Dr Felicitas Rost

Professional biography

My area of interest is in psychotherapy outcome and process research. More specifically, my focus has been on psychoanalytic treatment, mental health problems with a particular interest in loss, developmental trauma, chronic depression, and problems with sexuality and violence.

I am also interested in the person’s private theories and lived experiences of their problems and difficulties (including, for example, that of depression, paraphilia or with their couple relationships), as well as in exploring taxonomies and prototypes using Q-methodology.

I have worked in a variety of developmental and adult mental health research projects within the NHS and private sector. It followed a natural progression from carrying out front-line quantitative and qualitative research with particularly vulnerable participant groups (including infants and toddlers) to managing the day-to-day running of a large-scale RCT on the effectiveness of psychotherapy for chronic depression. This led on to the developing and overseeing of an extensive service evaluation, collecting real-world data, from forensic patients receiving psychotherapy, to being the Principal Investigator of two studies currently: One investigates the cost of patients with highly complex relational disorders, the other is a pilot study of psychodynamic couple’s therapy.

I integrated a qualitative part into all research programs to provide a dialogue between robust quantitative, formal qualitative and clinical research methodology. I believe a perspective from several angles provides us with a closer estimation of a true understanding of whatever we study.

I have become very interested in Q-methodology, an innovative technique capable of bridging the divide between nomothetic and idiographic inquiry. It provides an avenue for psychological and counselling research to study process and outcome that could be utilised more often. I have been running workshops and recently published a paper that aims at making this method more accessible to students and clinicians:

Rost, F. (2021). Q‐sort methodology: Bridging the divide between qualitative and quantitative. An introduction to an innovative method for psychotherapy research. Counselling & Psychotherapy Research, 21(1): 98-106. https://doi.org/10.1002/capr.12367

Ongoing research projects:

• Since 2019: Pilot and feasibility Study: Change with PCP at the Tavistock and Portman NHS Foundation Trust. The study assesses change in couple’s distress after 12-months psychodynamic couple psychotherapy. It also investigates couple’s private theories on problem and change formulation. I am PI, Co-Investigators: Joanna Rosenthall, Leezah Hertzmann, Nikolas Heim & Andreas Vossler. 

• Since 2018: HEARD Study. A health economic analysis of the cost of highly complex relational disturbance in public sector health and social care services. In collaboration with Devon Partnership NHS Trust, West London NHS Trust & The Centre for Mental Health. Funder and steering group: Talking Therapies Taskforce. I am PI, Co-Investigator: Sue Mizen.

• Since 2015: Portman Clinic Service Evaluation, Tavistock and Portman NHS Foundation Trust. I implemented an extensive routine outcome monitoring and naturalistic outcome/process evaluation of group and individual psychotherapy for patients experiencing problems with violence, paraphilias and sexual problematic behaviours. Besides collecting a range of outcome data from both therapists and patients, we conduct qualitative interviews with both about their experience of their specific problems and of the treatment received.

• Since 2009: Tavistock Adult Depression study (TADS), Tavistock and Portman NHS Foundation Trust. The TADS is a RCT evaluating the effectiveness of psychoanalytic psychotherapy for treatment-resistant depression (PI: Peter Fonagy). Since 2010 I have been PI on a qualitative study linked to the trial exploring problem formulation, pathogenesis, and change formulation of patients and therapists. My for PhD I developed a Q-sort measure to assess subtypes of chronic depression and explored important differential treatment effects. Currently, we are completing the health economic analysis of the TADS (in collboartion with Leonardo Koeser) as well as two systematic case studies on long-term psychoanalytic psychotherapy (in collaboration with Jochem Willemsen).

Supervision and Viva examination

I feel honoured to have had the opportunity to supervise a range of BSc and MSc theses at UCL and the Tavistock Clinic over the years that included both quantitative and qualitative projects within the field of psychology and psychotherapy. I have also supervised 10 Professional Doctorates in Psychology and Child and Adolescence Psychotherapy Training.  I have also been Internal and External Examiner for both Clinical Psychology and Child and Adolescent Psychotherapy Professional Doctorates.

If you are interested in doing a Doctorate or PhD with me, please do email me.

Teaching at the Open University

Having just joined, this section is brief, but I am looking forward to updating it in due course! The modules that I am currently involved with are DD310 Mad or Bad module in presentation and production of the short course DXS003 “Working with the therapeutic relationship” as well as the level-1 course DD110.

