4 Psychotherapy effectiveness Flashcards
What is the cause and treatment for psychological distress according to the psychoanalytic model?
Cause: unresolved conflict
Treatment: insight
What is the cause and treatment for psychological distress according to the behavioural model?
Cause: learned responses to stimuli (e.g. generalised responses - bitten by dog, afraid of all)
Treatment: new learning
What is the cause and treatment for psychological distress according to the humanistic model?
Cause: thwarted self-actualisation
Treatment: empathy, unconditional positive regard
What is the cause and treatment for psychological distress according to the cognitive model?
Cause: negative core beliefs, biased thinking
Treatment: cognitive restructuring
What did Eysenck’s classic 1952 study demonstrate about psychotherapy?
Hypothesised that most neuroses get better autonomously over two years. Found people in therapy were no better-off than control. Some were worse, particularly those in psychoanalysis.
What is an EST?
An Empirically Supported Treatment
What non-specific factors might account for finding that treatment is better than none, but that all treatments are equally effective?
- Motivation of client
- Illusion of progress
- Being heard
- Therapist-client alliance
What was the objective of the APA Task Force on Promotion and Dissemination of Psychological Procedures?
To promote psychological procedures that have empirical backing. Known as ‘well-established’ treatments.
What are the two broad APA criteria for a treatment to be classed as ‘well established’?
1) At least two good between group design experiments (RCTs) must show treatment is superior to:
- placebo pill
- psychotherapy placebo
- other treatment
OR
- equivalent or better to an already established treatment
What measures should be put in place to ensure the specific effects of a treatment are measured?
- use treatment manuals
- random allocation, double-blind
- exclude pps with comorbidity (otherwise how do we know which disorder is being affected?)
- characteristics and treatment expertise of therapist must be specified (cf. mindfulness training is more effective if therapists practice mindfulness)
What are the two broad APA criteria for a treatment to be classed as ‘probably efficacious’?
- At least two experiments show that the treatment is superior to waiting-list control group OR
- Meets well-established criteria but experiments not carried out by two different teams
What are the 3 ESTs for anxiety disorders?
- Exposure
- Exposure and Response Prevention
- Cognitive Behavioural Therapy (CBT)
What are the 2 ESTs for major depression?
- CBT
- Interpersonal Therapy
What is the EST for child ADHD and conduct disorder?
Parent Management Training
What is the EST for child anxiety disorders?
CBT w parent involvement
What are 3 criticisms of EST research?
- reliance on DSM to define samples (but any better idea?)
- diagnosis is dehumanising
- treatment manuals preclude individualised treatment (but shown better outcomes for treatment with manuals anyway)
Why do randomised controlled trials favour CBT and Behavioural treatments?
Because the outcomes in these treatments are measurable –so easier to test. This doesn’t mean alt. therapies don’t work, just no evidence. (But better way of testing than RCT?)
Why can the generalisability of RCTs establishing ESTs be compromised?
Because trials are conducted in universities by leading experts with carefully selected clients. In real life, may be social worker or nurse delivering treatment, clients are random.
Do lab-proven treatments tend to work in real-life settings?
Yes, but effect sizes tend to be smaller.
