The Basics of Psychotherapy: An Introduction to Theory and Practice (Theories of Psychotherapy) by Bruce E. Wampold

Author:Bruce E. Wampold
Language: eng
Format: mobi
ISBN: 9781433807510
Publisher: American Psychological Association
Published: 2012-04-11T21:00:00+00:00

For Specific Disorders

Space does not allow an examination of the literature for all diagnoses, so here the review is constrained to the most prevalent mental disorders, depression and anxiety disorders, as well as alcohol use disorders, personality disorders, and childhood disorders.

Depression

By 1998, many treatments were designated as ESTs for depression, including behavior therapy, cognitive therapy, interpersonal therapy, brief dynamic therapy, reminiscence therapy (for geriatric populations), self-control therapy, and social problem-solving therapy (Chambless et al., 1998). If the EST list were updated today, many additional treatments would need to be added, including process experiential therapy (Ollendick & King, 2006), which has been shown to be equally effective as cognitive–behavioral therapy (CBT; J. C. Watson, Gordon, Stermac, Kalogerakos, & Steckley, 2003), the most validated psychotherapy for any disorder. Thus, it appears that a variety of treatments, based on a variety of theories, have been shown to be effective for the treatment of depression.

Meta-analyses of clinical trials of depression have consistently verified, with some qualifications, that all treatments of depression are equally effective. An early meta-analysis (Robinson et al., 1990) classified treatments into four categories: cognitive, behavioral, cognitive–behavioral, and verbal. The latter contained dynamic, humanistic, and experiential treatments. Generally, they found that behavioral, cognitive–behavioral, and cognitive treatments were superior to general verbal therapies and that CBT was superior to behavioral therapy. Two critical issues—ones that were discussed in the previous section—complicate interpretation of the results. First, likely many of the verbal therapies in these comparisons were not treatments that were really intended to be therapeutic—that is, some of the verbal therapies were in actuality control groups meant to control for common factors such as meeting with an empathic therapist. As has been discussed, this type of treatment typically has no cogent rationale for the treatment and few actions that practicing psychotherapists would consider to be therapeutic. A later meta-analysis found that cognitive therapy for depression was superior to “other” therapies, which were noncognitive, nonbehavioral treatments (Gloaguen, Cottraux, Cucherat, & Blackburn, 1998). However, many of the “other” treatments were not intended to be therapeutic; when these treatments were omitted, cognitive therapy was not superior to “other” treatments intended to be therapeutic (Wampold, Minami, Baskin, & Tierney, 2002).

The second, and not unrelated, issue is that of researcher allegiance. It is well documented that the allegiance of the researcher exerts quite large and robust effects on the results of studies; that is, studies conducted by an advocate of a particular treatment consistently find effects for that particular treatment (Berman et al., 1985; Luborsky et al., 1999; Wampold, 2001b). The explanation for allegiance effects is somewhat ambiguous, leaving unanswered the question, How does the allegiance of the researcher translate into larger effects for the favored treatment? There are several possibilities, including translation of researcher allegiance to therapist allegiance (e.g., the therapists in the study know which is the preferred treatment, as would be the case when the researcher trains and supervises the therapists), the study design favors one treatment (e.g., the preferred treatment has a greater dose of therapy), or the comparison treatment is poorly constructed (e.

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