Lecture 15: The Effectiveness of Psychotherapy

Question 1

What are some of the reasons it is so difficult to determine whether therapy is effective?

Question 1

Describe characteristics of an RCT for psychotherapy and how these characteristics differ from
how therapy is typically practiced in the “real world.”

Answer 1

RCT
- manualized treatment (very structured, little deviance b/w each therapist)
- can’t choose therapist
- fixed sessions
- patients meet criteria for a single disorder
- outcomes are well operationalized

Actual
- not fixed duration
- patients choose therapist
- more flexibility in therapy
- comorbidty
- concerned w/ improvement in general, not just reduction of specific symptoms

Question 1

What would it mean to talk about a “clinically significant” effect of therapy?

Answer 1

How much of an impact does the therapy have a patient (what exactly is the difference?)

• ex: do they feel better, are they going to class more often, getting good grades, having good social relationships

Question 2

Explain the “Dodo Bird Effect” and what might account for this effect.

Answer 2

“Everyone is a winner”, all therapy is effective and helps!

• for the most part, therapy instills a sense of hope and include empathy and attentiveness!!
• warmth, connection, belief you’ll get better

Question 3

What are the methodological critiques of those who find the Dodo Bird verdict invalid or over-
stated?

Answer 3

• Since the Dodo research, used meta-analysis (by lumping together similar treatments and diagnoses, it can hide key differences)
• This research only used their good results!! (harmful results were not included bc they most likely dropped out of trails, so their outcome wasn’t counted)
• For things like anxiety and mood disorders, behavior and cognitive treatments are more effective
• For things like phobias, exposure is negative
• Childhood Disorders -> behavioral treatment

Question 4

In what ways could you argue that most therapists are not engaging in fully informed consent?

Question 5

Explain what the scientist-practitioner gap is and the basic evidence for this gap. How might
some therapists respond to criticism suggesting that they are not using scientific findings to
guide their therapy?

Answer 5

Therapists can argue that science has not caught up with insight yet

• Experience is VALUABLE!
• Ppl are complex so science might not always be the answer!!