General Issues and Psychodynamic Psychotherapy Review

question of vital importance

question: does psychotherapy work?

ancedotes, testimonials, and case studies

subjective descriptions of individual’s client’s progress typically written by therapist themselves

1950s

when controlled studies began regularly appearing

hans eysenck

published historic study concluding that msot clients got better without therapy and was of little benefit

meta analysis

statistically combines the results of many separate studies to create numerical representations of the effects of psychotherapy as tested across masisve number of settings, therapists, and clients; yielded conssitently supportve results about how well psychotherapy works

hans strupp

identified 3 parties called the tripartite model that acknowledged the viewpoints of the client, therapist, and society

client

the first party of the tripartite model; the ones whose lives are affect by therapy; their opinions are valuable but also could be biased (overestimate the benefits of therapy or underestimate)

therapist

the second part of the tripartite model; typically have more experience in mental health in comparisson to the client resulting in more accurate expections, but can be biased as well

society

the third party of the tripartite model, an outsider to the therapy process who has an interest in how therapy progressess; tend to bring a perspcetive that emphasizes the client’s ability to perform expected duties ina stable way

after therapy and some later period

when should researcher ask if the therapy has benefits?

self report

a questionnaire or interview that solicit the opinions of an interested party

behavioral measures

observing the subject to determine whether their behavior has changed

efficacy

the sucess of a particular therapy in a controlled study conducted with clients who were chose according to particular study criteria; maximize internal validity

well defined groups

those who meet criteria for one specific disorder but no others

random assignment

used to control and treat groups to stop bias

manualized treatment guidelines

minimize variability among therapists

effectiveness

the sucess of a therapy in actual clinical settings in which client problems span a wider range and are not chosen as a result of meeting certain diagnostic criteria; measure the extent that therapy works in the “real world” (maximize external validity); features wider range of clients, greater variability between therapist’s methods, and may or may not include control group

external validity

methods that better match therapy that actually takes place in clinics, private practices, hospitals, and other realistic settings to generalize to others

Smith, glass, and miller

included 475 psychotherapy efficacy studies and found average person who receives therapy is better off at the end of it than 80 percent of persons who do not

psychotherapy

appears in most cases to endure over long periods of time, exceed palcebo effects, and represent clinically significant change in cleint’s well being

panacea

what psychotherapy is not; a solution or remedy for all problems; doesn’t work with some clients

gap

created when practitioners refuse to open their eyes to scientific data regarding the outcome of various therapies and resist changing their practices accordingly (people who conduct research on psychotherapy vs people who practice psychotherapy)

reason for gap

Therapists place a higher value on their own intuition and judgement than on any data collected more methodically.

consumer reports

study by martin selignman that found treatment by a mental health professional usually worked and most respondents got a lot better

infighting

cuased after finding out psychotherapy works, due to viewing different forms of therapy as adversaries, competitors, or contestants

virtual tie

typical result found when comparing the efficacy of one form of therapy with another; both work about equally well

Dodo bird verdict

nickname for the common research finding that different forms of psychotherapy are roughly equally effective (Luborksy, singer, and lyborsky)

active ingredients

what common factors function as in all forms of psychotherapy, not being just merely present

therapeutic alliance

the most important common factor; coalition between 2 allies working in a trusting relationship towards a mutual goal

quality

what part of the therapeutic relationship strongly contributes to psychotherapy outcome

surveys

find that clients prefer a warm therapist with whom they can relate to over a treatment with empirical support

behaviorists

type of therapists that tend to deemphasize therapy relationship

congitive

type of therapists that place a moderate emphasis on the therapy relationsship

humanists and psychoanalysts

type of therapists that focus heavily on therapy relationships

CBT

theoretically emphasize relationship variables less than brief supportive therapy does according to arnow’s study

kazdin

brings up that a good therapeutic relationships and client improvement is not necessarily a one-way street (correlation does not qual causation)

hope

another common factor; optimism that things will begin to improve that therapists provide; idea that improvement can begin before their implementation

