Effectiveness studies of IRT directed by Ken Critchfield, Ph.D.

Patient progress through stages of change in readiness to relinquish GOLs is associated with remission of patient’s depression.

Effectiveness Studies of IRT by Ken Critchfield, Ph.D.

The CORDs population at the IRT clinic in the University of Utah IRT clinic presently cannot be studied using the standard Randomized Control Trial (RCT) paradigm for establishing effectiveness. There is a lack of funding, personnel and time to train practitioners or to implement a long term protocol within usual time limits for therapy effectiveness studies. Moreover, the CORDS population is comprised of patients who are screened out of RCT trials because they are too comorbid and too likely to deteriorate and have to be taken off protocol. So we have chosen instead to show that better adherence to the IRT treatment model yields better results. Ken Critchfield is co-Director of the IRT clinic with Thomas Woolf who is director of clinical services at the hospital. Ken also is Director of Research at the clinic and has been creative and convincing in his ways of exploring which aspects of the treatment model do the most work and when. He is joined in that by Christie Pugh Karpiak, Ph.D. of the University of Scranton. Using Ken’s detailed rating scale of adherence guided by the charts and tables in the IRT book, they have obtained correlations between symptom change and ratings of therapist and/or patient adherence to each aspect of the treatment model in different contexts. Results show in general that the “purity” of the treatment matters and this effect can be seen at the level of single individuals (N=1). That is, patients of trainees who are less adherent do less well, and vice versa. When a patient shifts from a less adherent trainee to a highly adherent one, there is rapid improvement, provided the patient allows increased awareness of the costs of GOL and moves toward choosing to relinquish them. The figure above shows that even with a highly adherent therapist consistently and appropriately focusing on GOL the patient needs time to do the work needed to get free of GOL. The measures of engagement with GOL are: (double click to enlarge the figure; use back arrow to return here)

Stages of intent to change (top) and behaviors related to intent to change (bottom)

These early results are not to be cited without written permission from Ken Critchfield

PC Video of slides on effectiveness tests of IRT

Iphone video of slides on effectiveness tests of IRT

Following LSB’s retirement in 2012, the IRT clinic stopped offering long term outpatient treatment to new CORDS. Ken continued to supervise and gradually all cases terminated treatment by the time Ken began work as an Assistant Professor of Psychology at James Madison University in Harrisburg, Virginia July 1, 2014. Presently, Ken and LSB are analysing and summarizing data as LSB continues to provide IRT consultations for inpatients at UNI and Ken trains more coders to assess therapy sessions in the IRT archive.

His email address is

[email protected]