Week 6 - Therapist Drift

Question 1

What is Therapist Drift (TD)?

Answer 1

The tendency for psychologists to move away from the delivery of the evidence-based practices in which they are trained, even when resourced to implement them.

Question 2

What are the 9 correlating characteristics of therapist drift?

Answer 2

1. Therapist Knowledge
2. Attitudes toward research
3. Therapist Anxiety
4. Clinical Experience
5. Therapist Age
6. Theoretical Orientation
7. Critical Thinking
8. Personality Traits
9. Cultural Competency

Question 3

Which personality traits correlate with TD? Positive or negative?

(2)

Answer 3

1. Open-mindedness (negative)
2. Self-Efficacy and Therapeutic Optimism (Positive)

Question 4

T/F

Therapists who practice eclecticism are less likely to adhere to treatment manuals

Answer 4

True

Question 5

What should you ask yourself when having difficulties with structuring a session? (4)

Answer 5

Have you gently interrupted the client to direct the session?

Have you socialized the client into the structure and process of treatment?

Is the client sufficiently engaged in treatment?

Is the therapeutic relationship strong enough?

Question 6

When should you deviate from the agenda?

Answer 6

Clients are at risk or the put others at risk (address problems immediately)

If client so distressed that they cannot focus

If it will impair therapeutic alliance

If a new issue arises that is more important

Question 7

When do you begin preparing clients for termination?

Answer 7

In the first session

This done by sharing therapy goals and objectives

Question 8

List activities which can be done throughout therapy, and are intended to enhance relapse prevention (3)

Answer 8

Attributing progress to the client
(e.g., highlighting that they themselves have brought about changes in their mood by making changes in their thinking and behavior.)

Teaching Skills
(e.g., Measuring progress toward achieving their goals, Giving self-credit, and Using CBT techniques to overcome obstacles)’

Building Resilience and Well-Being

Question 9

What is the rationale behind tapering treatment?

Answer 9

Tapering treatment allows the client more time to transition out of therapy and test what they have learned.

Question 10

How do you know if there is a problem in treatment? (4)

Answer 10

Clients’ unsolicited feedback and by directly eliciting their feedback, during and at the end of the session.

Asking clients to summarize what you’ve just discussed in session and checking on their depth of understanding and agreement.

Tracking improvement according to objective tests and the client’s subjective reports and measuring progress toward goals.

Reviewing recordings of therapy sessions alone or with a colleague or supervisor and rating the tape on the Cognitive Therapy Rating Scale

Question 11

Levels at which a problem can occur? (3)

Answer 11

1. Technical problem
   * Inappropriate technique
   * Technique used incorrectly
2. Complex problem
   * Wrongly identified key dysfunctional cognition
3. Ongoing problem across several sessions
   * E.g. breakdown in collaboration

Question 12

What is an anchoring technique?

Answer 12

1. Formulate a functional thought/behaviour
2. Identify when and where would it be most effective
3. Find the baseline frequency of this thought/behaviour
4. Identify ways of increasing the frequency of the thought/behaviour

e.g., Cueing (internal/external)