Interventions Flashcards
What is an intervention?
1) Any treatment undertaken to halt, manage, or alter the course of the pathological process of a disease or disorder (APA, 2023)
2) Action on the part of a psychotherapist to deal with the issues + problems of a client (APA, 2023) - psychology definition
- Usually takes place when a child is experiencing difficulties
- Often solicited by the child, their family/carers or teachers (sometimes police/criminal justice system)
What do interventions aim to achieve?
- To make a change in the way people feel, think or believe
- Should be a two way process - based on thorough assessment + formulation, not just diagnosis
- Should be agreed goals between therapist + client
- Potential to do harm
What are the ethical principles of interventions?
All psychological intervention practice must comply with the BPS Code of Ethics + Conduct
1) Respect- Treating everyone with equal respect regardless of differences in social status, ethnic origin, gender, capacities or any other group-based characteristics
2) Competence- Therapist must have necessary skills in order to deliver the intervention, should have required skills, training + experience
3) Responsibility- Therapist should be aware of the position of power they have, avoid harm + prevent misuse or abuse of their contribution to society
4) integrity- Therapist should exercise honesty, accuracy, clarity + fairness in their interactions to avoid conflicts of interest + maintain personal + professional boundaries
What are the goals of interventions?
Medical Model (common):
- The ‘disorder’ is within the individual
- Focus would be on the cluster of symptoms the individual is presenting with
- Intervention focuses on reducing symptoms + ‘normalcy’
Social Model:
- Society is at the heart of the problems/challenges faced
- Focus is to identify social + environmental contributions to the client’s difficulties
- Focus is on quality of life, skills, goals + accommodation
How are interventions assessed?
Gold standard method for evaluating the efficacy of an intervention is to apply randomised control trials (2 components)
Before - after
Control condition
Describe the before - after condition
- Same measurements are taken from the ppts at the beginning + end of intervention
- Aim is to show that post-intervention measures are improved as compared to pre-intervention measures
If intervention is very long, there may be more time points - To measure progress, we would apply the same assessment to the child before the intervention + after the intervention + then see a significant improvement at the end
What are some potential issues with the before-after condition?
- Mere passage of time or ‘practice effect’ might affect responses (can be solved using control condition) -> may be an improvement after intervention compared to before, but this may be because time has passed or a problem that the child would grow out of
- Same measure may no longer be valid at time-2 -> assessment may not be valid at the time or if the child develops overtime (measurements have to be equally valid)
- People opting in for the intervention may be a ‘biased sample’ (e.g. too keen to improve)
- An effect found at the end of the intervention may not be sustained in the long term -> need to collect data at a follow-up timepoint as well
Describe the control condition
- Same measures taken from intervention + control ppts
- Commonly used control conditions are: wait-list control, treatment-as-usual (TAU), another intervention
- Aim is to show the intervention group improves more than the control group in the pre-post measures
What are some potential issues with the control condition?
- Tricky to find a ‘good’ control group - clinical/daily relevance
- Difficult to assign people to the conditions randomly, but not always possible in practice
- Wouldn’t be ethical to withhold a potentially effective intervention from the control group -> to overcome this, the intervention group would receive the intervention as they would + you would keep the control group either waiting or given them a different intervention, then once this intervention is finished you would give the same intervention to the control group
What do we mean by acceptability + feasibility?
Acceptability: How willing are the ppts to take the intervention?
Feasibility: How sustainable is it to apply to this intervention (e.g. for the health system, schools etc.)
What are some examples of common psychological interventions?
- Cognitive behavioural therapy (CBT) e.g. ‘Think good, feel good’
- Behavioural therapies e.g. Applied Behaviour Analysis (ABA), Exposure, Response Prevention (ERP)
- Parenting interventions e.g. Triple P
- Family therapy e.g. Systematic family therapy
- Play therapy e.g. Child centred play therapy
Describe the history of CBT
CBT emerged as a result of the ‘cognitive revolution’ that came in opposition to behaviourism in psychology
- We are more than just our behaviours, we have thoughts too
- Our thoughts influence our behaviour + vice versa
- Behaviours don’t always reflect thoughts, so changing only the explicit behavioural manifestation may not change the underlying cognitions
Aaron Beck in 1960’s:
- Pioneered the transfer of cognitive psychology into a therapeutic structure
- Most famous for developing the Beck Depression Inventory
Describe the CBT theory
- You have core beliefs about yourself, others and the future, which you conduct based on experiences
- Based on these core beliefs, you have certain thoughts, behaviours + emotions in the here and now
- What we think affects how we act + feel
- What we do affects how we think + feel
- What we feel affects how we think + do
Therefore, intervening with one of them (e.g. emotion) will change thoughts + behaviour as well
What is CBT?
- CBT aims to change the individuals cognition (i.e. thoughts) + behaviour
- CBT looks at how feelings, thoughts + behaviour influence each other + how these patterns may be changed
- Much of CBT is built on behavioural patterns (mostly operant conditioning but not always)
- Therapist has a not-knowing, not-leading position
- The most evidence-based psychotherapy method
- Offered within many national health systems, including NHS
What are some examples of biases/distortions/irrational thought patterns CBT can target?
Personalisation- “This is my fault” i.e. attributing the personal responsibility for events that aren’t under a person’s control + having the feeling of guilt that overrides them
Magnification- “Making a mountain out of a molehill” i.e. blowing things out of proportion
Overgeneralisation- Making sweeping conclusions based on a single event
Minimisation- “Useless, inadequate, failure” i.e. minimise the positive thoughts or emotions that you have + focus more on the negatives
