Week 1 Flashcards
___ percent of clients require treatment of more than ____ sessions
20-30%, 25
Beneficial effects of therapy can be reached in ___, with some improvements evident at the ____ session mark
5-10, 3-5
___% of clients relapse within ___
33.3%, 1-2 years
Is client outcome largely determined by therapist skill/technique, client variables or extratherapeutic factors?
Client variables and extratherapeutic factors
List some ways therapy can be harmful for clients…
Misdiagnosis, reliving trauma, wrong treatment
Outline the process of becoming an effective counsellor?
- Empathy and communication skills
- Psychologically minded theory and research based problem conceptualisation.
- Informed choice of action (research and theory)
- Ongoing supervision
- Appreciation of complexities
Outline some factors that bring about change in a person as a result of therapy
Skill building, dev of a healing relationship, opportunity to talk about problems, provision of support, opportunity to seek expert advice to solve problems.
Which therapy is most effective?
All the same effect
_____ factors accounts for significant portion of variance in patient outcome
common
_____ is the most robust predictor of outcome of client
working alliance
List the 4 factors effecting change during therapy
40% extratherapeutic, 30% relationship, 15% placebo, 15% technique
List some constituents of a positive working relationship
Positive regard, empathy, management of counter-transferrance, alliance, consensus of goals, collecting client feedback, repairing ruptures, congruence.
What are the 3 interdependent components of the working alliance as proposed by Borden?
Bond: positive attachment, including trust, acceptance, and confidence.
Task: Counselling behaviours, interventions and cognitions that form the counselling process.
Goal: Agreed ideal outcomes and priorities.
Name some attributes that underlie the Bond component
Empathy, unconditional positive regard, warmth , trustworthiness, genuineness.
Name some attributes that underline the Task component
Tasks involved with specific technique. Type of technique not a strong predictor, but differing response of clients is likely due to individual characteristics and perceptions
Talk about the goal component
Must have an explicit agreed upon overall goal for therapy
Name 3 major areas of focus in contemporary counselling?
Mental health difficulties and disorders, developmental issues, and prevention.
List some extra therapeutic factors
Chance events, clients assest (IQ, EQ), Supportive environments
List some factors effecting variance in outcome of clients?
Severity of disturbance, motivation, capacity to relate, psychological mindedness, ability to identify a focal problem
List some basic microskills of counselling
Attending, active listening, paraphrasing, questions (Open/closed), reflection of feeling, reflection of content
What is the single most important factor in determining outcome in therapy?
Clients participation in therapeutic alliance
What are the core components of effective therapy, as posited by Carl Rodgers?
Empathy, respect, and genuineness.
Some estimates of variance in outcome have put the differences in models account for as low as___ differences in outcome
1%
Therapies that involve constant client evaluation of progress, as well as feedback to the client relating such information, provides significantly better outcomes. T/F?
T!
Lack of _____ is a good predictor of ____ outcome in therapy
focus/structure, negative
There is ____ correlation between the length of treatment and the strength of the alliance
No
Some authors consider the ______ as the single most important contributor to outcome
quality of patients participation
Human potential for self-healing comes from what sources?
1) Self-generated change and spontaneous recovery 2) Placebo effects 3) Resilience and post traumatic growth 4) Corrective effects of self-expression or disclosure
Describe extratherapeutic factors
Any and all aspects of the client and their environment, regardless of formal participation in therapy.E.gs Clients readiness to change, strengths, resources, level of functioning, support network, socioeconomic factors, personal motivations and life events.
Describe how the clients contribution to therapy can influence the outcome. 5 factors.
- Involvement and participation - openness and willingness to contribute, collaborative approach
- Client perceptions of psychotherapy. Clients perception of therapy a strong indicator of outcome
- Client agency, activity, reflexivity and creativity. Client working to arrange events to benefit there therapy. ‘Following suggestion the therapist never made’
- Integration of therapy to everyday life.
- Early Change.
Describe how recognising clients as a major common factor has implications for clinical implementation.
- Enlisting and promoting clients strengths, supports networks, resources and personal agency.
- Belief that clients are motivated and capable of change.
- Promotion of client involvement - clients as active collaborators.
- Listening to clients and privileging their experience and ideas.