Lecture 1 Flashcards
What is theory? (2)
-A set of concepts and their defined relationships
-Intended to explain some phenomonen or interest
Why use Psychological Theories?
5 points
Framework: to develop a consistent and coherent approach
Behaviour: explains and predicts behaviour and the change process
Formulation and treatment planning: helps organize important information- ‘map to treatment’
Therapist: can keep focussed and efficient
Provides a map for assessment, diagnosis and treatment - The map needs to match the terrain
EMPIRICALLY SUPPORTED THERAPIES -CRITICISM (4)
Difficult and controversial to put into practice as ‘intervention’ can be a fluid, mutual, interactive process.
Most evidence we have is for behavioural or cognitive-behaviour perspectives
Diagnosis specific: some clients may not meet threshold criteria
Much of the research on empirically supported treatments based on Eurocentric clients
HOW TO SELECT THE THEORY? (4)
Knowledge about main psychological theories
Competency to practice
Identify the theory that is consistent with own values, assumptions and culture
Consider research evidence
What are some of the main theory in counselling pysch? (4)
Strengths focused
Oriented toward health not dysfunction
Commitment to scientist-practitioner model
Attention to individual and cultural diversity
What are four principles of intervention?
Match treatment to a specific psychological or physical pathology
Match treatment to patient characteristics
Match treatment to setting (effectiveness research)
Match treatment to therapist (knowledge, values, ethics, etc.)
What are three cultural considersations for using theory?
Psychopathology manifests in differently in different ethnic groups
Much of the research on empirically supported treatments based on Eurocentric patients (Chambless et al. , 1996)
Generalizability and representativeness
What is the Maori term and definition of mental wellbeing?
TAHA HINENGARO
Holistic view of mental wellbeing: recognises the interdependence of good mental health on good physical, social and spiritual health
What are 6 important contributors to Maori mental wellbeing? And their Maori names
Relationships (whakawhanaungatanga)
Strong cultural identities (tuakiri ahurea)
Healthy physical environment (taha tinana)
Healthy lifestyles (hauora)
Being able to participate in society (taha whanau) Community leadership (Rangatira, te kaiarahi hapori)
Autonomy (mana motuhake)
What is the Maori definition/origin of mental distress? (2)
Derive from transgression of sanctity through breaches of tapu or mākutu, resulting in unusual manifestations of the mind
Without the ability to practice reciprocity, to manaaki others, and to ensure whānau and other social relationships remain intact, hauora hinengaro Māori is threatened
What is the scientist practioner approach about for a psychologist?
A scientist-practitioner needs to research which models work best with which clients and which problems and develop practice based on these approaches (BPS, 2005)
What term is used for which evidence to use?
Hierarchy of evidence
-Quantitative research is often prioritized
Name the order of those in the heirachy of Research Design/levels of scientific evidence (7)
1) Clinical Practice Guidelines
2) Meta Analysis/systematic reviews
3) RCTS
4) Cohort studies
5) Case control studies
6) case reports/case series (narraticve review)
7) Animal lab studies
Learn Pryamid pic
What are the 3 major groups within heirachy of evidence and describe?
- Systematic reviews and metanalyses review primary studies that use explicit thorough objective methods to locate and appraise research studies.
- Randomized Controlled Trials (RCT’s) are studies where people are
assigned by chance alone to one of several interventions in order to compare the effects of treatments. - Quasi-experimental studies compare groups on basis other than randomization (include single case experimental designs).
What is the Dodo Bird Effect?
(who, when, what)
- The Dodo bird verdict (Rosenzweig, 1936) refers to the claim that all psychotherapies, regardless of
specific components, produce equivalent outcomes → “Everybody has won and all must have
prizes.“ - Common factors are more important than specific technical differences → so they all produce
equally effective outcomes. - Specific techniques or treatment strategies → only minor importance
- Meta analysis by Budd & Hughes (2009)
What are common theraputic factors?
a) Demonstratbly effective (3), b) Probably Effective (3) and c) Promising (insuffucent evidence (4)
a) Alliance, Empathy, Collecting clients feedback
b) Goals consensus, collaboration positive regard
c) congruence/genuineness, repairing of alliance ruptures, self-disclosure, managing countertransference
What are the factors influcing effective therapy and their %s?
Client factors - 40%
Relationship - 30%
Client expectations - 15%
Therapy techniques - 15%
(Lambert and Barley, 2001)
How do psychologists use research? (3)
- Scientist-practitioner model : research-orientation in clinical practice and applied relevance in
research. - Research informed approach: research is one important consideration in informing therapy with a
client. - Other factors informing the choice of intervention include professional training and practice, and
ethics.
What are 5 practice recommendations?
1- Create and cultivate the therapeutic relationship
2- Use elements found to be demonstrably and probably effective
3- Adapt therapy to specific client characteristics
4 - Routinely monitor clients’ responses to the therapeutic relationship and the ongoing treatment
5 - Concurrent use of evidence-based therapy relationships and evidence-based treatments
(Norcross & Wampold, 2011)
Name 5 reasons to monitor progress and outcome?
1) To notice changes in symptoms
2) To determine effectiveness of intervention
3) To determine if need to alter treatment
4) Limited health dollar/money/resources – need to be used effectively
5) Funding! Health care organizations often need to provide problem-focused, time-limited treatment
and be able to demonstrate the effectiveness of treatment
What are 3 ways to monitor progress/outcome?
1- informal client feedback or cinical judgement
2 - standardised psychological tests/progress measures
3 - Purpose designed outcome measures
What was Hatfield and Ogles (2004) findings for outcome measures?
It was a survey of use of outcome measures in clinical practice
- 37% used outcome assessment
- Most common were BDI, Global Assessment Scale, Child Behavior Checklist, Structured Clinical Interview
- Individualized measures includes focus on target behaviours and target complaints.
- Clinicians who assess outcome in practice were more likely to be younger, have a cognitive– behavioural orientation, conduct more hours of therapy per week, provide services for children and adolescents, and work in institutional settings.
- Clinicians who do not use outcome measures endorsed practical (e.g., cost, time) and philosophical (e.g., relevance) barriers to their use
What is the SRS? Plus 4 parts of it?
Session Rating Scale
Client rates how session went on a scale for
- Relationship (feeling heard, undeestood and respected
- Goals and Topics (what they wanted to cover)
- Approach/Method (a good fit?)
- Overall (something missing/or session was right for me)
What is the PWI and its 7 items?
Personal Wellbeing Index -
‘How satisfied are you with your life as a whole?’
1. Standard of living
2. Health
3. Achieving in life
4. Relationships
5. Safety
6. Community-connectedness
7. Future security.
Name 3 summary points for the scientist/practitioner model for counselling psychs?
Psychologists as scientist practitioners use findings from a wide variety of research approaches
including quantitative and qualitative.
Counselling psychologists take a research informed position in their work with clients.
Progress and outcome monitors are important to incorporate in treatment.
