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Psych 360 > Psychotherapy Research Methods > Flashcards

Psychotherapy Research Methods Flashcards

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1
Q

there is no _________________ in psychotherapy

A

one size fits all

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2
Q

4 components of psychotherapy research

A

what works

for whom

in what context

and why

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3
Q

stages of intervention development

A

basic science

creation and preliminary testing

pure efficacy

real world efficacy

effectiveness

implementation and dissemination

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4
Q

stage 0 of intervention development

A

basic science
- things to go into intervention/why the intervention will work
- identify problems that need treatment (brain, family history, etc.)
- understand treatment gap/things that are/aren’t working

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5
Q

stage 1 of intervention development

A

creation and preliminary testing
- stage 1a:
- developing intervention components with clear explanation for replication
- done with patient input (focus groups to make changes/feedback)
- by the end should have materials for trials

  • stage 1b
    • feasibility and testing
    • can we do this, get people to sign up?
    • often done in lab, goal is to see if investing is worth it
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6
Q

stage 2 of intervention development

A

pure efficacy
- controlled/internal conditions
- efficacy = how well it works under perfect controlled conditions

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7
Q

stage 3 of intervention development

A

real world efficacy
- trial in more external environment/real-world setting
- ex. train then closely monitor therapists

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8
Q

stage 4 of intervention development

A

effectiveness
- understand what happens once you take some controls off
- less strict
- ex. train then don’t monitor therapists

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9
Q

stage 5 of intervention development

A

implementation and dissemination
- how to get interventions to be used clinically?
- delay between research and implication b/c…
- people do not like change
- environment isn’t necessary for implication (where feasibility plays in)

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10
Q

prospective treatment assignment

A

we have more than 1 group and assigned before condition takes place

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11
Q

if there is prospective treatment assignment, we are conducting an _________ study. If there is NOT prospective treatment assignment, we are conducting an _________ study

A

experimental; observational

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12
Q

key difference in experimental and observational studies

A

ex: observe cause and effect
obs: no manipulation

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13
Q

observational study

A

precursor for intervention/seeing if study needs to take place

more external validity

used when experimental cannot be (studies to do with smoking, children, etc.)

cheaper and shorter time frame

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14
Q

If there is a comparison group, we are conducting a(n) _______ study. If there is NOT a comparison group, we are conducting a(n) ________ study.

A

analytical; descriptive

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15
Q

types of observational studies

A

descriptive
analytical

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16
Q

descriptive study

A

establishing phenomenon

first study type in new research area

tells frequency, progression over time, correlations, etc.

cannot conclude cause and effect

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17
Q

how results are biased in observational studies?

A

confirmation bias
- looking for one thing and only measure/record this

selection bias

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18
Q

how do we determine the type of analytical study?

A

when were treatment and outcome identified/assessed?

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19
Q

cohort study

A

treatment then outcome

studying effectiveness
- follow the groups forward in time to determine if they experience outcomes

no assignment takes place/no manipulation

steps: identify groups then measure outcome

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20
Q

cohort study strengths

A

treatment comes before outcome (establishes temporal precedence)

less prone to recall bias (longer ago an event took place, the least likely you are to remember details)

provides estimates of incidence of outcomes overtime

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21
Q

cohort study limitations

A

cost

rare outcomes are hard to observe

studies may need to be very long to observe outcomes

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22
Q

case control study

A

outcome then treatment assessed

assess whether there were differences in treatment exposure retrospectively
- chart reviews
- self-report
- interviews

23
Q

case control study strengths

A

useful for rare outcomes

can save time and money

24
Q

case control study limitations

A

difficult to select an appropriate control group

recall bias

cannot tell you how prevalent the outcome or treatment is - only odds of experiencing both

