7930037
Description
Flashcards by Nichola Livermore, updated more than 1 year ago
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Created by Nichola Livermore
about 7 years ago
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| Question | Answer |
| What were the four variables that Lambert (1994) identified from outcomes in psychotherapy research and what percentages did they contribute to the variability in outcome of therapy? (LO3) | 40%: Client variables and extra-therapeutic events 30%: Therapeutic relationship 15%: Expectancy and Placebo 15%: Models and techniques |
| What is one possible implication of Lambert's finding? (LO3) | - Could imply a "common factors model" which proposes that outcomes in therapy are accounted for by common factors seen in all models (such as therapeutic relationship) as opposed to specific techniques used by the models |
| What is the dodo bird verdict? (LO3) | Luborski et al (1975) and Wampold et al (1997) compared different therapies in meta analysis Found that all therapies have similar effect sizes and that the therapist is the most important variable influencing this. No reliable difference between therapies Consistent with Common factors model |
| What are the implications of the dodo bird verdict? (LO3) | Suggests that there is no "best therapy" and undermines the idea that certain therapies may be recommended for specific issues Perhaps supports common factors model and implies that less focus should be on the development of new techniques as these are likely to be insignificant in influencing outcomes |
| What did Marcus et al (2014) suggest about how accurate the dodo bird verdict is of more recent research? (LO3) | -Re-examined Dodo bird verdict in meta analysis - Found that CBT was superior to all other models in reducing symptoms (primary outcomes - But this difference didn't extend to secondary outcomes or in follow up |
| What are the implications of Marcus et al (2014) for the dodo bird verdict? (LO3) | - Provides evidences both for and against verdict - Suggests that, in terms of primary outcomes, differences in model may be important - But, in terms of secondary outcomes or in the long term, the model of therapy may not be so important. |
| Describe the basic principles (in terms of focus, length/setting, therapist role, and techniques) of psychoanalytic therapy? (LO1) | |
| Describe the basic principles (in terms of focus, length/setting, therapist role, and techniques) of psychodynamic therapy? (LO1) | |
| Describe the basic principles (in terms of focus, length/setting, therapist role, and techniques) of person centred or humanistic therapy? (LO1) | |
| Describe the basic principles (in terms of focus, length/setting, therapist role, and techniques) of behavioural therapy? (LO1) | |
| Describe the basic principles (in terms of focus, length/setting, therapist role, and techniques) of cognitive therapy? (LO1) | |
| What are the three stages of therapy? (LO4) | 1. Assessment 2. Formulation 3. Intervention |
| What are three factors that contribute to the therapy alliance between therapist and client? (LO2) | 1. Emotional bond and partnership: this relates to how the client feels with the therapist 2. Relationship history of the participant: this relates to transference in terms of how your past relationships influences your current relationships. So client may bring these expectations of previous relationships to the therapist. 3. Consensus on goals, methods, and tasks |
| What is often considered the golden standard in assessing the effectiveness of therapies? | Randomised Control Trials (RCTs) Meta-analyses have been conducted investigating the effectiveness of psychological therapies by combining the results of these studies. |
| What have meta-analysis generally indicated about the effectiveness of psychotherapies? | Overall, meta-analyses have had positive outcomes favouring psychological therapies. Indeed, it has been estimated that psychotherapy is successful for 75%-80% of people (Jarrett, 2017) |
| What did a recent meta-analysis suggest about the effectiveness psychological therapies? | In a recent meta-analysis of 247 studies investigating the effectiveness of multiple psychological therapies, Dragioti al al (2017) found that only 16 of these studies provided convincing evidence for their effectiveness. The researchers found many instances of the “small study bias”, which is the tendency for smaller, less robust studies to report larger effects. They found evidence of “excess significance bias“, which is when an over-abundance of trials seem to report positive findings given what we know so far about psychotherapy’s effectiveness. This suggests negative findings are remaining unpublished for whatever reason. |
| What are implications of Dragioti et al (2017)? | Suggests that evidence supporting psychotherapy may be limited by methodological issues in terms of publication bias and small sample bias. Authors propose that, in order to establish reliable evidence, researchers should place more importance on minimising sources biases. |
