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Class 10

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Class 10

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  1. Class 10 Heppner et al. Chap 12, 18 Hogg & Deffenbacher(1988)

  2. Hogg & Deffenbacher (1988) • Design • Independent Variables • Dependent Variables

  3. Hogg & Deffenbacher (1988) • Design • Pre-test/post-test; experimental • Independent Variables: Categorical • Group IP Treatment • Group Cognitive Behavioral Trtmnt. • Control Group

  4. Hogg & Deffenbacher (1988) • Dependent Variables- Continuous • BDI Depression • MMPI-D Depression • ATQ Automatic Thghts. • Coopersmith SEI Self Esteem • Therapist Assessment of Client Behavior: • one item assessment of: depression, coping, anxiety, motivation to change, group participation

  5. Types Outcome Studies Kazdin (chap 18) • Treatment Package Strategy • Dismantling Strategy • Constructive Strategy • Parametric Strategy (structural components) • Comparative Outcome Strategy • Client and Therapist Variation Strategy Moderation Designs

  6. Types Outcome Studies Kazdin (chap 18) • Treatment Package Strategy • Dismantling Strategy • Constructive Strategy • Parametric Strategy (structural components) • Comparative Outcome Strategy • Client and Therapist Variation Strategy (Moderation Designs )

  7. Types of Control Group • No – treatment • Placebo ?? • Matched

  8. Internal/External Validity • Inclusion Criteria • Cng Center Clients • BDI>14 • Exclusion Criteria • Co-morbidity • Suicidal lethality • In therapy • Drug abuse/depend. • Internal Validity • Key issue • External Validity • Key issue

  9. Treatment Implementation Validity • Specificity of Treatment • Therapist Training • Fidelity Checks

  10. Treatment Validity • Treatment Specificity • CBT: emotional transactions • IPT : CB techniques for daily life • Therapist Training • Crossed by sex and theoretical orientation • Weekly supervision; rating tapes on fidelity • Fidelity Checks: • End of treatment blind raters, and • Client Evaluation of Treatment

  11. 3 X 2 Repeated Measures ANOVADep vs. Pre-test BDI & Post-Test BDI

  12. Treatment Effect: Between GroupsDo the treatment groups differ in the BDI, regardless of TIME? NS

  13. Trial Effect**: Within GroupsDo the Time groups differ regardless of Treatment? Time effect S*

  14. Interaction Effect : Do the Time groups differ in the BDI, by Treatment Group? NS

  15. Questions Addressed • Do clients who receive CBT, or IPT or no treatment show lower (or higher) BDI post-test scores than pre-test BDI scores? Trial Effect – Repeated Measures • Do clients who receive CBT show lower BDI scores at the end of the 8 weeks than clients who receive IPT or than clients who do not receive any treatment? (regardless of Time) Treatment Effect- Repeated Measures

  16. Questions Addressed • In which of the three experimental groups clients showed change in depression following treatment? Treatment x Trial Interaction – Repeated Measures • In which of the three experimental groups clients showed lower levels of depression at the end of treatment? Treatment Effect/Reg ANOVA

  17. Specific Change Mechanisms • Greater early change in • IPT: Self-esteem • CBT: Automatic thoughts

  18. Specific Treatment Changes

  19. Cholesterol Level (mg/dl) treatment placebo 12 10 0 6 8 2 4 TIME (months) Profile Plots Illustrating the Questions of Interest TIME*TREATMENT INTERACTION Here the effect of time is NOT the same for both groups. Thus we say that there is TIME and TREATMENT interaction.