Module 72: Evaluating Psychotherapies & Prevention Strategies

Question 1

What is the evidence that psychotherapy works?

Answer 1

In one study, 90% of the 29000 Consumer Reports readers who related their experiences with mental health professionals were at least “Fairly well satisfied”

Among those who recalled feeling fair or very poor when beginning therapy, 9 in 10 now were feeling “very good, good, or at least so-so”

Question 2

What reasons do critics note to be skeptical of the success of psychotherapy?

Answer 2

• people often enter therapy in crisis. when the crisis passes people credit the therapy rather than passing time
• clients believe that the therapy will help and the placebo effect helps heal the person
• clients generally speak kindly of their therapists even if there are problems or unresolved issues
• clients want to believe the therapy was worth the time, effort, and money

Question 3

Do clinicians believe psychotherapy works?

Answer 3

• many successful case studies
• therapist are prone to confirmation bias and may only perceive the positive client’s comments that support what the therapist already believes about the therapy
• like client testimonials, psychotherapist claims may also be subject to human bias

Question 4

Meta-Analysis

Answer 4

A procedure for statistically combining the results of many different research studies

• gives bottom-line results of lots of studies
• look through the results of dozens, hundred, and summarize the data using statistics to get the larger picture

Question 5

Does psychotherapy work?

Answer 5

Those not undergoing therapy often improve, but those underlying going therapy are more likely to improve- - and to improve more quickly and with less risk of relapse
*many people exhibit a more stable and outgoing personality after therapy

Question 6

Which disorders respond favorably to therapy?

Answer 6

• The more specific the problem, the greater the hope that psychotherapy might solve it
• those who experience phobias or panic or who are unassertive, can hope for improvement
• those with less-focused problems, such as depression and anxiety, usually benefit in the short term but often relapse later

Question 7

Which disorders are Cognitive and Cognitive-Behavioral most effective with?

Answer 7

Anxiety, posttraumatic stress disorder, insomnia, and depression

Question 8

Which disorders are Behavioral therapies most effective with?

Answer 8

Specific behavioral problems

bedwetting, phobias, compulsions, marital problems, and sexual dysfunctions

Question 9

What additional therapies seem most effective for Depression and Anxiety?

Answer 9

Psychodynamic

*Nondirective (client-centered) counseling - mild to moderate depression

Question 10

Evidence-Based Practice

Answer 10

Clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences
*integrates the best available research w/ clinical expertise, patient preferences & characteristics

Question 11

Eye Movement Desensitization Reprocessing (EMDR)

Answer 11

• mixed feelings about the therapy
• the client pulls back traumatic memories and simultaneously focus on external stimuli, such as the therapists waving a finger, or an external focal point
• skeptics acknowledge that EMDR does work better than doing nothing

Question 12

What do skeptics state about the alternative therapy EMDR?

Answer 12

• just as effective with fixed eyes. If that conclusion is right, what’s useful in the therapy (behavioral desensitization), is not new
• skeptics think it is a combination of exposure therapy - repetitively calling up traumatic memories and reconsolidating them in a safe and reassuring context and perhaps some placebo effect

Question 13

Light Exposure Therapy

Answer 13

National Institute of Mental Health researchers in the early 1980s had an idea; give people a timed daily dose of intense light

• people reported they felt better
• people with seasonal pattern had a decrease in depression symptoms after 90 minutes of bright light rather than a placebo treatment
• Studie shave shown that 30 minutes of morning exposure to 10,000 lux white fluorescent light produces relief for most depressed people

Question 14

What are the three benefits all psychotherapies share?

Answer 14

• Hope: any psychotherapy offers the expectations that, with commitment from the therapy seeker, things can and will get better
• New Perspective: every therapy offers people a plausible explanation of their symptoms
• Empathic, Trusting, Caring Relationship: effective therapists are empathic, seek to understand the client’s experience. They communicate care and concern, and they earn trust through respectful listening, reassurance. and guidance

Question 15

Therapeutic Alliance

Answer 15

A bond of trust and mutual understanding between a thera[ist and client, who work together constructively to overcome the client’s problem

Question 16

What should a person look for when selecting a therapist?

Answer 16

• ask about the therapist’s treatment approach
• ask about the therapist’s values
• ask about their credentials and how much the therapist charges

Question 17

How does culture impact the client-therapist relationship?m

Answer 17

In North America, Europe, and Australia, most psychotherapists reflect their culture’s individualism (gives priority to personal desires and identity) while clients with a collectivist perspective may assume people will be more mindful of social and family responsibilities, harmony, and group goals.
These clients may have trouble relating to therapies that require them to think only of their own well-being

Question 18

Why might clients not seek therapy?

Answer 18

People living in “cultures of honor” prize being strong and tough. They may feel that seeking mental health care is an admission of weakness rather than an opportunity for growth
*Some minority groups tend to be both reluctant to seek therapy and quick to leave it

Question 19

Why might the therapist and the client be mismatched?

Answer 19

Client-psychotherapist mismatches may also stem from religious values as well as culture
*highly religious people may prefer and benefit from a religiously similar therapist and may have trouble forming an emotional bond with the one who does not share their values

Question 20

When should a person see therapy?

Answer 20

• feelings of hopelessness
• deep and lasting depression
• self-destructive behavior, such as substance abuse
• disruptive fears
• sudden mood shifts
• thoughts of suicide
• compulsive rituals, such as hand washing
• hearing voices or seeing things that other’s don’t experience