Effectiveness of Treatment - Abnormal Psychology Flashcards
How is effectiveness of treatment measured?
Effectiveness of psychotherapies, arguing that spontaneous remission alone was responsible for the individual’s improved condition - in other words, even if the individual did not have therapy, he or she would have improved, simply through a natural process of recovery, just as with a common cold.
Questions to consider when evaluating the effectiveness of treatment
For how long must a person show relief from his or her symptoms to be categorized as a treatment success? If the patient eventually relapses, does this mean that the therapy was not successful?
Should the focus only be on the reduction of symptoms? Is a total absence of symptoms the only criterion for successful treatment that should be used?
Is the original diagnosis valid? Can we really compare two clients who both suffer from depression if they exhibit different symptoms? What role do the extent and the duration of the disorder prior to treatment play in determining the success of treatment?
Should only observable behavioral changes be used to assess success? Or should we rely on the self-reported data of the client?
Who decides whether a therapy is successful? The therapist? The patient? An objective observer?
Double-blind placebo-controlled studies
some of the participants are given the treatment, others are given a fake treatment (the placebo), and neither the researchers nor the participants know which is which until the study ends; thus, they are both “blind.”
outcome studies - what is it and why is the other not good?
Focuses on the result - improvement or not?
the other is not good because: Therapist reporting success in their own therapy lack objectivity. Self-reporting from client is also unrealible as it is unsure whether they are in the right state of mind. Family and friends may be part of the problem.
Meta-analysis
systematically assesses the results of previous research to derive conclusions about that body of research. Researchers carrying out a meta-analysis are examining the consistency of the results - or what is known as the effect size - the standardized difference between the results among the chosen studies. It is important that the studies that are chosen are testing the same hypothesis. A meta-analysis helps researchers to compare data from a much larger sample than is usually possible in a single study. However, there is the danger of researcher bias when choosing which studies to include in a meta-analysis. Another concern is that research that does not support a hypothesis often is not published - this form of bias is known as the publishing bias or the file drawer effect.
Smith and Glass (1977)
AIM:
Evaluate the effectiveness of psychotherapy by analyzing outcomes across multiple controlled studies.
PROCEDURE:
Conducted a meta-analysis of 375 controlled studies on psychotherapy.
Compared outcomes of individuals who received therapy with those who did not (untreated individuals).
FINDINGS:
On average, clients who received therapy were better off than 75% of untreated individuals.
All types of therapy were found to be effective to some extent, with no significant differences in outcomes based on the type of therapy.
Researchers suggested that the therapeutic effect may be similar to the placebo effect, where the act of receiving treatment itself has a beneficial impact.
evaluation points for smith and glass
Strengths:
Large-scale analysis of 375 studies provides robust evidence for the effectiveness of psychotherapy.
Highlights the universality of therapeutic benefits across different types of therapy.
Supports the importance of seeking treatment for psychological issues.
Limitations:
Meta-analysis does not account for individual differences in therapy outcomes or preferences.
Potential variability in the quality and methodologies of the included studies.
Does not provide insights into the specific mechanisms that contribute to the effectiveness of therapy.
Comparison to placebo effect suggests a need for further research on the active components of therapy versus the contextual factors.
Cuijpers et al (2011)
AIM:
Investigate the overall effectiveness of psychotherapy in the treatment of adult depression compared to no treatment.
PROCEDURE:
Conducted a meta-analysis of 147 studies involving several thousand participants.
Compared outcomes of individuals who received psychotherapy with those who did not receive treatment.
FINDINGS:
All forms of psychotherapy were found to be superior to no treatment in alleviating symptoms of adult depression.
Results align with earlier findings by Smith and Glass (1977), reinforcing the general effectiveness of psychotherapy.
Both meta-analyses challenge Eysenck’s theory of spontaneous remission, which suggests that people recover from depression without intervention.
evaluation for cuijpers et al
Strengths:
Inclusion of a large number of studies and participants increases the reliability and generalizability of findings.
Confirms the effectiveness of psychotherapy across diverse approaches.
Challenges outdated notions of spontaneous remission in untreated depression.
Limitations:
As with Smith and Glass (1977), does not identify the specific mechanisms that contribute to the success of psychotherapy.
Potential variability in study designs and therapy implementations among the 147 studies.
Focuses on adults, limiting applicability to other populations such as children or adolescents.
Findings reinforce general trends but do not explore individual differences in therapy outcomes.
Publication bias
Researchers can use these files to conduct meta-analyses that include all studies, also those with negative results. One of the problems with most meta-analyses is that they depend on published work but studies selected for publication of clinical trials may not tell the whole story and therefore lead to unrealistic estimates of drug effectiveness.
file drawer effect
bias in the scientific literature where only successful or positive results of the research are published → null hypothesis not published
