Psychology 3301F/G Chapter Notes - Chapter 12: Randomized Controlled Trial, Psychotherapy Research, Gene V. Glass

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Chapter 12: Intervention Adults and Couples
Does Psychotherapy Work? Controversy and Its Impact
Hans: idea that no treatment just as successful as treatment (rates of remission)
o Issues of internal validity
Randomized controlled trial: experiment in which research participants are randomly assigned to one
of two or more treatment conditions
Meta-Analysis and Psychotherapy Research
Meta-analysis: set of statistical procedures for quantitatively summarizing the results of a research
domain
o First meta-analysis of psychotherapy literature by Mary Smith and Gene Glass was landmark in
efforts to review scientific literature on treatment outcomes
Effect sizes: standardized metric, typically expressed in standard deviation units or correlations, that
allows the results of research studies to be combined and analyzed
o To allow for meaningful integration of data
o A b/w groups effect size of d=.5 means there is a diff of one half standard deviation b/w treated
groups and control
o When correlational analyses used (e.g. r or R) effect size is expressed as r statistic
Smith and Glass reported the average effect of psychotherapy to be d=.68
o Means average person receiving treatment was better off at the end of treatment that 74% of
those that had not
o Found largest effect sizes for cognitive and CBT followed by behavioural, psychodynamic and
humanistic
Some of the largest effect sizes were for anxiety and mood problems and some sig diff b/w treatments
Criticism of meta:
o Problem of garbage in, garbage out if poor studies included negatively impact results
o Apples and organs concern about meaningfulness of including diff treatments and diff
measures in meta
Use of meta to review research is now gold standard for evaluating treatment effects and most other
areas of psych research
Quality of meta results largely dependent on methodological decisions
o Publication bias: to selectively publish research w/ statistically sig results
Drew Westen: examined how number of methodological issues affected the results of treatment
research for depression, bulimia, PTSD etc
Stirman: found average severity of symptoms reported in RCTs of EBTs is greater than that found in the
patients seeking routine psychotherapy services
o Implications: a) likely to be efficacious treatment options for most even those with comorbid b)
in working with patients with comorbid diagnoses psychologists must decide which diagnosis
should be treated first
Evidence-Based Treatments: Initiatives and Controversies
Compelling evidence that psychotherapy has the potential to improve the psychosocial functioning of
adult patients with a wide range of disorders
Clinical practice guidelines: summary of scientific research, dealing with the diagnosis, assessment and
or treatment of a disorder, designed to provide guidance to clinicians providing services to patients
with a disorder
o Empirical evidence used to assist in making assessment and treatment decisions
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