Wk 2 - Therapeutic effectiveness Flashcards
What is psychotherapy? (x3)
Treatment of mental disorder by psychological means.
Specialised formal interaction between a mental health practitioner and a client in which a therapeutic relationship is established to help to resolve symptoms of mental disorder, psychosocial stress, relationship problems and difficulties in coping in the social environment.
A regulated profession - only call yourself one with specific training, psych or medical
Discuss the differences between counselling and psychotherapy? (x4)
Highly regulated profession in many European countries (Germany, Italy, Austria, UK), practiced only by psychologists/medically trained practitioners with specialised training in psychotherapy
Less meaningful diffs in Australia -
Counselling is general term for verbal treatment of everyday problems.
Ie, in QLD, you can be a counselling psychologist, or a counsellor with various other quals (from certificate through to Masters Counselling).
Name six providers of psychotherapy
Psychologists Psychiatrists Social workers Other allied health professionals Guidance officers Counsellors (various)
What are four training pathways to practicing psychology (within UQ)?
If you want to register as a psychologist with the National Board (AHPRA):
• Degree -> Hons (Psy) -> Masters / Doc Clin / Neuropsych
• Degree -> Hons (Psy) -> Masters Applied Psy (Couns / Health / Sport), Masters Org Psych
If you want to practice as a counsellor but not a registered psychologist:
• Degree -> Masters Counselling
If you’re interested in studying mental health / psychotherapy but don’t want to practice: PhD (in a clinical topic)
What are four benefits to psychotherapy over having your tea-leaves read?
Set requirements for ongoing training – very high standard to qualify/maintain it
Registered psychologist has to do an accredited training and supervision program, regulated by external agencies such as APAC and AHPRA.
National Psychology exam: To continue practising, have to complete prof devept activities each year and have ongoing supervision.
Practice is informed by theory and research evidence.
In what ways do we ensure that particular psychotherapy is theory driven and evidence-based? (x6)
Chart process from:
• Assessment and observation
• Case formulation is collaborative – give clients chance to tinker with the plan you’re making
• Treatment plan - matched very closely to formulation, so client can see the link
• Evaluation - apply for set time, then assess, check against case formulation
Then back to the start again…
Why do we need to practice from good theory? (x2)
“The best technique is a good theory” – Prof Tian Oei
“Counsellors who don’t have a theory are likely to get lost in their efforts to help their clients” – Nancy Murdock
According to Murdock (2009) a good theory has… (x5)
Precision and testability - precise enough to enable you to operationalise plan for client
Parsimony – the simplest explanation for the data
Practicality – readily applied
Stimulation – it gets people excited!
Empirical validity – case study; RCT; meta-analysis; etc
What are the five considerations in a CBT formulation? (plus egs from Chinese PhD student)
Historical factors: Deeply, long held beliefs become part of historical factors. Family history of mood disturbance? Core beliefs about self – not smart enough. Feed down to…
Precipitating event/s: Moved away from home, lonely and isolated. Link down to…
Intermediate thoughts: those we don’t necessarily explicitly think, say, but that govern our behaviours. I’ll only be loved and supported by others if I succeed in my PhD. Link down to the following three…
Current triggers: working long hours
Automatic thoughts: I’m not smart enough, I’ll let my family down if I don’t do well, catastrophising, self-critical thinking
Consequences: Depression, sleep disturbance, fatigue
What are five methods for assessing the effectiveness of pychotherapy?
Single case study designs Efficacy studies Cochrane library Effectiveness studies Systematic reviews and meta-analyses of research
What is involved in single-case/N1 experimental designs? (x3)
Repeated measures of individual’s behaviour,
Compared across conditions imposed, and
Assessment of measures’ reliability within/across conditions
When is an intervention-only N1 design useful? (x1 plus e.g.)
And what is one disadvantage?
Where it would be unethical or impractical to go back to baseline
e.g. forensic setting where the behaviour is shoplifting or rehab where the behaviour is injecting drug use
No control to compare it to
When do we use a Baseline-Intervention (A-B) N1 design?
Which has what advantage over intervention-only?
In majority of clinical treatments (if they measure a baseline!)
Target behaviour in eg chart of results is something desired that client wants to increase – e.g. exercise, fruit and veg intake, homework completion, minutes on-task in classroom, etc.
Person provides their own control condition – bit of an understanding about relationship between treatment and outcome
What are four possible drivers of change in the DV, that are indistinguished in an A-B N1 design? (x4)
Changes in DV may be due to B, or other alternative explanations:
• History – factors outside of the experiment; e.g. for quit smoking – tax increases could inflate apparent intervention effect
• Maturation – processes occurring within the participant over time; e.g. using stickers as reinforcers, development might influence effectiveness. Or, spike in stress at exams time – misleading if that’s when you do your post test
• Testing effects – repeated measurement itself might affect the behaviour simply due to increased attention and accountability
When are N1 designs with successive conditions most useful?
With the advantage that they… (x1)
For reducing unwanted behaviours – it’s decreasing with intervention
Strengthen evidence, as we can see that behaviour increases again when intervention stops
