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Psychotherapy Research - According to Eysenck, how large are the effects of psychotherapy and what caused positive effects?
Small to nonexistent
spontaneous remission
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Psychotherapy Research - Who were the first to apply the statistical technique known as meta-analysis?
Smith and Colleagues
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Psychotherapy Research - What is meta-analysis?
combining the results of multiple studies
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Psychotherapy Research - What is an effect size?
converting data from different studies to a common metric so that results can be quantitatively combined and compared.
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Psychotherapy Research - What did Smith, Glass, and Miller (1980) discover in their meta-analysis about the effects of therapy?
The average therapy client is better off than 80% of those who need therapy but remain untreated.
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Psychotherapy Research - Effects of Treatment Length - According to How and his colleagues (1996), the relationship between treatment length and outcome levels off at about how many sessions? What do the authors refer to this as?
75% of patients showed measurable improvements at 26. This number increased to only 85% at 52 sessions
dose-dependent effect
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Psychotherapy Research - Effects of Treatment Length - Phase model - What is the first phase of the phase model?
Remoralization - feelings of hopelessness and desperation respond quickly to therapy, with remoralization usually being accomplished in the first few sessions
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Psychotherapy Research - Effects of Treatment Length - Phase model - What is the second phase of the phase model?
Remediation - the focus is on the symptoms that brought the client to therapy. Symptomatic relief usually requires about 16 sessions
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Psychotherapy Research - Effects of Treatment Length - Phase model - What is the third phase of the phase model?
Rehabilitation - focuses on unlearning troublesome maladaptive habitual behaviors and establishing new ways of dealing with various aspects of life.
sessions required to achieve goals depends on the type and severity of the problem
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Psychotherapy Research - Efficacy versus Effectiveness Research - What are efficacy studies what are arguments against them?
clinical trials
omits too many crucial elements of what is actually done in the field; thereby, limiting generalizability of results
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Psychotherapy Research - Efficacy versus Effectiveness Research - What are effectiveness studies?
correlational or quasi-experimental
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Psychotherapy Research - Research on Psychotherapy with Members of Diverse Populations - According to Sue at al (1991), rank the following groups based on improvements gained from therapy. Asian, Hispanic American, African American, Anglo
Hispanic
Anglo
Asian
African American
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Psychotherapy Research - Research on Psychotherapy with Members of Diverse Populations - Utilization of Mental Health Services - African American usage
receive smaller amounts of services but receive a disproportionate amount of mental health services in emergency rooms and psychiatric inpatient settings
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Psychotherapy Research - Research on Psychotherapy with Members of Diverse Populations - Utilization of Mental Health Services - Asian Americans usage
underrepresented in both outpatient and inpatient settings
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Psychotherapy Research - Research on Psychotherapy with Members of Diverse Populations - Premature Termination Rates - What percent of racial/ethnic minorities terminate therapy after the first session compared to whites?
50% compared to 30% white
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Psychotherapy Research - Interventions for Older Adults - What are the three most common mental health problems with older adults and list them in order of incidence
anxiety
severe cognitive impairment
depression
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Psychotherapy Research - Interventions for Older Adults - What interventions are well established for problems associated with dementia?
behavioral and environmental
memory and cognitive retraining
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Psychotherapy Research - Interventions for Older Adults - What interventions are well established for problems associated with depression
cognitive, behavioral, and brief psychodynamic
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Psychotherapy Research - Interventions for Victims of Spousal/Partner Abuse - What is the best single predictor of cessation of battering?
Family income
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Psychotherapy Research - Interventions for Victims of Spousal/Partner Abuse - Clinical Interventions for Battered Women - What should the goals of the interventions be?
appropriate to the woman's need and emphasize self-determination
Should include methods for ensuring safety, increasing self-esteem, and sense of empowerment and control
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Psychotherapy Research - Interventions for Victims of Spousal/Partner Abuse - Factors Affecting the Decision to Remain in an Abusive Relationship - What are the factors that determine if a woman will stay in an abusive relationship?
commitment to the relationship
economic dependence
a belief the batterer will change
feat of retaliation against the woman and/ or children
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Psychotherapy Research - Other Issues in Psychotherapy Practice and Research - What is diagnostic overshadowing?
