Deck 16: A: Psychological and Biological Treatments

Question 1

Why is the choice of a therapist who uses effective methods an important one as a person enters into psychotherapy?

Answer 1

Answers will vary but should include the following points in the discussion to earn full credit.
--Many people have been dealing with the problem for several months or years prior to seeking out professional help.
--An effective therapist provides a patient with hope,empathy,advice,support,and opportunities for new learning experiences.
--An effective therapist works with the patient to find the best treatment and to provide appropriate feedback about his or her progress.An ineffective therapist dictates and seeks to control a patient's behaviour through the therapist's preferred method of treatment.
--An effective therapist is open,honest,and focused on improvement with a patient,while an ineffective therapist is secret,guarded,and lacking focus on the bigger issue of improving the patient's functioning.
--Given that training and years of experience aren't critical determinants of what makes a good therapist,what is? Effective therapists (Garske & Anderson,2003)are likely to be warm and direct (Westerman,Foote,& Winston,1995)and to establish a positive working relationship with clients (Kazdin,Marciano,& Whitley,2005;Luborsky et al. ,1997),and tend not to contradict clients (Friedlander,1984).Effective therapists also select important topics to focus on in sessions (Goldfried,Raue,& Castonguay,1998)and match their treatments to the needs and characteristics of clients (Beutler & Harwood,2002).Differences among therapists in their abilities and characteristics may be so great that they overshadow differences in the effectiveness of the treatments they provide (Ahn & Wampold,2001;Luborsky et al. ,1986).So when it comes to the success of psychotherapy,the choice of therapist is every bit as important as the choice of therapy (Blow,Sprenkle,& Davis,2007).
--What makes a good therapist from the client's point of view? The composite view of the "good" therapist is that of an expert who's warm,respectful,caring,and engaged (Littauer,Sexton,& Wynn,2005;Strupp,Fox,& Lessler,1969).This description fits exactly the sort of therapist we advise you or your loved ones to seek

Question 2

What is the dodo bird verdict and how is it related to the effectiveness of different treatments?

Answer 2

Answers will vary but should include the following points in the discussion to earn full credit.
--Psychotherapy researchers use the term dodo bird verdict to refer to the conclusion that all therapies are equivalent in their effects.Not all investigators accept this verdict.
Beginning in the late 1970s,a scientific consensus emerged that psychotherapy works in alleviating human suffering (Landman & Dawes,1982;Smith & Glass,1977)-a consensus that holds to this day.This conclusion derived from studies using a technique called meta-analysis,meaning "analysis of analysis," is a statistical method that helps researchers to interpret large bodies of psychological literature.Today,some researchers using meta-analysis have claimed to support the dodo bird verdict.Studies with experienced therapists who've practised behavioural,psychodynamic,and person-centred approaches have found that all are more successful in helping clients compared with no treatment,but no different from each other in their effects.
Other researchers aren't convinced.They contend that the dodo bird verdict,like the real dodo bird,is extinct.Although most forms of psychotherapy work well,and many are about equal in their effects,there are notable exceptions (Beutler,2002;Hunsley & DiGuilio,2002).For example,behavioural and cognitive-behavioural treatments are clearly more effective than other treatments for children and adolescents with behavioural problems (Garske & Anderson,2003;Weisz et al. ,1995).Moreover,behavioural and cognitive-behavioural therapies consistently outperform most other therapies for anxiety disorders,including phobias,panic disorder,and obsessive-compulsive disorder (Addis et al. ,2004;Chambless & Ollendick,2001).
Also calling into question the dodo bird verdict are findings that some psychotherapies can make people worse (Barlow,2010;Dimidjian & Hollon,2010;Lilienfeld,2007).Although we might assume that doing something is always better than doing nothing for psychological distress,research suggests otherwise.A nontrivial proportion of clients,perhaps 5 to 10 percent,become worse following psychotherapy,and some may become worse because of psychotherapy (Castonguay et al. ,2010;Rhule,2005;Strupp,Hadley,& Gomez-Schwartz,1978).For example,several researchers have found that crisis debriefing (see Chapter 12)can sometimes increase the risk of posttraumatic stress symptoms in people exposed to trauma.

Question 3

Discuss how focusing on the importance of critical thinking would be helpful as one perused the bookshelves for a helpful,self-guided treatment.

Answer 3

Answers will vary but should contain at least three of the following for full credit.
--Extraordinary claims require extraordinary evidence.A person needs to focus on the strength of the data for distinguishing between possible treatments,and also needs to remember that anecdotal,personal testimonies are not strong evidence.
--Replicability.Other independent sources should have verified the efficacy of one's claims.Secret knowledge is not usually useful knowledge because it is not connected with other important areas of human behaviour.There needs to be reference citation information given to find the sources of the claims made in the book.
--The author has the credentials and expertise to write on the topic.It is based on scientific/empirical evidence rather than on biased opinion.
--Recognizes the complexity of human behaviour.There is not just a "one-size-fits-all" approach or the focus on a single,magic bullet solution to the problem.
--Serious problems require professional help,not self-help.More serious psychological disorders are not going to treated by a self-guided process.