Unit 3 Learning Objectives Chapter 11 Psychological Interventions 1 Psychotherapy a Rewards i Reducing unwanted thoughts feelings behaviors Increasing wanted thoughts feelings behaviors ii b Risks Costs i Deterioration ex trauma therapy for homosexuality getting wrong treatment messes with your mind makes you worse Injury death ex rebirthing therapy wrap kids up tight can cause serious injury or death ii iii Money iv Time v Opportunity cost different therapy and not getting better when you could be doing a therapy that does get you better Giving up the chance to do something else a 2 Efficacy vs Effectiveness a Efficacy an intervention associated with significant positive changes benefits in controlled clinical settings i High internal validity ii High I V is because the patient gets better purely because of the therapy There are no external factors affecting the patient and they only have the 1 disorder the therapy is treating associated with significant positive changes benefits in real iii Done in hospitals b Effectiveness world settings i High external validity ii High E V because there might be external factors affecting patient and they might have more than 1 disorder but they still improve significantly than when they first came in for treatment iii Outpatient 3 Generalizable a When findings are generalizable it means they can be applied in a wide range of situations Seen in effectiveness studies because they can be applied in real world settings b This is important because it is almost impossible for a patient to be in a setting where everything is controlled Most patients get therapy in real world settings 4 4 main finding of Consumer Reports Study effectiveness study a Readers of Consumers Reports took a poll that asked general questions about therapy b Findings i Psychotherapy leads to improvements most of the time 5 Common Factors in therapy ii All mental health professionals clinical psychologist clinical social worker etc received equally high marks iii Therapy alone worked just as well as psychotherapy and medication iv More treatment sessions led to more improvement c Limitations i If all mental health professionals worked equally then people will not pay more money for a clinician when they can pay less for a clinical social worker If just psychotherapy works just the same as with medicine then people will not pay for a psychiatrist who is more expensive ii a Relationship Therapeutic alliance to discuss concerns and therapist should be accepting objective insightful and professional Clients should feel comfortable enough i Can be difficult for therapist especially if what the client is saying goes against the therapist s personal beliefs ii Ex Man who has raped women difficult subject matter to remain objective about b Expert Role Client puts their trust in their therapist that they will help them get better because the therapist has specific skills assessment diagnostics treatment specific knowledge about normal and abnormal psychological conditions and specific responsibilities ethics and professional guidelines i High levels of directness leads to bad outcomes ii iii Therapist should offer a few choices instead of telling client what Important to have high humility rapport and empathy they should do but not too many choices c Building Competence Mastery can reach their goals self efficacy Important for client to believe that they i Improvement leads to increases in self efficacy and increases in self efficacy leads to improvement d Non specific factors outcomes hope faith encouragement expectancy These are vague factors that promote positive i Every client has different n s factors Some are required to have therapy so they are cynical and don t think it will work they have low faith hope etc 6 Specific Therapeutic Variables a Client i Age not related to outcome any age just as likely to reap benefits ii Gender not related to outcome but gender of therapist does matter 1 Ex Female rape victim would feel more comfortable with a female therapist iii Ethnicity race not related to outcome iv Intelligence related to outcome use of different therapies for different levels of intelligence High IQ cognitive therapy Low IQ behavioral therapy v Relationship between degree of distress and outcome has mixed findings b Therapist i Age sex ethnicity not related to outcome ii Empathy warmth genuineness related to outcome its necessary but empathy alone is not enough for client to get better iii Emotional well being mixed results not necessary but if the therapist has experience being in therapy themselves they can better understand what its like to be a client 7 Stages of Change a It s important to know the client s stage of change regardless of what therapy is being used Clients are not always in the same place for therapy b A client s behavior change is a process that involves a progression through a set of stages c Not all clients are ready to commit to therapy or ready to make changes so it s the therapist s job to move client from pre contemplation to contemplation d Clinicians should only use interventions that match the stage their client is in i Ex If client is not ready to change pre contemplation and the client is an alcoholic can t ask them to give up all alcohol because their not ready to change their behaviors yet 8 Empirically Supported Treatments a Treatments for various psychological conditions that have been shown through careful empirical study to be well established or probably efficacious meaning these are treatments that have research behind them and therefore work b Some therapies are better for specific disorders than others ex Exposure therapy great for specific phobias but not for BPD c Online access to the latest empirically supported treatments increases therapists knowledge for those who don t have time to read through research papers d Treatment manuals are used for standard application a The size of a treatment effect how effective is a treatment did it work a b This is important when comparing treatments to see which has the biggest effect size and therefore works the most best most effective c This goes against the Dodo Bird Hypothesis because the DBH says all treatments are equally effective and work the same way But effect sizes show that some treatments are more effective than others 9 Effect Sizes lot or a little 10 Manualized Treatments a These are treatment manuals that have guidelines to follow they help ensure standard application of
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