1. What are two questions that consider the effectiveness of psychotherapy? Some people say that psychotherapy is not effective and that Christians should not be doing it. First question, how does one conduct good outcome research (that gives answers that you can have confidence in)? Second question, how does one make sense of the many studies once they are done?

2. Discuss the types of outcome research, their purpose, and their potential validity. Case studies usually happen early in psychotherapy. It is not controlled, and it has a problem with its validity (may not measure what it is supposed to). Internal validity may be low, but it is supposed to help design techniques for the therapeutic process. Single case design is a very carefully controlled design on the counseling of one person. It shows what treatment actually works for a given condition. Treatment is applied. When the client improves, then the treatment is not applied. The therapist can make decisions about the treatment based on how this process works with one person. This therapy has high internal validity but low external validity. Stopping the treatment might be an ethical issue, however, unless the client knows what is being done. Analogue is an analogy to real counseling. It is a very carefully controlled treatment but not with real patients. The people used are volunteers who may or may not meet all the conditions for the test. This technique has high internal validity, and external validity can be low or high. Clinical trials test theory in a clinical situation. The external validity is very high, but the internal validity is moderate and not as well controlled.

3. Discuss Eysenek's (1952) criticism of the effectiveness of psychotherapy. His study was not very good. He was a behaviorist and probably very biased. He wanted to compare the effectiveness of psychotherapy and no psychotherapy. He concluded that people were better off with no psychotherapy.

He chose people in state hospitals around 1917 and 1926-1933. He saw that two-thirds got better without treatment over two years, but in actuality, only one-third to one-half actually got better. He made some of these decisions based on who was still getting insurance payments once their therapy had begun. After 2 years to 5 years, respectively, those still drawing insurance were 28%, 18%, 13%, and 9%. His conclusion was that those not getting insurance were getting better (spontaneous remission curve), but this was not a good conclusion. World War I and the Great Depression could have been major factors with these results.

4. Discuss the Sloan, et al, (1975) Temple University study according to STP and summarize the major findings. This study involved 3 well qualified behavioral therapists and 3 psychotherapists. Using the STP of research (subjects, treatments, and performance), this study was very well done. The subjects, treatments, and performance measures were all well controlled. The performance measures showed that both therapies (behavioral and psychotherapy) were about equal and also better than no therapy.

5. Discuss making sense out of research findings. Box score keeps track of how many clients get better. Review of the Literature involves carefully defining the topic, attending to the methodology, organizing the findings logically, and looking for contradictions in the studies. Then, the difference in methods should be analyzed and the implications determined. Meta-analysis quantifies how well people do relative to a control group. Effect size is equal to mean of treatment group minus mean of the control group divided by the standard deviation of the control group. A higher effect size suggests better results for the test group.

Smith and Glass (1977) did a study on the effectiveness of psychotherapy. The effect size for Psychodynamics was 0.59, for Adlerian was 0.71, for Transactional Analyis was 0.58, for Rational Emotive was 0.77, for Gestalt theory was 0.26, for Carl Rogers approach was 0.63, for Desensitization was 0.91, and for Behavioral was 0.76.

6. What are a few things we can know about the effectiveness of psychotherapy? First, most therapy helps most people, but some people do not benefit and a few get worse. Second, not all psychotherapies are equally effective. Cognitive therapy is good for depression. Desensitization therapy is good for people who have phobias. Family counseling works well for marriages in trouble. Third, most change occurs within the first seven sessions.

7. Does Christian psychotherapy work better than secular therapy for Christian clients? First, William Wilson (Duke University) studied 17 clients and used some Christian techniques. According to him, sixteen out of seventeen got better, but the tests were not well controlled. Second, Rebecca Propst (1980) did an analogue study, using cognitive treatment, and compared group using religious imagery, group using non-religious imagery, group monitored and talked to, and group just monitored. She found no real differences in any of the four groups. Third, David Pecheur and Keith Edwards (1985) compared cognitive-behavioral modification with Christian and non-Christian programs. They found that the secular and biblical programs did not show any significant differences. Fourth, Propst (1985) used religious and non-religious therapists. She found no overall difference but did note that non-religious therapists had more success with religious cognitive therapy than religious therapists. Fifth, Brad Johnson and Chuck Ridley (1991) observed 18 graduate theology students and 3 church members, using Christian and non-Christian rational emotive therapy. The Christian therapy might have performed a little better.

In considering all of these studies, there is not much evidence to support Christian therapy. However, the subjects were all analogue and not real religious in most cases. The treatment was cognitive. Performance measures were always related to depression. Many important things were not measured, and drop out rate was not considered. An unsatisfied statistic was not kept either. Therefore, the research was very rudimentary.

8. Can there be (in principle) a Christian psychotherapy, or is it prohibited by Scripture? This is a hotly debated question. The fundamental question is, "What view of Scripture do you hold?" Is the Bible the soul source of truth? If true, then only the Bible should be used for therapy. However, while the Bible is truth, it is not the only source. Also, one's interpretation of Scripture can distort and twist their view of truth. Special Revelation (Bible) is more valuable than General Revelation (nature), but the Bible does not teach a therapist how to do psychotherapy. One can find knowledge about people and about their relationship with God. A therapist should never contradict Scripture, and he or she should counsel in the general light of the Bible's message.

				Tom of Bethany

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