11. Common factor and integrative models

Question 1

Common factors are misleading

Answer 1

1. Comparative therapy studies ignore therapist effects and thus overestimate treatment effects
2. Lack structural equivalence
3. Outcome differences often due to allegiance effect (researchers favourite)

Question 2

What are integrative therapies?

Answer 2

Proliferation of therapies
- inadequacy of single therapy for all patients and problems
- opportunities to observe and experiment with various treatments

Question 3

Technical eclecticism

Answer 3

Tools
- Improve ability of treatment selection
- Guided by research
- Actuarial rather than theoretical
- Not to be confused with syncretism (unsystematic blending of concepts, chaotic)
- Uses evidence-based technique for each problem

Question 4

Theoretical integration

Answer 4

Ideas
- 2 or more theories integrated so that composite is more effective
- Blend both theory and technique
- eg Cognitive-Behavioural therapy

Question 5

Multimodal therapy

Answer 5

Representative of technical eclecticism
- Psychological disturbance as a result of numerous influences (conflict/maladaptive habits/biological/external/…)

Question 6

Multimodal therapy
Comprehensive assessment of patient’s deficits and excesses

Answer 6

BASIC ID
Behaviour
Affect
Sensation
Imagery
Cognition
Interpersonal relationships
Drugs/biology

Question 7

Systematic treatment selection
Assumptions

Answer 7

1. there is no treatment method or model that works well on all patients
2. most treatment methods work well on some patients

Question 8

Systematic treatment selection
Aim

Answer 8

Aims to identify the specific pattern of patient traits and states that best fit with a treatment strategy and a therapist’s particular relationship style.

Question 9

Systematic treatment selections
Phases of assessment of Functional Impairment

Answer 9

• Functional Impairment Complexity (determines treatment frequency, duration and intensity)
• Patient’s coping style (select methods of intervention that rely on insight or beh. cog. training)
• Resistance ( state and trait properties, opposition to therapists efforts)

Question 10

Motivational distress Yerkes and Dodson’s inverted-U law

Answer 10

Performance on a complex task increases up to an optimal point as arousal increases and performance decreases.
- If low arousal: arousal-induction to increase motivation
- If high arousal: arousal-reduction to concentrate on therapy process

Question 11

Limitations of integrative models

Answer 11

• Lack of evidence
• Research mainly focused on specific factors

Question 12

Future directions of integrative models

Answer 12

• Incorporate neuroscience and cognitive science into psychotherapy
• Therapies matched not only to clinical diagnosis but to transdiagnostic features
• Cognitive-behavioural-acceptance therapies will rival and perhaps overtake integrative.