Course overview & Intro

Question 1

What is the aim of the course?

Answer 1

To provide me with a:
- personalised
- practiced
- theoretical 
- researched based 
Intro to aspects of psychotherapy and counselling

Question 2

What is psychotherapy?

Answer 2

Specialised therapeutic relationship between practitioner and client to help resolve disorder/ stress/ difficulties coping in social environment.

Question 3

Psychotherapy is theory driven:

Answer 3

Murdock (2009); a good theory has:

• precision and test ability
• parsimony
• practically
• stimulation
• empirically valid

Question 4

How is psychotherapy delivered?

Answer 4

• individual
• family
• couple
• therapeutic communities
• e-therapy

Question 5

How is psychotherapy evacuated?

Answer 5

• single case study designs
• efficacy studies
• effectiveness studies
• Cochrane library reviews
• systematic reviews and meta-analysis of research

Question 6

Single case experimental design (aka N=1)

Answer 6

• repeated measurements of individuals behaviour
• comparisons across experimental conditions imposed on that individual
• assessment of the measurements reliability within and across the conditions

+ intervention only (B)
+ baseline intervention design (A-B)

Question 7

What is the purpose of efficacy?

Answer 7

To emphasise the interval validity of the experimental design by;

• control types of patients
• standardise treatment delivery
• training & monitoring therapists
• controlling number of treatment sessions
• random assignment to conditions

Question 8

What is effectiveness?

Answer 8

The effectiveness of a treatment is considered real- life (naturalistic) clinical situation
- where intervention implemented without same internal validity

Question 9

Is psychotherapy efficacious?

Answer 9

Yes, better than placebo and control conditions

Question 10

Is psychotherapy better than pharmacotherapy?

Answer 10

Both the same in treatment of depression and anxiety disorders.

Question 11

Why does psychotherapy work?

Answer 11

Common factors among therapies:
- Lambert & Barley (2001) and Hubble, Duncan & Miller (1999) state;
\+ expectancy effect 15%
\+ therapeutic alliance 30%
\+ extra therapeutic change 40%
\+ techniques 15%

Question 12

Core components in the therapist- client relationship?

Answer 12

• therapist variables: interpersonal style, therapist attributes
• facilitate factors: therapist empathy, respect, non judgemental attitude
• therapeutic alliance: tasks, bond, goals

Question 13

Who did not agree with Dodo theory?

Answer 13

Larry Beutler, 2002, the Dodo bird is extinct

- some therapies are more effective than others, therefore not all can be labelled “dynamic therapies”

Question 14

Finding the active therapeutic ingredients that make psychotherapy work?

Answer 14

• mediation and moderation are needed to determine this

Question 15

What is the first challenge facing psychotherapy interventions?

Answer 15

1. Focus on the negative dimensions of mental health
   - focus on removing/ reducing negative symptoms
   - neglect patient strengths

Need to think about the health not just absence of mental disorder

Mental health has two dimensions:

1. Absence of psychopathology
2. Presence of disorders

Question 16

What is the second challenge facing psych other interventions?

Answer 16

2. Single disorder focus
   - different psychotherapy interventions for specific psychiatric syndromes
   - huge number of highly specialised treatment protocols for an ever-expanding number of DSM disorders

• takes so long and not finding out much

Question 17

What is the third challenge facing psych other interventions?

Answer 17

3. Dissemination and sustained uptake is evidence-based interventions by clinicians
   - practitioner training in dissemination context
   (Costly no adequate training)
   - adaption if interventions tested under the controls of efficacy research (consult with stakeholders, and don’t represent real world)

Question 18

What are the solutions to the challenges?

Answer 18

• strength and Capacity vs distress focused (focus on whole person; cognitive, emotional, physical, social, personal values)
• trans-diagnostic Vs single disorder (harness generic therapeutic processes)
  Barlow “both single and trans are effective but trans is more economical)
• ecologically valid & sustainable (self practice approaches, manualised but must be tailored to individual needs, inclusive, easily accessible)

Question 19

How to move towards process-based therapy?

Answer 19

1. Evidence based generic therapeutic processes (acceptance)
2. Linked to evidence-based procedure (mindfulness techniques)
3. That target a core psychopathology process (experiential avoidance)

Question 20

How is CBT moving towards process-based therapy?

Answer 20

• modern CBT is open to wider range of humanistic, existential, analytic and spiritual approaches
• shift from purely syndromes to psychological prosperity and thriving
• mental health is about health not the absence of disorders