W8: Client centered psychotherapy Flashcards
How do Wampold & Imel define psychotherapy?
An INTERPERSONAL treatment (talk+relationship) based on psychological PRINCIPLES (empirically derived). Involves a TRAINED therapist and a client who is seeking HELP.
It is intended by the therapist to be REMEDIAL. It is adapted/INDIVIDUALIZED for the particular client and their disorder/problem/complaint.
Levels of psychotherapy: Supportive approach
What is the ultimate goal of this approach?
Goal is to resolve EQUILIBRIUM, to deal with stress until they can get back to their healthy lifestyles. To SUPPORT their ALREADY HEALTHY characteristics.
Levels of psychotherapy: Supportive approach
Does this approach change the individual’s personality?
No, this approach does not change characteristics of the individual. Instead, it focuses on restoring equilibrium to the patient’s life.
Levels of psychotherapy: Supportive approach
Does this approach change the individual’s personality?
No, this approach does not change characteristics of the individual. Instead, it focuses on restoring equilibrium to the patient’s life.
Levels of psychotherapy: Supportive approach
True or false: Patient’s who are met with this therapeutic approach usually have environmental causes of stress.
True.
Levels of psychotherapy: Supportive approach
List some examples of therapy with this approach.
Guidance, Environmental manipulation, Reassurances, Persuasion, Catharsis, Medications, Psychoeducation, ECT (electroconvulsive therapy)
Levels of psychotherapy: Insight with Re-educative Goals
What is the ultimate goal of this approach?
To achieve insight into more conscious attitudes and conflicts (awareness of behavioral patterns)
Levels of psychotherapy: Insight with Re-educative Goals
Does this approach change the individual’s personality?
Insight not deep enough to make significant personality changes.
Levels of psychotherapy: Insight with Re-educative Goals
What does this approach to therapy examine?
1) How person relates to self and others
2) Sources of anxiety and tension
Levels of psychotherapy: Insight with Re-educative Goals
List some examples of therapy with this approach.
Client centered therapy,
Individual therapy (ex. CBT; what determines your mood is the way you think about things),
Various group therapy
Levels of psychotherapy: Insight with Re-constructive Goals
What is the ultimate goal of this approach?
To achieve extensive insight into personality and how they relate to the self and others
Goal: Emotional maturation from extensive understanding (especially in regards to their life choices involving interpersonal relationships)
Levels of psychotherapy: Insight with Re-constructive Goals
List some examples of therapy with this approach.
Psychoanalysis,
Psychodynamic longer-term therapies (a couple years)
What did Hans Eysenck’s paper claim about psychotherapy?
Published a paper with findings to present that psychotherapy was not effective at all; if you do nothing for those people they would get better in the same way they would through psychotherapy. (the only reason they get better is bc of Spontaneous Remission)
What did Hans Eysenck’s paper claim about psychotherapy?
Published a paper with findings to present that psychotherapy was not effective at all; if you do nothing for those people they would get better in the same way they would through psychotherapy. (the only reason they get better is bc of Spontaneous Remission)
What did Bergin and Lambert find in their meta-analysis? (4)
1) Psychotherapy facilitates remission of symptoms
2) Effects tend to be lasting
3) Psychotherapy effects beyond non-treated, placebo, and pseudo-therapy groups
4) Differences in outcome (positive effects) among types of therapy are not great/significant (ex. CBT is not superior to Psychodynamic therapy and vice versa!)
If the type of psychotherapy does not affect patients significantly differently, why do all psychotherapies help patients (according to research)?
The most important thing in predicting an outcome is actually the therapeutic alliance (that trust).
As a result, most therapists become eclectic in orientation.
Describe Martin Seligman’s (1995) experiment and his findings.
Consumer reports (magazine) readers asked to complete small questionnaire on effectiveness of psychotherapy.
R:
Psychotherapy helped 9/10 people
Those in psychotherapy >6 months did best (long-term)
Psychotherapy alone did the same as psychotherapy + meds (in certain circumstances, the two together are really effective though!)
No specific form of psychotherapy was more effective than any other
List some similarities of psychotherapies. (5)
1) Relationship
2) Release of emotions (not trying to get rid of emotions, but trying to understand them)
3) Anxiety reduction
4) Building competence
5) Nonspecific factors: expectations, hope, optimism
What is the use of effect size in meta-analyses?
Reflects the difference between the treatment group and control/other groups.
True or false: Smith & Glass showed an effect size of .75 from 475 psychotherapy studies. (big effect size)
True!
Describe Shedler’s 2010 meta-analysis of meta-analyses on the the efficacy of psychodynamic psychotherapy and his findings.
Accumulated meta analyses of psychotherapy in general
Looked at all their effect sizes (0.85, 0.75, etc. (high))
He then looked at CBT psychotherapy and effect sizes (around 0.75 and 0.80 too (high))
Then looked at Antidepressant medication and effect sizes (around 0.20 (lowwww))
Looked at Psychodynamic psychotherapy effect sizes too (.75-.8)
Conclusion: Psychotherapy (regardless of orientation) is highly effective, with not one being better than anyone else).
Rogerian Psychotherapy: Client Centered Psychotherapy:
Is this psychotherapy humanistic?
Yes.
Rogerian Psychotherapy: Client Centered Psychotherapy:
List 8 assumptions about Humanistic therapy.
