Week 2 Research Methods
Transcript of Week 2 Research Methods
![Page 1: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/1.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 1/32
Dee McKiernanCounselling Psychologist
Cert, B.A., MSc
1
![Page 2: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/2.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 2/32
Overview
Introductions
Module Descriptor
Discussion
What is Counselling Psychology?
About Counselling Psychology
What do Counselling Psychologists do?
Who do they work with?
2
![Page 3: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/3.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 3/32
TYPES OF PSYCHOTHERAPY
![Page 4: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/4.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 4/32
![Page 5: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/5.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 5/32
Types of psychotherapy:
Integrative psychotherapy:- combines previous types of therapy
![Page 6: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/6.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 6/32
Researching outcome of
psychotherapy
Does it work?
![Page 7: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/7.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 7/32
Outcome Measurement instruments
Perspective taken: Clients (they find changes)
Significant others and
Institutional data (less likely to find changes) Physiological data (small changes),
Behavioral data (if relevant can be sensitive tochange)
Therapists (likely to see changes, but it dependon context),
Extern expert raters (if do not know about therapylikely to find changes, if know even more likely
Lambert, Hill, 1994
![Page 8: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/8.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 8/32
Outcome Measurement instruments
Measured construct:
Personality questionnaires
Symptom self-reports Individual problems formulated by
client
Mental health constructs (e.g. self-esteem)
![Page 9: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/9.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 9/32
When do we talk about change?
Reliable Change Index: pre-post difference issignificantly bigger than error of measurementof the used instrument
Cut-off score – client gets to the norm
Clinically significant change: there is a reliablechange that goes beyond particular cut-offscore (Jacobson, Truax, 1991)
![Page 10: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/10.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 10/32
Size of the measured change:
Effect size: difference of the means of
compared groups is divided by their
average standard deviation
Effect sizes (Cohen’s d ): small
effect=0,3; medium effect=0,5; large
effect=0,8
![Page 11: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/11.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 11/32
Example of Pre - Post difference
Figure 2.1.1. Distributions of BDI scores of our illustrative example with the pretreatment mean score 25 (standarddeviation 7) and posttreatment mean score 10 with the same standard deviation.
BDI
Pre-treatmentPost-treatment
![Page 12: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/12.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 12/32
RANDOMIZED CLINICAL TRIALS
![Page 13: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/13.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 13/32
Randomized clinical trials (RCT)
Randomization and experimental control
Forms of control group:
placebo (double-bind condition problematic),
waiting list
alternative treatment
other bona fide psychotherapy
![Page 14: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/14.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 14/32
Randomized clinical trials (RCT)
Combined and dismantled designs
Types of measurement instruments
Acceptability of treatment
Follow-up (optimally at least 2 years)
Cost-effectiveness
![Page 15: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/15.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 15/32
Randomized clinical trials (RCT) -
Two psychotherapies for depression (cognitiveand interpersonal) were compared withantidepressants and drug placebo
Roughly 50% patients who started psychotherapywere without depression after 4 months
Approx. 25% or slightly more after 2 years
Elkin et al. (1989)
![Page 16: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/16.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 16/32
Alternatives to RCT:
Experimental case studies and complex
case studies
Trials based on clients preferences
Naturalistic studies
Surveys mapping consumers
satisfaction
Qualitative outcome studies
![Page 17: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/17.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 17/32
What do we know :
Average client treated in psychotherapy is better off than80% of untreated people (Smith et al., 1980)
Psychotherapy can alleviate moderate and mild forms ofdepression
CBT is very powerful in treatment of some anxietydisorders (e.g. panic disorder, Craske & Barlow, 2001)
About 5-10% of clients can get worse in the course of
therapy (Ogles & Lambert, 2004)
Long term psychotherapy with clients with personalitydisorders can bring significant improvement (Bateman &Fonagy, 2004)
![Page 18: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/18.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 18/32
![Page 19: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/19.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 19/32
![Page 20: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/20.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 20/32
Examples of dose-effect research:
Figure 2.5.2. The clinically significant recovery in time based on the sample of approximately 6.000 patients, who
completed psychotherapy (results regardless of diagnosis; mostly patients with affective, adjustment and anxiety
disorders) (adapted from Lambert, Hansen, & Finch, 2001).
Therapy session
P e r c
e n t a g e
o f p a t i e n t s
![Page 21: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/21.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 21/32
![Page 22: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/22.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 22/32
![Page 23: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/23.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 23/32
Process-outcome research:
What must happen in therapy, so the outcome was good
Some findings:
The quality of therapeutic relationship significantlypredicts the outcome (Horvath & Bedi, 2002)
Perfectionist clients have problem to form a stablealliance (Blatt et al., 2002)
Clients with insecure attachment have problem to form astable alliance (Meyer & Pilkonis, 2002)
![Page 24: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/24.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 24/32
More Findings:
Empathy of the therapist as perceived by the clientpredicts therapy outcome (Bohart et al., 2002)
Internalizing people benefit from relationships and
insight oriented therapies and externalizing people fromdirective and behaviorally oriented therapies (Beutler et
al., 2002)
Interpretations can be helpful for people who havereasonably good relationships (Crits-Christoph &
Connoly-Gibbons, 2002)
![Page 25: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/25.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 25/32
Descriptive process research:
Investigates impact of interventions
Investigates significant moments
Intensive case studies that were successful
Some findings:
- the clients defer to their therapists (Rennie, 1990)
- the clients have strategies for the sessions and
evaluate the therapists whether they are compatible withthese strategies (Rennie, 1990)
![Page 26: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/26.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 26/32
Descriptive process research:
Some findings:
The therapist admission of his/her contribution to the
tension in the therapeutic relationship helps resolve this
tension (Safran & Muran, 1996)
The clients can tolerate if the therapist interpretation is
not totally perfect (Elliott, 1984)
Successful interpretation is delivered in parts to the
client (Elliott, 1984)
![Page 27: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/27.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 27/32
Therapeutic ruptures
![Page 28: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/28.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 28/32
![Page 29: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/29.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 29/32
Testing theories of therapeutic change:
The therapy sessions are assessed as to their
compatibility with proclaimed theories
Some findings:
- the conflicts that clients have in relationships in their
life repeat themselves in the relationship with theirtherapist (Luborsky & Crits-Christoph, 1990)
- if the conflicts are worked through in therapy, the clientpsychopathology resolves as well (Luborsky & Crits-Christoph, 1990)
- the clients test their therapists if they can handleproblematic situations that the clients cannot handle; ifthe therapists do, it leads to improvement in the clientsfunctioning (Weiss & Sampson, 1986)
![Page 30: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/30.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 30/32
Testing therapeutic change:
Some findings:
- the clients who experienced deeper emotions in
emotion-focused therapy for depression show more
improvement than the clients who experienced lessemotions (Greenberg & Watson, 2005)
- the clients who explore fruitfully their feelings and
reflect on their meaning benefit from client-centredtherapy (Sachse & Elliott, 2001)
![Page 31: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/31.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 31/32
QUESTIONS
![Page 32: Week 2 Research Methods](https://reader031.fdocuments.net/reader031/viewer/2022021322/577cd4d61a28ab9e78993dd7/html5/thumbnails/32.jpg)
8/13/2019 Week 2 Research Methods
http://slidepdf.com/reader/full/week-2-research-methods 32/32
THANK YOU VERY MUCH