Intro to clinical exam 3

Does Hans Eysenck think psychotherapy works?

No

Why?

Found that people would improve on their own

efficacy

the extent to which therapy works in a controlled research setting

efficacy studies maximize…

internal validity

three common features of efficacy studies

well-defined group of clients, manualized treatment, random assignment

effectiveness

the extent to which psychotherapy works in actual clinical settings

effectiveness studies lack ___ validity but typically have greater ____ validity

internal, external

3 common features of effectiveness studies

wider range of clients, greater validity b/w therapists’ methods, may or not have control group

Three parties Hans identified in his tripartite models to identify how well therapy works

the client, the therapist, society

Did efficacy studies say that therapy works?

Yes!

Consumer Reports study

surveyed its subscribers about their experiences with psychotherapy, found that therapy had positive, lasting effects for the vast majority of respondents

Criticisms of Consumer reports study

potential sampling bias, how many people would have improved without psychotherapy, how reliable and valid are self-reports

Why this there a gap between research and practice of psychotherapy?

research has little influence over therapists’ clinical decisions

What is practice-oriented research

increasing collaboration between researchers and practioners

What is the transdiagnostic approach

a relatively new way of understanding psychological disorders that emphasizes core factors that underly multiple disorders rather than separate, distinct disorders

What are alternate ways of measuring outcomes of psychotherapy (aside from efficacy and effectiveness studies)?

using a transdiagnostic approach?

What is was the dodo bird verdict?

competing therapies were often found to work equally well

Common factors that different therapies tend to share

therapeutic relationship/alliance, hope, attention

Therapeutic Alliance

a partnership between two allies (client and therapist) working in a trusting relationship toward a mutual goal

What did Dianne Chambless work to establish

a prescriptive approach to therapy

prescriptive approach

specific techniques are viewed as the treatment of choice for specific disorders

Stages of change model

precontemplation stage, contemplation stage, preparation, action, maintenance

What is eclectic therapy?

involves selecting the best treatment for a given client based on empirical data from studies of the treatment of similar clients

What is integrative therapy?

involves blending techniques in order to create an entirely new, hybrid form of therapy

What trends in psychotherapy do experts predict for the future"?

increased use of technology, approaches that are based on culture/diversity-based adaptations for specific clients, mindfulness-based approaches, cognitive-behavioral therapy, motivational interviewing

what is Freud’s major “contribution’ to the field

the existence of the unconscious

What is the primary goal of psychodynamic psychotherapy

making the unconscious conscious

All methods of accessing the unconscious are

inferential

Free association

technique in which the therapist simply asks client to say whatever comes to mind without censoring themselves

What is the difference between free association and word association

in word association, clients are asked to respond to a list of words with the first word that comes to mind rather than continuing to say what first comes to mind

True or false? Freud believes that people make mistakes

False, mistakes do not exist and if a behavior cannot be explained by conscious motivation, unconscious motivations must be the cause (Freudian Slips)

Freud believed that when we sleep, our minds convert _____ content (the raw thoughts and feelings of the unconscious) to _____ content (the actual plot of the dream)

latent, manifest

the process of converting latent content to manifest content is called

Dreamwork

Resistance

When clients feel that certain unconscious thoughts or feelings are being discussed too extensively or quickly, they feel anxious

What do psychodynamic therapists do when resistance occurs

dig deeper in exploring that topic

Defense mechanisms

belief that identifying clients’ unconscious defense mechanisms and bringing them to the clients attention can improve clients’ lives

Id

part of the mind that generates all the pleasure seeking, selfish, indulgent, animalistic impulses

Superego

part of the mind that establishes rules, restrictions, and prohibitions

Ego

the mediator, makes compromises between the id and superego

One way the ego can handle id/superego conflict is

defense mechanisms

Transference

tendency to form relationships with the therapist in which they unconsciously and unrealistically expect the therapist to behave like an important person from their past

