PSY 322 1st Edition Exam 3 Study Guide Lectures Chapter 11 15 Psychotherapy March 3 Pages 39 41 Psychotherapy is the primary activity of clinical psychologists today but in the past most in the field worked in academia and it was not until the 40s 50s that psychotherapy began playing a significant role in the history of clinical psychology Psychological consequences of World War II on U S soldiers caused demand for psychotherapy because many soldiers returned home with shell shock and other psychological effects of the battle In the middle of the 20th century psychotherapy rose to prominent place and the psychodynamic approach to therapy dominated Overtime challengers to the psychodynamic approach arose and in the 50s and 60s behaviorism surfaced Behaviorism emphasizes empirical methods behavior such as progress and problems measured in quantifiable observable terms Humanistic client centered alternative to both psychodynamic and behavioral approach growth oriented approach to therapy Cognitive Therapy most recent interest has emphasis on logical thinking as the foundation of psychological wellness Most Popular Movement arising of combining different approaches Chapter 11 General Issues in Psychotherapy pgs 264 284 Psychotherapy most common professional activity of clinical psychologists Hans Eysenck 1952 published historic study concluding that most clients got better without therapy and that in general psychotherapy was of little benefit after reviewing early empirical studies on the approach his claims have been criticized and overturned but his claim inspired researchers to complete studies on therapy outcomes Meta analysis statistically combines the results of many separate studies and creates numerical representation of the effects of psychotherapy as tested across massive numbers of settings therapists and clients Running an empirical study to measure effects of psychotherapy is difficult because researches have different vantage points Hans Strupp pioneering psychotherapy researcher who identified three parties who have a stake in how well therapy works and who may have different opinions about what makes a successful therapy outcome the theory was labeled the tripartite model tripartite three parties Different parties that can affect an empirical studies results 1 The client have their lives affected by the therapy clients opinions can be valuable but also can be biased 2 Therapist has more experience possible more reasonable expectations views can be biased as well only witness a fraction of clients lives may feel negative evaluations reflect poorly on them 3 Any outsider to the therapy process general public legal system client s friends and family client s employers managed care companies that pay the psychotherapy bills these third parties usually stable predictable and unproblematic When should researchers ask about therapy outcome Immediately after How long should benefits last 1 month 6 months 2 years 5 years Benefits before therapy ends There could be multiple answers to these questions depending on the researchers but the way these questions are answered can influence results Efficacy the extent to which psychotherapy works in the lab controlled Maximize internal validity ability to draw conclusions about the cause effect relationship between therapy and outcome Well defined group of patients meeting diagnostic criteria for chosen disorder but no others Minimized variability between therapists random assignment to control treatment groups Effectiveness the extend to which psychotherapy works in the real world Includes wider range of clients with more complex diagnostic profiles and greater variability between therapists methods Studies the lack of internal validity of efficacy studies Have greater external validity because their methods better match therapy that takes place in clinics Results of Efficacy Studies Average effect size for psychotherapy 85 indicating that the average person who receives psychotherapy is better off at the end of it than 80 of the persons who do not Pomerantz 2014 Psychotherapy is beneficial Benefits endure over long periods of time exceed placebo effects represent clinically significant change in clients well being Gap in those that believe this by researchers that conduct artificial studies by clinicians refusing to open their eyes to the scientific data Results of Effectiveness Studies Have not been conducted as frequently as efficacy studies Similar positive results Efficacy says worked when tested in controlled settings and effectiveness says it worked in realistic settings Dodo Bird Verdict Virtual tie between different psychotherapy approaches equally work Everybody has won and all must have prizes Psychoanalysis Humanism Cognitive Behavioral and others consistently produce similar results Common factors attributed to that Most common factor Therapeutic Relationship Alliance Strong relationship between client and therapist most common factor in psychotherapy approaches Partnership between two allies Therapeutic relationship is perhaps most crucial single aspect of therapy Possibility as client improves relationship improves or reciprocal relationship Therapist ability to provide empathy and acceptance to client Other Factors Hope positive expectations support is common factor Attention Hawthorne effect improved results due to observation Lambert and Ogles three stage sequential model of common factors 1 Support factors stage a Strong relationship with therapist warmth acceptance trust 2 Learning factors a Changing expectations new insights 3 Action factors a Taking risks practicing and mastering new behaviors working through problems Dodo Bird Effect has been challenged Some researchers have made the case that certain psychotherapies are superior to others in the treatment of specific problems Dianne Chambless psychotherapy researcher has argued strongly against the idea that all psychotherapy approaches are equal Prescriptive Approach to Therapy specific therapy techniques are viewed as the treatment of choice for specific disorders should be replaced by an approach that more broadly emphasizes common factors especially therapeutic relationship Elective integrated therapy most commonly endorses until 2010 when cognitive became number one endorsed Surveys suggest combination of cognitive and behavioral approaches is most common Stages of Change Model Pre contemplation Stage no intention to change at all unaware of problems