Intro to Clinical Psych Exam 3

Hans Eysenck

Concluded that psychotherapy may not be effective, most people improve on their own

Efficacy studies

the extent to which therapy works in controlled research study (in the lab)

-maximize internal validity.

Effectiveness studies

the extent to which therapy works in actual clinical settings (the real world)

-maximize external validity.

Hans Strupp’s Tripartite model

Identifies three parties to consult for psychotherapy outcomes: the client, the therapist, and society (often significant others, insurance companies, the legal system).

Efficacy studies conclusion

Have generally concluded that psychotherapy is effective.

Consumer Reports study

A study on psychotherapy outcomes that had major flaws, such as non-randomized samples

-magazine asked subscribers about their experiences with therapy

Gap between research and practice

There is often a disconnect between scientific findings and clinical application

-therapists tend to focus on subjective clinical judgement rather than scientific findings

-research can be costly to access, boring

Practice-oriented research

Research that focuses on practical applications of psychotherapy in real-world settings, increasing collaboration between researchers and practitioners

Alternative outcome measures

neurobiological studies (fMRI, PET scans) and medical cost offset (do people who seek therapy spend less on medical costs? yes!)

Dodo bird verdict

The conclusion that all forms of psychotherapy work equally well

Common factors

-Therapeutic alliance

-Hope (positive expectations)

-Attention

Dianne Chambless

Argued that not all forms of psychotherapy are equivalent, focusing instead on specific treatments for specific problems

-proposed using a prescriptive approach to therapy

-specific treatment choices for specific disorders

Stages of Change Model

A model outlining the stages of readiness for change in clients

Precontemplation: no intention to change at all

Contemplation: aware of problem, considering change, not ready to commit to effort or direction

Preparation: intention to take action within a short time

Action stage: actively changing behavior, making effort to overcome problem

Maintenance: prevent relapse, retaining gains

Eclectic approaches

Utilizing techniques from various therapeutic modalities in therapy, based on empirical data.

Integrative approaches

Combining different theoretical approaches into a coherent therapeutic framework to create new hybrid forms of therapy

Freud's contributions

Pioneered psychoanalysis and introduced concepts like the unconscious mind

Goal of Psychodynamic Psychotherapy

to make the unconscious conscious

-if clients are aware of the unconscious, they can make efforts to control it directly

Methods to access the unconscious

free association, Freudian slips, dream analysis, resistance, defense mechanisms, transference

Free association

A technique where clients express their thoughts freely to unlock the unconscious.

Word association

A technique involving responding to words to reveal mental associations.

Freudian slip

An unintentional error that reveals subconscious thoughts.

Dream work

The process through which a therapist interprets a client's dreams to understand their unconscious mind

-in sleep we convert latent content (unconscious thoughts and feelings) into manifest content (dream plot)

Defense mechanisms

Psychological strategies utilized to manage anxiety arising from internal conflicts (e.g. projection)

Resistance

A client's subconscious defense against confronting painful feelings or thoughts.

Transference

When a client projects feelings onto the therapist that are linked to past relationships.

Working through process

The ongoing process of confronting and resolving issues in therapy.

Blank screen role

A therapist's neutral stance to facilitate transference.

-often sits away from client, showing no emotion or reaction

Psychosexual stages of development

Freud's stages focusing on conflicts surrounding different erogenous zones.

oral stage: birth -1.5 years

-pleasure through the mouth, feeding

-dependency (overbearing - too dependent, neglectful - too independent)

-smoking, drinking, biting nails

anal stage: 1.5-3 years

-toilet training, learning control

-demanding parents - overly concerned w/ getting everything right

-lenient parents - lax children

-OCD, relationship problems

Phallic stage: 3-6 years

-oedipus and electra complexes

-forming special relationships w/ parents, self worth

-too positive → overinflated ego, too negative → lower esteem

-depression, anxiety, relationship problems, issues with self worth

Interpersonal Therapy focus

Addresses interpersonal relationships and social functioning

-depression treatment

-focuses on interpersonal relationships, role transitions, role disputes, interpersonal deficits, grief

