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lec 32

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Ryerson University
PSY 102
Margaret Buckby

Lecture #32 Psychotherapy (Part III) Ÿ Counterintuitive things to learn and discover about process of psychotherapy Ÿ 1997, when prof was 24, on his first internship, he has his first patient, and a supervisor, one Monday he arrived to his office and found out his supervisor was gone, so he had this patient with no supervisor which was extremely alarming, he was as good a therapist when he started as he is today, underlying art of psychotherapy Ÿ Psychotherapy outcome literature, the literature that exists and concerns relative efficacy and effectiveness of psychotherapy, do people get better, disclosure, revealing oneself, and the role of disclosure in conveying a narrative, or one’s life story Ÿ Various schools of psychotherapy, three primary forces, psychodynamic, behavioural and humanistic approaches of trying to remedy a patient Ÿ Psychoanalysis, psychodynamic model key ideas is conflict and production of anxiety, and wide range of defences we have Ÿ Processes of producing change in psychoanalysis, transference is basic process in which patient comes into office and projects their issues to therapist, and therapist role is to interpret what is going on which produces resistance and insight Ÿ Cognitive behavioural approach to change, learning model where there is a situation, behaviours and a consequence Ÿ Mechanisms we use to produce change, restructuring cognition and beliefs and testing them (behavioural experiments) Ÿ Humanistic approach, how children become equipped with what it is we need to do to attain love, a set of beliefs and thoughts, which we systematically internalize these principles, to tell us how we should be in the world to be loved and accepted, many of their traits are hidden and sealed to be accepted, humanists try to bring these traits out Ÿ Point of the slide is that different therapies seem to be very diverse, from a technical point of view, what the analyst is doing seems very different from what the behaviourist and what the humanist is doing, and they believe change is produced in very different ways, what produces symptoms and how to treat them Ÿ Which form of therapy is the best? Hundred of controlled clinical trials have run these various forms of therapies together, two different therapies and see which patient is better off, and in conclusion of this research they sent out a survey to consumer reports to see their various satisfaction, about 7000 readers responded to the mental health, and the result of the survey was almost identical to the controlled clinical trials= Ÿ End result is: all therapy works, you are far better off being in a room with a therapist then in a waiting room, psychotherapy on the whole works, and all of the therapies seem to be equally effective Ÿ Years of experience, level of training, academic background doesn’t change your qualification of being a therapeutic context, they perform equally well Ÿ Conclusion form the outcome literature is no differential efficacy despite technical diversity Ÿ This is known as the dodo bird effect, (in Alice in wonderland, the dodo bird was asked to watch the race but it didn’t watch it and at the end it said that everyone won and should receive prizes) Ÿ Explanation for why they are equal is that maybe there are differences that do exist but were not finding them, all of the studies must be wrong because they cant possibly be equal, were probably not measuring the changes that are occurring by the patients accurately Ÿ Another reaction to this literature is to say that each of these therapies works, because there is some substance to the change mechanism, so all of these therapies use a different strategy to produce change and they are all equally goodàproblem with this is its not likely that three DIFFERENT approaches are equally valued Ÿ The third reaction is the notion that there is some kind of common factor that cuts across all of the therapies and accounts for the changes that are occurring, despite of the fact that different therapists have different ideas of what is producing change, the therapists are wrong, they are using a common change mechanism without them knowing it, which is what accounts for the treatment of the patients Ÿ What woul
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