Therapeutic relationship

Question 1

Within the context of CBT, the term ‘collaboration’ refers to the client and practitioner being ACTIVE and EQUAL members of a team who do what?

Answer 1

Work together to bring about a specified change (Beck, 2011; Blackburn & Twaddle, 2011).

Question 2

Who examined the impact of ‘coach’ style on treatment outcome, and found that a more collaborative ‘coach’ style was a stronger predictor of positive treatment outcomes, compared to other styles?

Answer 2

Poddell et al (2013) found that a more collaborative ‘coach’ style was a stronger predictor of treatment outcome compared to other styles.

Question 3

Farrand and _____ (2010) argued that PWP’s may not necessarily have time to be ____ and may instead need to be more _____ in their approach.

Answer 3

Farrand and Williams (2010) argued that PWP’s may not necessarily have time to be collaborative and may instead need to be more direct in their approach.

Question 4

Normalising can be defined as the process of helping a patient to believe that they are not ____ in their experience of certain _____, _______ or behaviours (Dudley & ______, 2015).

Answer 4

Normalising can be defined as the process of helping a patient to believe that they are not alone in their experience of certain thoughts, feelings or behaviours (Dudley & Turkington, 2015).

Question 5

Dudley and Turkington (2015) found evidence to suggest that normalising has therapeutic value. In particular they found that normalising can be useful in two key ways. What are they?

Answer 5

1. Reduces secondary emotional responses (i.e. feeling anxious about being anxious or feeling depressed about being depressed).
2. Reduces secondary behaviours which perpetuate the primary problem (i.e. reduces safety behaviours in the case of anxiety disorder and reduces social withdrawal in cases of depression).

Question 6

A critique of normalising is that it may be interpreted by some patients as what?

Answer 6

A critique of normalising is that it may be interpreted by some patients as a dismissal of their experience. This may in turn damage the therapeutic alliance.

Question 7

Who argued that empathy is notoriously difficult to define?

Answer 7

Padesky (1993) argued that empahty is notoriously difficult to define.

Question 8

How can we define empathy?

Answer 8

Empathy can be defined as having a felt sense of waht it is like to be in another’s shoes (Bennett-Levy et al, 2003).

Question 9

Provide a piece of empirical evidence for the importance of empathy.
Clue: Published in 2013.

Answer 9

Empathy, as rated by the therapist’s supervisor during a session, positively predicts treatment outcomes (Poddell et al, 2013).

Question 10

Provide two critiques of Poddell (2013)’s finding that supervisor ratings of empathy predict treatment outcome.

Answer 10

1. Correlational- causal inferences cannot be drawn.
2. Were the same findings be replicated if patient ratings of empathy were taken and correlated with treatment outcome? To what extent would patient ratings and supervisor ratings converge? Would one party’s rating more reliably predict outcome than another?

Question 11

Socratic questions are what?

Answer 11

Socratic questions are questions asked with the aim of guiding a patient’s discovery rather than changing the patient’s mind (Padesky, 1993).

Question 12

According to James (____), when is Socratic questioning particularly useful?

Answer 12

James (2009) argued that Socratic questionning is particularly useful when establishing the patients’ goals, or gauging key cognitions such as NAT’s or rules for living.

Question 13

Provide one evaluative point surrounding the evidence base for the use of Socratic questionning.

Answer 13

Distinct lack of empirical evidence which investigates the differences in outcomes between CBT with, vs. without, the use of Socratic questions, whilst keeping all other factors constant. Nevertheless the method is generally accepted as good practice (Padesky, 1993).

Question 14

The therapeutic relationships is best understood as the ____ and _____ of the _____ relationship between the patient and practitioner (_____ and Barends, 2006).

Answer 14

The therapeutic relationships is best understood as the quality and strength of the collaborative relationship between the patient and practitioner (Hatcher and Barends, 2006).

Question 15

With reference to Colli and Ligiardi (2009) provide three examples of what collaboration might look like in practice.

Answer 15

1. Jointly deciding treatment goals
2. Equal contribution to discussion
3. Jointly planning homework tasks

(Colli & Lingiardi, 2009).

Question 16

Who argued that a good therapeutic relationship is a necessary but not sufficient condition to bring about therapeutic change?

Answer 16

Carey et al (2012) argued that the therapeutic relationship is a necessary but not sufficient condition to bring about therapeutic change.

Question 17

Who argued that 30% of therapeutic change is attributable to the quality of the therapeutic relationship?

Answer 17

Norcross (2002) argued that 30% of therapeutic change is attributable to the quality of the therapeutic relationship.

Question 18

What, according to Reiss and Brown (1999) is the most common reason for dropping out of, or not complying with, a talking treatment?

Answer 18

Dissatisfaction with the therapeutic relationship is the most common reason for dropping out of, nor not complying with, a talking treatment (Reiss & Brown, 1999).

Question 19

The quality of the therapeutic relationship seems particularly important for CBT outcomes, with one study finding that there is a stronger association between the therapeutic relationship and treatment outcome in the case of CBT, compared to other types of talking treatment. Name the study.

Answer 19

Stiles et al (1998).