To attribute all of a person's psychiatric symptoms to their intellectual disabilities
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Psychotherapy Research - Other Issues in Psychotherapy Practice and Research - What is an alloplastic intervention?
to make changes in the environment so that it better accommodates the individual
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Psychotherapy Research - Other Issues in Psychotherapy Practice and Research - What is an autoplastic intervention?
To change the individual so they are better able to function effectively in their environment
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Psychotherapy Research - Other Issues in Psychotherapy Practice and Research - Psychiatric Hospitalization - For both men and women, what marital population has the lowest, intermediate, and highest admission rates?
widowed
married or divorced/separated
never married
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Psychotherapy Research - Other Issues in Psychotherapy Practice and Research - Psychiatric Hospitalization - For both men and women, what age range has the highest admissions?
25 - 44
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Based on the results of his review of the literature, Eysenck concluded that the apparent benefits of psychotherapy are due to _________. His conclusion was based on the finding that 72% of no-treatment control group patients improved while ________% of the patients receiving eclectic therapy and 44% receiving psychoanalytic psychotherapy showed a substantial improvement in symptoms.
In contrast, a meta-analysis of the research by Smith, Glass, and Miller (1990) produced a mean effect size of ________, indicating the average therapy client was better off than 80% of those not receiving treatment.
spontaneous remission
66
.85
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According to Howard et al., the duration of therapy has a positive correlation with outcomes, at least up to about _______ sessions, when the relationship begins to "level off." Their phase model predicts that the benefits of therapy vary, depending on the number of sessions. Specifically, feelings of ________ (remoralization) are apparent during the first few sessions, ___________ (remediation) requires about 16 sessions. and establishing new ways of dealing with various aspects of life (rehabilitation) occurs in subsequent sessions.
26
hopelessness and depression
Symptomatic relief
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A current debate in the literature is whether efficacy or __________ studies are more useful for assessing psychotherapy outcomes. While the former are most useful for establishing whether or not a treatment has had an effect, the latter are considered better for assessing __________.
effectiveness
clinical utility
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With regard to the utilization rates, there is evidence that ________ receive a disproportionate share of mental health services in the emergency room or psychiatric inpatient settings. The research has found that about ________% of therapy clients from racial/ethnic minority groups drop out after the first session compared to 30% of white clients
African Americans
50
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Sue et al. (1991) found that, client-therapist matching in terms of ethnicity, culture, or race may reduce ___________ for Asian, Hispanic, and White therapy clients but not for African Americans.
premature termination
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Research examining the effects of various psychological interventions for older adults has generally confirmed their effectiveness. For example, cognitive, behavioral, and brief psychodynamic therapies have been found to be __________ as treatments for depression
probably efficacious
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Surveys have found that women are more likely to be victims of spouse/partner abuse when they are younger, heterosexual, ___________ (followed by African Americans), and in families that have yearly incomes less that $10,000.
American Indian/Alaska Native
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Factors that increase the likelihood that a woman will stay in an abusive relationship include her commitment to the relationship, _______ dependence, and the belief that the batterer will change.
economic
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Treatment manuals were originally developed to ________ psychotherapeutic treatments so their effects could be empirically evaluated and to provide guidelines for training therapists
Standardized
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In medical research, a "placebo" is an inert substance or treatment, but in psychotherapy research, placebo control groups most often provide participants with ___________ factors
nonspecific or common
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The term _________ was originally used to describe the tendency of health practitioners to attribute all problems to mental retardation in individuals with this diagnosis
diagnostic overshadowing
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In the context of psychotherapy, the goal of an ________ intervention is to makes changes in the individual's environment, while the goal of an ________ intervention is to change the individual.
alloplastic
autoplastic
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With regard to distress, therapists are most likely to say that _________ is the single most stressful aspect of their work and that issues related to _________ are the most frequently encountered ethical/legal dilemmas.
lack of therapeutic success
confidentiality
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Makes have higher rates than females of admission to inpatient mental health programs. In terms of marital status, admission rates are highest for ________ for both males and females
Never married
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Efficacy studies are most useful for establishing:
treatment effect
Efficacy studies are most useful for establishing whether or not a treatment has an effect, while effectiveness studies are best for assessing clinical utility; i.e., for determining a treatment's generalizability, feasibility, and cost-effectiveness.