| What are some issues with assessing the the effectiveness of psychotherapy? | 1. Heterogeneity of mental health issues: - Mental health problems represent a diverse range of symptoms and issues. 2. What makes a good outcome? |
| Describe the focus of a behavioural approach? | Historically, this was the first major contributions to clinical interventions by clinical psychologists and is still widely in use. The focus of a behavioural approach is on modifying current behaviour, via the encouragement of new learning or the modification of maladaptive patterns of behaviour. |
| What are the techniques used in the behavioural approach and the role of the therapist? | Using both operant and classical conditioning paradigms, the psychologist will attempt to understand and alter cues that elicits dysfunctional behaviour. The role of therapist is therefore active as it is focused on helping the client to solve problems through promoting behavioural change. Techniques used in doing this include selective reinforcement, shaping, modelling, and systematic desensitisation (Wolpe, 1985). An example of one of these techniques in application is the use of systematic desensitisation for phobias. This involves pairing imaginary reconstruction of the feared situation or object with relaxation techniques (usually muscle relaxation) and therefore aims to break the classically conditioned association between fear and the object of the phobia by encouraging the association with relation instead. |
| What is the length and setting of a behavioural approach? | It is typically time limited and length is typically around 10-20 session Therapy using the behavioural approach will typically occur in a traditional setting such as a therapist office. However, a behavioural approach may also involve a therapist working with clients in vivo out of the office. This may be motivated by treatment necessitating exposure to situations outside of the office (e.g travelling on a train for a person who has a phobia of public transport) or due to the condition of the client. For example, some clients may need home visits as the severity of their agoraphobia may mean they are unable to come to the office. |
| Describe the focus of a cognitive/cognitive behavioural approach (CBT)? | The most prominent therapeutic model The fundamental assumption and focus of CBT and CT is that psychological distress is best understood and resolved by addressing the cognitions (thoughts, meanings, and beliefs) the person has about themselves and their difficulties. These cognitions are seen to have a reciprocal relationship with behaviour and emotion and many psychological difficulties are viewed to have developed due maladaptive or negative patterns developing, sometimes through behavioural mechanism, between cognition, behaviour and emotion. Therefore, a cognitive approach aims to address psychological difficulties by attempting to change these patterns. |
| What is the basis of treatment for a cognitive approach | In addressing the patterns of maladaptive cognition and behaviours a cognitive therapist may use a range of techniques but, typically, every case will first involve a careful assessment of how the problems arose and the specific faulty cognitions as well as inappropriate learned behaviours that may be maintaining them. This then provides the basis of treatment guiding the therapist on what techniques may be most appropriate. |
| Describe techniques used in a cognitive approach | In addressing maladaptive or negative cognitions one key technique is 'socratic questioning'. This is a guided discussion during which clients are invited to examine the rational evidence for and against their beliefs in order to encourage them to recognise their irrationality. For example, a client with depression may be encourage to think of the evidence against their belief that they 'fail everything'. Another technique is behavioural experimentation. A key aspect of this technique is making predictions about a specific situation and then testing out new more adaptive behaviours in response to these situation as part of 'homework' outside of therapy. For example, a client with social anxiety disorder may be encouraged to have short conversation with a work colleague as opposed to avoiding social contact. In doing this, they may come to realise that their predictions about the situation (i.e I will embarrass myself) do not always happen. |
| Describe the role of the therapist in a cognitive approach | As can been seen from the above, many of the techniques in cognitive therapy involve an iterative process of discussion or experimentation and feedback. Due to this, the therapists role is seen as collaborative with client in helping them to solve problems. |
| Describe the length and setting of a cognitive approach. | A cognitive approach is typically time limited and usually lasts 10-20 sessions- however, this will be evaluated on a case to case basis. More complex cases may require longer. Usually is carried out in traditional setting in a therapist office. However, due to CBTs popularity, therapy now may occur across a range of different settings. For example, on hospital wards as well as online in computerised versions of CBT. |
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