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Are All Psychotherapies Equally Effective?
Transcript of Are All Psychotherapies Equally Effective?
Aim is to compare the efficacy and to see what method would help the treatment of PTSD
Patients with PTSD were randomly assigned to brief eclectic psychotherapy or EMDR therapy
They were assessed at all sessions on self- reported PTSD using the Impact of Event Scale- Revised (IES-R: a short easily administered self- report questionnaire, consisting of 22 questions to capture the DSM-IV criteria for PTSD)
Both treatments were effective in reducing PTSD symptoms
However, response patters indicated that EMDR had a sharper decline in PTSD symptoms, than brief eclectic psychotherapy.
EMDR results in a faster recovery compared with the more gradual improvement with brief eclectic psychotherapy.
Stig Poulsen Ph. D, et. al
Bulimia Nervosa Controlled Trial
What is psychotherapy?
A general term for treating mental health problems by talking with a psychiatrist, psychologist, or other mental health provider
Learn about your conditions, moods, feelings, thoughts, and behaviors
Learn how to take control of your life and respond to challenging situations with healthy coping skills
Type of psychotherapy you receive depends on your individual situation
Referred to as: talk therapy, counseling, psychosocial therapy, therapy
Thursday, May 8, 2014
Psychotherapy works, but they are not all equally effective
Different disorders require different techniques
May not cure your condition
Are All Psychotherapies Equally Effective?
Psychologist Stig Poulsen, and researchers at Copenhagen and Oxford compared Psychoanalytic Psychotherapy and cognitive behavioral therapy in the treatment of Bulimia Nervosa - binge eating and purging.
A randomized control trial was conducted with 70 patients with Bulimia Nervosa.
The patients either received 2 years of weekly Psychoanalytic Psychotherapy or 20 sessions of CBT for over 5 months.
The outcome was measured with the Eating Disorder Examination interview, after 5 months, and after 2 years.
Notable difference between the CBT and the psychoanalytic psychotherapy.
After 5 months, 42% of patients in CBT group, and 6% of patients in psychoanalytic psychotherapy group had stopped binge eating and purging.
At 2 years, 44% in CBT group and 15% in the Psychoanalytic Psychotherapy group had stopped binge eating and purging.
The changes took place faster in the CBT group.
Support for the Dodo bird effect comes from meta-analyses that aggregate (combine) the results of multiple treatments for multiple disorders, instead of examining each treatment's effect on each individual disorder.
Overall, every form of psychotherapy is equally effective for all disorders, but some forms work better for certain disorders than others. Aggregation can mask the difference (Crits-Christoph, 1997).
Siev and Chambless (2007):
Cognitive behavioral therapy works better for panic disorder than generalized anxiety disorder, but relaxation works equally well for both disorders
Studies supporting the Dodo bird effect combine primary and secondary outcome measures.
This does not show us how effective a therapy is among different disorders
An individual is more concerned with how well a treatment is going to work for their specific condition than with all conditions
Brief Eclectic Psychotherapy vs. Eye Movement Desensitization and Reprocessing Therapy
for Post Traumatic Stress Disorder
Shorter, Edward, Dr. "All Psychotherapies Are Not Equally Effective." Psychology Today: Health, Help, Happiness + Find a Therapist. N.p., 26 Jan. 2014. Web.
Technique compared to common factors
Centre for Psychological Trauma, Department of Psychiatry,
Academic Medical Centre at University of Amsterdam,
Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. firstname.lastname@example.org
Common Factors are non-specific factors that are present during therapy.
Research found that expectancy, relationship factors, and common factors account for about 40% of treatment outcomes and technique accounts for only about 10% - 15% in therapy
Therefore therapists can only manipulate the effectiveness of a treatment by the technique
*This research was done in 1986
Siev, Jedidiah; Huppert, Jonathan D.; Chambless, Dianne L. From Behavior Therapist, vol. 32, no. 4, April 2009, pp. 32, 69,75
Clark et al. (2006): In this study, people with social anxiety disorder were treated with either cognitive behavioral therapy or exposure therapy. Even though the common factors of alliance, credibility and expectancy were the same for both groups, CBT outperformed the other treatment.
"Psychotherapy." Mayo Clinic. N.p., n.d. Web.