Exam 3 psych review
What did Ericsson have to say about how people become "the best of the best?"
"The search for stable heritable characteristics that could predict or at least account for superior performance of eminent individuals [in sports, chess, music, medicine, etc.] has been surprisingly unsuccessful. . . . Systematic laboratory research . . . provides no evidence for giftedness or innate talent." The best of the best simply work harder at improving their performance than others.
Jungian Ideas
"general life energy" ▫ the collective unconscious ▫ archetypes
What are the criticisms of this approach (in the article, and your own)?
"sounds less like a 'science' than a frame of reference for a new religion ... Haven't we all been down that dark pathway before?" "It reminds me a lot of a pseudoscientific cult of personal will."
What are some of the specific elements of PPT treatment program?
"three blessings" "signature strengths"
Cognitive Therapy
- Goal: To change "irrational" and "maladaptive" thoughts/interpretations (because this leads to changes in behavior and emotion) - Method is also quite directive; may involve challenging
Newer additions to Seligman's model include:
- Relationships/Social Connections ▫ Accomplishment ▫ "PERMA" (Positive Emotion, Engagement, Relationships, Meaning, Accomplishment)
. Seligman admits that there were limitations to these studies. Name a few of them
-First, both therapy trials had small samples -the clients in both of our studies were university or professional students. This may well limit the generalizability of PPT to other populations varying in age, ethnicity, socioeconomic status, and IQ -doubt that the effects of PPT are specific to depression, and we expect that increasing positive emotion, engagement, and meaning promote highly general ways of buffering against a variety of disorders and troubles -did not counterbalance therapists, and so we don't know if we have "talented" therapist effects -mechanisms by which PPT operates, including the moderating role of therapists and the commonalities of PPT and other therapeutic approaches, are matters for further research.
How is the transtheoretical model different than approaches traditionally associated with addictions treatment?
-Precontemplation >No recognition of a problem -Contemplation >Starting to consider changing -Preparation >Makes a commitment to change, starts to prepare for it -Action >Implementing the plan -Maintenance >Avoiding relapse -Model focuses on "doing the right thing at the right time"
What were the major outcomes of the 1995 study by Wampold and Brown, published in the Journal of Consulting and Clinical Psychology?
-Psychotropic drugs as treatment didn't perform consistently -Drugs were 10 times more effective with the "best" therapists than with the "worst"
PPT emphasizes
1. Pleasure (positive emotion) 2. Engagement (involvement, absorption) 3. Meaning (using strengths to serve)
What is the three-step "basic formula" for success advocated by these authors?
1.)Determine baseline of effectiveness 2.)Engage in deliberate practice 3.)Get feedback
Explain what is meant by the "Dodo Bird verdict" and when it was introduced.
1936, all therapies are equal
. How easily do addicts change? How likely is a smoking cessation program to work for at least a year?
20%-40% for intensive cessation programs 10%-20% for minimal intervention
About how long does "action" last for addicts? In which stages does detoxification occur?
3-6 months, detoxification takes place in action stage
All of the following statements about the Stages of Change Model are true EXCEPT: A. It is a universal model that can be applied to all clients without the need for specific tailoring B. It can be used in combination with multiple approaches C. It is a circular model that accommodates the possibility of relapse D. It focuses on doing the right thing at the right time
A
Who of the following is most likely to seek treatment? • A. Angela, 38, white female, bachelor's degree and divorced • B. John, 21, Latino male, high school graduate and single • C. Pam, 75, African-American female, some college education, married • D. Richard, 43, white male, Ph.D, separated
A
Is there any research supporting ACT with depressed people, psychotics, and drug addicts? How did they change?
ACT has been shown to increase effective action; reduce dysfunctional thoughts, feelings, and behaviors; and alleviate psychological distress for individuals with a broad range of mental health issues-relieved distressing symptoms associated with psychotic episodes
ACT
Acceptance and Commitment Therapy
How has the managed care system impacted the practice of psychotherapy? Advantages and disadvantages?
Advantages: More care rendered the more fees are charged. There is little motivation to provide less care when the more the care, the larger the profit Disadvantages: Denies and limits access to necessary treatment, narrows patient's choice of provider, disrupts continuity of care, uses less qualified providers to render and review care, and risks patients confidentiality. Follows a business ethic and profit motive
Which of the following matches is INCORRECT? • A. Steven Hayes; acceptance • B. Martin Seligman; engagement in life • C. Jung; mindfulness • D. Rollo May; freedom
C
• In the TED video seen in class, Kelly McGonigal discussed the possibility that the reframing stress as a positive thing has dramatic physical and emotional benefits. What type of psychotherapy does this best represent?
