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 emotinoal needs, 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 2022.  Co-Investigator of Pilot Study: What happens after leaving residential childcare? Research into young people’s experiences and outcomes post-placement at the Mulberry Bush School. OU Team: Heather Price, Caryn Onions, David Jones, Felicitas Rost, Katie Rix. Project Partners: School of Psychology and Counselling, Mulberry Bush School.

• Since 2019. Principal Investigator of Pilot and Feasibility Study: Change with Psychodynamic Couple Psychotherapy (REC/IRAS: 2777737). 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. Co-Investigators: Joanna Rosenthall, Leezah Hertzman, Nikolas Heim, Sasha Kreel, Andreas Vossler. Sponsor: Tavistock and Portman NHS. Protocol: Access protocol here.

• Since 2018. Principal Investigator of the HEARD Study – A Health Economic Analysis of the cost of Highly Complex Emotional Needs in public sector health and social care services (REC/IRAS: 19/HRA/2595). Co-investigators: Sue Mizen, Oliver Dale, Frederico Cardoso, Hope Kent, Samantha Rosser. Sponsor: Talking Therapies Task Force. Partners: Centre for Mental Health, Devon Partnership NHS Trust, West London NHS Trust.

• Since 2009: Tavistock Adult Depression study (TADS), a randomised controlled trial (RCT) of the effectiveness of psychoanalytic psychotherapy for treatment-resistant depression (PI: Prof Peter Fonagy). I am principal investigator of the qualitative adjunct 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. We completed the health economic analysis of the TADS and are currently writing up two systematic case studies in collaboration with Dr Jochem Willemsen on a successful and a non-successful outcome.

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 ten 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

I currently co-chair of the production of a new level 2 module D230 Advancing your counselling practice. It is one of two new modules for the new Counselling Qualification (R86 – BSc Counselling). I am also contributing to the delivery of the level 3 module DD310 Counselling and forensic psychology: investigating crime and therapy which is going through a mid-life review. 

Previously, I have contributed to the production of D110 Exploring Psychological Worlds: Thinking, feeling, doing, a Level-1 module by writing content on attachment and systemic psychotherapy. I have also co-produced a level 2 Short Course Advanced Working with the therapeutic relationship (DX003)  that offers continuous professional development on how to gain an advanced, evidence-based understanding of working effectively with the therapeutic relationship. This is a suit of three 25-hour CPD short courses.

Teaching interests

My teaching is informed by my clinical practice. Most of my previous teaching has centred around introduction to psychoanalytic theories and concepts, mental health assessment and diagnosis with a specific focus on depression, loss, developmental trauma, attachment, and personality functioning. I also enjoy teaching a variety of quantitative and qualitative research methods, statistics, and project design at undergraduate, postgraduate and professional training level. 

I got involved with the Society for Psychotherapy Research (SPR) as a student member in 2009 and held various offices since, including the presidency of the UK Chapter from 2017-2020.

As part of my presidency, I led on a review that identified serious methodological flaws in the NICE guideline for depression in 2017. These rendered the treatment guidelines not fit for purpose and threatened to produce treatment recommendations that would be misleading and impede good care and patient choice. To do something about it, I initiated and spear-headed a 5-year-long stakeholder campaign calling on NICE to revise the guidelines. I brought together more than 50 UK mental health organisations and over 60 MPs and peers from across all major parties supported our campaign. Together we achieved something unprecedented: NICE did revise the guidelines twice! 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 the ampaign positions statement here: bit.ly/3bEuDJS and read out full response to the publication of the guideline here: https://t.co/R1fN6pdqm8

Invited talks and keynotes 

Conference presentations and method workshops (Past 5 years):

1. Rost, F. (2023). Q-Methodology: Making Measures Clinically Meaningful. Society for Psychotherapy Research Conference, Dublin, Ireland, June 21-24, 2023.
2.  Rost, F.(2023). ‘Introduction to Q-sort Methodology’. Methodology Workshop, University of Louvain, Belgium
3. Rost, F. (2022). Integrating qualitative and quantitative methods in psychotherapy research: the way forward? Society for Psychotherapy Research Conference, Rome, 22-24 September 2022
4. Rost, F. (2022) Q-Sort Methodology: Bridging the divide between qualitative and quantitative methodology.’ Methodology Workshop, SPR, Denver, USA
5. Rost, F. (2021) ‘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, Heidelberg, Germany/Online June 2021
6. Rost, F. (2021) ’Subtypes of Pedophilia: A Q-methodological study’. Society for Psychotherapy Research Conference, Heidelberg, Germany/Online, June 2021
7. Rost, F. (2019) ‘Patients experience and conceptualization of their pedophilic disorder: a qualitative study’. Society for Psychotherapy Research Conference, Krakow, Poland, September 2019
8. Rost, F. (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, September 2019.
9. Rost. F. (2019). Q-Sort Methodology: Bridging the divide between qualitative and quantitative methodology.’ Methodology Workshop, SPR conference, Krakow, Poland.
10. Heim, N, Rost, F. ‘Paraphilias, Violence and Personality Disorder: Changes in personality functioning as a result of long-term psychoanalytic psychotherapy. Society for Psychotherapy Research Conference, Krakow, Poland, September 2019
11. Rost, F. (2019) ‘Therapist's private theories on curative and hindering factors in long-term psychoanalytic psychotherapy for treatment-resistant depression’ Society for Psychotherapy Research Conference, Buenos Aires, Argentina, June 2019

Society for Psychotherapy Research (SPR)