Psychotherapy Research

Question 1

What are thepsychotherapy outcome literature studies published between 1920 and 1950 by Eysenck?

Answer 1

In that article, Eysenck concludes that the effects of psychotherapy are “small or nonexistent” andthat any positive effects may reflect nothing more than spontaneous remission. Eysenck based his conclusion on the finding that 72% of the neurotic adults in his no-therapycontrol group showed improvement within twoyears of the onset of their sxs, while only 66% of pxs receiving eclectic psychotherapy and 44% receiving psychoanalytic psychotherapy showed a substantialdecreased in sxs.

Eysenck’s conclusions were quickly challenged on methodological grounds. Critics pointed out, for instance, that Eysenck’s therapy and no-therapy pxs may not have been equivalent in terms ofseverity of sxs or other relevant characteristics. In addition, many ofthe no-therapypxs receivedmedical txaswellasattention and support from their physicians, hospital staff, familymembers, friends, and others; and, as a consequence, their recovery cannot be considered entirely “spontaneous.”

Question 2

What is meta-analysis and effect size?

Answer 2

Smith andhercolleagues were the first to apply the statistical technique known as meta-analysis to psychotherapy outcome research, and the results of their analyses contraindicated Eysenck’s finding. Meta-analysis is used to combine the results of multiple studies and involves calculating an effect size, which converts the data from different studies to a common metric so that results can be quantitatively combinedand compared.

Question 3

What is the Smith, Glass, and Miller (1980) meta-analysis results?

Answer 3

475outcome studies published between 1941 and 1976 andobtained a mean effect size of .85: This figureindicates that at theendoftherapy, the average client “is better offthan 80 percent of those who need therapybut remain untreated.” Finally, the meta-analyses have not found any one type of therapy to beconsistently superiortoany other typeacross differentdisorders, although there is some evidence that cognitive-behavioral txs are more effective for some disorders such as panic, phobias, andcompulsions. This finding suggests that positive change in therapyis not dueto any unique or specific techniques but instead to factors that thevarious txs share in common– e.g., catharsis, a positive relationship with the therapist, behavioralregulation, and cognitive learning and mastery.

Question 4

What is the dose-dependent effect by Howard and collegues?

Answer 4

It indicates that the relationship between tx length and outcome “levels off” at about 26 sessions: Their results revealed that about 75% of pxs showed measurable improvement at26 sessions; and at 52 sessions, this numner increased to only about 85%. These authors refer to this as the dose-dependent effect.

Question 5

What is the phase modelof therapy?

Answer 5

It predicts that the benefits oftx vary, depending on the number of sessions. Specifically, they found that the effects of therapy can be described in terms of 3 stages that are related to the length of tx:

• Remoralization: A client’s feelings of hopelessness and desperation respond quickly to therapy with remoralization usually being accomplished during the first few sessions.
• Remediation: During the second phase of therapy, the focus is on the sxs that brought the client to therapy. Sx relief usually requires about 16 sessions.
• Rehabilitation: The third phase focuses on “unlearning troublesome,maladaptive, habitual behvaiors and establishing new ways of dealing with various aspects of life”

The numberof sessions required to achieve these goals depends on the type and severity of the client’s problems.
First phase: measures of well-being
second phase: measures of sxs
third phase: evaluations of functioning