PSYC 3082 - Psychotherapies and Counselling Exam Questions Answered Correctly
What is psychotherapy? - Answers - treatment of mental disorders by psychological means
- formal interaction between mental health practitioner and client
- psychological approach to relieving human suffering
Accorsing to Murdock, what are the elements of a good theory? - Answers 1. Precision and
testability
2. Parsimony
3. Practicality
4. Stimulation (exciting)
5. Empirical validity (case study, RCT, meta-analysis)
What are the basic stages of psychotherapy? - Answers 1. Assessment and observation -
thorough, atheoretical, simply gathering info about the client
2. Case formulation - theoretically-driven within framework you work in, hypothesised
mechanisms underlying problem behaviours
3. Intervention plan
4. Intervention implementation
5. Evaluation - review the case formulation accordingly
What are some of the ways that psychotherapy is delivered? - Answers - individual (one-on-one)
- family
- couple
- therapeutic communities (e.g. addiction support)
- e-therapy
What are some of the techniques used to evaluate psychotherapies? - Answers - single case
study designs
- efficacy studies
- effectiveness studies
- Cochrane library reviews
,- meta-analyses
What is a single-case experimental design? - Answers - aka N=1 design
- repeated measurements are taken of an individual's behaviour
- comparisons across experimental conditions imposed on that individual
- assessment of the measurements' reliability within and across the conditions
What is an intervention-only (B) design? - Answers - type of single case experimental design
- frequency of problem behaviour is observed at different time points throughout the
intervention
What is a baseline-intervention (AB) design? - Answers - baseline measure of problematic
behaviour compared to during the intervention
What are the weaknesses of the AB design? - Answers - better than B (because we have a
baseline to compare to)
- but changes in dependent measure between A and B phases may be due to B, but also due to
alternative explanations
- history, external influences (e.g. change in employment
- maturation (occurring in client over time, e.g. adolescent hormonal fluctuations impacting
anxiety)
- testing effects (repeated measurement itself might affect the behaviour due to increased
attention and accountability)
What is an ABAB design? - Answers - successive conditions
- initial baseline, then introduce the treatment, then revert to baseline again, then reintroduce
treatment
- should show corresponding change in target behaviour as we alternate (i.e. symptoms should
worsen with return to baseline, then diminish again with treatment)
- seldom used due to practical and ethical concerns
What are efficacy studies? - Answers - emphasise internal validity of the experimental design
- usually done via RCTs
- controlling the types of patients included in the study (e.g. limiting comorbidity)
- usual manuals to standardise treatment delivery
,- training and monitoring therapists
- controlling number of treatment sessions
- random assignment to conditions and use of blinding procedures for raters
- not very representative of the real world but good initial test of efficacy of treatment
What are effectiveness studies? - Answers - effectiveness of treatment is considered in real life
clinical situations
- when intervention is implemented without the same level of internal validity, is the treatment
still beneficial?
- emphasise external validity of the experimental design (i.e. practical utility)
- clients are not preselected
- therapy is not manualised
- therapy adherence is not monitored
- effect size of the intervention is generally based on within-subject changes from pre to post-
intervention
Is psychotherapy efficacious? - Answers - yes!
- results collated across hundreds of studies
- average client improved more than 80% than clients who were not treated
- better than placebo and control conditions
Is psychotherapy effective? - Answers - most likely yes
- most clients report improvements from real life psychotherapy
- differences in outcome between various forms of therapy are not as pronounced as might be
expected
Is one type of psychotherapy better than the other? - Answers - some specific disorders seem to
respond better to certain types of psychotherapy (hence, treatment guidelines)
- but could be researcher bias, selectivity in criteria for change, or a real effect
- on the whole, there is NO real "superior" psychotherapy
What is the Dodo bird conjecture? - Answers - all psychotherapies, regardless of their specific
components, produce equivalent outcomes
, Is pharmacotherapy better than psychotherapy? - Answers - psychotherapies are AS effective as
pharmacotherapy in treatment of depression and anxiety
- 75% of patients prefer therapy over medication
- but it is less available and accessible than drugs
Why does psychotherapy work? - Answers - similar outcomes of many different
psychotherapies > must be commonalities among therapies that are the real curative factors
- therapeutic alliance (30% variability in patient outcomes)
- expectancy effect (15%)
- extra-therapeutic change (40%) e.g. getting a job, starting a relationship
- actual therapy technique (15%)
Describe the components of the therapist-client relationship - Answers - therapist variables (e.g.
interpersonal style, attributes)
- facilitative factors (e.g. therapist's empathy, respect, non-judgmental attitude)
- therapeutic alliance
Describe the 3 components of the therapeutic alliance - Answers 1. tasks - behaviours and
processes that constitute the work of therapy
2. bonds - trust, confidence and acceptance between client and therapist
3. goals - objectives of therapy that both client and therapist endorse
What are some of the counter arguments to the Dodo theory? - Answers - is it legitimate to put
all outpatients into one group? given that some disorders do have interventions that seem to
work best
- e.g. CBT is more effective than non-directive relationship therapy for GAD
- is it legitimate to collapse across treatments?
