psychotherapy - ESTs

step 1 of developing an RCT

develop the protocol

step 2 of developing an RCT

choose comparison to treatment of interest

step 3 of developing an RCT

select participants of interest

step 4 of developing an RCT

randomly assign participants to conditions

step 5 of developing an RCT

administer treatment and assess fidelity

step 6 of developing an RCT

evaluate outcomes at end of treatment

step 7 of developing an RCT

evaluate outcomes at follow-up points

why do we include step 7 in RCTs?

in case of sleeper effects

what comparisons can you choose from for an RCT of psychotherapy?

waitlist control, supportive psychotherapy (placebo therapy), another kind of therapy

what was the first meta-analysis of therapy?

Smith & Glass (1977)

what was the main conclusion of Smith & Glass (1977)?

therapy clients better off than 75% of non-therapy clients

what did Smith & Glass (1977) find about different types of therapy?

the effect sizes were similar, no one therapy was significantly more effective than the others

what did Chambless & Hollon (1998) do?

establish guidelines for determining which treatments were “well-established”

what is needed for a therapy to be “well-established”?

at least 2 studies showing a benefit of the treatment compared to medication or psychotherapy placebo

what criteria do the studies have to meet for “well-established" treatments?

protocol needs to be written down, characteristics of participants well-defined, at least 2 diff teams need to investigate

what is needed to be “probably efficacious”?

the same as “well-established” but compared to waitlist control

why are Chambless & Hollon (1998)’s guidelines insufficient?

number of studies needed is too low, focus on symptom reduction instead of functional and quality of life improvements, no guidance for which “well-established” treatment to choose