Spinrad/Psychology
Spinrad/Psychology
III. Evaluating Psychotherapy
A. The scientist-practitioner gap
1. Conflict between scientists and practitioners about the relevance of research findings to clinical practice
a. Practitioners believe it is very difficult to study psychotherapy empirically
b. Scientists want the effectiveness of psychotherapy scientifically demonstrated
2. Short-term therapy is usually sufficient
B. When therapy helps
1. Psychotherapy is better than doing nothing at all
2. Qualities of successful participants
a. Motivated to improve
b. Have support of family and deal actively with problems
c. Cooperate and have positive feelings during therapy sessions
3. When there is a good therapeutic alliance or bond between the client and therapist
4. Therapists and clients from different ethnic and/or racial groups may misunderstand each other—therapists need to be aware of cultural variations in behavior
a. Therapists must differentiate cultural patterns from psychological problems
b. Therapists must not stereotype clients based on culture
C. Which therapy for which problem?
1. Problems of assessing therapy
a. Placebo affect
b. Justification of effort principle
2. Empirically-validated treatments must meet stringent criteria
3. For many specific problems and emotional disorders, behavioral and cognitive therapies are the methods of choice—particularly affective for anxiety disorders, depression, health problems, and anger and impulsive violence
4. “Depth therapies” may be more appropriate for less clearly defined therapeutic issues
5. Cognitive-behavior therapies do not successd well with personality disorders and psychoses, or people who are not motivated to carry out a cognitive and behavioral program
6. Combined approaches
a. For certain types of problems, combinations of medication and psychotherapy work best
b. Other types of problems require use of a combination of psychotherapeutic approaches
D. When therapy harms
1. Coercion by the therapist to accept the therapist’s advice, sexual intimacies, or other unethical behavior
2. Bias on the part of the therapist who does not understand some aspect of the client
3. Therapist-induced disorders—unconsciously inducing the client to produce the symptoms they are looking for. Therapists are often in therapy themselves to prevent the above problems
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