Exposure therapies (G07)

Question 1

Which of the following is NOT a cause of therapist drift for a clinician:

a. Personal beliefs and attitudes
b. Questioning your current practice
c. Overconfidence in your current practice

Answer 1

b. Questioning your current practice

Question 2

Explain what is meant by the concept of therapist drift.

Answer 2

Failure to apply evidence based treatment that therapists have been trained to deliver adequately. This can be conscious or unconscious.

Question 3

Longitudinal research on the effectiveness of treatment methods based on standardised protocols or clinicians’ intuitions suggests that:

a. Judgements based on clinicians’ intuitions and experience are more effective than protocol-based judgements.
b. Protocol-based judgements are more effective than judgements based on a clinician’s intuition.
c. Clinicians with many years of experience make intuitive judgements that are more effective than standardised protocols, while inexperienced clinicians do not.

Answer 3

b. Protocol-based judgements are more effective than judgements based on a clinician’s intuition.

Question 4

Therapist drift describes a situation in which a clinician does not utilise optimal evidence-based therapeutic methods, even though they possess the necessary skills and knowledge to do so. What causes therapist drift? Name three important aspects.

Answer 4

1: Clinicians’ cognitions: a) Attributional biases concerning potential reasons for success/failure of specific treatments. b) Clicians’ schemas about how therapy should proceed and clients’ motivations. c) Other biases, for example when it comes to assessing therapeutic success.
2: Clinicians’ emotions: Performance anxiety, fear of evaluation and/or shame/guilt about perceived failure to provide help may lead to avoidance of certain treatments and/or accurate analysis and consequent implementation. Positive emotions may lead to excessive optimism and confidence in one’s abilities.
3: Clicians’ behaviours: a) Context-driven factors such as excessively high caseload, fatigue, stress or pressures may lead to suboptimal performance and a lack of time spent for skill development. b) Clinicians’ safety behaviours may lead to avoidance of pushing for behavioural changes in order to prevent putting clients under stress in the short term.

Question 5

Therapist drift occurs when…

a. clinicians fail to deliver the optimum evidence-based treatment
b. clinicians drift towards their own interpretation when diagnosing instead of evaluating objectively
c. clinicians base their practice on methods that apply only for other disorders

Answer 5

a. clinicians fail to deliver the optimum evidence-based treatment

Question 6

Why does therapy drift occur?

Answer 6

It is the product of a range of human experiences and characteristics (such as anxiety by both patient and clinicians and the safety behaviours employed by them to cope with that).