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EPPP B1: Clinical Psychology > 07_Psychotherapy Research > Flashcards

07_Psychotherapy Research Flashcards

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1
Q

General Outcome Studies:

Eysenck 1952: Overview

A

1st efficacy studies of psychotherapy

Effects are “small or nonexistent”

Positive effects are result of spontaneous remission

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2
Q

General Outcome Studies: Eysenck

Percent Improvement of Comparative Therapies

A

Control Group: 72% improvement within 2 years

Eclectic: 66%

Psychoanalytic: 44%

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3
Q

General Outcome Studies:

Meta-Analysis

A

Combined results of multiple studies to calculate an effect size

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4
Q

Smith, Glass, Miller (1980)

Meta-Analysis Results and Conclusion

A

Effect size = .85

Psychotherapy equal or exceed medical/educational interventions

“Efficacious in practical as well as statistical terms”

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5
Q

Meta-Analysis:

Therapy Efficacy

A

No one type of therapy to be consistently superior

Positive change due to common factors

*Not any unique or specific techniques

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6
Q

General Outcome Studies:

Four Common Factors

A

Catharsis

Positive relationship with the therapist

Behavioral regulation

Cognitive learning and mastery

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7
Q

Effects of Treatment Length: Howard (1996)

Leveling off of outcome based on treatment length

A

75% at 26 sessions

85% at 52 sessions

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8
Q

Effects of Treatment Length: Howard (1996)

Phase Model: Three Stages

A

Remoralization

Remediation

Rehabilitation

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9
Q

Effects of Treatment Length: Howard (1996)

Phase Model: Remoralization

A

Hopelessness and desperation respond quickly to therapy

Remoralization occurs within the first few sessions

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10
Q

Effects of Treatment Length: Howard (1996)

Phase Model: Remediation

A

Focus on presenting symptoms

Symptom relief usually requires ~ 16 sessions

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11
Q

Effects of Treatment Length: Howard (1996)

Phase Model: Rehabilitation

A

Behavior change and skill building

Number of sessions dependent on symptomatology and severity

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12
Q

Efficacy Studies

A

Clinical trials

Determines whether or not treatment has an effect

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13
Q

Effectiveness Studies

A

Correlational or quasi-experimental

Determines clinical utility
i.e. generalizability, feasibility, cost effectiveness

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14
Q

Seligman’s critique of Efficacy studies

A

Not applicable for empirical validation of psychotherapy

Clinical trials omit too many elements of what is actually done in the field

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15
Q

Sue (1991): Psychotherapy with Diverse Populations

Racial/Ethnic Groups with best outcomes:
High to Low

A

Hispanic American

Anglo

Asian

African-American

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16
Q

Utilization of Mental Health Services:

African-Americans

A

Lower rates of general MH services than whites

Higher rates in ER and psychiatric inpatient settings

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17
Q

Utilization of Mental Health Services:

Asian Americans

A

Underrepresented in both outpatient and inpatient settings

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18
Q

Racial/ethnic group who receive most treatment for:

Depression

A

Whites

Followed by African-Americans and Hispanics

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19
Q

Racial/ethnic group who receive most treatment for:

Illicit drug use

A

African-Americans

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20
Q

Premature Termination Rates:

Racial/ethnic groups % dropout after first session

A

50%: Minority groups

30%: Whites

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21
Q

Premature Termination Rates:

Community Mental Health Setting
Racial/ethnic groups dropout High to Low

A

African-Americans

White & Hispanics

Asian-Americans

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22
Q

Effects of Therapies-Client Matching:

Sue, et al. (1991)

A

Reduced premature termination rates for Asian, Hispanic, and Whites
*but not African-Americans

Improved treatment outcomes for Hispanics only

23
Q

Effects of Therapies-Client Matching:

Individual factors

A

Ethnic identity

Level of acculturation

Gender

Trust of whites

24
Q

Effects of Therapies-Client Matching:

Factors more important than racial/ethnic matching for members of culturally diverse groups

A

Therapist education

Shared values

Shared worldview

25
Q

Interventions for Older Adults:

Most Common Health Problems: High to Low

A

Anxiety

Severe cognitive impairment

Depression

26
Q

Interventions for Older Adults:

