Evaluating Psychotherapies Flashcards
Specificity Question
the ultimate question of psychotherapy research: Which types of therapy, administered by which kinds of therapists to which kinds of clients having which kinds of problems produce which kinds of effects?
What would a behaviouralist say is the best measurement of change?
A psychodynamic therapist?
A Humanistic therapist?
Behaviouralist: Observation of behaviour
Psychodynamic: How client feels and how much insight in child roots of problems
Humanistic: self concept change
What types of measures are used to assess the outcome of therapy?
- therapist’s ratings
- Client’s self reports
- Ratings of client by acquaintances
- Client’s self monitoring of behaviour
- Behavioural observations
Spontaneous remission
improvements in symptoms in the absence of any therapy
•Opposed Freud’s view that people needed therapy to get better
•Eysenck found rate of spontaneous remission and therapy growth was the same.
•Not actually true
Randomized Clinical Trials (RCTs)
a research design that involves the random assignment of clients having specific problems to an experimental (therapy) group or to a control condition so as to draw sound causal conclusions about the therapy’s efficacy
Placebo Control Group
a control group that receives an intervention that is assumed to have no therapeutic value
Placebo Control Group
a control group that receives an intervention that is assumed to have no therapeutic value
How do therapists standardize their testing methods?
There is a manual with procedures that they must follow exactly
•Monitored by having other’s observe sessions or taping them
Who would object to the standardization of treatment?
Psychodynamics and humanistic therapists
They believe that every therapy case they have is unique in its course, client characteristics and procedures used
Are antidepressant drugs or psychodynamics therapy better for the treatment of depression? How was this conclusion made?
Psychodynamic therapies
•Shown through follow up studies
•Fewer relapses
What are the 5 phases of the randomized clinical trial?
1) Preparation phase
2) Participant Screening Phase
3) Treatment Phase
4) Outcome Assessment Phase
5) Follow up Phase
What is characteristic of the preparation phase?
- Define disorder to be treated
- Train diagnosticians to do structured interview
- Develop treatment manual to standardize treatment
- Train therapists to administer treatments
- Select measures used to assess outcomes
What is characteristic of the participant screening phase?
•Choose participants diagnosed as meeting criteria (Assess reliability to diagnoses)
•Administer outcome measures
Results in random assignment to conditions
What is characteristic of the treatment phase?
Treatment condition(s)
–administered by trained therapists (at least 3)
(obtain rating of therapists adherence and competence)
Control Conditions
–If another therapy, equal number of sessions
What is characteristic of the Outcome Assessment Phase?
•Readminister outcome measures
•Assess client’s attitudes toward treatment, quality of relationship
(Statistical analyses of treatment/control group differences )
What is characteristic of the Follow-up Phase
•Readminister outcome measures
•Collect Relapse Data
(Statistical analyses of treatment/control group differences)
Meta-Analysis
a statistical procedure for combining the results of different studies that examine the same topic
Effect Size Statistic
common measure of treatment effectiveness. Tells researchers what percentage of clients who have received therapy had a more favourable outcome than that of the average control client.
Dodo bird effect
the finding of similar efficacy for widely differing therapies
•Therapy tends to be better by around 65% from those who have not had therapy
Clinical Significance
a definition of therapeutic success in which, at the end of therapy, an individual getting treatment for a particular disorder falls within the range of people not experiencing that particular disorder rather than simply experiencing the disorder less often
What did CR survey tell us?
That 89% of people who received therapy for mental health were somewhat satisfied or very satisfied
What 3 factors influence therapy outcomes?
Therapist Variables (empathy, genuineness, experience)
Client Variables (nature of problem, client motivation)
Techniques (timing of interpretations, specific techniques)
What are 3 important factors of client variables?
- Openness to therapy
- Self relatedness
- Nature of the problem
Openness
a willingness to invest oneself in the process of therapy that predicts favourable therapeutic outcomes