25
Q

cross-sectional study

A

outcome and treatment assessed at the same time

use on timepoint to assess both outcome and treatment exposure

can provide estimates of frequency or prevalence of an outcome or treatment

no temporal precedence and subject to recall bias

26
Q

rate

A

frequency of an event in the population over a defined period of time

27
Q

proportion

A

frequency of an event without a defined time period

28
Q

ratio

A

number of people in one condition relative to the number in another

29
Q

absolute risk

A

probability of outcome

30
Q

odds ratio

A

likelihood of membership in one group, given membership in another (also relative)

ex. given membership in the treatment group (vs. nontreatment group, how likely are you to also be in the outcome group

30
Q

relative risk

A

ratio representing how often the outcome happens in the treatment group, relative to the untreated group

31
Q

types of experimental studies

A

randomized-control trial

non-randomized-control trial

32
Q

key difference in experimental studies and why does it matter

A

if the treatment conditions are randomly assigned

matters because of:
- selection bias and open-label trial

33
Q

randomized-control trial

A

control for what works for who

can claim cause and effect

34
Q

non-randomized control trial

A

used in early stages of a trial

more exposed to bias

cannot claim cause and effect

35
Q

inclusion criteria for randomized-control trials (RCTs)

A

diagnosis
clinical staging
prior treatment and iatrogenic comorbidity

36
Q

clinical staging for RCTs and specific stages

A

ways to grade out severity of disorder symptoms/symptoms experienced

symptoms on continuum

stages:

0: no symptoms
1: some symptoms that aren’t specific
2: moderate-severe symptoms, meet criteria for diagnosis
3: some level of remission
4: persistent/severe, not going away or getting better

37
Q

iatrogenic comorbidity

A

had other treatments that didn’t work or potentially make things worse

past treatment experiences impact future reactions and so you don’t repeat any treatments

38
Q

recruitment for RCTs

A

how are participants identified?
is the sample representative?

can become biased (socio-economically and culturally)

39
Q

control groups for RCTs

A

no treatment or waitlist

minimal attention

treatment as usual
- standard treatment that is currently being used in field

attention placebo control
- rigorous, doing as much as we can to mimic the intervention

other active treatment

additional controls needed when pharmacotherapy is added

40
Q

designs for RCTs

A

parallel treatment
- most common! groups assigned then followed simultaneously

adaptive
- changing course of movement throughout treatment based on how they respond, aka “stepped care”

dismantling
- tries to figure out active ingredients, pull apart to figure out further which produces the larger effect/most essential part of treatment

41
Q

assessments for RCTs

A

treatment allocation should be concealed from those administering assessment

pre and post treatment, consider length follow up

must be sensitive to change

incremental validity

patient-reported vs. observer-rated

assess for adverse effects, not just desired effects

42
Q

demand effects

A

the more you include, the easier a patient may guess what you are studying and sway/bias their answers

43
Q

incremental validity

A

what we are measuring while adding something new

44
Q

patient-reported vs observer-rated

A

subjective or objective: who’s perspective is represented in outcome?
value both things: feelings and observations

45
Q

assessing for adverse effects, not just desired effects

A

focusing on people who didn’t respond to treatment that may be affecting averages

46
Q

outcomes for RCTs

A

define a priori

what level of improvement will mean the treatment worked?
- remission (no longer meet criteria for diagnosis)
- reduction of symptoms (still meet criteria)
- longevity of change

47
Q

priori

A

established before start to gauge what a success is considered to be in an experiment

48
Q

drift

A

expect therapists to naturally drift from adhering strictly to treatment overtime because:
- find things that work with patients
- become less rigorous or just forget steps/get distracted

49
Q

the more ________ = the more confident one can be in the results of the study

A

rigorous

50
Q

efficacy vs. effectiveness

A

efficacy:
- emphasis on internal validity
- very controlled

effectiveness:
- less control
- emphasis on external validity
- comorbidities that influence treatment

51
Q

empirically-supported treatments

A

stringent criteria for study designs
- active control, large sample, etc.

subject to limitations of RCTs
- efficacy vs. effectiveness
- manualized interventions

may be difficult to adapt or not applicable to a wide range of patients

52
Q

evidence-based practice has 3 components

A

best research evidence

clinical expertise

patient values and preferences

Psych 360 (27 decks)

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