Master thesis / Hovedoppgave in psychology (e.g. Psykologisk institutt, UiO) or other places

Are you considering pursuing a Master's degree in psychology and looking for a meaningful project to work on? I invite you to reach out to me to discuss potential topics for your thesis at the Psychological Institute at the University of Oslo (UiO). Not only can a Master's thesis be a valuable opportunity to delve into a clinically relevant topic, but it can also serve as a stepping stone for a research career. While we are open to exploring a range of options, it would be especially advantageous if you are interested in publishing an English-language article based on your thesis. As such, it is strongly recommended that your thesis be written in English. Below are some examples of Master's theses that I have previously supervised.

I am interested in supervising master's theses at the University of Oslo, particularly in the field of psychology (e.g., Hovedoppgave ved Psykologisk institutt). We have access to a database of assessments and results from professional interventions in various areas, such as leadership and coaching, and have already supervised one master's thesis on personality coaching. We are also open to working on projects that are clinically useful or that could serve as a stepping stone for a research career, and prefer that the projects are published in English. Below, we have listed a few, of many, potential project ideas (e.g., comparisons of different affect theories and interventions in MBT (a type of therapy), comparisons of two fidelity scales for MBT, an exploration of the relationship between individual and group therapy in MBT, a theoretical article on the concept of "embedded alliance," and an examination of the role of the therapeutic alliance in therapy for personality disorders.

Through our collaboration with Human Content AS, we can support you to design and deliver research. You will have the opportunity to benefit from access to their substantial database of assessments and subsequent results from professional interventions in organisations, leadership, team, competences, recruitment, coaching and more. The work Human Content and their network of certified professionals have done internationally and in Norway has improved the performance of  hundreds of  organisations, leadership teams and individual leaders. So far, we have supervised one master thesis/hovedoppgave (Vinge, 2022). Personality coaching—unlocking subjectivity with «universal» methods), but there are between 10 and 20 possible projects to chose from. We also collaborate with other institutions, depending on your field of interest.

Please navigate to the page where we have ranked and summarized our own publications. This evaluation provides a thorough and unbiased overview of our work.

Here is a selection of potential projects for master's thesis students

  1. A comparison of the affect theories and interventions in MBT and Affect Consciousness The findings can be illuminated by Karterud & Kongerslev's new TAM model for personality (https://goo.gl/M5xfvL). The lab has previously scored hours in affect-awareness with the MBT scale, and it is of interest to continue the investigation of this.

  2. I would be very interested in collaborating on performing research (theoretical and/or empirical) on adult development. Both Otto Scharmer and Robert Kegan have very interesting, and similar theories:

    Scharmer's theory of adult development outlines five levels of development that individuals go through as they grow and evolve. These levels are:

    1. Egocentric: At this level, individuals are primarily focused on their own needs and desires. They may struggle to take others' perspectives into account and may prioritize their own interests over those of the group.

    2. Ethnocentric: At this level, individuals begin to recognize the importance of their own culture and the values and beliefs of their group. They may become more aware of other cultures, but may view their own culture as superior.

    3. Worldcentric: At this level, individuals become more open-minded and accepting of diversity. They are able to see the value in different cultures and perspectives, and may be more inclined to work towards global solutions to problems.

    4. Kosmocentric: At this level, individuals begin to see the interconnectedness of all things and recognize that their actions have an impact on the world as a whole. They may become more focused on sustainability and the common good.

    5. Integrated: At this level, individuals have achieved a deep understanding of their place in the world and are able to integrate their understanding of self, others, and the world into a cohesive whole. They may have a strong sense of purpose and be able to act in a way that aligns with their values and beliefs.

    Robert Kegan, a professor at Harvard University, developed a theory of adult development that consists of five levels. These levels are:

    1. The Impulsive Level: At this level, individuals are focused on meeting their immediate needs and desires, and they have little awareness of their own internal states or the perspectives of others.

    2. The Imperialistic Level: At this level, individuals are more aware of their own thoughts and feelings, but they are still primarily focused on their own needs and desires. They may be more responsive to the needs of others, but only to the extent that it serves their own interests.

    3. The Interpersonal Level: At this level, individuals are more aware of the needs and perspectives of others, and they begin to value relationships and connections with others. They may prioritize maintaining harmony in their relationships, even at the expense of their own needs.

    4. The Institutional Level: At this level, individuals become more aware of the larger social and cultural systems that shape their lives and the lives of others. They may be more focused on creating positive change in these systems and may be more willing to challenge the status quo.

    5. The Interindividual Level: At this level, individuals are able to see themselves and others as part of a larger, interconnected whole. They are able to hold multiple perspectives simultaneously and are able to see the world from multiple angles. They are able to think about complex issues in an integrative and holistic way.

    Kegan's theory of adult development has been influential in the field of psychology and has been applied in a variety of settings, including education and leadership development.

    The concept of the "self-authoring mind" refers to a stage of psychological development proposed by Robert Kegan, a psychologist and educator. According to Kegan's theory of adult development, the self-authoring mind is the fourth of five stages of development that individuals go through as they mature.

    At the self-authoring level, individuals are able to take a more objective, self-reflective stance towards their own thoughts, feelings, and behaviors. They are able to consider multiple perspectives and to change their own beliefs and behaviors in the light of new information or experiences. This allows them to be more autonomous and self-directed, and to take more ownership of their own lives.

    According to Kegan, the development of the self-authoring mind is characterized by a shift from a focus on social roles and relationships to a focus on individual identity and purpose. Individuals at this stage are able to take a more critical and reflective stance towards their own beliefs and values, and to consider how these shape their actions and decisions. They are also able to form and maintain more complex and nuanced relationships with others, and to engage in more open-ended and flexible forms of communication.

    Scharmer's and Kegan's theories both outline different stages of adult development, with Scharmer's theory consisting of five levels and Kegan's consisting of five levels. Scharmer's theory emphasizes the evolution of an individual's perspective, with levels ranging from egocentric to kosmocentric, while Kegan's theory focuses on the development of an individual's self-awareness and ability to hold multiple perspectives, with levels ranging from the impulsive level to the interindividual level.

    One key difference between the two theories is the focus on cultural influences. Scharmer's theory includes a level specifically focused on cultural influences, with individuals at the ethnocentric level becoming more aware of their own culture and the values and beliefs of their group. Kegan's theory does not explicitly address cultural influences, instead focusing on the development of the individual's self-awareness and ability to hold multiple perspectives.

    Both theories have been influential in the field of psychology and have been applied in a variety of settings, including education and leadership development. Kegan's theory, in particular, has gained widespread recognition and has been used to understand and promote personal and professional development in individuals.

