Exam 3 Flashcards

Question

Once treatment starts, does assessment stop? Why or why not?

Answer 1

No, assessment is a dynamic and continuous process that supports and improves the effectiveness of treatment

Answer 2

Psychotherapy is an unscientific, emotionally charged "talk therapy" that uses a broad range of tools with no required theoretical basis. Psychological treatment, on the other hand, involves science-based interventions tailored to specific issues and has been proven effective in controlled studies.

Answer 3

○ 1920s: Freud's psychotherapy outcomes using limited data from psychiatric institutions (Specifically psychoanalytical/ today as psychodynamic therapy) § Focus on therapist-perceived improvements § Vague diagnoses on small heterogenous samples ○ Carl Rogers emphasized client insight § Through "Talk therapy" § Used empathy, genuineness, and positive regard ○ Hans Eysenck (1952) § Proposed benefit due to spontaneous remission § Psychotherapies & research methodologies challenged □ Provocative 1952 article “The effects of psychotherapy"

Answer 4

○ Psychotherapy research more sophisticated ○ Case studies replaced by controlled trials, self-reports, observations (slightly better) ○ Primary outcomes + Secondary outcomes identified ○ Process research emphasized § Focuses on the mechanisms responsible for improvement § What is actually helping the person to get better § Ex: communication patterns between therapists and clients ○ Large datasets allowed treatment researchers to examine predictors of good and poor outcome § During this time, many world events (WWII, Vietnam war, segregation, civil riots, etc.) occurred that caused more people obtain major stressors => needing therapy

Answer 5

-Client-therapist relationship impacts outcomes. -Outcome measures assess progress (e.g., improvement in functioning). -Meta-analysis developed and (475 studies) shows treatment is more effective than no treatment. -Dodo bird verdict; All therapy types win; Eysenck wasn't right in it just being spontaneous/ nonfunctional =>Treatment better than no treatment -DSM-3 came out in 1970

Answer 6

○ Randomized Controlled Trials (RCT) ○ Empirically supported treatment (EST) ○ Online and internet-assisted versions on the rise ○ Help rural communities and those unable to attend office-based sessions ○ Lack of diversity participants limits generalizing study findings; push for culture sensitivity

Answer 7

- Client's Opinion: May be biased, underestimating or overestimating progress due to investment -Practitioner's Perspective: Limited by lack of insight into client behavior outside the clinic and potential self-serving bias -Third Parties: Mixed responses; family may underestimate, while insurers may overestimate treatment benefits

Answer 8

○ Use standardized, reliable, and valid methods (dependent variables in treatment outcome studies) ○ Interview or self-report questionnaire for client ○ Direct observations of behavior, especially in settings where problem behavior occurs

Answer 9

depends on aims of study, and clinician § Pre-treatment assessment serves as a baseline for post-treatment comparison § Some assess progress (during treatment) at each session to assess client's progress § Post-treatment assessment § Follow-up assessments weeks, months, or even years after treatment ends

Answer 10

Efficacy: How well a treatment works in research studies (e.g., RCTs). Measured by comparing treated clients to those on a waiting list. Focuses on internal validity. Effectiveness: How well a treatment works in real-world settings. Focuses on external validity, showing how well treatments work outside of controlled research environments.

Answer 11

-Control group -Random assignment to treatment or control groups -Annualized treatment and well-trained therapists -Carefully selected and homogeneous client groups -Blinded assessment

Answer 12

External Validity: How well study results apply to real-world settings. Importance: Ensures treatments work outside of research

Answer 13

Common Factors: Features that many therapies share and contribute to positive change (e.g., client-practitioner alliance, hope, optimism). Specific Factors: Unique therapeutic techniques that target specific psychological processes (e.g., CBT, behavioral interventions).

Answer 14

Common factors -They represent the emotional connection and positive expectations that enhance therapy outcomes

Answer 15

Research aimed at identifying the most effective components of multi-part treatments.

Answer 16

Common and specific factors work together; a strong client-therapist relationship enhances the effectiveness of specific techniques.

