Eysenck's Challenge

CH.17 - Treatment of Psychological Disorders

Eysenck's Challenge (1952)

  • Overview: Eysenck reviewed insurance records and made notable claims regarding the effectiveness of psychotherapy.

    • Spontaneous Remission Rates:

    • Found that spontaneous remission rates were high among clients.

    • Defined Spontaneous Remission: Reduction of symptoms without formal treatment.

    • Main Claim:

    • Therapy clients improve no more than untreated patients, which sparked significant debate and backlash.

  • Impact of the Challenge:

    • Eysenck's critique led to a revolution in psychological research methodology, pushing the field towards more experimental designs.

What Is a Good Psychotherapy Study?

  • Randomized Clinical Trial (RCT):

    • A RCT is essential for testing the effectiveness of therapy.

    • Participants are randomly assigned to either treatment or control groups.

Characteristics of a Good Psychotherapy Study

  • Participants:

    • All participants should share the same disorder (e.g., unipolar depression).

  • Comparative Analysis:

    • Compare therapy effectiveness against:

    • No treatment

    • Placebo treatments

    • Alternative treatments

    • This controls for expectations and eliminates bias in the results.

  • Ethical Issue with Placebos:

    • Often, participants in the placebo group are promised real treatment later, which raises ethical concerns.

Desirable Standards for Research

  1. Treatment Standardization:

    • Utilize Manualized Treatment:

      • Therapists follow the same procedures, decreasing variability between therapists.

      • This allows for proper outcome comparison across studies.

      • Notably, psychodynamic and humanistic therapists often oppose this idea, arguing for the uniqueness of therapy, whereas Cognitive Behavioral Therapy (CBT) has widely adopted such manuals.

  2. Blind Outcome Evaluation:

    • Observers evaluating outcomes should not know the treatment group assignments of the clients to avoid bias in interpreting results.

  3. Follow-up Assessment:

    • Critical to the evaluation of therapy effectiveness over time.

    • Important to note that more than 75% of untreated people can experience improvement.

    • Some therapies show positive short-term outcomes, while others are found to be more effective in the long term.

      • Example: CBT has been shown to produce fewer relapses compared to medication when used alone.

Outcome Comparisons

  • Dodo's Verdict: Most therapies, despite different approaches, yield similar average outcomes, leading to the famous quote, "All must have prizes."

Debate on Differential Effectiveness

  • While many therapies produce similar results overall, there's debate regarding Differential Effectiveness:

    • Some therapies are more effective for certain disorders compared to others.