  3. A comparison of two fidelity scales for MBT The student(s) will be trained in scoring two scales (Karterud et al. 2013 & Bateman, in review?) for MBT fidelity, and will have access to selected hours that are scored with both instruments. The hours can be analyzed quantitatively and/or qualitatively, and the instruments compared and evaluated. IPA is a possible method. Possible thematic analysis, ARIMA or other quantitative methods.

  4. Exploring conjoint therapy: the relation between individual and group therapy in MBT The student(s) will receive finished transcripts of individual hours with accompanying group hours. Research questions: Do individual and group therapists work in the same directions and do the processes in each component of the combined therapy potentiate each other? Data collection and transcribing has already been completed.

  5. Elaborating on the concept of "embedded alliance", and use the findings of Finsrud et al. 2021 (patients do not necessarily differentiate between different therapist qualities, such as empathy and expertise, and that, broadly speaking, theory mainly differentiate between their (1) confidence in the therapist, and their (2) confidence in the treatment) to show that therapeutic alliance (and/or therapist effects) along with the change narrative (e.g. the culture the patient is taken into through therapy) is (some of) the most important in "talking cures". In other words, the same thing we would expect if we took piano lessons from András Schiff, subjected ourselves to acupuncture sessions, went to daily psychoanalysis, or practiced Buddhism: the person we meet is a "channel" for a "cultural connection" (also in the power of placebo and social healing), and can be a good or bad channel for this, and in addition to the change-promoting aspects of giving attention/love. The importance of the change narrative has probably been overshadowed by the alliance, probably for good reason - but when we now interview patients who have been in, for example, DBT and MBT, their narratives are totally different: MBT patients understand themselves and their process in the light of the core concepts offered by that therapy, and the same with DBT. Those of us who have gone through long individual therapy courses, either with shamans in Peru or in other (more or less) wise traditions, have felt this on our bodies. The ability of the therapist to not get caught in their own motor transfers, and thus maintain themselves as the clearest possible "channel" is absolutely essential, and perhaps also the ability/willingness to professionally doubt oneself. At the same time, it is essential to be a good representative of one's psychotherapy tradition and/or (other) culture.

  1. An investigation of pedagogical and "therapeutic" interventions in the superb teachings of András Schiff. Navigate to this page to investigate this topic further.

  2. How can dynamic psychotherapy best balance between a knowing, and a not-knowing stance? In this article (open access), we challenge the current paradigm in MBT, suggesting guidelines for psychopedagogical interventions in this evidence-based treatment.

  3. Research related to the role of "transformer CLOs": How can organizations best ensure that they constantly learn, and how can such progress be measured?
  4. Research related to "VR tripping". You can read more here, see what MIT Technology Review writes on the topic (https://www.technologyreview.com/2022/08/06/1056727/vr-virtual-reality-psychedelics-transcendence/) and/or simply read the brilliant article in Nature: Glowacki, D.R., Williams, R.R., Wonnacott, M.D. et al. Group VR experiences can produce ego attenuation and connectedness comparable to psychedelics. Sci Rep 12, 8995 (2022). https://doi.org/10.1038/s41598-022-12637-z

Examples of previous Master's theses

Feel free to contact me to discuss possible projects. I will be happy to provide more information and answer any questions you may have. I look forward to hearing from you and supporting you in your research endeavors. Here are some articles you may consider reading as inspiration.

Den terapeutiske relasjonen i DBT og MBT

Garred, S., Gough, E. M. (2021). Den terapeutiske relasjonen i DBT og MBT [Unpublished master’s thesis, University of Oslo]. https://www.duo.uio.no/bitstream/handle/10852/87426/1/Hovedoppgave_Den-terapeutiske-relasjonen-i-DBT-og-MBT_Elina_Susanne.pdf

Summary

The objectives of this study were to identify strategies to foster a therapeutic relationship in two evidence-based treatments for Borderline Personality Disorder (BPD): Dialectical Behavior Therapy (DBT) and Mentalization Based Treatment (MBT). The therapeutic relationship, or working alliance, is an important factor in the success of psychotherapy and can be particularly challenging to establish in the treatment of BPD due to the nature of the disorder. The study used interpretative phenomenological analysis to examine the interaction between therapists and patients in these treatments to understand how the therapeutic relationship is fostered and how it may contribute to the effectiveness of the treatments.

An article will be publised based on this master thesis.


Chronic Feelings of Emptiness’ – a Useful Criterion in the Diagnosis of Borderline Personality Disorder?

Stølsnes, M. (2021). ‘Chronic Feelings of Emptiness’ – a Useful Criterion in the Diagnosis of Borderline Personality Disorder? [Unpublished master’s thesis, University of Oslo]. https://www.duo.uio.no/bitstream/handle/10852/86649/thesis.pdf

Summary

This thesis focused on the topic of chronic feelings of emptiness and its relationship to borderline personality disorder (BPD). The study used data from the Norwegian Network for Personality Disorders and included 1702 patients with various personality disorders who were diagnosed using the DSM-IV and assessed according to LEAD principles. The study found that chronic feelings of emptiness occurred almost twice as often in patients with BPD compared to those with other personality disorders, and that chronic emptiness was a more robust indicator of BPD in men than in women. Chronic emptiness was also found to be correlated with neuroticism. The study concludes that chronic feelings of emptiness may be a hallmark of BPD, but can also be observed in other personality disorders.

An article will be publised based on this master thesis.


The cultural change narrative as a core component of therapeutic change

Sundal, T., Tobiassen, A. H. (2022). The cultural change narrative as a core component of therapeutic change [Unpublished master’s thesis, University of Oslo]. https://www.duo.uio.no/bitstream/handle/10852/86649/thesis.pdf

Summary

This study aimed to investigate the similarities and differences in the change narratives provided by Mentalization-based treatment (MBT) and Dialectical behavior therapy (DBT) for patients with borderline personality disorder (BPD), and how these narratives reflect the rationale, explanations, and procedures of the treatments. A qualitative analysis of seven interviews with three informants who received MBT and four informants who received DBT was conducted using an interpretative phenomenological analysis (IPA). The results showed that the change narratives described by the informants reflected the treatment they received, with DBT informants highlighting explicit learning of a provided approach with predictable and safe therapists, and MBT informants emphasizing a long-lasting process of exploring to create procedural learning with therapists who followed their lead. The study also found that the change narratives provided by MBT and DBT reflect the different rationale, explanations, and procedures of the treatments, and suggests that further research could explore how these differences may impact therapeutic outcomes. Additionally, the results showed that the DBT informants emphasized explicit learning and the use of skills, while the MBT informants focused on an implicit process of change and the development of a mentalizing stance. The study concludes that the change narratives provided by MBT and DBT for patients with BPD reflect the specific ingredients and techniques of the treatments, and suggests that further research could explore how these differences in change narratives may impact therapeutic outcomes.