Answer 17

= Awareness and skills in recognizing what psychologists don’t know about clients due to unique life experiences, challenging personal assumptions and biases.

Answer 18

= Educational component in treatment helping clients understand themselves, their problems, and treatment, while correcting misinformation.

Answer 19

= Client reads informative material independently as part of treatment to address psychological issues

Answer 20

= progressive muscle relaxation -A long-standing tradition in therapeutic interventions, particularly within acceptance and commitment therapy (ACT). -They provide a powerful tool to harness the strength of language in order to comprehend and address stuckness, as well as facilitate behavioral change.

Answer 21

-The passengers on the bus -Quicksand -The chessboard -Leaves on a stream -The polygraph machine

Answer 22

○ Clients review progress between sessions with clinical psychologist ○ Clients practice skills taught in therapy sessions § Self-monitor behaviors and cognitions

Answer 23

§ Lack of follow-up § SES or value disparity § Unclear explanations of assignments

Answer 24

An intervention or technique that has produced significant change in clients in controlled trials. ○ Interventions or techniques that demonstrate beneficial effects in RCTs

Answer 25

= treatments informed by a number of sources, including scientific evidence about the intervention, clinical expertise, and client needs and preferences. -Broader category with treatments informed by many sources

Answer 26

"Well-established" > "Probably efficacious" > "Experimental" >"Possibly efficacious" developed by Chambless

Answer 27

Some clinicians prefer psychotherapy as an "art" and reject Evidence-Based Treatment (EBT) due to personal biases and belief in their own methods. This creates a research-practice gap, where research and clinical practice don’t align. Clinicians believe multiple factors, not just treatment, contribute to a client's improvement. Observed changes after treatment don’t necessarily mean they were caused by the treatment itself.

Answer 28

-Placebo effects -Spontaneous remission -Regression to the mean and natural fluctuations in psychological problems -Effort justification -Multiple treatment interference -Reporting bias

Answer 29

Goal: Integrate EBTs into routine practice. Success Features: Accessible, cost-effective, and culturally adaptable. Reach underserved groups, train non-experts. Ensure acceptability for clients and clinicians. Challenges: Intensive clinician training, high costs, disinterest. Success Factors: Educate on benefits, implement quality assurance, consider cultural diversity.

Answer 30

○ Intensive training for clinicians ○ Training workshops might be expensive ○ Therapists disinterested in changing treatments

Answer 31

Behavioral Treatment: Techniques derived from learning theory (operant conditioning, classical conditioning, modeling, skills training). Focus: Observable, measurable behavior.

Answer 32

○ US= unconditioned stimulus ○ UR= unconditioned response ○ CS= conditioned stimulus ○ CR= conditioned response

Answer 33

○ Helps an organism prepare for the future § The bell triggers behaviors to prepare for the food ○ Represents an association between the CS and the US § Bell associated with food ○ Innate reflex § US -> UR ○ Training § CS -> dog § US -> UR ○ Conditioned § CS -> CR

Answer 34

○ Initially, lots of behaviors are tried out ○ Track outcomes of behavior § S^D -> R -> O § S^D= discriminative stimulus § R= response § O= Outcome ○ This knowledge guides future behaviors § Behaviors with positive (+) outcomes increase § Behaviors with negative (-) outcomes decrease

Answer 35

* Maladaptive behavior is understood as classically, operantly conditioned * Behaviors are the problem, motives are unimportant * Treatments should focus on behavior maintaining processes * Adaptive behavior can replace maladaptive behavior by applying learning principles * Behavioral treatments are client-specific

Answer 36

Conditioned a child to develop a phobia

Answer 37

Demonstrated how learned fears can be removed, "reconditioned" * These paved the way for systematic desensitization and contemporary exposure therapy techniques

Answer 38

Modified behavior of hospitalized psychotic individuals ○ Taught some skills and modified their environment

Answer 39

1-Target definition and baseline assessment 2-Functional analysis and treatment planning 3-Implementation 4-Outcome assessment 5-Reformulation