CBT
In the article, The Effectiveness of Psychotherapy: The Consumer Reports Study, which of the following was NOT a result of the 1995 CR study?
CBT worked better than any other type of therapy
Individual Differences:
Characteristics or traits that vary across people (e.g. intelligence, personality) and that are relevant to understanding human behavior
What leads to therapeutic change?
Client Effects/ExtraTherapeutic Change: 40% Non-Specifics: 35% Therapist Effects: 20% Specific Tx Effects: 5%
Based on over 100 outcome studies, what contributes to leading to the most therapeutic change?
Client effects and extra-therapeutic change
Therapy
Confession, insight, and transformation Doing is preferable to talking ▫ Empty chair, psychodrama ▫ Dream work
Michael has been smoking for 4 years. He quit smoking for a few months, but ended up relapsing. He is now thinking about quitting again. Michael is most likely in which stage of change?
Contemplation
What are the 4 problems of existence in existentialism?
Death, isolation, freedom, and meaninglessness
Jade has borderline personality disorder. Of the following, which psychotherapeutic approach would be most appropriate for her disorder?
Dialectical Behavior Therapy
In order to gain the benefits from placebo groups in randomized clinical trials, experimenters had a cognitive behavioral group, a behavioral group, and a cognitive group. What is this an example of
Dismantled interventions
Martin Seligman, founder of Positive Psychotherapy emphasized three main points. Which of the following were NOT one of these points?
Empowerment
Is there any research to support this model? In addition to addictions, for what other health-related behaviors has the model been successful?
Exercise, mammography, diet, respirator use, and HIV prevention all demonstrate similar stage-based groups
Do therapists typically get more effective through the years, as they gain experience? Has psychotherapy in general improved much in the past 30 years?
Experience has no correlation with effectiveness. no measurable improvement in the effectiveness of psychotherapy has occurred in the last 30 years.
For her study, Joan used a sample of 120 female college undergraduates from a Western university. Because of this, Joan will have a hard time generalizing her results to the general public. This poses a threat to which aspect of Joan's research?
External Validity
Francine Shapiro
Eye Movement Desensitization & Reprocessing (EMDR)
Murray Bowen
Family Systems Theory ▫ Key Concepts: -Multigenerational patterns - Roles - Differentiation ▫ Therapy: Facilitate better family functioning
Behaviorism
Focus is on observable behavior (and empirical validation) ▫ Therapy goal: Unlearn old behavior, replace with new, more adaptive behavior ▫ Therapist is a teacher, method is direct instruction
Which of the following statements best describes the effect of therapist gender on psychotherapy outcomes?
Gender does not have much of an effect
Tamara seeks out therapy for help in dealing with a strained relationship with her father. Her therapist has her speak to an empty chair as though her father were present and talking with her. Tamara's therapist is most likely practicing which psychotherapeutic approach?
Gestalt
Common factors matter...
In MAINSTREAM psychotherapies -That is, some psychotherapies could be harmful and should be avoided! -Ex: rebirthing and crisis debriefing that includes re-experiencing trauma
Bob is running an experiment. When he divides the participants into the experimental and control groups, he does not use any kind of randomization. By over looking this random assignment, Bob is threatening which part of his study?
Internal Validity
• Efficacy studies have more ____ , and effectiveness studies have more_____ .
Internal validity; External validity
What are some of the author's suggestions for improving the survey in a study like this?
Large scale. Samples treatment as it is actually delivered in the field. Samples without obvious bias. Measures multiple outcomes. Statistically stringent and finds clinically meaningful results. Captures how and to whom treatment is actually delivered and toward what end.
What makes psychotherapy work?
Large-scale comparisons show that client and therapist factors are more influential than specific interventions
Which of the following statements is TRUE regarding therapists improving over time?
Most therapists make large improvements early on in their careers but they usually perceive that they are only getting better with time
According to the article, Are all Psychotherapies Created Equal?, what does the "Dodo Bird verdict" refer to?
No modality of therapy works better than another
In Hiatt and Hargrave's study, did the most ineffective therapists know they were ineffective? Why do you think this is?
No, they thought they were right on par with the best therapists! If poor therapists do not follow up with their diagnoses and rather just assume that their analysis is correct they cannot learn, grow and adapt to become better!
During an interview, Mr. Wainwright claims that he doesn't have anxiety. He feels as though nothing is wrong with him. In fact, he states his wife is the one who needs treatment. This is an example of which stage of change?