Responsiveness to Treatment

A

Benefit from a variety of forms of psychotherapy

Similar degree of benefit to younger adults

*However, often have a slower response to treatment

27
Q

Effective Interventions for Older Adults: Dementia

A

Behavioral and environmental interventions

Memory and cognitive retraining

28
Q

Effective Interventions for Older Adults: Depression

A

Cognitive

Behavioral

Brief psychodynamic

29
Q

Individualization of treatment for Older Adults:

A

Incorporate caregivers/family members

Adapt intervention to setting

Modify therapy for age-related changes in functioning

30
Q

Factors that increase likelihood Spousal/Partner Abuse:

A

Younger

Heterosexual

American Indian/Alaska native

African-American

Income below $10,000

31
Q

Best single predictor of cessation of Spousal/Partner Abuse:

A

Family income

Low income families are most likely to report continued violence

32
Q

Interventions for Spousal/Partner Abuse:

Main Goals

A

Ensuring safety

Developing and rehearsing a safety/escape plan

Self-determination, Self-esteem, Empowerment

33
Q

Interventions for Spousal/Partner Abuse:

Considerations for the Clinician

A

Vicarious traumatization

Alterations in beliefs related to trust and safety

34
Q

IPV: Expressive Abuse

A

Primarily expression of emotion

Mutual or reciprocal

Followed by remorse

35
Q

IPV: Appropriate therapy for Expressive Abuse

A

Conjoint (couples) therapy

36
Q

IPV: Instrumental Abuse

A

Committed without provocation

Goal-directed

Unilateral

Not followed by remorse

37
Q

IPV: Therapy Approach to Instrumental Abuse

A

Main Priority = Physical Safety

Physical Separation of victim and perpetrator

Separate Services

38
Q

Factors that Increase Likelihood of Staying in Abusive Relationship

A

Fear of retaliation against victim or children

Economic dependence

Greater length of relationship

Belief that abuser will change

39
Q

Placebo Effect: Research Definition

A

Placebo = nonspecific/common factors Psychotherapy

Greater symptom reduction than no treatment / waitlist

40
Q

Effect Size of Treatment compared to Placebo and Control Groups

A

.67 = compared to no treatment

.48 = compared to Placebo Control Groups

41
Q

Psychotherapy Practice and Research:

Diagnostic overshadowing

A

Attribution of all psychiatric symptoms to intellectual disabilities

42
Q

Psychotherapy Practice and Research:

Alloplastic vs. Autoplastic Intervention Focus

A

Allo = make changes in environment

Auto = changes in individual increases functionality in environment

43
Q

Prevalence and Effects of Therapist Distress

A

74% = experienced personal distress in past 3 years

36% = decreased quality of work

4% = resulted in inadequate treatment

44
Q

Therapist Distress:

Most stressful client behavior

A

Suicidal statements

45
Q

Therapist Distress:

Most stressful aspect of work

A

Lack of therapeutic success

46
Q

Most frequently encountered ethical/legal dilemma

A

Issues related to confidentiality

47
Q

Psychiatric hospitalization: Role of Gender

A

Higher hospitalization of men
*Increased likelihood to exhibit threatening behaviors

Women have higher prevalence of mental illness
*anxiety and depression mostly treated outpatient

48
Q

Psychiatric Hospitalization:

Perceived Dangerousness

A

Criterion for commitment that became greater focus than “psychopathology” starting the in the 1960’s

Increased male-to-female hospitalization ratio

49
Q

Psychiatric Hospitalization:

Four Relevant Demographic Characteristics

A

Marital status

Race/ethnicity

Age

Diagnosis

50
Q

Psychiatric Hospitalization Rates:

Marital Status, Highest to Lowest

A

Never married

Married or divorced/separated

Widowed

51
Q

Psychiatric Hospitalization Rates:

Race/Ethnicity

A

Whites represent largest total number of inpatients (and outpatients)

In terms of population proportions, patients from other races are overrepresented

52
Q

Psychiatric Hospitalization Rates:

Age Range with Largest Proportion of Admissions

A

25-44 age range for both men and women

53
Q

Psychiatric Hospitalization Rates:

Most common diagnosis: 18 to 44 age range

A

Schizophrenia

54
Q

Psychiatric Hospitalization:

Most common diagnoses: age 65 and older

A

Organic disorder

Affective disorder

EPPP B1: Clinical Psychology (24 decks)

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