Answer 40

-Addressing skill deficits -Modifying behavior with rewards/consequences -Reducing clinical anxiety and fear -Improving depressed mood -Modifying habit behaviors -Improving sexual functioning

Answer 41

-Social skills training -Assertiveness training

Answer 42

-Contingency management -Token economies

Answer 43

-Exposure therapy (In vivo exposure, Imaginal exposure, Interoceptive exposure, Exposure hierarchy, Danger-based expectation) -Progressive Muscle Relaxation (PMR)

Answer 44

-Behavioral Activation (BA)

Answer 45

-Habit Reversal Training (HRT) -Cue exposure

Answer 46

-Sensate focus

Answer 47

* It is an unpleasant stimulus paired with undesirable target behavior; works on punishment principle * Covert sensitization is same idea, but relies on imagery, not actual consequences ○ Causes distress * Aversive conditioning is incompatible with APA ethics code * Positive reinforcement produces longer-lasting behavior changes, instead of punishment

Answer 48

Efficacy: Proven effective for many clinical problems, superior to psychodynamic and humanistic therapies in meta-analysis. Efficiency: Shorter, focused consultations with specific procedures; cost-effective and can be delivered by technicians. Breadth of Application: Accessible to clients with limited resources, cognitive disabilities, or chronic conditions, reaching a wider population in need.

Answer 49

○ Behavioral interventions ineffective in treating psychosis, severe depression, bipolar disorder, and some personality disorders ○ Better when included in multicomponent treatment programs ○ Skill-based treatment; need client’s effort ○ Behavioral terminology discomforting ○ Therapists sometimes seen as “cold” or manipulating and not fostering “inner growth” ○ Aversion techniques regarded by some as immoral

Answer 50

- Aaron T. Beck - Albert Ellis - Albert Bandur - Julien Rotter

Answer 51

Background: Initially trained in psychoanalysis but found it inefficient and unscientific. Contributions: Developed Cognitive Therapy (CT), emphasizing the role of negative thinking patterns in mental health issues. Introduced the idea that cognitive distortions (e.g., catastrophizing) contribute to depression, anxiety, etc. Beck’s approach led to Cognitive Behavioral Therapy (CBT), combining cognitive restructuring and behavioral techniques

Answer 52

Background: Also trained as a psychoanalyst but dissatisfied with its methods Contributions: Developed Rational Emotive Behavior Therapy (REBT), which focused on challenging irrational beliefs that lead to emotional distress. -Emphasized that people’s emotional responses are shaped by their interpretations, not external events

Answer 53

Background: Influenced by behaviorism but added cognitive factors Contributions: Developed Social Learning Theory (later Social Cognitive Theory), emphasizing vicarious learning (learning through observation) and the role of self-efficacy (belief in one's ability to influence outcomes) -His work integrated cognitive processes into learning theory, showing that people actively process information and shape their behaviors based on their beliefs

Answer 54

Background: Focused on the interaction between behavior and cognitive expectations Contributions: Introduced locus of control (internal vs. external), suggesting that beliefs about control over life events influence behavior. -This concept linked cognition with behavior and influenced later developments in CBT, which focused on modifying beliefs to change behavior.

Answer 55

= thoughts about events, situations in environment ○ Appropriate behavior from healthy constructive thoughts ○ Irrational, inaccurate congitions bias our thoughts ○ Thoughts become automaticl cause emotional distress, unhealthy behavior, and poorer quality of life ○ Thoughts are appraisals, interpretations, and attributions

Answer 56

= emphasizes how our thinking — that is, our beliefs, interpretations, judgments, attributions, expectations, and other forms of “self-talk” — influence our emotions and behaviors.

