Course overview & Intro Flashcards
What is the aim of the course?
To provide me with a: - personalised - practiced - theoretical - researched based Intro to aspects of psychotherapy and counselling
What is psychotherapy?
Specialised therapeutic relationship between practitioner and client to help resolve disorder/ stress/ difficulties coping in social environment.
Psychotherapy is theory driven:
Murdock (2009); a good theory has:
- precision and test ability
- parsimony
- practically
- stimulation
- empirically valid
How is psychotherapy delivered?
- individual
- family
- couple
- therapeutic communities
- e-therapy
How is psychotherapy evacuated?
- single case study designs
- efficacy studies
- effectiveness studies
- Cochrane library reviews
- systematic reviews and meta-analysis of research
Single case experimental design (aka N=1)
- 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)
What is the purpose of efficacy?
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
What is effectiveness?
The effectiveness of a treatment is considered real- life (naturalistic) clinical situation
- where intervention implemented without same internal validity
Is psychotherapy efficacious?
Yes, better than placebo and control conditions
Is psychotherapy better than pharmacotherapy?
Both the same in treatment of depression and anxiety disorders.
Why does psychotherapy work?
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%
Core components in the therapist- client relationship?
- therapist variables: interpersonal style, therapist attributes
- facilitate factors: therapist empathy, respect, non judgemental attitude
- therapeutic alliance: tasks, bond, goals
Who did not agree with Dodo theory?
Larry Beutler, 2002, the Dodo bird is extinct
- some therapies are more effective than others, therefore not all can be labelled “dynamic therapies”
Finding the active therapeutic ingredients that make psychotherapy work?
- mediation and moderation are needed to determine this
What is the first challenge facing psychotherapy interventions?
- 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:
- Absence of psychopathology
- Presence of disorders
What is the second challenge facing psych other interventions?
- 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
What is the third challenge facing psych other interventions?
- 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)
What are the solutions to the challenges?
- 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)
How to move towards process-based therapy?
- Evidence based generic therapeutic processes (acceptance)
- Linked to evidence-based procedure (mindfulness techniques)
- That target a core psychopathology process (experiential avoidance)
How is CBT moving towards process-based therapy?
- 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