Teaching at the Tavistock Clinic and UCL

• I have been running 3-day training courses on how to conduct DSM SCID-I (general mental health disorders) and SCID-II (personality disorders) interviews and diagnostic assessments since 2009.

• I taught research skills on how to conduct systematic literature reviews to students doing a Pg Dip/MA in Psychological therapies with children, young people, and families (M34), and to students doing an MSc in KUF Personality Disorder

• I taught research methods to students doing a BSc in Psychodynamics of mental health practice (D65)

• I was a seminar tutor for on the BSc Medicine course, introducing psychoanalytic concepts, and on the BSc Psychology course on to critically read and write academically.

• For six years I led a fortnightly discussion group on critical paper-reading of psychoanalytic theory.

I got involved with the Society for Psychotherapy Research as a student member in 2009 and served first on the Council for a few years and then as the president of the UK Chapter from 2017-2020. I have served on several programme and organising committee and our collaborative efforts have led to many enjoyable and very successful national and international conferences and workshops.

I have been leading a stakeholder campaign for NICE to adopt sound methodology in the production of its guideline for depression in adults. It started in 2017 when I found myself shocked about the number of significant methodological flaws. Since then, around 50 stakeholder organisations from across the UK, representing service users; professionals from psychiatry, psychology, social work, counselling and psychotherapy; research methodologists; GPs; pharmacists; nurses; and mental health charities and survivor-led organisations, have supported the campaign. Together we have argued strongly that the draft guideline wasn’t fit for purpose and that the resulting treatment recommendations would be misleading and impede good care and patient choice. The campaign received support from over 100 MPs and Peers from across all the major parties. Although NICE has not addressed all our methodological concerns, as a result of our campaigning, we now have a much-improved guideline with a far greater emphasis on personalised care, service user choice and shared decision-making.

In 2019, I received the British Psychoanalytic Council's ‘Outstanding Professional Leadership Award’ for my work on the campaign.  

You can find our positions statement here: bit.ly/3bEuDJS and read out full response to the publication of the guideline here: https://t.co/R1fN6pdqm8

Conference papers and keynotes since 2017

2022

Rost, F. Time for a Sea-Change: NICE Guidelines need a revised methodology OR is it time to develop an alternative? Society for Psychotherapy Research, July 6-9, 2022, Denver, USA

Rost, F. Pre-conference workshop. Q-Sort Methodology: Bridging the divide between qualitative and quantitative methodology.’ Society for Psychotherapy Research, July 6-9, 2022, Denver, USA

2021

Rost, F. Research Impact Symposium: Using research to impact counselling and psychotherapy practice and mental health policy - NICE stakeholder campaign. Open University & Society for Psychotherapy Research, virtual July 2, 2021

Rost, F. Routine Outcome Monitoring (ROM) at the Portman Clinic: A national health psychoanalytic psychotherapy clinic for forensic patients in the UK. Society for Psychotherapy Research conference, virtual, June 23-26, 2021

Heim, N & Rost, F. Subtypes of Paedophilia: A Q-methodological study.Association of Clinical Psychologists UK Annual conference, virtual, April 2021

Rost, F. Psychotherapy in the Era of Evidence-Based Practice and why it’s time for a Sea-Change for NICE Guideline Developments. Association of Clinical Psychologists UK Annual conference, virtual, April 2021

2020

Rost, F., Busse, A., Heim, N., Ahlers, I, Blumenthal, S & Yakeley, J.The routine outcome monitoring and treatment evaluation at the Portman Clinic: A national health psychoanalytic psychotherapy clinic for forensic patients in the UK. Society for Psychotherapy Research conference, Amhurst, USA, Jun 17-20, 2020. [conference cancelled due to COVID-19]

2019

Rost, F. Pre-conference workshop. Q-Sort Methodology: Bridging the divide between qualitative and quantitative methodology. An introduction to an innovative tool for psychotherapy research. Society for Psychotherapy Research conference, Krakow, Poland, September 19-21, 2019

Rost, F. Treatment guidelines need a revised methodology. It's high time for a sea-change and viable alternatives. Society for Psychotherapy Research conference, Krakow, Poland, September 19-21, 2019 [structured discussion]