An article will be publised based on this master thesis.


Personality coaching—unlocking subjectivity with «universal» methods

Vinge, A. (2022). Personality coaching—unlocking subjectivity with «universal» methods. [Unpublished master’s thesis, University of Oslo]

Summary

This is a study that investigates the experiences of nine leaders and managers who participated in coaching using a specific method and coach. The study uses the qualitative method of Interpretative Phenomenological Analysis to analyze data collected from interviews with the participants. The results suggest that the participants' general high level of interpersonal trust facilitated the establishment of a personal bond with the coach and increased their engagement in the tasks and goals of the coaching. The participants also emphasized the importance of belief in and acceptance of the coaching method, and described how the coach's competent application of a personality framework increased their awareness of themselves, others, and their social reality. The study concludes that psychotherapy research and coaching research could learn from each other, and that integration work appears to be an ongoing process during and after coaching.

The major findings of this text are that the coaching method used in this study was successful in increasing the participants' awareness of themselves, others, and their social reality, and that the establishment of trust with the coach and belief in and acceptance of the method were important factors in the success of the coaching. The study also found that learning experiences between sessions and after the coaching facilitated the integration of the personality framework and that integration work appears to be an ongoing process during and after coaching. It is suggested that psychotherapy research and coaching research could learn from each other.

An article will be publised based on this master thesis.

Important articles

Here are some central articles to read before deciding on research topic. I have provided a summary, and a quiz for every article.

The generalizability of the psychoanalytic concept of the working alliance

Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, research & practice, 16(3), 252. https://doi.org/10.1037/h0085885

Summary

This is simply one of the most important articles in psychotherapy research. Bordin perceived alliance as a vehicle that enables and facilitates specific treatment techniques (Horvath & Greenberg, 1989). Thus, the alliance is embedded within the specific treatment method (Bordin, 1979). The goals and tasks specified appear intimately linked to the nature of the relationship between therapist and patient.

For example, the kind of bond developed when a therapist presents a patient with a form and asks him to make a daily record of his submissive and assertive acts, and of the circumstances surrounding them, appears quite different from the bond developed when a therapist shares his or her feelings with a patient, in order to provide a model, or to provide feedback on the patient’s impact on others. (Bordin, 1979, p. 254) 

According to the article, the working alliance is a concept that refers to the collaboration and agreement between a patient and therapist in the goals and tasks of therapy. It is believed to be an important factor in the effectiveness of therapy, as a strong working alliance can facilitate the therapeutic process. The demands of different working alliances may vary, and the strength of the alliance may depend on the fit between the patient's characteristics and the demands of the particular therapeutic method being used. It is suggested that the assessment and investigation of personal characteristics, such as psychological-mindedness and readiness to collaborate in therapy, could be useful in improving the effectiveness of therapy by helping to match patients with the most appropriate treatment approaches.

The strength of the working alliance between the therapist and patient may have a significant impact on the effectiveness of psychotherapy. In 1979 there was limited direct evidence to support this proposition, but Bordin presents two lines of inquiry that provide indirect evidence. The first line of evidence was from research on the influence of expectations on therapeutic outcome, which suggests that the process of reaching agreement on goals and tasks is important in achieving a strong working alliance. The second line of evidence was from research on client-centered therapy, which found that the strength of the therapeutic alliance was related to the client's expressive style and ability to enter into the self-experiencing task of therapy. Other research has also shown that the strength of the therapeutic alliance is related to therapeutic outcome, regardless of the specific treatment method being used.

The working alliance is an important concept in psychoanalysis that refers to the collaborative relationship between the therapist and patient. It is suggested that the strength of the working alliance is a major factor in the success of psychotherapy and that the goodness of fit between the personalities of the patient and therapist is a key determinant of the strength of the alliance. The working alliance is considered to be applicable to a wide range of change situations, including the relationship between student and teacher and between community action group and leader. The concept of the working alliance can be used to differentiate various modes of psychotherapy and to point toward new directions for research. In addition to agreement on goals and tasks, the working alliance also involves a bond between the therapist and patient and a positive therapeutic atmosphere. Research on the working alliance can provide a way to integrate knowledge about psychotherapy and facilitate convergence in the field. Overall, the working alliance is an important factor in the therapeutic relationship and its impact on the success of psychotherapy.

References

Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, research & practice, 16(3), 252.

Horvath, A. O., & Greenberg, L. S. (1989, Apr). Development and Validation of the Working Alliance Inventory. Journal of counseling psychology, 36(2), 223-233. https://doi.org/Doi 10.1037/0022-0167.36.2.223

Quiz

  1. According to the article, what is the main goal of psychoanalytic treatment?
    A. To examine and modify the patient's own contributions to their difficulties
    B. To provide immediate relief from suffering
    C. To change the patient's external circumstances
    D. To focus on changing specific acts of the individual

  2. What is the focus of attention in behavior therapy (according to the article)?
    A. The continuous flow of inner experience
    B. Self-observation of inner experience
    C. Specific, narrow segments of the individual's life
    D. All of the individual's ways of thinking, feeling, and acting in all situations

  3. What is the relationship between the strength of the working alliance and therapeutic effectiveness?
    A. There is a strong positive relationship
    B. There is no relationship
    C. There is a strong negative relationship
    D. The relationship is dependent on the specific therapeutic method used

  4. What are some characteristics that may influence a person's readiness to enter into a psychodynamically-oriented alliance?
    A. Situational pressures and psychological sophistication
    B. Personal characteristics and dispositions
    C. The patient's social class
    D. All of the above

  5. What is the focus of the working alliance approach to therapy?
    A. The manipulation of expectations
    B. The process of reaching agreement between therapist and patient
    C. The patient's expressive style
    D. The patient's adherence to therapy tasks

  6. What is the main goal of client-centered therapy?
    A. To change specific acts of the individual
    B. To examine and modify the patient's own contributions to their difficulties
    C. To facilitate self-exploration and self-awareness
    D. To focus on changing the patient's external circumstances

  7. According to the article, what is the main factor in the strength of the working alliance in behavior therapy?
    A. The therapist's expertness and status
    B. The fit between the patient's characteristics and the demands of the therapy
    C. The therapist's take-charge attitude
    D. The patient's level of development of object relations

  8. What is the main factor in the strength of the working alliance in psychoanalysis?
    A. The fit between the patient's characteristics and the demands of the therapy
    B. The therapist's expertness and status
    C. The therapist's take-charge attitude
    D. The patient's level of development of object relations

