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Evaluating psychotherapy

This comprehensive analysis of psychotherapy highlights the significance of the therapeutic alliance between therapist and client, emphasizing its role in effective therapy. It evaluates various therapy methods, revealing which disorders they best address, and identifies potential harms in therapy, including inappropriate techniques and therapist biases. Evidence suggests that cognitive therapies are particularly effective for mood and anxiety disorders, while emphasizing the importance of cultural sensitivity. This exploration underscores the complexities of therapy and the necessity for scientifically supported practices to ensure patient well-being.

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Evaluating psychotherapy

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  1. Evaluating psychotherapy Sec 3

  2. objectives • Summarize the Therapeutic alliance • Evaluate the problems with therapy • Analyze what therapies work with what disorders • List the ways therapy harms patients (4)

  3. Therapeutic alliance • Psychotherapy is relationship • Success depends on what both parties bring to table • Therapeutic alliance- the bond of confidence and mutual understanding established between therapist and client, which allows them to work together to solve problems • Goals same

  4. Qualities of the participants • Most likely to do well in therapy=motivated to improve • Support from family • Develop personal style to deal with problem • Personality traits hostile and negative more resistance to therapy • Carl Rodgers (ch 2)- empathy, warmth, being genuine= best traits for therapist

  5. Culture and therapeutic connection • Different backgrounds= may be successful • But cultural differences may cause misunderstanding • Lifetime of racism and cultural distrust African American’s may distrust White therapist • Asian-Americans, Latinos, African Americans more likely to stay with ethnic matched therapist

  6. Science-Practitioner Gap • Breach between scientist and therapists • One reason: professional schools not connected to academic psychology departments- train solely for therapy • New therapies trying to gain foothold with no scientific support at all • Neurolinguistic programming (NLP)- match learning styles with brain type- BOGUS

  7. Problems in assessing Therapy • Proliferation of therapies + economic pressures from drug companies= need scientific evidence • Can’t just ask someone did therapy help?

  8. Problem with therapy • Testimonials “ I would have never found love, taken that job, moved to Escalon without Dr. Blitznik • Can’t be own control group: how do you know would not have found love without Dr. Blitznik • Placebo effect: anticipation of success, buzz. About Dr. Blitznik • Never here about people who drop out or get worse • Thanks to justification of effort, people put time, money effort in tell you its worth it • Don’t want to say “ saw Dr. B. for 5 years and boy was it a waste of time!”

  9. What works? • Here comes the evidence showing the benefits of psychotherapy • Emotional disorders; cognitive and behavior therapies

  10. Depression • Cognitive therapy best success Mood disorders (especially depression) • Often as effective as antidepressant drugs, and less likely to relapse when treatment over • LEARN LESSONS in therapy last long after therapy • Evidence: randomized, controlled study 120 adults that had attempted suicide: given 1 of 2 conditions cog. Therapy or referral and call back • Cog. Study group ½ as likely to attempt suicide

  11. Anxiety disorders • Exposure techniques most effective for P.T.S.D., agoraphobia, specific phobias like public speaking • Cog. Behavior therapy for generalized anxiety, O.C.D. and panic disorder

  12. Anger and impulsive violence • Cognitive therapy • Reducing chronic anger, abusiveness, hostility • Teaches people how to express anger more calmly and constructively

  13. Health problems • Cog. Behavior therapy cope with pain, chronic fatigue syndrome, headaches and irritable bowel syndrome

  14. Childhood and adolescent behavior problems • Behavior therapy is the most effective • For bed wetting, anger impulsiveness

  15. Relapse prevention • Cognitive behavior approaches highly effective • Substance abuse, depression, sexual offenses

  16. When Therapy Harms • Every treatment carries risks • Even asprin • So does psychotherapy • Risks increase with following factors

  17. Harms #1 • The use of empirically unsupported, potentially dangerous techniques • Memory does not work like movie camera so can misremember • Hypnosis, sodium amytal (barbituate called truth serum) • Can enhance suggestability

  18. Harms #2 • Inappropriate or coercive influence, which can create new problems for the client • Inadvertently creates disorders through suggestion • 1980’s 90’s = multiple personality disorder

  19. Harms #3 • Prejudice or cultural ignorance on the part of the therapist • Prejudeced against gender, culture sex

  20. Harms #4 • Sexual intimacies or other unethical behavior on the part of the therapist • Unethical

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