Chapter 16 - Psychological Treatment

Question 1

What are the characteristics of a therapeutic alliance?

Answer 1

1) both the client and therapist need to work collaboratively
2) agreement on goals and tasks of therapy
3) an affective bond (client should trust therapist)

Question 2

1) Describe the 5 different ways of measuring success in therapy, and the weaknesses or strengths of each of
these methods.

Answer 2

1) ) a client’s reports
- not very reliable
- many reasons (will be more included to say they feel better)
- justification of effort
- placebo effect
- therapists are nice!

2) a clinician’s ratings
- not as unreliable as a client, but still pretty unreliable
- will be more inclined to say they’re doing better bc they want to be believe their treatment was a success. (also they only see client’s during a limited time)

3) reports from the client’s family or friends (third-party)
- can also include independent raters
- client’s family (even more objective)
- but they can still be swayed to say they see improvement
- independent raters are most objective, especially when they are BLIND to what the patients are being treated for

4) comparison of pretreatment and posttreatment score
- regression toward the mean!
- even though these tests are saying that you feel better, in reality you can just be reverting back to your average self

5) improvement on overt behaviors
- be very helpful for treating phobias (you couldn’t touch a bug before but now you can!) but not very helpful for internalizing disorders

Question 3

What is manualized therapy? Why was it developed?

Answer 3

-> structure therapy!! (little variability from each therapist)

Efforts to “manualize” therapy represent one way that
researchers have tried to MINIMIZE this variability in patients’
clinical outcomes (during clinical trials) that might result from characteristics of
the therapist themselves (such as personal charisma)

Question 4

Describe the major approaches to behavior therapy (exposure, aversion, modeling, systematic
reinforcement, token economies).

Answer 4

• Exposure: for anxiety, patient is confronted with the fear-producing stimulus in a therapeutic manner!
  
  • Pair this fear-inducing activity with something relaxing, this will teach the patient to relax when in the present of anxiety-producing stimuli.
• Aversion: modifying undesirable behavior with PUNISHMENT! (ex: take a drug that makes you vomit everytime you drink, to help fix your drinking problem!)
• Modeling: the patient MODELS a parent, peer, or therapist! (they learn new skills by imitating them!)
• Systematic Reinforcement: Using systematic programs to reinforce the frequency of desired
  behavior
• Token Economies: a patient receives some token or monetary item that could be used to RECEIVE rewards or privileges. (similar to systematic reinforcement that it increases good behaviors!)

Question 5

In what types of situations is neurosurgery still used today to treat psychological disorders?

Answer 5

• Today, selective destruction of small areas of the brain! (can be used for patients with severe OCD, treatment-resistant severe self-injury, or intractable anorexia nervosa!)