Psychology 3301F/G Chapter Notes - Chapter 14: Posttraumatic Stress Disorder, U.S. Air Force Aeronautical Rating, Therapeutic Relationship
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26 Apr 2018
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Chapter 14: Intervention: Identifying Key Elements of Change
Intro
• Process research = research that examines patterns, using therapist and or client data, that are evident w/in and across
therapy sessions
• Process-outcome research = research that examines the relation b/w variables related to the process of providing
psychotherapy and outcome of therapy
• Common factors = therapeutic elements that occur in all or most treatments and are believed to be critical for successful
client outcomes
Psychotherapy process and process-outcome research
• Treatment-outcome research, look at outcomes under varying conditions
• In order to look at how achieved need to examine process (sports analogy)
• Treatment-outcome research address the question of which intervention is more efficacious, whereas process research and
process outcome ask about how much an intervention works
• Therapists tend to behave in ways that are consistent with the theoretical orientations they espouse
Examining Client Factors
• Vast majority of RCTs psychotherapy studies examine treatment outcomes for different groups of clients classified on the
basis of diagnoses or presenting problems
• No psychotherapy researcher believes that diagnosis is the primary factor that determines treatment outcome
• Client characteristics other than diagnosis may be very important predictors of treatment success or failure
• Client age unrelated to treatment outcome
• Hard to detect patterns across research that have used diff types of measures and diff timing of assessment
• Many psych in private practice have sliding fee scales that allow patients w/ lower incomes to pay reduced fees
• Access to affordable services may make the difference between Shari engaging in therapy and prematurely ending services
• Once treatment starts, relationship between client and psychologist is likely to generate a far more powerful influence on
the course and outcome of treatment
• Ultimate outoe of teatet is affeted a liet feels aout pshologist, pshologist’s esposes to liet
questions and challenges, degree of benefit client experiences early in treatment, extent to which treatment influences
clients daily life
Client variables that influence treatment
• SES, ethnicity, gender, age = socioeconomic characteristics
• Symptom severity, functional impairment = psych functioning
• Personality disorders, ego strength, psych mindedness, psych reactance, treatment expectations = personality
characteristics
Examining therapist factors
• A) manner in which interactions b/w patient and therapist occur and evolve over course of treatment and
• B) power such interactions exert on the process of therapeutic change
• su of the theapist’s pesoal ualities should e a ipotat igediet i a recipe for good therapy
• variability in client to outcomes due to therapist factors has been noted in RCTs and clinical settings in which therapists had
been trained to deliver a specific type of EBT for PTSD
• found therapist effects accounted for 3% of the treatment outcome in efficacy trials and 7% of the treatment outcome in
effectiveness trials and naturalistic studies of psychotherapy provision
• impact of therapist effects on treatment outcome was 3x greater for patients w/ most severe problems compared to those
w/ least severe problems
Therapist variables that influence treatment
• Sociodemographic characteristics = ethnicity, age, gender
• Professional background = professional discipline, professional experience
• Personality characteristics = personality traits, emotional well-being, values, attitudes, beliefs and use of self disclosure
Examining Treatment Factors
Interpretation
• Of client behaviour often occurs in psychodynamic and experiential approaches
• Ilude eplaatios fo liet’s poles as ell as laellig of uosious poesses that ae elieed to ifluee
thoughts, emotions and behaviours
• Interpretations strongly correlated with positive outcomes
Directiveness
• Reatae = tede to eat agaist attepts to dietl ifluee oe’s ehaiou
• Low-reactant clients usually open to therapists being directive in therapy, high prefer less directive therapist
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