ANXIETY & AGORAPHOBIA:
A Consumer's Guide to Psychological Treatment
SPECIFY TREATMENT GOALS
The goals of treatment should be specified early in the treatment process. Otherwise, the treatment risks floundering.
Many therapists arrive at an agreement with clients, not only regarding goals of treatment, but also how long treatment will last. That agreement is put in the form of a contract that serves to remind each party of their aims and obligations. Though not universal by any means, such contracts appear to hasten progress in treatment, especially when time seems to be running out. Then, clients really bend their energies toward getting the most out of what time is left.
When a therapist cannot specify the goals of treatment
fairly concretely, or when client and therapist do not share a common understanding
of these matters, it may be wiser to seek help elsewhere.
Avoiding the wrong therapist reduces the probability of dissatisfaction
and harm. And finding the right therapist, one who gratifies expectations
and promotes effective hope, goes a long way toward ensuring therapeutic
progress. But it does not guarantee such progress by any means. Beyond the
personal qualities of the therapist are the techniques that he or she employs.
Some of these techniques are highly effective for certain kinds of problems.
Others are less effective.
THERAPEUTIC EFFECTIVENESS
Broadly speaking, there are three ways in which one can assess the effectiveness
of therapy. First, one can collect opinions regarding satisfaction with
treatment from the client, as well as from his or her family, friends, and employers.
Second, one can examine changes on a variety of personality measures,
some of which were discussed before. Third, one can look at
target behaviors-the behaviors that brought the client into treatment and
that treatment is supposed to change. In a proper evaluation study, several
measures of each of these types will be used. But some of these measures
seem weaker than others.
Personal Satisfaction
Consider satisfaction. The fact of the matter is that most clients express considerable
satisfaction with treatment. Indeed, it is rare to encounter someone
who says that his therapy did him or her no good. Yet, client
satisfaction, while important, cannot be a significant criterion of effectiveness.
People can be satisfied for a variety of reasons having little or nothing
to do with whether they were changed in significant ways. They may be inclined
to indicate that they were satisfied merely because they had spent a
good deal of time and money on treatment. It would make them quite uncomfortable to believe that it had all been for naught. Because their investment
is so large, they may be motivated to seek genuine reasons for
satisfaction, such as "I learned a lot about myself," even though those reasons
are unrelated to the ones that brought them into treatment in the first place.
Personality Change
Global assessments of personality change are a second index of the effectiveness
of treatment. Such measures are taken at the outset of therapy, often
during therapy, and surely at the end of it, with "improvement" (or "deterioration")
being attributed to the effects of the treatment.
This criterion of effectiveness is fraught with two kinds of hazards, the
first commercial, the second scientific. The commercial one is straight for ward: people rarely enter treatment to have their personalities changed
(London, 1964).
Rather, they seek help because they suffer a particular
problem: they find it difficult to find and hold a job, hard to sustain a loving
relationship, uncomfortable to be in school. They present problems, and it is
those problems that they want to eliminate. Were it demonstrable that their
problems arose from underlying personality difficulties, much as fever arises
from an underlying virus, one would have little to complain about. But the
relationship between presenting problems and the global personality characteristics
that are said to underlie them has yet to be demonstrated. Thus,
the client came to purchase one kind of help, but is sold another. That may
simply be unfair from a business point of view.
Using personality change as a criterion for effectiveness encounters analogous
scientific hazards, for until we truly know that a troublesome behavior
is caused by an underlying personality trait, the law of parsimony suggests
that therapy should attend to the client's desire that the behavior be
changed. In fact, when a troublesome symptom is treated successfully, one
often sees personality change. Thus, a person who is unassertive may also
experience low self-esteem. Merely training him or her to be more assertive
may have dramatically positive effects on self-esteem. But one ought to treat
the symptoms first, on the grounds that behaviors clearly affect personality,
while the reverse is not always so obvious.
Behaviors
Examining the impact of treatment on target behaviors is one of the most
Effective ways to assess treatment outcome. This criterion involves a careful,
behavioral assessment of the problems the client presents at the outset of
treatment, with further similar assessments during and at the end of treatment.
These assessments may be conducted jointly by client and therapist,
and they may also be conducted by outside "blind" evaluators.
Treating Social Anxiety
Generalized Anxiety Treatment
Treating Panic Disorder
Agoraphobia Treatment
All other Phobias Treatment
More at:
http://social-anxiety-treatment-cure.weebly.com/
Of course you know the treatment method I recommend!
http://theliberatormethod.com/Welcome.html
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Generalized Anxiety Treatment
Treating Panic Disorder
Agoraphobia Treatment
All other Phobias Treatment
More at:
http://social-anxiety-treatment-cure.weebly.com/
Of course you know the treatment method I recommend!
http://theliberatormethod.com/Welcome.html
END
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