Evaluating psychotherapy

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Evaluating psychotherapy. Sec 4 Evaluation is level 6 . objectives. Summarize the Therapeutic alliance Evaluate the problems with therapy (-) Analyze what therapies work with what disorders (+) List the ways therapy harms patients (4) . chapter 12. - PowerPoint PPT Presentation

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Evaluating psychotherapy

Evaluating psychotherapySec 4 Evaluation is level 6 1objectivesSummarize the Therapeutic allianceEvaluate the problems with therapy (-)Analyze what therapies work with what disorders (+)List the ways therapy harms patients (4) Common ingredients in successful therapyTherapeutic alliance: bond between therapist and client

When clients want to be helped

When therapists distinguish normal cultural patterns from individual psychological problemschapter 12

3Therapeutic alliancePsychotherapy is relationshipSuccess depends on what both parties bring to tableTherapeutic alliance- the bond of confidence and mutual understanding established between therapist and client, which allows them to work together to solve problems Goals sameQualities of the participantsMost likely to do well in therapy=motivated to improveSupport from family Develop personal style to deal with problemPersonality traits hostile and negative more resistance to therapy Carl Rodgers (ch 2)- empathy, warmth, being genuine= best traits for therapist

Culture and therapeutic connection Different backgrounds= may be successful But cultural differences may cause misunderstandingLifetime of racism and cultural distrust African Americans may distrust White therapistAsian-Americans, Latinos, African Americans more likely to stay with ethnic matched therapist

Successful therapychapter 12

7Science-Practitioner GapBreach between scientist and therapistsOne reason: professional schools not connected to academic psychology departments- train solely for therapy New therapies trying to gain foothold with no scientific support at allNeurolinguistic programming (NLP)- match learning styles with brain type- BOGUS The scientist-practitioner gapSome psychotherapists believe that evaluating therapy using research methods is futile.

Scientists find that therapists who do not keep up with empirical findings are less effective and can even harm clients.

Economic pressures require empirical assessment of therapies.chapter 12

9Problems in assessing Therapy Proliferation of therapies + economic pressures from drug companies= need scientific evidenceCant just ask someone did therapy help?

Problem with therapyTestimonials I would have never found love, taken that job, moved to Escalon without Dr. Blitznik Cant be own control group: how do you know would not have found love without Dr. BlitznikPlacebo effect: anticipation of success, buzz. About Dr. BlitznikNever here about people who drop out or get worseThanks to justification of effort, people put time, money effort in tell you its worth itDont want to say saw Dr. B. for 5 years and boy was it a waste of time!

What works? Objective #3 Here comes the evidence showing the benefits of psychotherapyEmotional disorders; cognitive and behavior therapies

Which therapy?DepressionCognitive therapy

Anxiety disordersExposure techniques

Anger and impulsive violenceCognitive therapy

Health problemsCognitive and behavior therapies

Childhood and adolescent behavior problemsBehavior therapy

chapter 12

13DepressionCognitive therapy best success Mood disorders (especially depression)Often as effective as antidepressant drugs, and less likely to relapse when treatment overLEARN LESSONS in therapy last long after therapyEvidence: randomized, controlled study 120 adults that had attempted suicide: given 1 of 2 conditions cog. Therapy or referral and call backCog. Study group as likely to attempt suicide

Anxiety disordersExposure techniques most effective for P.T.S.D., agoraphobia, specific phobias like public speakingCog. Behavior therapy for generalized anxiety, O.C.D. and panic disorder

Anger and impulsive violenceCognitive therapyReducing chronic anger, abusiveness, hostilityTeaches people how to express anger more calmly and constructively

Health problemsCog. Behavior therapy cope with pain, chronic fatigue syndrome, headaches and irritable bowel syndrome

Childhood and adolescent behavior problems Behavior therapy is the most effectiveFor bed wetting

Your turnYou have arachnophobia, an intense fear of spiders. What kind of therapy should you seek out for the best chance of resolving your problem?1. Direct brain intervention2. Cognitive therapy3. Psychodynamic therapy4. Behavioral therapychapter 12

19Your turnYou have arachnophobia, an intense fear of spiders. What kind of therapy should you seek out for the best chance of resolving your problem?1. Direct brain intervention2. Cognitive therapy3. Psychodynamic therapy4. Behavioral therapychapter 12

20Relapse preventionCognitive behavior approaches highly effectiveSubstance abuse, depression, sexual offenses

When Therapy HarmsEvery treatment carries risksEven aspirinSo does psychotherapyRisks increase with following factors

When therapy harmsUse of empirically unsupported, potentially dangerous therapeutic techniques

Inappropriate or coercive influence, which can create new problems for the client

Prejudice or cultural ignorance on the part of the therapist

Unethical behavior, especially sexual intimacy, on the part of the therapistchapter 12

23Harms #1The use of empirically unsupported, potentially dangerous techniquesMemory does not work like movie camera so can misrememberHypnosis, sodium amytal (barbiturate called truth serum) Can enhance suggestibilityHarms #2Inappropriate or coercive influence, which can create new problems for the client Inadvertently creates disorders through suggestion1980s 90s = multiple personality disorder

Harms #3 Prejudice or cultural ignorance on the part of the therapistPrejudiced against gender, culture sexHarms #4 Sexual intimacies or other unethical behavior on the part of the therapist Unethical Summary Types of disorders with treatment= psychoanalyst