L7 - Humanistic-Existential 2

• [Do they work?]

  • Rogers – ‘father of psychotherapy research’.
  • But more recently, HEPs lack evidence.

    - Relatively little interest from NICE (Khele, 2008).
• [Do they work?]

  Rosenzweig (1936): common rather than specific factors

       - the Dodo Bird conjecture.

  Many meta-analyses (e.g. Wampold, 2006): all therapies lead to comparable effect sizes

       – the Dodo Bird effect.
• [Common factors research]

  ‘Common Factors’ most frequently studied: accurate empathy, positive regard, congruence or genuineness

   (Lambert & Bergin, 1994)

  
• Preference for ‘gold-standard’ evidence (RCTs) for therapies to be classed as Evidence Based Treatments (EBTs) (see Lecture 5):–Based on Medical Model.–Suited to therapies adopting DSM categories, and using specific techniques to treat symptoms.
• HEP's

  • reject medical model
  • avoid use of DSM
  • rely on few 'set' techniques
  • treat person not symptoms
• King et al (2000) – RCT

  • Mild – moderate depression
  • PCT and CBT equally effective in reducing depressive symptoms at 4 months – both better than GP care.
  • However – no difference between 3 groups at 12 months.
  • Patients in PCT group more satisfied with treatment at 12 months.

  
• Gibbard and Hanley (2008) – Primary Care

  • PCT effective for anxiety and depression (over 5 years).
  • NOT limited to mild/moderate – also moderate/severe.
• Counselling included as option of first-line treatment for new episodes of less- and more-severe depression

  BUT, considered less-well supported than many other options (weighing up clinical evidence and cost effectiveness).
• McArthur et al (2013)

  • School-Based Humanistic Counselling (SBHC) vs waiting list control.
  • SBHC: Non-directive, based on work of Rogers.
  • Assumes that distress is brought about by acting in accordance with extrinsic demands rather than intrinsic authentic needs.
  • Promotes self-awareness, self-acceptance, actualisation.
  • Young people (13 – 16 years) experiencing moderate – high psychological distress.
• McArthur et al (2013)

  • Measure: YP-CORE at baseline, 6 weeks (midpoint) and 12 weeks (endpoint).
  • SBHC may be effective in reducing psychological distress in young people.

  BUT – small sample, lacking diversity

  
• Pearce et al (2017)

  Supported McArthur et al (2013) in more ethnically-diverse sample.

  Short-term effectiveness only demonstrated.
• Freire et al (2005)

  PCT children & adolescents in a residential shelter in Southern Brazil.

  At 6 mths ‘observable improvements’ in relationships with shelter staff, peers, family

  NOT a randomised controlled trial.
• Culture: ‘the values and behaviours shared by a group of individuals’ (Corey, 2013).

  •Encompasses: ethnicity, race, age, gender, religion, sexual orientation, physical & mental ability, socio-economic status.
• Ethical obligation for psychotherapists to develop cultural sensitivity.
• Minority groups can experience prejudice, marginalisation à poor mental health.
• Dominant ‘mainstream’ psychotherapies à White, male, Western roots.

  Support monocultural worldview à not suited to culturally diverse clients.

  à can lead to ethnocentrism.

  Minority groups may not seek/be offered appropriate help.