Psychotherapy I
(Dr. Nupur Singhal)
Thursday, July 13, 2023 10:51 AM
EFFECTS OF PSYCHOTHERAPY
(Eyesenck, 1952)
1. In favor- social skills required in the process of psychotherapy.
2. Landis realized quite clearly that in order to evaluate the effectiveness of any form of therapy, data from a control group of nontreated patients would be required in order
to compare the effects of therapy with the spontaneous remission rate.
3. The criteria of "recovery" used by Denker were as follows: (a) return to work, and ability to carry on well in economic adjustments for at least a five-year period; (b)
complaint of no further or very slight difficulties; (c) making of successful social adjustments.
4. More psychotherapy but less improvement. A lot of setbacks.
• Outcome of therapy: impact of intervention
• Process of psychotherapy: whatever happens between the baseline and the outcome. Factors that facilitate and interfere with change (therapeutic relationship, kind of
disorder, age, etc). How is the intervention being administered.
Key research questions
key issues raised
methodologies used in research
outcome/contribution
1950s-1970s PHASE 1 PHASE 4 PHASE 5
key research questions: Key research questions: Key research questions:
1. is psychotherapy effective? How can research findings be put into clinical practice? How can the quality of treatment delivery be improved ?
Justification of psychotherapy.
2/3rd of the population will improve in two year Focus: Focus:
2. What Is the unit of measurement? Effectiveness and clinical significance Evidence based approach
3. Subjective nature of measuring change
Number of improved cases/100 admissions Issues: Issues:
4. Within what time frame? 1. Evidence based practice 1. Empirically validated treatment
5. Criteria for recovery? 2. Practice guidelines 2. Routine outcome monitoring
3. Increased focus on treatment gap 3. Parsimonious approach to treatment
Key issues: 4. User perspective
1. Spontaneous recovery Methodology:
2. Efficacy Methodology: 1. Patient focused research
1. Clinical significance 2. Predictive modelling
Methodology 2. Meta analysis 3. Meta analysis
1. Control group comparison
2. Effect size Outcome:
3. Metanalysis Development of treatment manuals PHASE 6
Key research questions:
Contribution: How can treatment outcome be improved?
Spur of research establishing effect of psychotherapy
[smith and glass 1977] Focus:
Practice-based evidence
PHASE 3 Issues:
Key research questions: 1. Routine outcome monitoring
How can treatment be made for effective? 2. Patient feedback
3. Practice oriented research
Focus: 4. Different patterns of change
Efficacy and cost effectiveness 5. Various low cost interventions we can provide the
clients.
Key issues:
1. Low cost interventions Methodology:
2. Evidence based interventions 1. Research started focusing on multisite trials
3. Health economics and dose response 2. Predictive modelling
3. Patient focused research
Methodology: 4. Meta analysis
1. Power analysis
2. Structural modelling
3. Profit analysis
Outcome:
More number of sessions was associated with
diminishing returns.
Howard(1986), Lambart(1996), Barkham(2006)
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