  9. What is the main goal of behavior modification therapy?
    A. To change specific acts of the individual in commerce with others or the environment
    B. To facilitate self-exploration and self-awareness
    C. To examine and modify the patient's own contributions to their difficulties
    D. To focus on changing the patient's external circumstances

  10. What is the main factor in the strength of the working alliance in client-centered therapy?
    A. The fit between the patient's characteristics and the demands of the therapy
    B. The therapist's expertness and status
    C. The therapist's take-charge attitude
    D. The patient's level of development of object relations

  11. Which of the following statements best describes the concept of a "working alliance" in psychotherapy?
    A. A therapeutic relationship in which the therapist exerts complete control over the patient
    B. A collaborative effort between the therapist and patient to identify and address the patient's problems and goals
    C. A form of therapy that focuses on changing specific behaviors in the patient's environment or interactions with others
    D. A therapy that concentrates on examining and modifying the patient's thoughts, feelings, and actions in all situations

  12. According to the article, which of the following factors may influence a patient's readiness to enter into a psychodynamically-oriented working alliance?
    A. The patient's level of education and psychological sophistication
    B. The patient's economic status and environmental pressures
    C. The patient's faith, hope, and previous therapy experiences
    D. All of the above

  13. What is one way in which the demands of different working alliances may differ?
    A. The goals and tasks of the therapy
    B. The therapeutic modality used
    C. The patient's personal characteristics and dispositions
    D. The therapist's personality and therapeutic style

  14. What is one way in which the strength of the working alliance may be related to the fit between the patient and therapist?
    A. The patient's level of psychological-mindedness
    B. The patient's preference for certain work styles
    C. The therapist's level of empathy and warmth
    D. All of the above

  15. Which of the following methods has been used to indirectly assess the relationship between the strength of the working alliance and therapeutic outcome?
    A. Measuring the influence of expectations on therapeutic outcome
    B. Developing a linguistic measure of client-expressive style
    C. Examining the relationship between therapeutic technique and outcome in controlled studies
    D. All of the above

  16. According to the article, which of the following factors may influence the formation of a strong working alliance?
    A. The patient's personality traits and coping strategies
    B. The patient's environmental stresses and supports
    C. The therapist's personality traits and therapeutic style
    D. All of the above

  17. Which of the following statements about the assessment and diagnosis of patients in psychotherapy is true according to the article?
    A. There has been a marked disaffection with assessment and diagnosis among psychologists in recent years
    B. There is little evidence on the validity of personality assessment methods
    C. Assessment and diagnosis are not useful in making treatment decisions
    D. All of the above

  18. How does the concept of the working alliance lead to more specific formulations about the function of personal characteristics in psychotherapy?
    A. By identifying the specific goals and tasks of the therapy
    B. By recognizing the influence of the patient's dispositions on their readiness to enter into certain therapeutic collaborations
    C. By acknowledging the role of the therapist's personality and therapeutic style in the formation of the alliance
    D. All of the above

  19. Which of the following is NOT a way in which the strength of the working alliance has been measured in research studies?
    A. Through independent interviews with the patient
    B. By inferring the level of development of object relations from early memories
    C. By rating the patient's compliance with therapeutic tasks
    D. By administering a standardized questionnaire to the patient

Correct answers

  1. A. To examine and modify the patient's own contributions to their difficulties
  2. C. Specific, narrow segments of the individual's life
  3. A. There is a strong positive relationship
  4. D. All of the above
  5. B. The process of reaching agreement between therapist and patient
  6. C. To facilitate self-exploration and self-awareness
  7. B. The fit between the patient's characteristics and the demands of the therapy
  8. A. The fit between the patient's characteristics and the demands of the therapy
  9. A. To change specific acts of the individual in commerce with others or the environment
  10. A. The fit between the patient's characteristics and the demands of the therapy
  11. B. A collaborative effort between the therapist and patient to identify and address the patient's problems and goals
  12. D. All of the above
  13. A. The goals and tasks of the therapy
  14. D. All of the above
  15. D. All of the above
  16. A. The patient's personality traits and coping strategies
  17. D. All of the above
  18. By identifying the specific goals and tasks of the therapy
  19. D. By administering a standardized questionnaire to the patient

It's the therapist and the treatment

Finsrud, I., Nissen-Lie, H. A., Vrabel, K., Høstmælingen, A., Wampold, B. E., & Ulvenes, P. G. (2021). It's the therapist and the treatment: The structure of common therapeutic relationship factors. Psychotherapy Research, 1-12. https://doi.org/10.1080/10503307.2021.1916640

Summary

The purpose of this study was to investigate the underlying structure of common therapeutic relationship factors in psychotherapy. Common therapeutic relationship factors are considered important predictors of therapeutic outcome, but their underlying structure when studied simultaneously is not clear. To address this gap in the literature, the authors developed a new instrument called the MPOQ Common Factor Scale, which contained items measuring six domains of common factors: agreement on goals, agreement on tasks, therapist empathy, client expectations, therapist expertise, and treatment credibility. The scale was administered to two samples of patients (N=332) undergoing intensive psychotherapy for various disorders in an inpatient setting. An exploratory factor analysis of the first sample found a two-factor structure, with one factor representing "confidence in the therapist" and the other representing "confidence in the treatment." These factors were supported by a parallel analysis and were replicated in the second sample using exploratory structural equation modeling. The model also demonstrated measurement invariance between the first and sixth weeks of treatment. These results suggest that there is substantial overlap among previously established relationship factors and that patients differentiate between their evaluation of the therapist and the treatment when both are assessed simultaneously.

The method of this study involved collecting data from patients undergoing intensive psychotherapy at an inpatient mental health facility in Norway. The researchers developed a questionnaire, the MPOQ Common Factor Scale, which contained items measuring relationship factors that have been identified as important predictors of treatment outcomes, such as therapist empathy and patient expectations. The questionnaire was administered to two consecutive samples of patients, one containing 164 patients and the other containing 168 patients. The patients were diagnosed with conditions such as depression, anxiety disorders, eating disorders, and trauma, and were treated with various psychotherapeutic methods, including cognitive behavioral therapy and short-term psychodynamic therapy. The researchers used exploratory factor analysis and exploratory structural equation modeling to analyze the data and determine the underlying structure of the common therapeutic relationship factors. They also conducted measurement invariance analysis to examine the stability of the factor structure. Overall, the study aimed to examine how patients differentiate between their evaluation of the therapist and the treatment when both are assessed simultaneously.

