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27 Cards in this Set
- Front
- Back
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What are the main tenets of the Medical Model?
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1. Problem
2. A psychological explanation 3. A mechanism of change based on explanation 4. Specific therapeutic ingredients 5. Specific ingredients resolve the problem |
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Frank's (1991) model states the components that all forms of psychotherapy share. What are these 4 common factors?
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- Emotionally charged, therapeutic relationship
- Healing environment - Rationale - Ritual |
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Which model supports a multicultural perspective?
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Contextual Model
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Compare and contrast the models on the issue of absolute and relative efficacy.
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Absolute Efficacy
- Both agree psychotherapy is efficacious Relative Efficacy - Pro medical model (variation in efficacy across therapies) - Anti contextual model (uniform efficacy across therapies) |
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According to Lambert (1992), what is the relative contribution of the four main areas to psychotherapy outcomes?
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Specific Techniques - 15%
Expectancy Effects (Placebo) - 15% Common Factors - 30% Client Variables/Extratherapeutic Change - 40% |
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Wampold (2001) empirically derived the relative contribution of specific and general effects. Describe these contributions.
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Participation in psychotherapy accounts for 13% of variance in client outcome.
WITHIN this... Common Factors - 70% Specific Effects - 8% Unexplained - 22% |
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Who stated the Dodo Bird Conjecture?
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Rozenweig (1936)
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Who criticized psychotherapy claiming the proportion of those helped was equivalent to the proportion that experienced spontaneous remission? He is what set off the quest to show absolute efficacy for psychotherapy.
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Eysenck (1952)
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Who did the 1st meta-analysis of psychotherapy outcome research?
What were the findings? |
Smith & Glass (1977) found that the average psychotherapy participant was better off than 75% of people who did not participate in therapy.
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Wampold's (2001) research claims that the average effect size for psychotherapy is _______.
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.80 (accounts for 64% of the variance in client outcome)
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While the medical model proposes to find evidence of differences in relative efficacy across treatments, what two meta-analyses have not found this to be the case?
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Smith & Glass (1977) and Wampold et al. (1997)
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What are two designs used to do relative efficacy research?
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Comparative Outcome Design & Meta-Analyses
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What are some 4 with Comparative Outcome Designs that explore relative efficacy between therapeutic treatments?
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1. Difficult to know if treatments are equally efficacious due to the specific ingredients
2. Threat of inequivalent common factors across groups 3. Allegiance effects 4. Type 1 Error (false positive) |
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What are 3 issues with Meta-Analyses?
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1. Which studies make the cut? Selection issues.
2. Garbage In = Garbage Out 3. File drawer problem |
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____________ studies take place under highly controlled conditions while __________ studies involve mimic-ing real world conditions.
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Efficacy; Effectiveness
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What advice does Wampold have regarding specific versus general effects?
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- Limit clinical trials
- Focus research on general effects or unexplained variance - Decrease manual use (decreases performance of best therapists) - Focus on effectiveness rather than efficacy (efficacy studies don't have higher effect sizes than effectiveness studies) - Abolish EST movement - Choose the best therapist - Choose the therapy |
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Consumer Reports (1995) for therapy found that ____% of individuals that started in very poor condition reported therapy made things a lot better.
Other details? |
54%
Type of therapist didn't matter, outcome improved as length of therapy increased |
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If we drop the Medical Model, how do we decide which treatments to use?
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- Align with the client's personal characteristics and view of the problem (Frank ,1991)
- Therapist allegiance taken into account - Specific Ingredients are still used as a part of the process (but not most important) |
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What are the four main directions of psychotherapy integration?
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(1) Theoretical (2) Assimilative (3) Common Factors (4) Ecclecticism
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What is the fusion of two or more theoretical orientations or procedures are added from other orientations while adhering primarily to one?
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Theoretical Integration
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What is it called when a therapist maintains a central theoretical position but incorporates techniques from other orientations?
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Assimilative Integration
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What is it called when techniques are used without subscribing to theories that created them?
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Eclecticism
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Who formalized Technical Eclecticism and what is it?
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Lazarus - Uses social and cognitive theories as a framework and focuses on assessing BASIC ID to choose techniques. Its main argument is that techniques are effective, not the theories.
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What is McFall's cardinal principle?
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Scientific psychology is the only legitimate form of psychology.
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List the 4 corollaries of McFall's (1996) Manifesto
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I. Tx shouldn't be administered to public until (1) nature can be described (2) Benefits and negative effects are found (3) Benefits are validated
II. Programs produce clinical scientists III. Scientific Epistemology (1) skepticism (2) burden of proof (3) absence of negative evidence doesn't equal positive support (4) untested do not get special status (5) Results are specific IV. Caring and Genuine = Rigor |
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What was Peterson's (1996) response to McFall?
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- McFall is pro-research and anti-practice
- Reduces practice to an applied science - Overlooks the complexity of clinical problems - Rejects the role of the clinician as an "Idiographic investigator" engaged in scientific inquiry - Starts and finishes with the client - applies all knowledge found or created |
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What do Chambless and Hollon (1998) make important arguments about?
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- Replication of efficacy
- Superiority to a rival tx is better than placebo - Manuals are required - Single case designs are ok but RCT's are the golden standard despite their limited external validity |
