Treatment models and outcome evidence
Introduced| English |
|---|
| counterconditioning/ˈkaʊntəkəndɪʃənɪŋ/ |
| common factors/ˈkɒmən ˈfæktəz/ |
A decision before an answer
- People often improve with no treatment at all, so a before-and-after gain is not yet evidence that a therapy worked.
- Your goal: Match major therapy families to their proposed mechanisms.
Learn the families by mechanism
- Each therapy family proposes a mechanism. Psychodynamic work targets unconscious conflict and early relationships, using transference; object-relations variants emphasise early relationships in particular. Behavioural treatment applies learning principles: systematic desensitisation traditionally pairs a graded fear hierarchy with relaxation (counterconditioning), while exposure approaches need not use relaxation pairing.
- Cognitive-behavioural therapy identifies and tests distorted thoughts and adds behavioural activation. Person-centred work offers empathy, unconditional positive regard and congruence; Gestalt work stresses the here and now. Biological treatment includes medication and, for severe depression, electroconvulsive therapy.
A client with a specific phobia is taught relaxation and then works through a graduated hierarchy of feared situations. This is:
Exposure paired with relaxation is counterconditioning, a behavioural method.
Match technique to presentation
- Match technique to mechanism and presentation: specific phobia points to graduated exposure; obsessive-compulsive disorder to exposure with response prevention; depression to cognitive restructuring plus activity scheduling.
- A therapist rooted in object relations will emphasise early life relationships, not medication or cognitive distortion lists.
The strongest design for concluding that a new therapy causes improvement is:
Only a controlled comparison separates treatment gain from spontaneous remission and regression to the mean.
Demand controlled comparisons
- Outcome claims need controls because of spontaneous remission and regression to the mean: people seek help at their worst and improve anyway. A randomised controlled trial with a waitlist or placebo comparison separates treatment gain from natural course.
- Efficacy is performance under controlled conditions; effectiveness is performance in ordinary practice. Meta-analysis pools trials for a more stable estimate.
A therapist rooted in object relations theory emphasises early life relationships. A phobia treated by a relaxation-paired hierarchy is counterconditioning. A treated group improving from pre-test to post-test shows change, not efficacy: without a control, regression to the mean and spontaneous remission remain open.
Systematic desensitisation pairs graduated exposure with ____.
The incompatible relaxed response counterconditions the fear response.
Weigh common factors
- When bona fide therapies show comparable mean outcomes, the common-factors hypothesis credits shared ingredients such as the working alliance, expectancy and empathy rather than branded techniques.
- Comparable means do not prove identical mechanisms, and a single trial cannot settle the question either way.
Inferring causation from a before-and-after gain without a control, or treating comparable means as proof of identical mechanisms.
Which answer fits this case?
Match major therapy families to their proposed mechanisms
Comparable mean outcomes across bona fide therapies prove that all therapies share identical mechanisms.
The common-factors hypothesis credits shared ingredients; equal means do not establish equal mechanisms.
Keep the distinctions
- counterconditioning 对抗性条件作用 — Replacing a conditioned response by pairing the stimulus with an incompatible response such as relaxation.
- common factors 共同因素 — Ingredients shared across therapies, such as alliance and expectancy, proposed to explain comparable outcomes.
- Match major therapy families to their proposed mechanisms.
- Evaluate treatment-outcome evidence against appropriate controls.
- Distinguish efficacy, effectiveness and common-factor claims.
Match each term with its precise meaning in this lesson.
Keep the distinctions stated in the teaching example.
Put this lesson’s reasoning or event sequence in order.
The order follows the stated process; check each stage before the next.