Precontemplation
Brad struggles with an alcohol-use disorder. He has realized he needs to get help and makes a call to sign up for an AA meeting. According to the Stages of Change model, what stage is Brad in?
Preparation
How does this author define psychotherapy?
Psychotherapy is a relationship among people. One person (or more) is defined as needing special assistance to improve his or her functioning as a person, and the other person is defined as being able to render such help.
Describe some of the methodological virtues and flaws of the CR study.
Sampling. No control groups.self-report. Inadequate outcome measures
What is the fundamental difference between positive psychotherapy and traditional approaches?
Seeks to not only reduce negative symptoms...but to also build positive emotions, character strengths, and meaning (and this is what becomes it's focus)
Why do you think Dawn's interaction with the grieving client changed his mind about coming back to therapy?
She made a connection with the man, was very up front with him that she did not understand what he was going through and that he probably thought there was nothing she could do to help. She encouraged him to come back so he didn't have to go through his grief alone.
How did Study 1 differ from Study 2?
Study 1: PPT Group therapy vs no tx control PPT group showed decrease in sx AND maintained them for 3, 6, and 12 mo follow-up PPT group showed increase in life satisfaction Study 2: Community Clinic - Individual PPT, Treatment as usual (TAU), Treatment as usual with medication (TAUMED) PPT better than TAU & TAUMED
Which of the following client factor would BEST predict treatment effectiveness?
Symptom severity
Which exercises worked best in the pilot study? What was the placebo activity?
TAU, TAUMED, PPT
In the article, Supershrinks, what did Ericsson say about becoming "the best of the best"?
The best work harder at improving than others do
Some gastroenterologists were found to be 10 times better at detecting polyps than others. What were they doing differently than the less successful doctors? How does this story relate to the theme of this article?
They spent more time and were more thorough during the procedure; despite this knowledge, many doctors continue to spend very little time doing this procedure
According to the article, Supershrinks, what is it that makes a therapist a supershrink?
They work at improving, solicit feedback and know their baseline
What is meant by non-specifics, mentioned at the bottom of the first page? (This is an important concept in clinical/counseling research.)
What is meant by non-specifics, mentioned at the bottom of the first page? (This is an important concept in clinical/counseling research.) influences as rapport, expectation of gain, and sympathetic attention
Humanism
Work toward a healthy, authentic sense of self
Does knowing your baseline performance matter, in therapy? Do the authors advocate sharing it with your clients? Explain.
Yes it does matter. Yes they do advocate for it. "those slowest to adopt a valid and reliable procedure for establishing their baseline performance have poorest outcomes"
Do nonspecifics have a place in PPT (according to the article Positive Psychotherapy)?
Yes; PPT therapists acknowledge that their treatment is more effective when nonspecifics are integrated with the therapy exercises
Allegiance effect
a characterization of psychotherapy outcome research such that investigators commonly find the most effective treatment to be one which they held a theoretical allegiance.
For what disorders do behavior and cognitive-behavior therapies seem effective?
anxiety,childhood depression and other behavioral problems
Postmodern or constructivist models
based on the idea that each person creates their own personal view of reality.
What is meant by "clinical significance," and how does it differ from "statistical significance?" What is the author's belief about the clinical significance of the CR study?
do people care about it enough. could these results have occurred by chance? Author believes CR study leaves little doubt about the human significance of its findings.
Distinguish between efficacy studies and effectiveness studies. Which type of study is typically considered to be the gold standard in research validating psychotherapies, and why?
efficacy studies are very useful for deciding whether one treatment is better than another treatment for a given disorder. a survey of large numbers of people who have gone through such treatments efficacy studies considered gold standard.
Humanist-existential model
emphasizes the individual underlying the cognition, emotions, and behaviors. Model assumes human beings have an innate potential to live a meaningful existence and the goals of therapy focus on discovering one's own true potential and achieving self-actualization
Sociocultural or culturally specific models
focus on the social context and larger social structures within which the person lives. Interpersonal relationships are at the center of their adjustment. The custom of a specific society and culture must be considered in order to understand the person.
What does the author conclude about the issue of random assignment? Do you agree?
may turn out to be worse than useless for the investigation of the actual treatment of mental illness in the field
Describe Csikszentmihalyi's concept of "flow."
mental state of operation in which a person performing an activity is fully immersed in a feeling of energized focus, full involvement, and enjoyment in the process of the activity.
Why do you think marriage counselors were perceived as less effective than psychologists, psychiatrists, and social workers?
most who seek help have doomed marriages already.
