The professional activity of clinical psychologists
Hans Eysenck (1952) published a historic study and concluded that most clients got better without therapy and that, in general, psychotherapy was of little benefit
Many of those empirical studies on therapy outcome were conducted in the 1960s and 1970s. By the late 1970s and 1980s, meta-analyses began to appear
Who researchers should ask about psychotherapy outcome
Clients
Therapists
Society
Clients' opinions about therapy outcome
Extremely valuable but can also be extremely biased
Therapists
Have more experience in mental health issues, may have more reasonable expectations, but could still be biased
Society
Tend to bring a perspective that emphasizes the client's ability to perform expected duties in a stable, predictable, unproblematic way
Efficacy
Extent to which psychotherapy works "in the lab"
Effectiveness
Extent to which psychotherapy works "in the real world"
Psychotherapy WORKS! Its benefits appear to endure over long periods of time, exceed placebo effects, and represent clinically (not just statistically) significant change in clients' well-being
Transdiagnostic approach
What needs treatment are not the superficial symptoms of a particular disorder, but the underlying pathology that causes those symptoms and the symptoms of related disorders
3 Basic Elements of the Unified Protocol
Reducing the amount of negative thought in which clients engage
Preventing unhealthy ways of avoiding unpleasant feelings
Encouraging behaviors that facilitate positive rather than negative feelings
Effectiveness studies indicate that psychotherapy works as it is commonly applied in realistic settings
In the hundreds of empirical studies designed to compare the efficacy of one form of therapy with the efficacy of another, the typical result is that the competing therapies are found to work about equally well
The "Dodo Bird Verdict"
The finding that different forms of psychotherapy are about equally effective
Common Factors in Psychotherapy
Therapeutic Relationship/Alliance
Hope (Positive Expectations)
Attention
Three-stage Sequential Model of Common Factors
1. Support Factors
2. Learning Factors
3. Action Factors
It would be premature to conclude that all therapies are equal for the treatment of all disorders
Client preferences are important to consider for retention (keeping the client from dropping out of therapy), enhancement of the therapy relationship, and, ultimately, outcome
Change in therapy can be attributable to many factors: client characteristics, therapist characteristics, problem characteristics, and extratherapeutic forces
Types of Psychotherapy Practiced by Clinical Psychologists
Eclectic/Integrative therapy
Combination of cognitive and behavioral approaches
Psychodynamic/psychoanalytic therapy (declining)
Psychotherapy with individual clients dominates the professional activities of contemporary clinical psychologists
Stages of Change Model
Precontemplation Stage
Contemplation Stage
Preparation Stage
Action stage
Maintenance Stage
Future Psychotherapy Trends
Mindfulness-based approaches
Cognitive and behavioral approaches
Multicultural approaches
Eclectic/integrative approaches
Therapies involving the use of the Internet and other forms of technology
Eclectic Approach
Involves blending techniques in order to create an entirely new, hybrid form of therapy
Integrative Approach
Involves selecting the best treatment for a given client based on empirical data from studies of the treatment of similar clients