The results of this study showed that when common therapeutic relationship factors are assessed simultaneously, patients differentiate between their evaluation of the therapist and the treatment. An exploratory factor analysis of the first sample of patients (N=164) found a two-factor structure, with one factor representing "confidence in the therapist" and the other representing "confidence in the treatment." These factors were supported by a parallel analysis and were replicated in the second sample of patients (N=168) using exploratory structural equation modeling. The model also demonstrated measurement invariance between the first and sixth weeks of treatment. These results suggest that there is substantial overlap among previously established relationship factors and that patients differentiate between their evaluation of the therapist and the treatment when both are assessed simultaneously.

Quiz

  1. What is the main objective of the study?
    To evaluate the effectiveness of different types of psychotherapy in treating depression, anxiety, eating disorders, and childhood trauma
    B. To understand the underlying structure of common therapeutic relationship factors when studied simultaneously
    C. To develop a new instrument for measuring common therapeutic relationship factors
    D. To assess the stability of the factor structure over the course of inpatient treatment

  2. How many patients participated in the study?
    A. 332
    B. 164
    C. 168
    D. 67

  3. What were the primary diagnoses of the patients in the study?
    Anxiety disorders
    B. Depression
    C. Eating disorders
    D. All of the above

  4. What were the types of psychotherapy used in the study?
    Cognitive behavioral therapy
    B. Compassion-focused therapy
    C. Trauma-focused therapy
    D. All of the above

  5. How was the common factors questionnaire developed for the study?
    It was translated from an existing instrument in English
    B. It was constructed through a team selection process using items from validated measurement scales
    C. It was developed using a systematic literature review
    D. It was generated through a focus group process with patients and therapists

  6. How many factors were identified in the exploratory factor analysis of sample 1?
    A. 1
    B. 2
    C. 3
    D. 4

  7. What was the correlation between the two factors identified in the exploratory factor analysis of sample 1?
    A. .53
    B. .68
    C. .83
    D. .92

  8. How were the items for the common factor measurement scale selected?
    A) They were chosen by a team of clinicians and researchers based on their empirical and theoretical support in the literature
    B) They were selected from existing measurement scales that were translated into Norwegian
    C) They were chosen based on the specific therapeutic methods being used in the treatment facility
    D) They were selected based on the diagnostic categories of the patients

  9. What was the structure of the common factor measurement scale supported by in the exploratory factor analysis of sample 1?
    A) A single factor
    B) A three-factor structure
    C) A four-factor structure
    D) A two-factor structure

  10. What did the confirmatory ESEM analysis of sample 2 show?
    A) The two-factor structure found in sample 1 was not replicated
    B) The two-factor structure found in sample 1 was replicated, but measurement invariance was not achieved
    C) The two-factor structure found in sample 1 was replicated and measurement invariance was achieved
    D) The two-factor structure found in sample 1 was replicated, but measurement invariance was only partially achieved

  11. What were the two factors identified in the study?
    A) Agreement on goals and tasks, and therapist empathy
    B) Therapist expertise and treatment credibility
    C) Confidence in the therapist, and confidence in the treatment
    D) Agreements on goals, tasks, and therapist empathy, and treatment credibility

Correct answers

  1. B. To understand the underlying structure of common therapeutic relationship factors when studied simultaneously
  2. A. 332
  3. D. All of the above
  4. D. All of the above
  5. B. It was constructed through a team selection process using items from validated measurement scales
  6. B. 2
  7. A. .53
  8. A) They were chosen by a team of clinicians and researchers based on their empirical and theoretical support in the literature
  9. D) A two-factor structure
  10. C) The two-factor structure found in sample 1 was replicated and measurement invariance was achieved
  11. D) Agreements on goals, tasks, and therapist empathy, and treatment credibility

Battles of the Comfort Zone

Folmo, E. J., Karterud, S. W., Kongerslev, M. T., Kvarstein, E. H., & Stanicke, E. (2019). Battles of the Comfort Zone: Modelling Therapeutic Strategy, Alliance, and Epistemic Trust-A Qualitative Study of Mentalization-Based Therapy for Borderline Personality Disorder. Journal of Contemporary Psychotherapy, 49(3), 141-151. https://doi.org/10.1007/s10879-018-09414-3

Summary

The article discusses how therapeutic strategies, alliance (the relationship between the therapist and the patient), and epistemic trust (a belief in the therapist's knowledge and understanding) interact in mentalization-based therapy (MBT) for borderline personality disorder. The study used interpretive phenomenological analysis to examine four individual MBT sessions and found that when therapists were able to identify and investigate maladaptive patterns, challenge the patient, and bring them out of their comfort zone, it facilitated the therapeutic alliance and process. On the other hand, when therapists were brought out of their own comfort zone and tried to repair the relational atmosphere by being supportive, the therapeutic alliance was weak and progress was not observed. The study suggests that a clear therapeutic strategy and the ability to challenge the patient's comfort zone can foster the therapeutic process, and that epistemic trust may develop as a result of a focus on tasks and goals in therapy. You can read more about this article here.


Research on the alliance: Knowledge in search of a theory


Horvath, A. O. (2018, Jul). Research on the alliance: Knowledge in search of a theory. Psychother Res, 28(4), 499-516. https://doi.org/10.1080/10503307.2017.1373204

Summary

The therapeutic alliance, also known as the working alliance or helping alliance, refers to the relationship between a therapist and a client in the context of psychotherapy. The therapeutic alliance is a key aspect of the therapeutic process and is considered to be an important predictor of therapeutic outcomes. The therapeutic alliance is often described as a collaborative relationship between therapist and client, in which both parties work together to achieve the client's therapeutic goals. It includes elements such as trust, mutual understanding, and a sense of collaboration between therapist and client. It is considered a key element in the therapeutic process, as it is believed to be a predictor of therapy outcomes. There is a lack of consensus on the precise definition and operationalization of the therapeutic alliance, and this has led to the development of a wide range of measurement tools and operational definitions. There are also challenges in understanding how different variables within the broader category of therapeutic relationships fit together, overlap, or complement each other. Some efforts to address these challenges include the use of "bottom-up" approaches, such as Conversation Analysis, and the development of more sophisticated and coordinated methods of operationalization. In order to advance research on the therapeutic alliance and contribute to practice, it is important to clarify the definition of the alliance and develop more coordinated methods of operationalization.

Horvath's review begins by situating the last four and a half decades of work on the alliance within the context of the evolution of research on psychotherapy. It then discusses the challenges facing research on the alliance, including the wide range of operational definitions that results in a diffusion of the identity of the concept. The review also argues that the lack of clarity regarding how several variables within the broader category of therapeutic relationships fit together, overlap, or complement each other is potentially problematic. He discusses efforts to resolve the lack of a consensual definition and concludes by arguing that a resumption of a conversation about the relationship in the helping context in general, and the alliance in particular, should be resumed. The review highlights the importance of clarifying the definition of the alliance and developing more sophisticated and coordinated methods of operationalization in order to advance research on the alliance and contribute to practice.

