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Clinical Psychology-third Year > Week 1 Helen > Flashcards

Week 1 Helen Flashcards

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1
Q

What year was Clark, Kingston, James… etc.?

A

2014

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2
Q

What are the strengths of Clark etc.?

A

Conducted in a clinic in Poole - high external validity

Implications

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3
Q

What are the weaknesses of Clark etc.?

A

Lacks generalisability - 45 pps but not generally used

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4
Q

What are the results of Clark etc.?

A

Both groups showed reduced symptoms immediately after intervention - improvements more sustained in ACT 6 months after
So RCT’s should look at group and individual means - clinical and statistical difference

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5
Q

What year was Parry?

A

2000

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6
Q

What are the strengths of Parry?

A

Patients have the right to know if therapies are effective

More systematic review - better need for good research as gaps in methods and evidence being identified

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7
Q

What are the weaknesses of Parry?

A

Psychotherapy harder to ‘set standard’ than drug - negative results could be down to poor delivery of intervention
Randomisation - systematic between group difference when people have strong preferences for therapy -> attrition and small groups
Researchers enthusiasm - allegiance effects

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8
Q

What are the results of Parry?

A

Still debate about applying - as research evidence to change psychotherapy practise may be unreliable / misleading and as such prematurely applied

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9
Q

What year is Dimidijan et al.?

A

2006

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10
Q

What are the strengths of Dimidijan?

A

Findings question assumptions that cognition is a vital, active ingredient in CBT - controversial???

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11
Q

What are the weaknesses of Dimidijan?

A

Doesn’t support CBT theory
If therapist can only offer few sessions - focus???
Conducted as Washington Uni where BA model was developed - allegiance effects
Attrition rates in study of PPs using ADM - larger than other trials, may deteriorate

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12
Q

What are the results of Dimidijan?

A

Example of CBT / Behav and dismantling study
Low severity dep - no difference in effec for all active conditions
High severity - BA + ADM equivalent, both more effective than CBT

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13
Q

What year was Pearson and Sulber Shatz?

A

1998

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14
Q

How did Pearson and silberschatz argue that RCT results are useful to psychotherapies

A

Ethics - responsible to inform and supply RCT treatment
Scientifically designed to show what’s most effective - best at doing so
Should rely on individualised case formation to guide therapy
Standardised - less bias and valid

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15
Q

How did Pearson and silberschatz argue that RCTs aren’t useful to psychotherapies

A

About the ‘average’ case
Only single not multiple disorders
No evidence of non. compliance
Compromise of validity

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16
Q

What are the results of Pearson and Sulber Shatz?

A

The findings are useful to provide top quality care (pyschotherapies), but there are many alternative research methods

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17
Q

What year is Kuyken et al.?

A

2010

18
Q

What are the strengths of Kuyken?

A

PPs still at risk of relapse - mindfulness based CT attempts to try and treat this
RCT showed that MCBT = significant fewer dep. symptoms at follow up than ADM

19
Q

What are the results of Kuyken?

A

Looking at mech of change - collected outcome data + data and changes in psych processes MCBT designed to impact (mindful and self-compassion)
Changes in mind and self compassion during MCBT, significant mediated effect of MCBT at 15 month follow up.
Mediators are ‘casual stepping stones’

20
Q

What year was Chambless and Hollon?

A

1998

21
Q

What were the strengths of Chambless and Hollon?

A

Prior to paper, we barely tested - he laid out rules

22
Q

What are the weaknesses of Chambless and Hollon?

A

In reality need:
Good quality RCT
Specific pop.
Findings replicated by independent research group (removes unconscious bias)

23
Q

What are the results of Chambless and Hollon?

A

Draws conclusions from 23 RCTs
Describes what empirically supported psychotherapies are
Said ‘comparison with control/ treatment/ placebo’ -
In a RCT/controlled single case
experiment/time samples design
Do statistically better than comparison at relieving symptoms - statistical power to detect difference
Efficacious - superior of the EST in 2 independent research settings

24
Q

What are the other key sources to quote?

