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Psychotherapy lecture 2.docx

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Amanda Uliaszek

Sep 18, 2012-- Lecture 2 PSYCHOTHERAPY WORKS * The average treated patient is better off than approximately 80% of those that were not treated (Smith & Glass, 1977) • 1930s What works best? • Mechanisms: What works out of all the parts of psychotherapy (do we need all the parts of psychotherapy or just some) • (treatment effect)Tx effect + Non-specific effect (going somewhere, getting dressed; you see this in most therapies; whatever ALL treatments do) + Error = Therapy Outcome (something that has nothing to do with therapy) Therapy works...But Not as Well for Kids > Treatment studies: effect size = .70 > Dissemination (teaching people in the community how to do the therapies) and implementation (a lot of people can't afford to implement empirical treatments so big communities help them) Error • Tx effect + Non-specific effect + Error = Therapy Outcome • What affects error? --> change in lifestyle (environmental change-> job loss or you got a new job; death, divorce; something positive is exercising) • Measurement error: bias of the person taking the measure (technically, every measure is biased) • Time : regression to the mean. In therapies, we control time. • Non-measured errors • Client-specific effects > motivation: isn't really a treatment effect. Generally, people start with some level of motivation. The more motivated you are, the better the treatment works > Severity: People who are less severe do better on treatment Dodo Bird Verdict • “everyone has won and all must have prizes” • Recently, there are recent winners. The therapy that was the loser, they also improved. So, everyone gets better, but now it's about how much they get better • You WILL feel better for going to therapy Common Factors • Non-specific factors • Definition > Factors shared by all treatment approaches (Almost all therapists have these factors) > Not model-specific > Efficacious above specific treatment effects Examples: Frank (1973) • Having a relationship with the therapists • Emotionally charged, confiding relations with a helping person • Healing setting: you should have a comfortable setting • Rationale for symptoms: person wants to know how the therapy is going to work. They want to know the model • Prescription for resolving symptoms • Ritual or procedure that requires active participation by patient and therapist and is believed by both to restore patient’s health • Liking your therapist will effect your treatment outcome Tx effect + Non-specific effect (80%)+ Error = Therapy Outcome Therapeutic Alliance (emotionally charged conversation; you have to make sure the therapist gets you) + Placebo Effect (your
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