The concept of the therapeutic relationship, or alliance, has been a focus of research in the fields of psychology, psychiatry, education, social work, nursing, physical therapy, and forensic sciences. However, the precise meaning of the term "alliance" is ambiguous and its role in therapy remains somewhat controversial. This review paper discusses the challenges facing research on the alliance and explores some possible ways to address these challenges in the future. One of the main challenges is the wide range of operational definitions of the alliance, which results in a diffusion of the identity of the concept. The review also discusses the lack of clarity regarding how several variables within the broader category of therapeutic relationships fit together, overlap, or complement each other. Efforts to resolve the lack of a consensual definition are reviewed, and it is argued that a resumption of a conversation about the relationship in the helping context in general, and the alliance in particular, should be resumed.

The therapeutic alliance is a key aspect of the therapeutic process and is considered to be an important predictor of therapeutic outcomes. The therapeutic alliance is often described as a collaborative relationship between therapist and client, in which both parties work together to achieve the client's therapeutic goals. It includes elements such as trust, mutual understanding, and a sense of collaboration between therapist and client. The concept has been influential in the field of psychology and has been studied by researchers in a variety of settings, including education and leadership development. There are a number of different approaches to understanding the therapeutic alliance, including psychoanalytic, behaviorist, and cognitive-behavioral perspectives. Despite some differences in the way the therapeutic alliance is conceptualized, there is a general consensus that it is a vital component of the therapeutic process and that it plays a significant role in determining the success of therapy.

The alliance is a concept that refers to the therapeutic relationship between a client and a therapist. It is considered an important factor in the effectiveness of psychotherapy, but there is a lack of consensus on its exact meaning and how it should be operationalized and measured. This lack of consensus has led to the development of a wide range of operational definitions and measurement tools, which can make it difficult to compare research findings and hinder the incremental growth of knowledge in this area. Some of the challenges facing research on the alliance include the diversity of operational definitions, the lack of clarity on how different variables within the broader category of therapeutic relationships fit together, overlap, or complement each other, and the technical challenges in measuring the alliance. To address these challenges, it is suggested that a more concise and nuanced definition of the alliance is needed, as well as more sophisticated, cohesive, and coordinated methods of operationalization. It is also recommended that researchers continue to engage in dialogue about the therapeutic relationship in general, and the alliance in particular, in order to better understand its role in psychotherapy.

The concept of the helping alliance, also known as the therapeutic alliance or working alliance, is a key factor in the effectiveness of psychotherapy. It refers to the positive, collaborative relationship between the therapist and the client that helps to facilitate the therapeutic process. The concept was first introduced by Lester Luborsky in the 1970s, but it has since been expanded upon and refined by other researchers, including Edward Bordin. There are numerous ways to measure the alliance, but the use of a large number of diverse measures has presented challenges in alliance research. Despite these challenges, research on the alliance has contributed significantly to our understanding of the importance of the therapeutic relationship in psychotherapy and has led to the development of training programs and interventions to improve the alliance and ultimately, therapy outcomes. There are currently ongoing challenges in the field, including the need to further clarify the concept of the alliance and to develop more reliable and valid measures of the alliance.

The research on the therapeutic alliance, or the relationship between a therapist and a client in therapy, has faced challenges due to the diversity of measures used to assess it. Many alliance measures provide evidence of construct validity based on statistical significance with another alliance measure or correlation with therapy outcome, but these criteria are problematic. The lack of overlap among alliance measures and the existence of so many measures suggest that they capture diverse aspects of the alliance concept. Despite these challenges, the research on the alliance has contributed to the understanding of its importance and the role of the relational side of the psychotherapy process in general. Some emerging approaches to studying the alliance, such as "bottom-up" approaches that focus on the alliance as an interactional process, offer the potential to address the challenges faced by alliance research and provide a more specific and constrained definition of the alliance concept.

The working alliance (the relationship between an athletic trainer and an athlete) in athletic training:

Quiz

  1. What is the main aim of this review article?
    A) To summarize the challenges facing research on the therapeutic alliance
    B) To explore the role of the therapeutic alliance in psychotherapy
    C) To review the different operational definitions of the therapeutic alliance
    D) To discuss the impact of the therapeutic alliance on therapeutic outcomes

  2. What is the therapeutic alliance referred to as in the fields of education and leadership development?
    A) Helping alliance
    B) Collaborative alliance
    C) Working alliance
    D) Therapeutic relationship

  3. What is the therapeutic alliance considered to be an important predictor of in the therapeutic process?
    A) Trust
    B) Mutual understanding
    C) Collaboration
    D) Therapeutic outcomes

  4. Which of the following is NOT one of the approaches to understanding the therapeutic alliance?
    A) Psychoanalytic
    B) Cognitive-behavioral
    C) Humanistic
    D) Behaviorist

  5. What is the main challenge facing research on the therapeutic alliance?
    A) Lack of consensus on the meaning of the alliance
    B) Limited research on the alliance in specific populations
    C) Lack of funding for alliance research
    D) Limited availability of measurement tools

  6. How does the lack of consensus on the definition of the alliance impact research in this area?
    A) It makes it difficult to compare research findings
    B) It hinders the development of new measurement tools
    C) It limits the ability to generalize findings to different populations
    D) All of the above

  7. What are some of the ways researchers have tried to address the lack of consensus on the definition of the alliance?
    A) By developing new measurement tools
    B) By engaging in a conversation about the relationship in the helping context
    C) By focusing on the therapeutic process as a whole
    D) All of the above

  8. What is the therapeutic alliance also known as?
    A) Helping alliance
    B) Working alliance
    C) Collaborative alliance
    D) Therapeutic bond

  9. Which of the following is NOT a challenge facing research on the therapeutic alliance?
    A) Wide range of operational definitions
    B) Lack of clarity regarding how different variables within the broader category of therapeutic relationships fit together
    C) Lack of consensus on the meaning of the alliance
    D) Limited research on the alliance in specific populations

  10. What is the therapeutic alliance generally described as?
    A) A collaborative relationship between therapist and client
    B) A power dynamic between therapist and client
    C) A one-sided relationship in which the therapist holds all the power
    D) A relationship based on confrontation and conflict

  11. What is a common method used to operationalize the therapeutic alliance in research?
    A) Self-report measures
    B) Observational measures
    C) Both self-report and observational measures
    D) Interviews with clients and therapists