Brief vs. long-term psychodynamic therapy

Brief

-form therapeutic alliance rapidly

-focus on specific narrowly defined problem

-high therapist activity

-clients psychopathology less severe

-focus on here and now

Long term

-form therapeutic alliance gradually

-focus on broad range of problems

-low therapist activity

-client’s psychopathology is more severe

-focus on present + past

Allegiance effects

influence of researcher’s own biases and preferences on the outcomes of their empirical studies

-strong relationship between orientation of researcher and way therapies rated

Humanistic Psychotherapy

Believes in the inherent goodness of people and their capacity for self-actualization

-Carl Rogers and Abraham Maslow

Goal of Humanistic Psychotherapy

To help individuals achieve self-actualization and realize their full potential.

Congruence

Alignment between the real self (who they really are) and the ideal self (who they want to be).

Self-actualization

The realization of one's potential and self-fulfillment.

Conditions of worth

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

-children typically aware of these conditions, try to meet them

Three necessary conditions for Humanistic Psychotherapy

Empathy, unconditional positive regard, and genuineness

-these conditions are actually necessary, but not sufficient in causing change in clients

Existential Psychotherapy

An approach to psychotherapy, related to the humanistic approach, that centers on the premise that each person is essentially alone in the world, and that realization of this fact can cause overwhelming anxiety.

Gestalt Therapy

An approach to psychotherapy, related to the humanistic approach, emphasizing a holistic approach to enhancing the client’s current experience and often relying on the use of role-play techniques during therapy.

Motivational Interviewing

¡An offshoot of humanistic therapy that was originally developed to treat addictive behaviors (substance abuse)

¡MI therapists do not pressure clients to make changes—they help clients see the discrepancy between their behaviors and their own values

¡Central principles of MI:

¡Expressing empathy

¡Developing the discrepancy

¡Avoiding argumentation

¡Rolling with resistance

¡Identifying “sustain talk” and “change talk”

¡Sustain talk = client statements in favor of continuing the problematic behavior

¡Change talk = client statements in favor of making changes

¡Supporting self-efficacy

Goal of behavior psychotherapy

observable behavior change

behavior psychotherapy

the clinical application of behavioral principles (operant conditioning, classical conditioning, modeling)

-clients behaviors are not symptoms of some underlying problem, behaviors are the problem

Thorndike and Skinner's discovery

operant conditioning

Exposure therapy

A technique used to treat phobias through controlled exposure to feared objects or situations.

-clients work through fear hierarchy

In vivo exposure

Direct exposure to the feared object or situation in real life.

Imaginal exposure

Exposure to the feared object or situation through imagination.

Systematic desensitization

A method combining exposure with relaxation techniques to reduce fear

-before each exposure the client achieves a relaxed state

Relaxation techniques

Methods like deep breathing or progressive muscle relaxation used in therapy.

Exposure and response prevention

Used to treat OCD by preventing the compulsive responses to anxiety

-expose the individual to what they are afraid of and prevent them from performing their typical response

Prolonged exposure

Involves repeated exposure to trauma-related stimuli to reduce fear responses

-used to treat PTSD

-teaches clients to gradually approach trauma related memories, feelings, situations

Assertiveness training

-specific application of classical conditioning that targets social anxiety

-includes elements of exposure therapy (exposure in facing interpersonal fears

Behavioral Activation

Used to treat depression by encouraging engagement in positive activities

-goal is to increase frequency of behaviors that are positively reinforcing to the client

Behavioral consultation

Collaborative approach to address behavioral issues in children

-3 parties: client, therapist, and consultee

-parent and teacher training

Parent training

A form of behavioral consultation that helps parents manage their children's behaviors.

Time Limited Dynamic Psychotherapy

-provides client with corrective emotional experience

-therapist makes client more aware of transference patterns and offers healthier interactions

-client-therapist relationship tool for change

token economy

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