Answer 57

○ Improves psychological functioning; corrects maladaptive thinking and behaving § Thoughts influence emotions ○ Changes thoughts and feelings about self, others, and unpleasant situations beyond client's control ○ Enhances problem solving, communication

Answer 58

* ABC model sets stage for CBT: ○ Distress can be conquered by changing B (thoughts) ○ Clients taught to use adaptive and rational thinking ○ Experiencing constructive negative emotions can motivate, help problem-solve ○Unconditional self-acceptance

Answer 59

* A: activating event, activity, and adversity ○ Whatever happens to kick off the situation * B: beliefs * C: emotional and behavioral

Answer 60

Beliefs ○ Can’t control the things or events, but can control the interpretation ○ Cognitive events will lead to different consequences * We build cognitive schemas around situations, people, activities, and objects ○ Incorrect schemas are problematic ○ Schemas depend on emotional situatiytrtiuon of person ○ Negative schemas lead to depression ○ Optimistic thinking leads to positive emotions

Answer 61

Cognitive Assessment (Cs): Open-ended questions Assess Consequences: Frequency, intensity, duration; self-monitoring forms Activating Events (A): Identify triggering facts via self-monitoring Client’s Beliefs (Bs): Find dysfunctional beliefs; sentence tasks, handouts Downward Arrow Technique: Identify adverse event, explore meanings, uncover dysfunctional thoughts.

Answer 62

○ universal experience that may be an appropriate response in certain circumstances useful, motivating one to take action and problem-solve ex: sadness, grief, sorrow, regret, concern, annoyed

Answer 63

○ more intense and long-lasting destructive negative emotions ○ Ex: hopelessness, worry, and rage, that stifle healthy coping and lead to impulsive or self-defeating behavior

Answer 64

Inaccurate, logically flawed, exaggerated, inflexible, way of thinking that is incongruent with goal attainment

Answer 65

= seeing things in either "black or white" categories

Answer 66

= seeing a single negative event as a never-ending pattern

Answer 67

= exclusively focusing on a negative aspects of a situation

Answer 68

rejecting positive experiences by instisting that they don't "count", for one reason or another

Answer 69

Making negative interpretations without adequate evidence

Answer 70

Assuming you know what others are thinking without adequate evidence

Answer 71

= attributing or anticipating extremely awful consequences to events

Answer 72

assuming that negative emotions necessarily reflect the situational reality

Answer 73

endorsing rigid yet arbitrary rules

Answer 74

taking one behavior or characteristic of oneself (or others) and applying it to the whole person

Answer 75

entirely blaming oneself, or someone else, for a situation that involved many factors or was out of your control

Answer 76

endorsing thoughts that are not necessarily irrational or distorted, but are nevertheless unproductive or unhelpful

Answer 77

* Client focuses on: ○ Structured sessions; goal-oriented ○ Little emphasis on causes of faulty thoughts ○ Some work may be out of clinical setting (homework) * Behavioral experiments may happen: method for clients to “put their beliefs to the test.”

Answer 78

-Downward arrow technique -Collaborative empiricism -Culturally responsive modification

Answer 79

REBT Founder: Albert Ellis Approach: More directive and confrontational Focus: Irrational beliefs (e.g., demandingness, awfulizing) Techniques: Disputation of beliefs using Socratic questioning Goal: Challenge and change irrational beliefs Beck's Cognitive Therapy Founder: Aaron Beck Approach: Non-directive and collaborative Focus: Cognitive distortions (e.g., overgeneralization, catastrophizing) Techniques: Guided discovery, structured exercises Goal: Identify and challenge automatic thoughts

Answer 80

Effectiveness High response rates in adults and children Effective in outpatient, residential, medical settings Works individually, in groups, and remotely Efficiency Practical, brief, and easy to master Can be integrated with managed care Trainable for providers with little experience Scope of Use Effective for depression, anxiety, and several other conditions Moderate effect on schizophrenia symptoms Less effective for anorexia nervosa, but helps with bulimia and binge-eating Efficacious for insomnia Mixed results for personality disorders

Answer 81

○ CBT developed on European Americans; not a diverse sample ○ Individuals of nondominant cultural identities form a minority in study samples § Efforts to recognize multiculturism ○ Effort required from client for treatment to work § Practice skills regularly and complete homework ○ Limited use for those with less motivation, severe and complex psychological problems, learning difficulties, or developmental disabilities