Questions and Answers
All federal government websites end in .mil.
False
The https:// in a website's URL ensures that any information sent is encrypted and transmitted securely.
True
Inclusion in an NLM database implies endorsement of the contents by NLM or the National Institutes of Health.
False
The National Library of Medicine is not a provider of access to scientific literature.
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The field of professional psychotherapy has seen a decrease in openness to diverse theoretical perspectives in recent years.
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Macro-theories of personality and therapeutic change have held up to scrutiny by empirical research.
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There are more classical analysts, strict behaviorists, or biomedical reductionists today than in the past.
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Behaviorists have rejected the importance of cognition in their treatment.
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The psychodynamic approach in psychotherapy is no longer focused on the therapeutic relationship.
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Research evidence suggests that transference interpretation is the key to efficacy in the psychodynamic approach.
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Psychotherapy is generally effective beyond the effects of placebo controls.
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Most cases of severe mental illness show good symptom change within about 26 weekly sessions.
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The demonstrated effects of psychotherapy are due to effects of small sample sizes, nonrandomized designs, or bias in published versus unpublished studies.
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Common factors, such as the therapeutic relationship, account for most of the outcome variance in psychotherapy.
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Specific technique differences do not emerge in the treatment of depression, phobias, and panic.
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Patient characteristics do not interact with variation in therapeutic techniques in producing differential outcomes.
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Suitable patients never achieve a successful outcome in psychotherapy.
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The therapeutic alliance is not important for the outcome of psychotherapy.
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Suitable patients are characterized by more problematic personality traits.
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Therapist differences do not produce differences in outcome.
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Skillful therapists often intervene in a critical, unfriendly, or unclear way.
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Variables such as age, personality, profession, formal psychotherapy training, years of clinical experience, personal psychotherapy, or amount of supervision have a significant relationship to the therapist's skillfulness.
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Medical doctors and clinical psychologists consistently achieve better outcomes than social workers or psychiatric nurses.
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The quality of the therapeutic alliance is not significantly associated with favorable outcome.
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A long waiting period before treatment is desirable.
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Precise measurement of clinical phenomena is not a problem in process and outcome research.
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Individual growth curve modeling is not recommended for outcome assessment.
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Meta-analysis can overcome the differences between measures in outcome research.
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Four mechanisms of change have been described: mastery/coping, problem actuation, personal resource activation, and learning.
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Therapists' allegiance to therapy schools and theoretical models can facilitate integration of different therapeutic procedures.
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Research findings are readily absorbed into therapist communities.
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Clinical judgment can be fully manualized.
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Training in only one treatment modality is sufficient to enhance therapist expertise.
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Nonspecific psychotherapy is as effective as structured psychotherapy for many psychiatric disorders.
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Manualized training in specific treatment modalities should not use audiotaped or videotaped sessions.
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Trainees do not need knowledge about patients' orientation, abilities, and willingness to accept the recommended treatment techniques.
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Evidence-based psychotherapy practice does not imply continuous exchange of information among researchers, clinicians, service providers, and third-party payers.
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Combined psychotherapy and pharmacotherapy treatment is not recommended for nonresponders.
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The media provides balanced and accurate information about mental health treatment.
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Research-based information about effective treatments can influence clinical practice in favorable directions.
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Long-term mode-specific changes in brief dynamic psychotherapy are not affected by the patient-therapy relationship.
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Cognitive-behavioral therapy is not effective for treating depression.
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Multisystemic therapy is not effective in reducing criminality and violence in juvenile offenders.
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Alprazolam is not an effective treatment for panic disorder with agoraphobia.
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Transference interpretations are not effective in brief dynamic psychotherapy.
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Multisystemic therapy is not effective in reducing symptoms of bulimia nervosa.
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Interpersonal therapy (IPT) is not effective in treating major depression among primary care patients.
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Most psychotherapy interventions are lengthy and require a year or more of treatment.
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Psychotherapy interventions that are not included on the list of empirically validated therapies have been subjected to controlled clinical trials.
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Cost-benefit analyses of psychotherapies are well-established and widely used to guide clinical decisions.
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The Consumer Reports study found that family doctors were more effective than mental health professionals in treating patients.
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Multisystemic therapy (MST) has been found to be effective in community mental health settings.
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The use of treatment manuals in psychotherapy research has been found to improve alliance and outcome.
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The question of how psychotherapy works is well understood and established.
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Supportive-expressive psychodynamic therapy is not effective in treating opiate dependence.
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The effectiveness of psychotherapy in the community is well established and extensively studied.
