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PSY 275
Ch. 11 General Issues in Psychotherapy
| Question | Answer |
|---|---|
| Hans Strupp | psychotherapy researcher, identified 3 parties who have a stake in how well therapy works and who may have different opinions about what constitutes a successful therapy outcome -Triparite Model |
| Triparite Model | One party is the client -2nd party is the therapist -3rd party is society-can take the form of any outsider to the therapy process who has an interest in how therapy progresses |
| Empirical studies of psychotherapy outcome fall in two 2 categories | efficacy and effectiveness studies |
| Efficacy | extent to which psychotherapy works in a controlled research study -maximize interval validity -features strictly defined groups of patients -RA to control and treatment groups -psychotherapy works! |
| Effectiveness | psychotherapy works with actual clients treated by therapists in clinics, private practices, hospitals, prisons etc. -tend to have looser criteria for the participants to be included -lack internal validity but greater external validity |
| Transdiagnostic Approach (David Barlow) | one core, underlying factor can be a cause of lots of different disorders; focus of treatment should be the underlying factor that causes those symptoms and the symptoms of related disorders |
| Unified Protocol (Treatment Strategy) | suggesting a single psychotherapy approach where there might otherwise be numerous separate approaches for different disorders |
| Unified Protocol (Treatment Strategy) focuses on a few basic elements | reducing the amount of negative thought in which clients engage -preventing unhealthy ways of avoiding unpleasant feelings and helping clients tolerate them -encouraging behaviors that facilitate positive rather than negative feelings |
| Bridging the Gap Between Research and Practice: the gap is caused by | either researchers who conduct studies that are artificial, contrived, and irrelevant to how clinicians really practice, or by practioners who refuse to open their eyes to scientific data regarding the outcome of various therapies and who resists change |
| One effort to bridge this gap focuses on | attempts to understand how much reluctance therapists actually have to practicing according to efficacy research, and why it exists |
| The reluctance of practioners to adopt treatments supported by efficacy studies has created a significant challenge in terms of | dissemination of these treatments |
| One dissemination strategy- ______ _______ focuses on increasing collaboration between researchers and practioners at all steps of the research process | practice-oriented research |
| Effectiveness studies indicate that psychotherapy works as it is commonly applied in | realistic settings |
| Evidence-based practices in mental health: debate and dialogues on the Fundamental Questions argued strongly that studies examining the efficacy of manualized therapies have commonly neglected issues of-- | ethnicity, gender, disability, LGBTQ clients |
| Dodo Bird Verdict | a nickname for the common research finding that different forms of psychotherapy are roughly equally effective -explain this finding by pointing to common factors across all forms of psychotherapy; they are therapeutic |
| Therapeutic Relationship/ Alliance | an established common factor in psychotherapy outcome research; a coalition between 2 allies working in a trusting relationship toward a mutual goal -the most crucial single aspect of therapy |
| The quality of the relationship is the | best predictor of therapy outcome and it accounts for more variability in therapy outcome |
| List of relationship components they label as demonstrably effective: | the alliance between therapist and client -sense of collaboration -goal consensus -cohesion for group therapy= to alliance -empathy -positive regard and affirmation -providing feedback to clients |
| Other Common Factors: Hope | has received empirical support as a common factor; the improvement may actually begin before any techniques that have been applied |
| Other Common Factors: Attention | the attention the therapist and client direct toward the client's issues may represent a novel approach to the problem |
| Other common factors include | goal consensus; empathy; positive regard and affirmation and therapist geniuses |
| Lambert and Ogles (2004) put forth a 3-stage sequential model of common factors beginning with | 1st stage-support factors 2nd stage-learning factors 3rd stage-action factors |
| 1st stage-Support factors | strong therapist-client relationship, warmth, and acceptance and trust |
| 2nd stage-learning factors | include aspects of changing expectations about oneself, changes in thought patterns, corrective emotional experiences and new insights |
| 3rd stage-action factors | taking risks, facing fears, practicing and mastering new behaviors and working through problems |
| 3 common steps in the 3-stage sequential model of common factors | 1. connecting with them and understanding their problems 2. facilitating change in their beliefs and attitudes about their problems. 3. encouraging new and more productive behaviors. |
| Client Preferences | are important to consider for retention (keeping the client from dropping out of therapy), enhancement of the therapy relationship and ultimately, therapy outcome |
| For targeted outcomes, the particular techniques of cognitive-behavior therapy were better predictors, but for general quality of life, | common factors were better predictors |
| Eclectic/integrative therapy was the most | commonly endorsed orientation in every survey until 2010, fell into 2nd place; blend multiple approaches than just one type |
| Cognitive therapy has witnessed a | rise in popularity since the 1980s. By 2010, far most commonly endorsed single-school approach and overtook eclectic |
| The endorsement of psychodynamic/analytic therapy has | declined significantly since 1960 |
| Most common type of Psychotherapy Format | Individual-98% -Couples-48% -Family-34% -Group-20% |
| Stages of Change Model | describe the various points where clients fall in readiness. May enter therapy at 1 of these 5 stages -1. precontemplation stage -2. contemplation stage -3. preparation stage -4. action stage -5. maintenance stage |
| Precontemplation stage | no intention to change at all. Largely unaware of their problems and have been pressured to enter therapy |
| Contemplation Stage | aware that a problem exists, consideration doing something to address it but not ready to commit. Often ambivalent and not willing to give up the benefits of the behavior |
| Preparation Stage | intending to take action within a short time. May be taking small steps but no drastic change |
| Action Stage | actively changing behavior and making notable efforts to overcome their problems; requires sustained effort and commitment to the therapeutic goals |
| Maintenance Stage | preventing relapse and retaining the gains made during the action stage. lasts indefinitely |
| The Future: Several provocative predictors, including a rise in the use of | psychotherapy by videoconference or by text or app -therapy approaches that are based on culture/diversity -mindfulness-based approaches to therapy -cognitive-behavioral therapy -motivational interviewing |
| An eclectic approach to therapy involves | selecting the best treatment for a given client based on empirical data from studies of the treatment of similar clients |
| An integrative approach to therapy involves | blending techniques in order to create an entirely new hybrid form of therapy -may combine elements of psychoanalytic, cognitive, behavioral, humanistic, or other therapies into a personal therapy style |
| In 1977 ____ _____ was one of the first to successfully integrate psychotherapy approaches, specifically, psychoanalysis and behavior therapy | Paul Wachtel |
| ____ ___ said that the psychotherapy integration movement grew out of "a dissatisfaction with single school approaches and a concomitant desire to look across and beyond school boundaries to see what can be learned from psychotherapy and behavior change | John Norcross |
| An assimilative approach in which the therapist maintains | "a firm grounding in one system of psychotherapy, with a willingness to selectively incorporate practices and views from other systems" |
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