Ahlers, I & Rost, F. (Sep 2019). Brief paper.  Patients experience and conceptualisation of their paedophilic disorder: a qualitative study. Society for Psychotherapy Research conference, Krakow, Poland, September 19-21, 2019

Rost, F, Maissis, G & Fonagy, P. (Sep 2019). Therapists' private theories on the helpful and hindering factors of long-term psychoanalytic psychotherapy for treatment-resistant depression (TADS study). Society for Psychotherapy Research conference, Krakow, Poland, 19-21, September 2019

Heim, N., Ahlers, I, Busse, . & Rost, F. (Sep 2019). Brief paper. Paraphilias, Violence and Personality Disorder: Changes in personality functioning as a result of long-term psychoanalytic psychotherapy. Society for Psychotherapy Research conference, Krakow, Poland, 19-21, September 2019

Rost, F & Maissis, G. Therapist's private theories on curative and hindering factors in long-term psychoanalytic psychotherapy for treatment-resistant depression. Society for Psychotherapy Research, July 4-6, 2019, Buenos Aires.

Rost, F. Have RCTs passed their time? A structured discussion on the value of RCTs in psychotherapy research today. Society for Psychotherapy Research, July 4-6, 2019, Buenos Aires.

Rost, F. Keynote. Psychotherapy in the Era of Evidence-Based Practice. Working with research in practice - universities and colleges conference, University of Cambridge & BACP, Cambridge, June 13, 2019

Rost, F. Public Talk. Time for a Sea-Change: NICE Guidelines Need a Revised Methodology. A report of an ongoing stakeholder campaign against the draft guideline on depression. British Psychological Society, London, June 4, 2019

Rost, F. Keynote. Psychotherapy in the Era of Evidence-Based Practice. Workshop on Q-Methodology; Metanoia Institute Research Academy, London March 18, 2019

2018

Rost, F. What is your vision of how we could develop contemporary practice through using research and the evidence base? Psychoanalytic Psychotherapy Now Conference, November 2018

Rost, F. & McPherson, S. Guidelines for depression – is it time to end our strategic ignorance? Society for Psychotherapy Research, Amsterdam, Netherland, June 27-30, 2018

Rost, F.  Personality and Outcome in TRD – Exploring differential treatment effects in the TADS study. Society for Psychotherapy Research, Amsterdam, Netherland, June 27-30, 2018

Ahlers, I. & Rost, F. You get to understand yourself better – Depressed patients’ experience of LTTP. Results from a thematic analysis of PTI interviews. Society for Psychotherapy Research, Amsterdam, Netherland, June 27-30, 2018

Rost, F Keynote: Systematic reviews for an ageing NHS Does NICE need to change its methodology? 11th Annual New Savoy Conference, London, March 21-22, 2018

Rost, F. & Ahlers, I. Unto those that have even more shall be given’? Greater or less benefit in different patients and their therapies. Depression Inside Out Conference, University College London, London, March 9, 2018

2017

Rost, F. Keynote: Long-Term Psychoanalytic Psychotherapy for Treatment-Resistant Depression. Primary and Secondary findings from the Tavistock Adult Depression Study. Psykoterapiecentrum, Stockholm, Sweden.  November 2017

Rost, F. Long-Term Psychoanalytic Treatment for Treatment-Resistant Depression – The TADS Study. Lausanne, Switzerland, September 27, 2017

Ahlers, I. & Rost, F. Giving depressed patients a voice: patients’ experience of the outcome and helpful and unhelpful factors of long-term psychoanalytic psychotherapy.  Society for Psychotherapy Research, Oxford, September 23, 2017

Rost, F., Yakeley, J. Blumenthal, S.  Paraphilias, violence and personality disorder: implementing clinical research at the Portman Clinic. Society for Psychotherapy Research, Oxford, September 23, 2017

Rost, F. Q-sort Methodology: Making Assessment Measures Clinically Meaningful. Society for Psychotherapy Research, Oxford, September 23, 2017

Rost. F. Who Benefited (and who did not) from Psychoanalytic Psychotherapy. Secondary analyses from the TADS. Joined Essex and Tavistock Annual Research Conference, Colchester, July 2017.

Rost, F. Q-Sort Methodology: Making Assessment Measures More Meaningful. Society for Psychotherapy Research, Toronto, Canada, June 21-24, 2017