I AM UAA: Joshua Swift

December 11, 2012

Dr. Joshua Swift, assistant professor Department of PsychologyAssistant professor in the Department of Psychology
Hometown: Puyallup, Wash.
Fun Fact: Favorite pastimes include reading and ‘sword play’ with his kids, three boys and a girl each born 18 months apart. The oldest is 6; the youngest is under one year.

For any undergraduate out there still searching for a major, Joshua Swift has a heartening tale on how he figured it out.

He grew up watching “Perry Mason” with his parents. From way back when, he just knew he was meant to be a lawyer. So when he signed on at Brigham Young University (BYU), he was all over the pre-law requirements.

But before long, he felt a nagging sensation. “I started attending all these law seminars,” he said, “and I just got this feeling—law is not for me.”

But he didn’t panic. Instead, he thought about what he really wanted to do. Two criteria stood out: He wanted to help people, and he didn’t want a field that was black and white: “You know…here are the facts. Learn the facts and you’ve got it.”

Psychology classes started to speak to him. For one thing, human behavior is decidedly NOT black and white.  And the logic minor he was pursuing really helped him think about how to analyze human behavior. So psychology became his home.

But there was still another fork to navigate. Originally, he imagined he would focus on a clinical practice; that really satisfied his desire to help people. But when he began to do some research, he found that equally rewarding. At UAA, he manages to do both.

Focus on process and outcomes

His first exposure to “psychotherapy process and outcome” research came as an undergraduate at BYU. He soon realized that if he could find ways to improve outcomes by fine tuning the variables in therapy—like patient expectation or practitioner behavior—he could improve the effectiveness of therapy for many. This has become the backbone of his work.

From BYU, he headed to Oklahoma State for a doctorate in clinical psychology and experience at the psychology department’s training clinic. A yearlong pre-doctoral internship at SUNY Upstate Medical University included rotations through a variety of clinics, including the adult outpatient unit, an inpatient unit and the child and adolescent clinic. His doctorate focuses on clinical psychology with quantitative specialization—the perfect tools for advancing his research.

At UAA since the summer of 2010, Swift balances research, clinical practice in UAA’s Psychological Services Center (PSC) (more on that below), and teaching in the UAF-UAA doctoral program in clinical-community psychology. His research focuses strongly on how to improve outcomes in psychotherapy by understanding patient and clinician roles, expectations and processes. His essential questions are:

  • What makes therapy work
  • What leads to better outcomes for clients
  • How can those outcomes be improved

To get there, he closely examines what goes on in therapy; which variables can Swift adjust or manipulate that may lead to improved outcomes? He collaborates with clinical psychotherapists across the United States and even internationally.

Here’s a good example of a recent study. This one focused on client expectations. When therapy candidates called up to make an appointment, they received a single-sentence detail that could shape their sense of the therapy timetable. They were told that 50 percent of clients who attend 15 sessions recover. Clients who got this information attended twice as many sessions as those who didn’t receive the information, or 11 to 6.

Dr. Joshua Swift with his wife and four childrenThis summer, Swift’s work in this area won national honors from the American Psychological Association, Division 29. His journal article in the April 2011 issue of Psychotherapy Research, called “Decreasing treatment dropout by addressing expectations for treatment length,” was honored as the best data-based published peer-reviewed article on psychotherapy in the preceding calendar year.

Drop out rates for clients are a key area of study for Swift. This month, he’s doing follow-up work on a paper he published in June regarding a meta analysis of every journal article that mentions dropout rates written in the last 20 years. Conventional wisdom had pegged the therapy dropout rate at 50 percent.  But by reviewing almost 700 articles, he discovered the true dropout rate to be a much lower 20 percent.  Now, journal articles on the topic require the inclusion of the actual dropout rate, he said.

New lab at UAA

As a home for this work, Swift opened a new lab, called the Psychotherapy Process & Outcome Research Lab. There’s no front door to this lab; in fact, the lab is really a virtual space rather than a physical one. Swift and his graduate students collect data and run studies through the campus therapy center or through outreach to the general campus community.  In fact, the Department of Psychology website features a left navigation element called Research Opportunities that is a portal to ongoing research and how to participate.  A UAA username and password are required.

In another recent study, Swift and a graduate student were curious about the therapist and whether how he or she prepared to meet clients influenced effectiveness. So they asked therapists to listen to a 5-minute meditation before meeting the client. Other therapists were permitted to eat their lunch, have a random conversation in the office, make a phone call—whatever they wished.

Clients did not know how their therapist had prepared before their arrival. They were simply asked to rate their therapist’s effectiveness after the session. Uniformly, clients rated therapists who had engaged in the mindfulness meditation as more effective than those who had not.

In all instances of research performed in the campus PSC, clients are informed of the opportunity to participate in advance; they can decline and not jeopardize their opportunity to take advantage of all services at the clinic. The PSC is one of only two in Anchorage that offer a sliding-fee-scale and is open to both the campus and the larger community. Students also have the option of visiting the UAA Student Health and Counseling Center.

New book

Swift and a SUNY colleague have a new book coming out this August, to be published by the American Psychological Association. Not surprisingly, it’s all about therapy dropouts.

The first couple of chapters discuss who it occurs to, advancing a model for why clients drop out. The model weighs perceived and anticipated benefits against perceived and anticipated costs and risks.

The second half of the book compiles ways to decrease the therapy dropout rate.

“I think psychotherapy is a valuable treatment option that is underused,” Swift says. He’s motivated to change that fact, “not because I am in this camp that supports psychotherapy, but change it because therapy is effective. People can get better through its use.”

Dr. Joshua Swift gave a relevant research lecture on psychotherapy April 1, 2011Going forward, his motivation continues to be:

  • What is it about therapy that makes it work
  • How can this treatment be refined so it works for more people.

ADDITIONAL RESOURCES:

  • Read about Dr. Swift’s April 2011 Relevant Research Lecture: Mental Disorders: If one in four suffers, why don’t we get help?
  • Visit the Psychotherapy Process & Outcome Research Lab website.
  • Volunteer for some campus-based research in psychotherapy at this website.
  • Find out more about UAA’s Psychological Services Center, SSB 255, open to the campus community and the general public M-F 8 a.m.-8 p.m, whenever classes are in session. This clinic will reopen Jan. 14, 2013. Students have the option of also visiting the Student Health and Counseling Center,  RH 116-120. 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