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An advantage of using treatment manuals in clinical practice is that they:
provide the clinician with concrete examples that illustrate the appropriate application of an intervention.
The use of treatment manuals in clinical practice continues to be controversial, with experts citing both advantages and disadvantages. Most current treatment manuals provide information on the delivery of empirically supported treatments and include concrete examples.
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Which of the following individuals is at greatest risk for death by suicide?
A.A 76-year-old widowed man
B.A 30-year-old divorced woman
C.A 23-year-old married man
D.A 39-year-old single woman
A
In general, suicide rates are higher for men, for single, divorced, and widowed (versus married) individuals, and for older people. Therefore, of the individuals listed in the answers, the risk would be highest for a 76-year-old widowed man.
Answer B: While being divorced is a risk factor, this individual does not present at a higher risk level than a widowed elderly man (three risk factors).
Answer C: Of the individuals listed, this individual presents at the lowest risk level for suicide.
Answer D: While being single is a risk factor, this individual does not present at a higher risk level than a widowed elderly man (three risk factors).
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Based on his review of the psychotherapy outcome studies, Hans Eysenck (1952) concluded that:
A.treated and untreated patients show very little improvement in symptoms.
B.treated and untreated patients both show improvement but are indistinguishable in terms of amount of improvement.
C.treated patients are consistently "better off" than untreated patients in terms of symptom improvement.
D.untreated patients are often "better off" than treated patients in terms of symptom improvement.
D
The debate about the effectiveness of psychotherapy was fueled in the 1950s by the results of Eysenck's study. Eysenck found that 72% of untreated neurotic adults improved, while only 66% of those receiving eclectic therapy and 44% of those receiving psychoanalytic psychotherapy showed a substantial decrease in symptoms.
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Howard et al. (1996) found that, after _____ sessions of therapy, approximately 75 percent of therapy patients evidenced a measurable improvement in symptoms.
26
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Research investigating the effectiveness of cognitive-behavioral therapy as a treatment for depression for older adults suggests that:
A.older adults benefit from cognitive-behavioral therapy when its duration is brief (less than 12 sessions).
B.older adults benefit from cognitive-behavioral therapy, especially when it is conducted at a slower pace.
C.older adults benefit from cognitive-behavioral therapy only when their therapist is the same gender and similar in terms of age.
D.older adults are not likely to benefit from cognitive-behavioral therapy.
B
he studies have generally confirmed that older adults benefit from a variety of forms of psychotherapy, including cognitive-behavioral therapy. While older adults generally benefit from cognitive-behavioral therapy, its effects are maximized when it is modified to fit the needs of members of this population. One effective modification is to present therapy at a slower pace.
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The first use of meta-analysis to evaluate the effectiveness of psychotherapy is attributed to:
A.Jacobson and Christensen.
B.Eysenck.
C.Smith and colleagues.
D.Howard and colleagues.
C
Meta-analysis was originally used by Karl Pearson in 1904 to evaluate the extent to which smallpox inoculation increased survival rates. At that time, the technique was not known as "meta-analysis." It was not until the 1970s that the term "meta-analysis" was introduced by Smith and Glass, who also refined the technique and were the first to apply it to psychotherapy outcome studies. [See Smith and Glass (1977), Meta-analysis of psychotherapy outcome studies, American Psychologist, 1977, 32, 752-760].
Answer A: You may be familiar with the names of these researchers from the Clinical Psychology chapter of your study materials, where they are cited as proponents of both efficacy and effectiveness research.
Answer B: One criticism of Eysenck's 1952 study on the effectiveness of psychotherapy is that the study did not utilize meta-analysis.
Answer D: Howard and colleagues studied the relationship between treatment length and outcome.
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Which of the following groups has the lowest psychiatric hospital admission rate?
A.Married persons
B.Never married persons
C.Divorced persons
D.Widowed persons
D
The statistics on psychiatric hospital admission rates vary from study to study. However, as it relates to marital status, the consensus suggests that the highest psychiatric admission rates are among those who have never been married while those who have been widowed have the lowest rates.
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