Psychology 3301F/G Chapter Notes - Chapter 14: Posttraumatic Stress Disorder, U.S. Air Force Aeronautical Rating, Therapeutic Relationship

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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 outoe of teatet is affeted  a liet feels aout pshologist, pshologist’s esposes to liet
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 theapist’s pesoal ualities should e a ipotat igediet 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
Ilude eplaatios fo liet’s poles as ell as laellig of uosious poesses that ae elieed to ifluee
thoughts, emotions and behaviours
Interpretations strongly correlated with positive outcomes
Directiveness
Reatae = tede to eat agaist attepts to dietl ifluee oe’s ehaiou
Low-reactant clients usually open to therapists being directive in therapy, high prefer less directive therapist
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