A

David and Montgomery (2011), Baker (2014) and Clay (2010)

25
Q

What is David and Montgomery all about?

A

We should now evaluate (for efficacy) therapies and theory based on
E.g. due to ‘bad air’ - malaria
They encouraged mediation studies / process research

26
Q

What is Baker all about?

A

Systemic reviews are top level quality info - empirical

27
Q

What is Clay all about?

A

RCTs = gold standard
Some RCT limitations - represent population ( -> change criteria), not random (lack external validity), control list (ethics)

28
Q

in reality what do we need for a good quality RCT

A

 a good quality RCT in favour of the intervention
 for a specific population
 with the findings replicated by an independent research group

29
Q

why should we find out the active ingredients of a therapy

A
  • Why? Poor theories lead to pseudoscience+ potentially damaging interventions/ therapeutic ‘blind alleys’ Example of the ‘bad air’ theory of malaria

thinking has moved on now seen as important to evaluate therapies and the theories they are based on (David & Montgomery, 2011)

30
Q

what are the 2 levels of analysis according to david and Montgomery

A

two levels in the analysis of evidence supporting psychological treatments.
o Psychological theory of therapeutic change should be scientifically evaluated
o The therapeutic package (psychological treatment) is derived from the theory about the mechanisms of change and is scientifically evaluated.”

31
Q

describe RCTs

A
  • Originally used in medical research: e.g. testing medication
  • Double blind RCT design not possible with psychotherapy research
    o Therapist knows what giving, and patient can look it up ( biases)
    o Also pps know when reciving no active treatment
  • Stats: mixed ANOVAs
    Rct pp experiences
  • If an nhs patient offered to put into intervention or control OR wait months for treatment
    Can see why lack of signup
32
Q

what are the strengths of RCTs

A
  • Currently= ‘gold-standard’ method of evaluating psychotherapy interventions.
    o (See Persons & Silberschatz, 1998; Clay, 2010)
  • High Internal Validity: high confidence the intervention caused the changes that participants report
  • Very clear guidelines on how to conduct and report RCTs
33
Q

what are the key design features of RCTs

A

randomisation and controlconditions

34
Q

whatis the limitations of using randomisation in RCTs

A

o Single blindness= claim pps doesn’t know about therapy but can google/ find out
 Leads to bad expectations
o Creates uncertaintys going into RCTs  which leads to issues as no people= no way to test

35
Q

whatarethe strengths of usingRCTs

A
  • Participants have an equal chance of being allocated to any of the study conditions
  • Minimises the risk of biases (systematic differences) between the different groups in the study
    o E.g. Age, gender, pre-treatment symptomology levels etc.
  • So, the therapy being tested should be the only significant difference between the different participant groups
36
Q

howcan weimprovethelimitations of RCTs through betterdesign

A
  • Some limitations might be improved through better design

o E.g. Participants do not represent patient population -> change inclusion/exclusion criteria

37
Q

what issues can wenotsolve as they are inherent to RCTs

A
  • But some limitations are inherent in the RCT design
    o Participants randomised to treatment condition
    o In normal life not randomly put in treatments therapist suggests it
     Looses external validity as randomization doesn’t normally happen – no discussion
  • This is an example of a threat to external, ecological validity
38
Q

what study shows that we can improve the inherent issues of RCTs through better design

A

Clarke,kingston ,james , bolderston and Remington 2014

39
Q

If you wanted to show how reposting clinical as well as individual not group means impacts research, which study would you use?

A

Clarke, Kingston, james, bolderston and Remington 2014

40
Q

If you wanted to show how mediation studies work and why we use them which study would you use and what’s the mechanism of change

A

Kuyken 2010- mech of change = changes mindfullnessband self compassion- this mediated the effect of MCBT

41
Q

If you wanted to show a dismantling study what would you use

A

Dimijian 2006

42
Q

What did Pearson and silberschatz argue

A

Whether RVT results are useful to psychotherapies

Clinical Psychology-third Year (6 decks)

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