Week 4 - non CBT Flashcards
What year was Bohart, Ohara etc.?
1998
What is Bohart, Ohara all about?
Criticised development of empirically validated therapies
‘Based on medical like model’ - called disorders + ‘cured’
Therapies had to be standardised
RCTs can’t be true double blind -> medicines
No RCT research fits with philosophy + theory that non-CBT therapies such as psychodynamic + humanistic are based on -> defaiming disenfranchisement = taking away power / opportunity from a person
Criteria for ‘empirical validation’ = restrictive and scientifically unjustified
General humanistic
- goal not to alienate disorder
- psychotherapy not disorder driven
- goal = provide relationship to re-evaluate their life choices - to alleviate stress (2ndary)
What year was Elliot and Freire?
2008
What are the results of Elliot and Freire?
Like Stiles - found large mean pre-post effect (1.01)
Improvements generally well maintained over range of periods
Results empirically supported by gold standard RCT
Difference in effectiveness - no evidence to say it doesn’t work or is worse
31 RCTs = compared to control - mean pos effect of .78
63 RCTs = compared to CBT - very small difference but in favour of CBT
Also did clinically and significant equivalent to other therapies - 109 studies = no diff.
What are the weaknesses of Elliot and Friere?
Many studies uncontrolled
31 RCTs = compared to control - mean pos effect of .78
63 RCTs = compared to CBT - very small difference but in favour of CBT
What is the method of Elliot and Friere?
Meta-analysis of 191 studies (14000 = N)
Data from 4x person centred therapies including PCT
What year was Stiles?
2005
What were the results of stiles 2005
People receiving all therapies benefitted
- mean effect size of 1.36
- no huge diff between therapies
Show as good as CBT
What were the weaknesses of Stiles?
Uncontrolled - can’t assume causality Poor internal validity - offering what they said -> no independent check No random assignment to groups No control Restricted to self report
What were the results of Stiles?
1309 = N, 58 NHS sites
Outcome measure = core (clinical outcomes in routine evaluation (pre/post treatment)) - measures symp. and functioning
Effectiveness of CBT, PCT and PDT in NHS settings
What year was Shedler?
2010
What are the strengths of Shedler?
Key benefit = results improve rather than decay over time
- empirical support for psychodynamic even when CBT = NICE funded
What are the weaknesses of Shedler?
Far more empirically supported (outcome) studies for CBT - extent to limitation = debate
What are the results of Shedler?
Psychodynamic / psychoanalytic psychotherapy = range of treatments based on psychoanalytic concepts / methods
Key relationship between therapist and patient - therapeutic relationship = vehicle for change
Study: reviewed a number of meta-analyses - Abbas, Hancock etc. (06), Liechsenring + Leibing (03) and Lipsey + Wilson (93)
Non-psychodynamic therapies may be effective due to using techniques central to PDT
What year was Antesis? What was it all about?
2011
Shedler 2010 + other psychodynamic therapies have been heavily criticised
Shedler failed to report meta-analyses which indicated psychodynamic to be less effective than other treatments -> bias
Main meta-analysis - thinly spread across diagnoses -> doesn’t state compelling evidence for 1 diagnosis such as empirical evidence should do.
In Leichsing - only 3/11 studies directly compare psychodynamic + CBT