What is the working through process

once transference is noticed the therapist will offer the client an interpretation that will be frequently re-evaluated

What does it mean for a therapist to play a blank screen role

they reveal little about themselves verbally and nonverbally

Primary issue of the oral stage

dependency

Primary issue in the anal stage

control

Primary issue in phallic stage

whether child is able to form a special relationship with parents shapes view of self

What does interpersonal therapy focus on

current interpersonal relationships and role expectations

What areas contribute to depression according to IPT

role transitions, role disputes, interpersonal deficits, grief

What does Time-Limited Dynamic Psychotherapy tend to focus on

making clients aware of transference patterns, and offering healthier, more realistic interactions

Working model of client’s primary issues

acts of self (how a person actually behaves), expectations about others’ reactions, acts of others towards self, acts of self toward self

What are the major differences between brief and long-term psychodynamic therapy

in brief therapy: therapeutic alliance forms rapidly, focuses on narrowly defined problem, therapist’s level of activity is high, client’s psychopathology is less severe, focus primarily on here and now

What are allegiance effects

influence of the researchers own biases and preferences on the outcome of their studies

What do humanist psychotherapists believe about the inherent nature of human beings

people are basically good or neutral, not bad

What is the primary goal of humanistic psychotherapy

to foster self-actualization

congruence

a match between the real self and the ideal self

self-actualization

the inborn tendency for humans to grow

How is self-actualization related to mental health

mental health is the result of the stifled growth

Conditions of worth

conditional positive regard communicated that we are only prized if we meet certain conditions

essential therapeutic conditions

empathy, unconditional positive regard, genuineness

Are these conditions necessary and sufficient?

they are necessary but not sufficient alone

How do humanists think about the blank screen role

they think it is bad and that therapists should be transparent with their clients

Existential psychology

centers on the premise that each person is essentially alone in the world and that realization of this fact can cause overwhelming anxiety

Gestalt psychology

emphasizes a holistic approach to enhancing the client’s current experience and often relying on the use of role-play techniques during therapy

Motivational Interviewing

centers on addressing clients’ ambivalence or uncertainty about making major changes to their way of life

Central principles of MI

expressing empathy, developing the discrepancy, avoiding argumentation, rolling with resistance, identifying “sustain talk” and “change talk”, supporting self efficacy

What is the primary goal of behavior psychotherapy

observable behavior change

What did Boyfriend Skinner and Eddie Thorndike discover

Operant conditioning

How does a behavioral psychotherapist define mental health problems

clients behaviors are not symptoms of an underlying problem, behaviors are the problem

Exposure therapy

often used to treat anxiety disorders and essentially involves the client facing their fears

In exposure therapy clients typically work through a

fear hierarchy

imaginal exposure

imagining anxiety-provoking situations

in vivo exposure

exposing the client to real-life items or situations that are anxiety provoking

Systematic desensitization

pairs the feared object with a new response that blocks the fear response, relaxation training is the first step

relaxation training

involves the therapist teaching the client various relaxation exercises (ex. progressive muscle relaxation)

exposure response treatment

expose the individual to what they are afraid of and prevent them from performing their typical response (used to treat OCD)

Prolonged exposure

teaches individuals to gradually approach their trauma-related memories, feelings, and situations (treatment for PTSD)

Assertiveness training

used to treat social anxiety, usually begins with direct instructions from the therapist, then effective assertive behaviors are modeled, then client is given opportunity to rehearse assertive behavior

Applied behavior analysis

a manualized, evidence based therapy used primarily with child clients with a diagnosis of ASD

Token economy

a setting in which clients can earn tokens for in predetermined target behaviors

Shaping

reinforcing successive approximations of the target behavior

behavioral activation

client and psychologist collaborate to form a list of rewarding behaviors and integrate them into the client’s life

behavioral activation is most commonly used to treat

depression

behavioral consultation

an indirect way to modify a client’s behavior

parent training

specific form of behavioral consultation in which parents seek help with problematic behaviors of their children