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About one-fourth to one-half of outpatient cases were considered cured at the end of psychotherapy.
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Untreated control patients tended to fall behind treated subjects with the passage of time.
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Cognitive therapy for depression has a significant relapse-prevention effect.
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Combined treatment has been consistently demonstrated to be significantly better than single modalities.
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Supportive or educational psychotherapeutic interventions for both patient and family, when added to long-term neuroleptic treatment, have no significant effect on the relapse rate.
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Exposure plus antidepressive medication is less effective in agoraphobia than either treatment alone.
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Combined therapy for severe depressions is inferior to psychotherapy alone.
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Benzodiazepines may enhance the long-term effects of exposure therapy for agoraphobia.
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There is systematic empirical evidence available to guide clinical decision making on whether nonresponders to medication do better with psychotherapy or with a combination of the two treatments.
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A psychotherapy treatment manual designed to facilitate the effects of medication or increase compliance with medication has been published.
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Study Notes
Psychotherapy Research and Practice
- Federal government websites, like NLM (National Library of Medicine), provide access to scientific literature, but inclusion in an NLM database does not imply endorsement or agreement with the contents.
Trends in Psychotherapy
- The field of professional psychotherapy has seen increased openness to diverse theoretical perspectives and a greater interest in empirical evaluation.
- Macro-theories of personality and therapeutic change have not held up to empirical research scrutiny.
- Promising approaches include hermeneutic, social constructionist, and qualitative approaches, as well as mini-theories centered on specific problem domains.
Empirical Analysis of Psychotherapy
- Behavioral and cognitive psychotherapy are merging, with behaviorists incorporating affect and unconscious processes into their treatment.
- Psychodynamic therapy has become more short-term and focused, with a growing emphasis on the therapeutic relationship and work on defenses.
- Psychotherapy is generally effective, with 63 out of 100 patients achieving successful outcomes, compared to 38 out of 100 with placebo or minimal treatment.
- Most cases of mild and moderate severity show good symptom change within 26 weekly sessions.
Common Factors and Specific Techniques
- Mainstream theoretical approaches assume that common factors exist in all therapies, accounting for a considerable amount of observed change.
- The therapeutic relationship, faith in the wisdom of the sanctioned healer, and "reconditioning" via learning may be common factors.
- Specific technique differences emerge in the treatment of depression, phobias, substance abuse, and schizophrenia, adding something unique over and above common factors.
- Patient characteristics, such as locus of control and interpersonal relationships, interact with therapeutic techniques to produce differential outcomes.
Therapist Characteristics and Skill
- Skillful therapists use techniques prescribed by the therapy method, but in a flexible and competent way.
- They adjust their interventions according to the patient's maturity and responses, and sustain an optimistic but realistic attitude.
- Research on what creates a skillful therapist is limited and inconclusive.
Future Directions in Psychotherapy Research
- Studying more clearly defined process units and their relationships to outcome is an area of significant progress.
- The quality of the therapeutic alliance is significantly associated with favorable outcome.
- Methodological problems, such as measurement and design issues, need to be addressed.
- Long-term effects of therapy and the role of combined treatments are areas of ongoing research.
- The effectiveness of psychotherapy in community settings, as well as its cost-benefit analysis, requires further study.### Therapist Expertise
- Trainees need research-based knowledge to educate and inform patients about psychiatric disorders and alternative treatments.
- Understanding patients' orientation, abilities, and willingness to accept recommended treatments is crucial for therapist expertise.
Recognizing Treatment Needs
- Trainees should be able to recognize when patients require more specialized care or long-term treatment.
- Knowledge of long-term maintenance treatments and relapse prevention procedures is essential for treating patients with recurrent disorders, high comorbidity, or poor social functioning.
Treatment Approaches
- Combined psychotherapy and pharmacotherapy treatment may be reasonable for nonresponders, despite limited evidence of its superiority.
- Therapists should learn how to monitor treatment delivery and patient progress using brief measures of symptoms and the therapeutic alliance.
Evidence-Based Practice
- Evidence-based psychotherapy practice involves continuous exchange of information among researchers, clinicians, service providers, and third-party payers.
- Providing users with research-based information about effective treatments can influence clinical practice in favorable directions.
Influences on Clinical Practice
- Consumers of psychotherapy are often exposed to unbalanced and potentially misleading information about mental health treatment through the media.
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Description
Learn how to identify official federal government websites and ensure a secure connection. NLM provides access to scientific literature and explains what inclusion in their database means.