attention

another common factor; where therapists acknowledge the problem and focus on it with the therapist which may result in improvement

eclectic/integrative therapy

most commonly endorsed therapy until 2010 when it fell to 2nd place

cognitive therapy

since 2010 it has become the dominant therapy in the field of clnical psychology

psychodynamic therapy

remains the second most commonly endorsed orientation among single-schhol approaches

psychodynamic approach

the therapy that came first historically, many therapies that arose were reactions agaisnt the approach, influences clinical psychology through adaptations of traiditonal methods into novel approaches

sigmund freud

pioneer of the psychodynamic appraoch to clinical psychology; psychoanalysis as well

goal of psychodynamic psychotherapy

to help clients become aware of thoughts, feelings, and other mental activities they are not aware of

insight

looking inside onself and noticing something that had previously gone unseen

unconscious

mental activitiy occuring outside our awareness; one of Freud’s most important contribution to clinical psych; exeerts powerful influence on our day ot day lives; processess underline depression, axiety, and all other forms of psychopathology

acessing the unconscious

throuhg inference, deduction, and conjecture rather than in an empircal way

free association

technique where therapists asks clients to say whateevr comes to mind without censoring themselevs; revealing their innermost thoughts and feelings

freudian slips

verbal or behavioral mistakes determined by uncouscious motivation; no such thing as a mistake or slip

dream work

process of converting the latent content of a dream to its manifest content

dreams

what happens when we sleepl our minds convert latent content to manifest content

resistance

client behavior that impedes discussion or conscious awareness of selected topics or emotions

id

part of the mind that generates all the pleasure-seeking, selfish, indulgent, animalistic impulses; seeking immediate statisfication of its wishes

superego

part of the mind that establishes rules, restriction, and prohibitions; tells us what we “should” do

ego

part of the mind that acts as the mediator and compromise maker between id and superego; two challenges of satisfying both these opposting forces and meeting the demands of reality

defense mechanisms

techniques used by ego to manage conflict between id and superego

repression

when id has an impulse and the superego reject it, the ego can repress conscious awareness of the impulse

projection

when the id has an impusle and superego reject its, the ego can project the id impulse onto other people around us; convince outself that the unacceptable impulse belongs to somoene else, not outselves

reaction formation

when id has impulse and superego rejects, the ego can form a reaction agaisnt the id impulsel; essentially doing the exact opposite

displacement

when id has impulse and superego rejects, the ego can displace the id impulse toward a safer target; redirect the impulse towards another person or object to minimize reprercussions

sublimation

when id has impulse and superego reject, the ego can sublimate it; reject it in such a way that the resulting behavior actually benefits others

immature defense mechanims

denial and repression as they dont satisfy the id and the demands end up resurfacing later

mature defnese mechanism

sublimation as it satisfies id impusles and societal needs simultaneously

transference

client’s tendency to form relationships with therapists in which they unconsciously and unrealistically expect the therapist to behave like important people from client’s past; most essential means to access a client’s unconsious material

countertransference

transference by therapists onto clients; strive to minimize this as it involes a reaction to the client that is unconsiouclty distored by the therpaists’s own personal experiences; why trainees are required to be clients

fixation

unsuccessful resolution of the psychological tasks of a particular developmental stage; usually happens when parent do “too much” or “too little” in response to child’s needs

oral stage

first of the psychosexual stages in which issues of dependency may emerge; occurs during first and half year where they experience pleasures throught the mouth

dependency

primary issue at the oral stage that results from parents overindulging their children and grow up to become overly trsuting, naive, and optimistic or

control

if too demanding of children at this stage they become overly concerned about getting everything just right

lenient

if too undemanding at this stage children become lax about organization and can contiune into adulthood

phallic stage

third of the psychosexual stages, stage from which issues of self worth may emerge; occurs age 3 to 6; most controversial

self worth

when parents respond to positively, they over inflate the child’s sense of self and make opinions of themselves unrealistically high