- Human beings are innately good
- Value of life is in present
- Human beings are purposive/purposeful and goal oriented
- Basic human need that guides everything we do: deep human relationships/connectedness, unconditional positive regard from others.
- Core of human life resides in self-experience
- Client’s behavior understood from a phenomenological approach
- Psychological maladjustment exists when there is incongruence/neurotic behavior (discrepancy between ideal and real self)
- We are generally taught to not trust our intrinsic desires and needs and look to the external world for guidance.
What is the Law of Effect - from a Behaviorist perspective and why is it regarded as the opposite as a Humanistic perspective?
Behaviorists thought the Law of Effect (reward and punishment) was demonstrated in every human/animal and they could be influenced and basically created through this.
Meaning, people are not driven by their human essence, but for a reward or to avoid a punishment - meaning, any behavior, essentially, can be trained to not exist/exist.
True or false: Behaviorists were not able to train a pig to not partake in its rooting (food focused) behavior.
True.
What are the APAs 5, listed, broad categories of psychotherpay?
- Psychoanalysis and psychodynamic therapies
- Behavior therapy
- Cognitive therapy
- Humanistic therapy
- Integrative therapy
Explain the Client-centered (humanistic) perspective of psychotherapy.
- No dividing line between normality and psychopathology
Thus, rejection of diagnostic labels - Motivation: Self-actualization - a drive to not only survive, but to survive in a positive manner (otherwise known as Libido by Freud).
- Self concept - conditions of worth
- Growth potential released in therapeutic relationship based on: realness, caring, nonjudgmental understanding (remaining neutral - not even positive reactions bc we don’t always know the context of outcomes)
- The therapeutic relationship is the primary intervention
- Therapy is only 1 relationship that can foster growth; they may discover someone else/someone enters their life. A therapist’s job is to set the stage, and the client is able to do what is necessary for positive growth and change.
- Focus on person not the problem.
What are the 3 elements of a good therapeutic relationship?
- Unconditional therapeutic regard: non judgmental, non possessive respect and caring for clients self-concept and feelings
- Empathy: attuned to clients feelings and beliefs
+ Evocative empathy; you not only want to understand, you want to be able to communicate it to the person. - Genuineness/Congruence: in touch with and sharing personal experiences.
What are some of your observations after watching Rogers’ client-centered psychotherapy demonstration video?
Patient explains her feelings of loneliness after her ex-husband passed; but its deeper than that, because she feels it was her responsibility (she used her ex-husband as a shield to not date other men).
Rogers re-communicates what she’s saying, tries to make connections but prioritizes her responses.
Her awareness isn’t new; it’s the question of what you do about it? ‘How does one stay safe, but still remain open with a person?’
Rogers talks about transference kind of; she opens up to a certain point, even in her therapeutic relationship (going further feels like a risk) - he reads her body language regarding this too.
He never asks why… he lets her explain when she’s ready.
Very gentle and calm
READING: Watson & Schneider [Humanistic umbrella of therapy]
What are the 4 major characteristics of Humanistic-Existential theory?
HUMAN BEINGS HAVE:
1) Individually subjective experience + the importance of it
2) Self-actualization; growth is the centre of the self that guides a search for meaning - thus the future
3) Ability of Self-reflection; make experience available to conscious awareness to reflect on it and choose different courses of action
AND:
4) Every human being is seen as unique and valuable; vital to the interpersonal, therapeutic alliance, aspect of therapy
READING: Watson & Schneider[Humanistic umbrella of therapy]
How was Rogers inspired by Rank’s (psychoanalyst) work + what was Rank’s work?
Rank’s work put emphasis on the here and now (present), the healing power of a therapeutic relationship, and the constructive forces within an individual.
These approaches can be seen in client centered therapy practices.
READING: Watson & Schneider [Humanistic umbrella of therapy]
What is Motivational Interviewing?
MI is based on Rogerian core relationship conditions, usually used to treat addictions and with patients who resist more directive treatments. (very useful in Health psychology).
MI aims to promote acceptance, self-responsibility, and
autonomy in clients - all reminiscent of Client centered therapy.
READING: Watson & Schneider [Humanistic umbrella of therapy]
What is Experiential and Emotion-focused therapy?
Experiential psychotherapy emphasizes the role of
experiencing or emotional processing in the change
process.
READING: Watson & Schneider [Humanistic umbrella of therapy]
What is Task Analysis (Rice & Greenberg)?
A task analysis is a process whereby a multi-step behavior or skill such as brushing teeth, is broken down into smaller steps that can be taught and reinforced.
READING: Watson & Schneider [Humanistic umbrella of therapy]
What was Greenberg integrating Rice’s influence (Roger’s client centered therapy) with in his formation of Emotion-focused therapy?
And what was achieved as a result?
Gestalt therapies.
Resulted in a method of examining micro-change
events in psychotherapy –> to explicitly state the steps
that clients need to engage in to resolve problematic
issues. (Task analysis assisted) –> known as Emotion-focused therapy.
READING: Watson & Schneider [Humanistic umbrella of therapy]
Whitaker’s Experiential therapy, what aspect of the human experience did it focus on: rational or non-rational/emotional?
Emphasized the non-rational aspects of human experience and saw change in psychotherapy
as emanating from patients’ feelings as opposed to
their intellect.
READING: Watson & Schneider [Humanistic umbrella of therapy]
How would Whitaker define healthy functioning?
As the capacity to choose.
