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Lecture 3

Psychotherapy lecture 3.docx

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Amanda Uliaszek

Graphs from this lecture are going to be on the midterm LECTURE 3- Sep 25, 2012 Empirically Based Treatments  Many names :  Empirically validated treatments  Empirically supported treatments  Empirically based practice Definition • Demonstrates a statistically significant change in an identified problem or disorder (binge eating, suicidal behaviour, psychotic breaks) • Systematic empirical research: very rigorous, very methodologically controlled • “Therapy is an art, not a science” : • WRONG!-> therapy IS a science Efficacy Vs. Effectiveness • Efficacy Studies > Highly controlled > Focused on a particular problem/disorder : only people with depression, only 18 years old, and have to come visit the clinic every week, etc > Efficacious treatment provides positive results in a controlled experimental research trial. A study that shows a treatment approach to be “efficacious” means that the study produced good outcomes, which were identified in advance, in a controlled experimental trial, often in highly constrained conditions • Effectiveness Studies > Applied: you take an efficacious therapy and bring it out in the community (real world), because the real world is very different > The more controlled, the less applied; the more applied, the less controlled • Effective treatment provides positive results in a usual or routine care condition that may or may not be controlled for research purposes but may be controlled in the sense of specific activities are undertaken to increase the likelihood of positive results. • Effectiveness studies use real-world clinicians and clients, and clients who have multiple diagnoses or needs The Path to EBP (they really just emburse for couple therapy--> eventually you're not going to have a livelihood) • Case studies/clinical observation : a publication of a person with a rare illness) -> Freud did a lot of case studies • Pre-post studies : measure them in pre-treatment and then post-treatment (ex. before depression and after depression) • Control Trials • Randomized control trials: (people are randomized between the two conditions) • Dissemination and Implementation : becoming really important • Generalizing Results : joined with above. CBT started of as a treatment for depression (can we take CBT and make a few changes and apply it to other people and illnesses) • Mechanism Research: looking at parts of a therapy and deciding what parts of a therapy is necessary and what's not Case Study • Individual accounts of a therapy working with a single patient. • Usually a new method or difficult patient. Pre-Post Studies • Assessments are made before and after Assess differences in assessments • Externalizing : punching, hitting, stealing, doing drugs • Internalizing symptoms: withdrawing, sad, don't want to talk to anyone, anxious ; generally harder to inform and record on • The graph: the information is very limited --> only shows the pre and post treatment • sometimes the teacher notices the externalizing kid and not the one who is sad or quiet (internalizing) Additional Questions • Adherence: how do you know someone said a DBT training. Maybe someone taught her how to do it and changed parts of it. Adherence is an issue for all therapies (if you say you did this treatment, how do we know you really did, and if you did, did you do it the correct way..) • > if I'm a certified person, that is going to make a difference (DBT doesn't have certification but CBT does) • > adherence measures: when people have to check off what they did in the session (kind of like a checklist) > video record what you d
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