The authors state that effective treatments might have similar outcomes because they include similar features. What might be some similar features of effective therapies?
provide plausible theoretical rational and specific therapeutic rituals,
Describe the Consumer Reports study. Who were the respondents? What were they asked? Do you think the questions regarding therapeutic effectiveness yielded valid responses?
readers. if they experienced mental health issues and if they sought help.
Regarding the 2006 survey by Boisvert and Faust, how did psychological researchers and practicing psychotherapists differ in their response to the question about whether all therapies achieve similar outcomes?
researchers agree therapies achieve similar outcomes, while psychotherapists only moderately agree.
Does the "dodo bird" hypothesis come as a "rude shock" to you as it has to many clinical researchers?
that all forms of psychotherapies do about equally well
According to Seligman, the main "methodological virtue" of the CR effectiveness study was:
that the treatment was done "in the field" in the way that the population actually gets it.
Summarize the results of study 1 and study 2 (article: Positive Psychotherapy)
the results of study one were very positive - substantial symptom relief lasted through one year of follow-up; the results of study two showed that individual PPT with severely depressed clients led to more symptomatic improvement and to more remission from depressive disorder than did treatment as usual **the improvement for subjects in both studies lasted for at least a year after treatment
Eclectic and integrative models
therapist uses experience and knowledge to choose the most appropriate interventions for a particular client. Therapists may blend two, three, or more theories.
Cognitive Models
thoughts shape human emotions and behaviors. To achieve good mental health people need to change their irrational and distorted thinking to more rational and realistic thinking
Describe the criteria Wampold used for "bona fide" treatments in his large 1997 metaanalysis. What was the general result of that study?
treatments delivered by trained therapists. minimal differences in therapy results.
CBT
type of psychotherapy that is different from traditional psychodynamic psychotherapy in that the therapist and the patient will actively work together to help the patient recover from their mental illness.
How does ACT (Acceptance and Commitment Therapy) generally differ from the traditional cognitive therapy approach?
uses mindfulness and behavioral activation to increase clients' psychological flexibility--their ability to engage in values-based, positive behaviors while experiencing difficult thoughts, emotions, or sensations. ACT has been shown to increase effective action; reduce dysfunctional thoughts, feelings, and behaviors; and alleviate psychological distress for individuals with a broad range of mental health issues
Clinical Psychology (traditional)
• "general practice and specialty in professional psychology." • "assess, diagnose, predict, prevent, and treat psychopathology....."
Counseling Psychology (traditionally)
• "general practice and specialty in professional psychology." • "focuses on personal and interpersonal functioning across the life span...centers on typical or normal developmental issues as well as atypical or disordered development...."
Psychotherapy
• Developed as a tx for post-trauma symptoms • Method: Combines CBT (desensitization through exposure, positive thought substitution) with rapid eye movements
Gestalt Therapy
• Fritz Perls Key ideas: ▫ The here-and-now ▫ Awareness of self and body It focuses on insight into gestalts in patients and their relations to the world, and often uses role-playing to aid the resolution of past conflicts.
Psychodynamic Approach
• Psychodynamic (NeoFreudians; Carl Jung & others)
Existentialism
• Rollo May Avoiding "non-being"
The 4 problems of existence, and themes for therapy:
▫ 1. meaninglessness ▫ 2. freedom ▫ 3. isolation ▫ 4. death
Key ideas and therapy goals of psychotherapy
▫ Be aware and non-judgmental of own emotions, thoughts ("mindfulness") ▫ Be willing to feel and accept negative emotions, thoughts, and pain ▫ Diffuse the power of thoughts by accepting them: "I'm having the thought that I'm depressed... but that's ok... it's just a thought" ▫ Committing to live by your values ▫ Act in the direction of your values, not on what thoughts your brain happens to be telling you
Positive Psychotherapy
▫ Formally began in the 1990s by Martin Seligman... Seeks to not only reduce negative symptoms but to also build positive emotions, character strengths, and meaning (and this is what becomes it's focus)
Therapists provide:
▫ Genuine acceptance and positive regard
Non-specifics aka common factors
▫ Important in PPT (and other forms of psychotherapy)! ▫ Individual PPT (esp. for severe depression) more effectively delivered with warmth, empathy, genuineness -Therapeutic alliance -shared goals -mutual liking, trust, and respect -Empathy -Positive regard -Instilling hope -Placebo effects >but "real" tx outcomes do exceed placebo outcomes
Feminist Psychotherapy
▫ Key concepts: - Social contexts - Empowerment - Mutuality in (and out of) therapy -The client is seen as the expert on herself/ himself -The therapist is more likely to self-disclose