Correct answers

  1. A) To summarize the challenges facing research on the therapeutic alliance
  2. C) Working alliance
  3. D) Therapeutic outcomes
  4. C) Humanistic
  5. A) Lack of consensus on the meaning of the alliance
  6. D) All of the above
  7. D) All of the above
  8. B) Working alliance
  9. D) Limited research on the alliance in specific populations
  10. A) A collaborative relationship between therapist and client
  11. C) Both self-report and observational measures

Ten Things to Remember About Common Factor Theory

Laska, K. M., & Wampold, B. E. (2014, Dec). Ten Things to Remember About Common Factor Theory. Psychotherapy, 51(4), 519-524. https://doi.org/10.1037/a0038245

Summary

Common factor theory suggests that the common factors present in all forms of psychotherapy, such as the therapeutic relationship and expectation of improvement, are more important for therapeutic change than specific techniques or interventions. Common factor models are not a closed system and there is no such thing as a "common factor" treatment. Rather, the goal of common factor models is to identify the factors that make psychotherapy effective. Common factors have been shown to be more important for therapeutic change than specific techniques or interventions, and the training and expertise of the therapist is more important for therapeutic outcomes than the specific treatment approach they use. Contextual factors, such as the client's cultural background and the therapeutic setting, are also important in the therapeutic process. Common factor theory also suggests that the mechanisms of change in empirically supported treatments (ESTs) are not well specified and there is little empirical evidence to support the claim that specific mechanisms are necessary for therapeutic change.

According to common factor theory, the common factors present in all forms of psychotherapy, such as the therapeutic relationship and expectation of improvement, are more important for therapeutic change than specific techniques or interventions. This does not imply that the same treatment should be applied to all patients, as the treatment should be adapted to the characteristics of the individual patient. The use of random controlled trials (RCTs) as the primary method of evaluating the effectiveness of treatments has limitations and may not always be the best path to knowledge. It is important to consider other forms of evidence, such as clinical expertise and client preferences, in addition to RCTs. The training and expertise of the therapist is more important for therapeutic outcomes than the specific treatment approach they use. Cultural adaptation of treatments and the use of feedback to improve the quality of services may also be important in the therapeutic process. Finally, common factor theory highlights the importance of contextual factors, such as the client's cultural background and the therapeutic setting, in the therapeutic process.

Quiz

  1. What is the main focus of common factor theory?
    a) The specific techniques or interventions used in psychotherapy
    b) The common factors present in all forms of psychotherapy
    c) The mechanisms of change in empirically supported treatments (ESTs)
    d) The cost of training necessary to disseminate particular treatments

  2. What has research shown about the importance of specific techniques or interventions in therapeutic change? a) They are more important than common factors
    b) They are equally important as common factors
    c) They have little impact on therapeutic change
    d) They are the primary driver of therapeutic change

  3. Which of the following is NOT a common factor identified by common factor theory?
    a) The therapeutic relationship
    b) Expectation of improvement
    c) Specific techniques or interventions
    d) The training and expertise of the therapist

  4. What is the goal of common factor models?
    a) To identify the factors that make psychotherapy effective
    b) To compare specific treatments to "common factor" treatments
    c) To provide a closed set of factors for all forms of psychotherapy
    d) To demonstrate the superiority of empirically supported treatments (ESTs)

  5. What is the relationship between cultural adaptation of treatments and therapeutic outcomes?
    a) Cultural adaptation of treatments has no impact on therapeutic outcomes
    b) Cultural adaptation of treatments is associated with worse therapeutic outcomes
    c) Cultural adaptation of treatments is associated with better therapeutic outcomes
    d) There is not enough evidence to determine the relationship between cultural adaptation and therapeutic outcomes

  6. How do common factor models view the role of the therapist in the therapeutic process?
    a) As the primary driver of therapeutic change
    b) As having a limited impact on therapeutic change
    c) As not relevant to therapeutic change
    d) As the sole determinant of therapeutic success or failure

  7. What is the relationship between the training and expertise of the therapist and therapeutic outcomes?
    a) The training and expertise of the therapist is not related to therapeutic outcomes
    b) The training and expertise of the therapist is more important for therapeutic outcomes than the specific treatment approach they use
    c) The training and expertise of the therapist is less important for therapeutic outcomes than the specific treatment approach they use
    d) The training and expertise of the therapist is equally important as the specific treatment approach they use

  8. What is the relationship between feedback and the quality of services in psychotherapy?
    a) Feedback has no impact on the quality of services
    b) Feedback is associated with worse quality of services
    c) Feedback is associated with improved quality of services
    d) There is not enough evidence to determine the relationship between feedback and quality of services

  9. What is the importance of contextual factors in the therapeutic process according to common factor theory? a) They are not important in the therapeutic process
    b) They are equally important as specific techniques or interventions
    c) They are less important than specific techniques or interventions
    d) They are a key aspect of the therapeutic process

  10. What is the role of random controlled trials (RCTs) in the evaluation of the effectiveness of treatments according to common factor theory?
    a) RCTs are the only valid method of evaluating the effectiveness of treatments
    b) RCTs should receive the highest prioritization among all forms of evidence
    c) RCTs have limitations and may not always be the best path to knowledge
    d) RCTs are not considered at all in the evaluation of the effectiveness of treatments according to common factor theory

 Correct answers

  1. b) The common factors present in all forms of psychotherapy
  2. c) They have little impact on therapeutic change
  3. c) Specific techniques or interventions
  4. a) To identify the factors that make psychotherapy effective
  5. c) Cultural adaptation of treatments is associated with better therapeutic outcomes
  6. a) As the primary driver of therapeutic change
  7. b) The training and expertise of the therapist is more important for therapeutic outcomes than the specific treatment approach they use
  8. c) Feedback is associated with improved quality of services
  9. d) They are a key aspect of the therapeutic process
  10. c) RCTs have limitations and may not always be the best path to knowledge

Healing in a Social Context


Wampold, B. E. (2021). Healing in a Social Context: The Importance of Clinician and Patient Relationship. Frontiers in Pain Research, 2, 21. https://doi.org/10.3389/fpain.2021.684768

Summary

The concept of social healing refers to the idea that the healing process can be influenced by social interactions and relationships. Social healing may be present in eusocial species, and particularly well-developed in humans. This article suggests that the role of the relationship between a healthcare provider and a patient in the healing process, is social healing. The text argues that this relationship, along with other contextual factors, can have a significant impact on the patient's health outcomes, beyond the specific treatment or medication being administered. This is supported by research on placebos, which have been shown to have a significant effect on subjective outcomes and physiology despite not containing any active ingredients. The text also discusses the role of the relationship in somatic medicine and psychotherapy, and suggests that the relationship may be a key factor in the effectiveness of these treatments. Wampold also discusses potential mechanisms by which the relationship may be therapeutic, including social support, protection, and assistance, and the importance of the relationship in regulating the patient's physiology and emotions. Finally, the text discusses the implications of this research for healthcare and the treatment of pain.

