part 1: psychotherapeutic interventions and evidence based practice

What is evidence-based practice (EBP)

• what is evidence?

Evidence is anything that may be used to determine/demonstrate an assertion of truth.

• evidence-based practice is the integration of the best scientific evidence, patient values and clinical experience

Why is EBP important in Psychology?

• RIPE

RIPE

• ensures effectiveness

• Promotes ethical practice

• Improves client outcomes

• Related to integrity

Key ethical foundations of EBP

• respect for persons

• Beneficence

• Justice

• Fidelity and responsibility

EBP Challanges

• Health related fields have an over -reliance on experience; senior = better

• Some professionals practice the same way they were taught in their undergraduate; no growth in practice

• Beliefs/practices may be outdated/inaccurate

• E.g. babies sleep better on their front —> later an association b/w SIDS and babies sleeping on their front was presented = to 16yrs for this evidence to be followed = 50000 deaths could have been prevented in the US, Europe and Australasia alone.

Barriers to Implementation of EBP

• access and/or understanding of quality evidence

• Limited resources

• Time constraints

• Resistance to change

• Sub-optimal training

• Barriers w/in an organisation or culture

• Difficulty accessing clear and consistent guidelines

Common Research Questions in Health and Wellbeing

What is the lowest level of evidence in health research? (Levels of evidence)

• expert opinion - commentaries, position papers, Editorials = due to potential bias and lack of empirical data

What characterises a case study/report in research?

• an in-depth analysis of a single case, often used to generate hypotheses, without statistical analysis

How does a case series differ from a case study?

A case study involves multiple cases over time without a control group limiting the ability to infer causality.

What is the main purpose of a case-control study?

To retrospectively compare individuals with a specific outcome (cases) to those without (controls) to identify potential risk factors.

What defines a cohort study in research?

A longitudinal study following a group sharing common characteristics over time to assess outcomes related to specific exposures.

What is a non-randomized control trial?

A study comparing outcomes between treatment and control groups without random assignment, limiting causal inferences.

Why are randomized controlled trials (RCTs) considered high-level evidence?

Because randomization minimizes bias, allowing for strong causal conclusions about the effect of interventions.

What is the purpose of a systematic review in research?

To comprehensively identify, appraise, and synthesize all relevant studies on a specific research question using systematic methods.

How does a meta-analysis enhance research findings?

By statistically combining results from multiple studies to provide a more precise estimate of the effect size.

What is the significance of understanding levels of evidence?

To critically appraise research quality, apply findings appropriately, and integrate evidence with clinical expertise and patient values.

What is psychotherapy?

Psychotherapy is an engagement between a therapist and a client, focusing on bringing about change within the client via the therapeutic alliance.

What factors are not defined by the format in psychotherapy?

• individual

• Group

• Family settings

• Short/long-term duration

• Frequency, etc

What correlates with outcomes in psychotherapy?

Core counselling and interpersonal skills

What is the primary focus of psychoanalysis?

Accessing unconscious conflicts formed in early childhood that cause neurotic anxiety.

Name some analytic processes used in psychoanalysis.

1. Free association

2. Interpretation (e.g. Rorschach test)

3. Dream analysis

4. Transference

Who are key theorists in psychoanalysis?

1. Signings Freud

2. Jung

3. Adler

4. Boom

5. Klein

What does behaviourism focus on?

Observable behaviour rather than internal mental states

What are key concepts in behaviourism?

• Classical conditioning

• Operant Conditioning

Name some techniques used in behaviourism?

• positive reinforcement

• Exposure therapy

• Behaviour modification

What does humanistic therapy emphasise?

• personal growth

• Self-actualisation

• Individuals subjective experience

What are key elements of the therapeutic relationship in humanistic therapy?

• unconditional positive regard

• Empathy

• Genuineness (congruence)

Who are notable theorists in humanistic therapy?

• Carl rogers

• Abraham Maslow

What is the focus of CBT?

Identifiable thought processes and definable behaviours that can be monitored and addressed with specific interventions

What are some “Third Wave” Approaches in CBT?

• ACT (Acceptance and Commitment Therapy)

• Mindfulness

• Meta-cognitive Therapy

• DBT (Dialectical Behaviour Therapy)

What is the ABC model in CBT?

A = Activating Event

B = Belief/Thoughts

C = Consequence (Emotional and/or behavioural)

What is the focus of Interpersonal Psychotherapy?

Improving interpersonal relationships and social functioning to help reduce distress.

What does Gestalt therapy emphasise?

Personal responsibility and focused on the individuals experience in the present moment.

What is the goal of Feminist Therapy?

Addressing the social, cultural and political causes of psychological distress, emphasising empowerment.

Cognitive Distortions

What us “All-Or-Nothing Thinking” in CBT?

Viewing situations in black and white terms, without recognising any middle ground/ignoring context.

Define “Mental Filter”

Focusing exclusively on the negative aspects of a situation, ignoring the positives.

What does “catastrophising” mean?

Imagining and expecting the worst possible outcome in a situation.

Explain “Overgeneralisation”

Making broad conclusions based on a single event or piece of evidence.

What is “Labeling” in cognitive distortions?

Assigning a fixed, global label to oneself or others based on specific behaviours or events.

Describe “selective abstraction”

Focusing on a single negative detail, ignoring the broader context.

Automatic Negative Thoughts (ANTs)

What are ANTs?

Spontaneous, involuntary thoughts that are negative and often irrational, influencing emotions and behaviours.

Provide an example of an ANT related to self-worth.

“I’m a failure; I can’t do anything.”

How do ANTs affect behaviour?

They can lead to avoidance, decreased motivation and reinforcement of negative beliefs.

Challenging thinking patterns

What is the first step in challenging a negative thought?

Identify the problematic automatic thought.

After identifying a cognitive distortion, what is the next step?

Use Socratic questioning to dispute the thought.

What is a rational rebuttal in CBT?

A balanced, evidence-based thought that counters the automatic negative thought.

Core beliefs and Maladaptive Assumptions

What is a core belief in CBT?

A deeply held belief about oneself, others, or the world m, often forms early in life.

Give an example of maladaptive assumption?

“ In order to be okay, I must always succeed at whatever I do”

How do maladaptive assumptions influence behaviour?”

They can lead to rigid rules and expectations, causing distress when unmet.

CBT Techniques

What is the purpose of Socratic Dialogue in CBT?

To help clients examine and challenge their beliefs through guided questioning.

Describe the process of Exposure Therapy.

Gradually and repeatedly exposing clients to feared situations to reduce anzxiety.

What is a Dysfunctional Thought Diary?

A tool where clients record negative thoughts, identify distortions, and develop rational responses.

Case conceptualisation and Functionsl Assessment .

What is the ABC model in CBT?

A framework identifying Antecedents, Behaviours, and consequences to understand behaviour patterns.

Why is case conceptualisation important in CBT?

It provides a structured understanding of a client’s issues, guiding effective treatment planning.