- e.g. collapsing across systematic, existential, transpersonal etc. and the labelling them all as
"dynamic therapies" and comparing these to "CBT therapies"
How do we determine the active therapeutic ingredients? - Answers - mediational and
moderational analyses (emerging research)
- e.g. intervention conducted and patients in study improve pre- to post-intervention, then
analyses conducted to test whether the theorised active ingredients are the "cause" of the
What is psychotherapy? - Answers - treatment of mental disorders by psychological means
- formal interaction between mental health practitioner and client
- psychological approach to relieving human suffering
Accorsing to Murdock, what are the elements of a good theory? - Answers 1. Precision and
testability
2. Parsimony
3. Practicality
4. Stimulation (exciting)
5. Empirical validity (case study, RCT, meta-analysis)
What are the basic stages of psychotherapy? - Answers 1. Assessment and observation -
thorough, atheoretical, simply gathering info about the client
2. Case formulation - theoretically-driven within framework you work in, hypothesised
mechanisms underlying problem behaviours
3. Intervention plan
4. Intervention implementation
5. Evaluation - review the case formulation accordingly
What are some of the ways that psychotherapy is delivered? - Answers - individual (one-on-one)
- family
- couple
- therapeutic communities (e.g. addiction support)
- e-therapy
What are some of the techniques used to evaluate psychotherapies? - Answers - single case
study designs
- efficacy studies
- effectiveness studies
- Cochrane library reviews
,- meta-analyses
What is a single-case experimental design? - Answers - aka N=1 design
- repeated measurements are taken of an individual's behaviour
- comparisons across experimental conditions imposed on that individual
- assessment of the measurements' reliability within and across the conditions
What is an intervention-only (B) design? - Answers - type of single case experimental design
- frequency of problem behaviour is observed at different time points throughout the
intervention
What is a baseline-intervention (AB) design? - Answers - baseline measure of problematic
behaviour compared to during the intervention
What are the weaknesses of the AB design? - Answers - better than B (because we have a
baseline to compare to)
- but changes in dependent measure between A and B phases may be due to B, but also due to
alternative explanations
- history, external influences (e.g. change in employment
- maturation (occurring in client over time, e.g. adolescent hormonal fluctuations impacting
anxiety)
- testing effects (repeated measurement itself might affect the behaviour due to increased
attention and accountability)
What is an ABAB design? - Answers - successive conditions
- initial baseline, then introduce the treatment, then revert to baseline again, then reintroduce
treatment
- should show corresponding change in target behaviour as we alternate (i.e. symptoms should
worsen with return to baseline, then diminish again with treatment)
- seldom used due to practical and ethical concerns
What are efficacy studies? - Answers - emphasise internal validity of the experimental design
- usually done via RCTs
- controlling the types of patients included in the study (e.g. limiting comorbidity)
- usual manuals to standardise treatment delivery
,- training and monitoring therapists
- controlling number of treatment sessions
- random assignment to conditions and use of blinding procedures for raters
- not very representative of the real world but good initial test of efficacy of treatment
What are effectiveness studies? - Answers - effectiveness of treatment is considered in real life
clinical situations
- when intervention is implemented without the same level of internal validity, is the treatment
still beneficial?
- emphasise external validity of the experimental design (i.e. practical utility)
- clients are not preselected
- therapy is not manualised
- therapy adherence is not monitored
- effect size of the intervention is generally based on within-subject changes from pre to post-
intervention
Is psychotherapy efficacious? - Answers - yes!
- results collated across hundreds of studies
- average client improved more than 80% than clients who were not treated
- better than placebo and control conditions
Is psychotherapy effective? - Answers - most likely yes
- most clients report improvements from real life psychotherapy
- differences in outcome between various forms of therapy are not as pronounced as might be
expected
Is one type of psychotherapy better than the other? - Answers - some specific disorders seem to
respond better to certain types of psychotherapy (hence, treatment guidelines)
- but could be researcher bias, selectivity in criteria for change, or a real effect
- on the whole, there is NO real "superior" psychotherapy
What is the Dodo bird conjecture? - Answers - all psychotherapies, regardless of their specific
components, produce equivalent outcomes
, Is pharmacotherapy better than psychotherapy? - Answers - psychotherapies are AS effective as
pharmacotherapy in treatment of depression and anxiety
- 75% of patients prefer therapy over medication
- but it is less available and accessible than drugs
Why does psychotherapy work? - Answers - similar outcomes of many different
psychotherapies > must be commonalities among therapies that are the real curative factors
- therapeutic alliance (30% variability in patient outcomes)
- expectancy effect (15%)
- extra-therapeutic change (40%) e.g. getting a job, starting a relationship
- actual therapy technique (15%)
Describe the components of the therapist-client relationship - Answers - therapist variables (e.g.
interpersonal style, attributes)
- facilitative factors (e.g. therapist's empathy, respect, non-judgmental attitude)
- therapeutic alliance
Describe the 3 components of the therapeutic alliance - Answers 1. tasks - behaviours and
processes that constitute the work of therapy
2. bonds - trust, confidence and acceptance between client and therapist
3. goals - objectives of therapy that both client and therapist endorse
What are some of the counter arguments to the Dodo theory? - Answers - is it legitimate to put
all outpatients into one group? given that some disorders do have interventions that seem to
work best
- e.g. CBT is more effective than non-directive relationship therapy for GAD
- is it legitimate to collapse across treatments?
- e.g. collapsing across systematic, existential, transpersonal etc. and the labelling them all as
"dynamic therapies" and comparing these to "CBT therapies"
How do we determine the active therapeutic ingredients? - Answers - mediational and
moderational analyses (emerging research)
- e.g. intervention conducted and patients in study improve pre- to post-intervention, then
analyses conducted to test whether the theorised active ingredients are the "cause" of the
