Evaluating psychotherapy Sec 3

objectives Summarize the Therapeutic alliance Evaluate the problems with therapy Analyze what therapies work with what disorders List the ways therapy harms patients (4)

Therapeutic alliance Psychotherapy is relationship Success depends on what both parties bring to table Therapeutic alliance- the bond of confidence and mutual understanding established between therapist and client, which allows them to work together to solve problems Goals same

Qualities of the participants Most likely to do well in therapy=motivated to improve Support from family Develop personal style to deal with problem Personality traits hostile and negative more resistance to therapy Carl Rodgers (ch 2)- empathy, warmth, being genuine= best traits for therapist

Culture and therapeutic connection Different backgrounds= may be successful But cultural differences may cause misunderstanding Lifetime of racism and cultural distrust African American’s may distrust White therapist Asian-Americans, Latinos, African Americans more likely to stay with ethnic matched therapist

Science-Practitioner Gap Breach between scientist and therapists One reason: professional schools not connected to academic psychology departments- train solely for therapy New therapies trying to gain foothold with no scientific support at all Neurolinguistic programming (NLP)- match learning styles with brain type- BOGUS

Problems in assessing Therapy Proliferation of therapies + economic pressures from drug companies= need scientific evidence Can’t just ask someone did therapy help?

Problem with therapy Testimonials “ I would have never found love, taken that job, moved to Escalon without Dr. Blitznik Can’t be own control group: how do you know would not have found love without Dr. Blitznik Placebo effect: anticipation of success, buzz. About Dr. Blitznik Never here about people who drop out or get worse Thanks to justification of effort, people put time, money effort in tell you its worth it Don’t want to say “ saw Dr. B. for 5 years and boy was it a waste of time!”

What works? Here comes the evidence showing the benefits of psychotherapy Emotional disorders; cognitive and behavior therapies

Depression Cognitive therapy best success Mood disorders (especially depression) Often as effective as antidepressant drugs, and less likely to relapse when treatment over LEARN LESSONS in therapy last long after therapy Evidence: randomized, controlled study 120 adults that had attempted suicide: given 1 of 2 conditions cog. Therapy or referral and call back Cog. Study group ½ as likely to attempt suicide

Anxiety disorders Exposure techniques most effective for P.T.S.D., agoraphobia, specific phobias like public speaking Cog. Behavior therapy for generalized anxiety, O.C.D. and panic disorder

Anger and impulsive violence Cognitive therapy Reducing chronic anger, abusiveness, hostility Teaches people how to express anger more calmly and constructively

Health problems Cog. Behavior therapy cope with pain, chronic fatigue syndrome, headaches and irritable bowel syndrome

Childhood and adolescent behavior problems Behavior therapy is the most effective For bed wetting, anger impulsiveness

Relapse prevention Cognitive behavior approaches highly effective Substance abuse, depression, sexual offenses

When Therapy Harms Every treatment carries risks Even asprin So does psychotherapy Risks increase with following factors

Harms #1 The use of empirically unsupported, potentially dangerous techniques Memory does not work like movie camera so can misremember Hypnosis, sodium amytal (barbituate called truth serum) Can enhance suggestability

Harms #2 Inappropriate or coercive influence, which can create new problems for the client Inadvertently creates disorders through suggestion 1980’s 90’s = multiple personality disorder

Harms #3 Prejudice or cultural ignorance on the part of the therapist Prejudeced against gender, culture sex

Harms #4 Sexual intimacies or other unethical behavior on the part of the therapist Unethical