The paper discusses the concept of natural, specific, and contextual effects in the course of a disorder and how the relationship between the patient and clinician can be considered a contextual effect. It also discusses evidence for the importance of the relationship in healing, including research on placebos, somatic medicine, and psychotherapy. The paper concludes by discussing the mechanisms through which the relationship may be therapeutic and the implications for healthcare and the treatment of pain.

In summary, the relationship between a patient and a clinician plays a significant role in the healing process. The importance of the relationship has been demonstrated through research on placebos, somatic medicine, and psychotherapy. The relationship can influence health outcomes through several mechanisms, including the interaction between specific ingredients and aspects of the relationship, providing social support and protection, and creating a sense of safety and trust. It is important for clinicians to recognize the importance of the relationship and to prioritize building a strong and positive relationship with their patients.

The article states that loneliness is a greater risk factor for mortality than other factors such as obesity, smoking, lack of exercise, and excessive drinking. It is well-established that socially isolated individuals lack the social connections necessary to thrive and survive, particularly when under threat. The article also mentions that perceived loneliness, or the feeling of not being supported by those in one's social network during difficult times, is particularly predictive of mortality. The article suggests that a caring and understanding clinician can provide needed social support for patients who are socially isolated and may improve health outcomes by combating loneliness.

According to the article, there is evidence that a good relationship with a clinician can improve patient adherence to the specific ingredients of a treatment, such as taking prescribed medication as directed. Meta-analytic evidence suggests that physician communication is positively correlated with patient adherence, and there is almost a 20% greater risk of non-adherence if the physician communicates poorly. However, the article also mentions that there is some evidence that makes interpretation of medical adherence studies ambiguous, as patients who adhere to placebos have been found to have lower morbidity and mortality in some large clinical trials. The article also discusses the idea that the alliance between the patient and therapist in psychotherapy may be therapeutic by itself or may be necessary for the difficult work of therapy, and that perceived loneliness may be an important factor in patient health outcomes and can be addressed through the therapeutic relationship.

Wampold writes:

"One possible mechanism for the therapeutic value of relationship, which was alluded to earlier, is that the specific ingredients and aspects of the relationship interact. The most obvious way that this may happen in medicine is that a good relationship with the clinician augments patient adherence to the specific ingredients of the treatment. That is, if a patient has a good relationship with the practitioner, then the patient will follow the prescribed course of treatment, say, by taking the medication as prescribed. There is meta-analytic evidence that physician communication is positively correlated with patient adherence; there is almost a 20 percent greater risk of non-adherence if the physician communicates poorly.

However, there is some evidence that makes interpretation of medical adherence studies ambiguous. Not surprisingly, patients have better outcomes if they adhere to effective drug therapies. A meta-analysis of adherence to effective drug therapy and mortality found that the odds of mortality were lower when patients used their medications as directed, not surprisingly, but interestingly odds of mortality were also lower when patients adhered to a placebo as well, suggesting the benefits of adherence might involve a contextual effect as well as a specific effect. Indeed, there several large clinical trials that show that adherence to placebos reduces morbidity and mortality."

In summary, this article suggests that a good relationship between patients and clinicians can improve adherence to treatment, which may in turn lead to better health outcomes. However, the evidence for this relationship is not strong and more research is needed to fully understand the extent of its impact. The article also highlights the importance of social support in healing, particularly for individuals who may be socially isolated or have low levels of perceived loneliness. Loneliness has been found to be a significant predictor of mortality, indicating the importance of addressing social connections in healthcare.

Quiz

  1. What is the purpose of the article?
    A. To summarize the effects of the relationship between patients and clinicians on health outcomes
    B. To discuss the importance of technology in medicine
    C. To provide an overview of natural, specific, and contextual effects on health outcomes
    D. To examine the impact of loneliness on mortality

  2. What are the three effects that compose humans' response to disease and injury?
    A. Natural effects, specific effects, and contextual effects
    B. Social effects, psychological effects, and behavioral effects
    C. Technological effects, physiological effects, and emotional effects
    D. Cognitive effects, physical effects, and cultural effects

  3. What is the primary evidence for the relationship in healing?
    A. Placebos
    B. Somatic medicine
    C. Psychotherapy
    D. All of the above

  4. What is the primary characteristic of the placebo response?
    A. The specific ingredients of the treatment
    B. The cognitive component of the treatment
    C. The emotional component of the treatment
    D. The psychosocial context in which the treatment is given

  5. What is the conclusion of Di Blasi et al.'s review of context effects on health outcomes?
    A. Practitioners who attempted to form a warm and friendly relationship with their patients were more effective than those who kept their consultations impersonal or formal
    B. Providing information in a warm and accepting way produced better health outcomes than a neutral situation
    C. The patient-clinician relationship has a small, but statistically significant effect on healthcare outcomes
    D. All of the above

  6. What are the three effects that compose humans' response to disease and injury, according to the article?
    A) Natural effects, specific effects, and contextual effects
    B) Physical effects, mental effects, and social effects
    C) Immediate effects, long-term effects, and environmental effects
    D) Psychological effects, social effects, and physical effects

  7. What is the term used to describe the interaction between specific ingredients and the relationship in psychotherapy?
    A) Collaborative interaction
    B) Dynamic interaction
    C) Therapeutic interaction
    D) Interactive alliance

  8. According to the article, which of the following is not a benefit of social support for healing?
    A) Reducing pain
    B) Enhancing the immune system
    C) Improving cardiovascular health
    D) Increasing the likelihood of dying from a disease

  9. What is the most predictive construct of mortality related to social isolation, according to the article?
    A) Social support
    B) Perceived loneliness
    C) Physical isolation
    D) Emotional loneliness

  10. Which of the following is not a benefit of good adherence to treatment, according to the article?
    A) Better health outcomes
    B) Reduced morbidity and mortality
    C) Improved mental health
    D) Increased risk of non-adherence

Correct answers

  1. A) To summarize the effects of the relationship between patients and clinicians on health outcomes
  2. A) Natural effects, specific effects, and contextual effects
  3. D) All of the above
  4. D) The psychosocial context in which the treatment is given
  5. A) Practitioners who attempted to form a warm and friendly relationship with their patients were more effective than those who kept their consultations impersonal or formal
  6. A) Natural effects, specific effects, and contextual effects
  7. D) Interactive alliance
  8. D) Increasing the likelihood of dying from a disease
  9. B) Perceived loneliness
  10. D) Increased risk of non-adherence

 

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