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a) Although drugs can produce tremendous improvements in
psychological functioning, research suggests that some
forms of therapy may have the same effect on the brain as a
course of drug treatment
VIII. Does Therapy Work?
A. Evaluating Therapeutic Effectiveness
1. Spontaneous-remission effect is one baseline criterion of naturally
occurring change against which effectiveness of therapies must be
assessed
2. Placebo therapy: A neutral therapy that creates expectations of heating
3. Meta-analysis: A statistical technique that evaluates general
conclusions from data across many different experiments or
evaluation studies
B. Treatment Evaluations:
1. A study by the National Institutes of Mental Health compared
treatments for depression
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a) Therapies evaluated were cognitive behavioral therapy,
interpersonal psychotherapy, and drug therapy
b) Evidence suggests that cognitive behavioral and
interpersonal therapies had an intermediate level of
effectiveness, and drug therapy had the greatest effect
c) Research indicates that virtually all therapies will bring
some relief
C. Prevention Strategies
1. Preventing a problem is the best solution.
2. Goal of prevention can be realized at different levels
a) Primary prevention tries to prevent a condition from ever
beginning
b) Secondary prevention attempts to limit duration and severity
of a disorder, once it has begun
c) Tertiary prevention limits the long-term impact of a
psychological disorder by seeking to prevent a relapse
3. Implementation of these three types of prevention focuses on
paradigm shifts in mental health care, with most important being:
a) Supplementing treatment with prevention
b) Going beyond a medical disease model to a public health
model
c) Focusing on situations and ecologies that put people at risk
and away from “at-risk” individuals
d) Looking for precipitating factors in life settings, rather than
predisposing factors in people
4. Clinical ecology expands the boundaries of biomedical therapies by
relating disorder to environmental irritants
5. Ultimate goal of prevention programs is to safeguard the mental
health of all members of society
DISCUSSION QUESTIONS
1. Does your university have a psychological counseling center for students? The years one
spends in college are often some of the more trying years of one’s entire life. If your
school is one that does provide counseling services for its students, check it out, in terms
of cost, usual duration of therapeutic intervention, treatment modality, and any
underlying philosophies. You may wish to prepare a summary of this information for the
class.
2. Ask the class what would be most frightening to them if it was learned that tomorrow all
the mental hospitals were to close, and all patients were to be released without
supervision, medications, or treatment. Elaborate on and discuss your class’s concerns.
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3. Have the class propose situations of transference and countertransference in the
therapeutic environment and in their own personal relationships outside of the
therapeutic milieu. Help them to understand the dynamics of these manifestations.
4. Phobias are a part of life for many of us, and many of us feel foolish in discussing them.
Ask students if they know someone who is phobic in some area (this lets them off the
hook, relative to self-identification) and ascertain what, if any, coping mechanisms may
be employed. Is the individual in therapy?