So I am having a friend from out of town visit this weekend, so I decided to do next week's reading & blog this week! So lucky you, Mr. or Miss Reader...you get a double dose of Shari! If you want to see what I have to say about CBT, scroll down to the next blog post. (In case you're wondering...I love CBT.)
I enjoyed the readings this week. I found them informative and interesting. I want to applaud the Jacobson (2001) article. I think he is doing psychology the way it SHOULD be done. Jacobson was part of a team that found that a certain type of therapy had a significant effect, so he formulated theories and models based on the therapy and after this, he did a large clinical trial to test the efficacy of the therapy (Jacobson et al., 1996). This is very different than what many clinicians (I'll call them the "unscientific clinicians") do: they find a therapy that they think works...so they do that kind of therapy, without any type of rigorous testing or theorizing. Based on the article we read, I think Jacobson is a true psychological scientist. I aspire to do work that is as scientific as his.
I'm very interested in Behavioral Activation. I have to admit that I knew relatively little about it before reading this article. I really approve of any type of therapy that has its roots in something with such a large amount of empirical support, like behaviorism. I like that the idea of using Behavioral Activation as a stand alone therapy came from a scientific study, rather than a random idea of a therapist. I think random ideas can also be brilliant (so long as they are tested soon after they are generated), but I think the fact that this form of therapy sprang from research adds to its credibility.
Although I am interested in Behavioral Activation, I am still a little skeptical of it. I think it is counter-intuitive to not treat cognitions in depressed clients. I feel like targeting both behavior and cognitive problems is a more thorough way to treat depression, but if it can save money and time for the clients, I suppose it is ok to only do one of the two if it is proved to be sufficient. I am very curious to know the results of the large study Jacobson was working on at press time of this article to see if BA truly is more efficacious than CT.
Some of the "unscientific clinicians" I mentioned earlier, the ones who practice without empirical support or plans of eventual empirical support, may complain that they shouldn't have to validate their therapy with empirical evidence because they can tell their therapy works just by interacting with their clients. Well, we learned from our first set of readings that this is not the case most of the time, since clinical judgment typically sucks. So if any of these "unscientific clinicians" are reading this (which I doubt, since I assume only our class reads this and we all seem to be supporters of empirical support), I'd like to tell you to get your act together and act like a scientist. You got a Ph.D. or Psy.D., which shows you're smart, so do some research or serious theorizing and prove that you deserve your title!
Alright, that's all for now! See you all in class. :)
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4 comments:
I agree with a lot of your analysis. Another common problem in a lot of the psychology articles I have read is rather than using an experiment to develop a theory that explains the results people first develop a theory then argue from that position using experiments that support their ideas. I'm with you...and science...always a good read.
-J
You asked about the results of the study, so I looked into it...
From: http://members.aol.com/njacbt/article13.htm
Jacobson and his associates compared “up to 20 sessions” of BA with cognitive-behavioral therapy (CBT) that included BA techniques plus cognitive interventions aimed at modifying core schemas. (A third treatment group included BA plus modification of automatic thoughts, but no attempt to modify core schemas.) The results are reported in Jacobson, et al. (1996) and Gortner et al. (1998). At post-treatment, and at 6, 12, 18, and 24 month follow-up, there were no significant differences between BA and CBT. The authors convincingly demonstrate internal validity as well as lack of experimenter bias. Jacobson and his colleagues cite this study as evidence that their BA can achieve results that are equal to CBT, and because their BA is simpler and easier to learn and administer, it is preferable to Beck’s cognitive-behavioral approach.
Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobson, N.S. (1998). Cognitive-behavioral treatment for depression: relapse prevention. Journal of Consulting and Clinical Psychology, 66, 2, 377-384.
Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E., & Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 295-304.
Sorry, I meant to post this:
Behavioral activation treatments of depression: A meta-analysis
Pim Cuijpers, Annemieke van Stratena and Lisanne Warmerdama
Clinical Psychology Review
Volume 27, Issue 3, April 2007, Pages 318-326
Activity scheduling is a behavioral treatment of depression in which patients learn to monitor their mood and daily activities, and how to increase the number of pleasant activities and to increase positive interactions with their environment. We conducted a meta-analysis of randomized effect studies of activity scheduling. Sixteen studies with 780 subjects were included. The pooled effect size indicating the difference between intervention and control conditions at post-test was 0.87 (95% CI: 0.60~1.15). This is a large effect. Heterogeneity was low in all analyses. The comparisons with other psychological treatments at post-test resulted in a non-significant pooled effect size of 0.13 in favor of activity scheduling. In ten studies activity scheduling was compared to cognitive therapy, and the pooled effect size indicating the difference between these two types of treatment was 0.02. The changes from post-test to follow-up for activity scheduling were non-significant, indicating that the benefits of the treatments were retained at follow-up. The differences between activity scheduling and cognitive therapy at follow-up were also non-significant. Activity scheduling is an attractive treatment for depression, not only because it is relatively uncomplicated, time-efficient and does not require complex skills from patients or therapist, but also because this meta-analysis found clear indications that it is effective.
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