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Evaluating psychotherapy

Evaluating psychotherapy. Sec 3. objectives. Summarize the Therapeutic alliance Evaluate the problems with therapy Analyze what therapies work with what disorders List the ways therapy harms patients (4) . Therapeutic alliance. Psychotherapy is relationship

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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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