:
>>>>>>>
>>>>>>> All I can put this down to is ego: Madeleine and you are tying yourselves to the GTFS for your reputation.
>>>>>>
>>>>>> ______________
>>>>>> Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
>>>>> ______________ Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
>>>>>
>>>>>
>>>>> --
>>>>> Peter (Philippson)
>>>>> [log in to unmask]
>>>>> ______________ Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
>>>> ______________ Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
>>>>
>>>>
>>>> --
>>>> Peter (Philippson)
>>>> [log in to unmask]
>>>> ______________ Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
>>> ______________ Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
>>
>> ______________ Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
> ______________ Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
______________
Gstalt-L is an independent eCommunity of people interested in gestalt therapy theory and its various applications. Its public archives can be found at http://listserv.icors.org/scripts/wa-ICORS.exe?A0=GSTALT-L, and subscriptions can be managed by clicking on "Subscriber's Corner," which is found at the archives.
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