CLP3305 Exam 3 Study Guide CHAPTER 11 PSYCHOLOGICAL INTERVENTIONS Psychological intervention a method of inducing changes in a person s behavior thoughts or feelings o Therapy involves intervention in the context of a professional relationship Does psychotherapy help o Empirical evidence supports the efficacy of psychotherapy but not everyone will benefit from it o Those who received psychotherapy and medication improved just as much as those who solely received psychotherapy o Longer treatment more sessions related to improvement Evidence based treatment EBT refers to those interventions or techniques that have produced significant change in clients and patients in controlled trials Evidence based practice EBP broader category that includes treatments informed by a number of sources including scientific evidence about the intervention clinical expertise and patient needs and preferences Features common to many therapies o Supportive factors EX trust lay the groundwork for changes in client s beliefs and attitudes learning factors such as insight which then lead to client action or behavioral change taking risks o Relationship therapeutic alliance Major reason for success and persistence of psychotherapy ability of therapists to rise above their personal needs and respond professionally non judgmentally with confidence understanding and warmth o Building competency mastery Self efficacy Bandura an individual s belief that he or she will be able to accomplish a specific task He believed that an essential component to accomplishing something is our confidence that we can Successful therapy tends to be associated with faith hope expectations for increased Nature of specific therapeutic variables o THREE VARIABLES LOOKING AT IN THERAPY o Nonspecific factors competence 1 Client patient 2 Therapist 3 Interaction o The patient or client The degree of the client s distress Curvilinear patients with little disturbance or extreme disturbance show poorer outcomes than do moderately disturbed patients Intelligence Age Motivation Openness process Some therapeutic approaches require a great deal of talking articulation of past insight and introspection Behavioral therapy behavior modification programs Best to consider the specific characteristics of the prospective client ex age When people are forced to become clients they rarely benefit from therapy Client is a better candidate for therapy when has openness to the therapeutic o The therapist Research does not support that sex of client is significantly related to outcome in Gender therapy Race ethnicity social class middle class clients Many therapeutic techniques have been designed developed for white upper and YAVIS syndrome young attractive verbal intelligent successful numerous reviews of existing research concludes there is virtually no relationship between social class and outcome Cultural sensitivity of therapist important o Important that clinical psychology develops these therapists who can work effectively with culturally diverse populations Therapist s reaction to patients Evidence shows clients who are more attractive or can better relate with the therapist are associated with better outcomes in therapy Role of personality warmth and sensitivity override therapist having a specific theoretical or therapeutic orientation Rapport so important to have warmth the personality to build trust Age sex and ethnicity Interaction therapists become more sensitized to age gender and racial identity issues when they can relate to them as well as the client Personality Therapist s personality is a potent force but other factors in combination largely determine therapy outcomes o You re not going to match every personality of every client Empathy warmth and genuineness Emotional well being Most say necessary but not sufficient conditions for good therapy outcome Therapists need to be able to look at their clients with objectivity and not become entangled in their personal dynamics o ITS NOT ABOUT YOU ITS ABOUT THE CLIENT It does not seem necessary for all therapists to undergo treatment as a qualification for conducting therapy Experience and personal identification No evidence supports one profession ex clinical psychologist psychiatric social worker psychiatrist psychoanalyst boasts superior therapists Clients often do not know what to expect when first go to clinician s office Important for someone to explain generally what the clinic is about what kind of help they provide Discuss client s r eason for coming Other staff qualifications fees confidentiality possible referral agencies r eferral question o Assessment Appointments for assessment Intake interview Administer psychological tests Client engage in self observation requires training Additional consultation with the person s permission Interview others Course of clinical intervention o Initial contact o Preliminary integration Comprehensive construction of the client s problems in light of all the psychological environmental and medical data available Specific therapeutic interventions to be undertaken On going process o Goals of treatment o Implementing treatment Discussion of goals and methods must be handled with discretion sensitivity skill Described to client of how treatment relates to client s problems length of time and potential difficulties ahead Exactly what is expected of client should be detailed o Termination evaluation and follow up Termination with insurance today you see the person until insurance runs out As termination approaches important to discuss in detail client s feelings and attitudes Important to evaluate with clients the progress they have made thoroughly o Q Is it ok for clinicians to hug their clients Its not about you Find a way to show client you care about them without touching them Some cultures more permissible to hug o Precontemplation contemplation preparation action maintenance termination Stages of change Psychotherapy research o Eysenck 1952 produced a report suggesting that psychotherapy with neurotics was no more effective than no therapy at all Randomly assigned people to see a therapist and to be on a waiting list After 6 months measured people at the same place both groups PROBLEMS o 1 Cannot randomly assign if someone said they are suicidal you can t put them on a waiting list Thus not randomly assigned o 2 Only made measurements at beginning and end not throughout the 6 months o 3 You will get to the same page 6 months later time heals
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