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Prescriptive v. Exploratory Psychotherapy

Outcomes of the Sheffield Psychotherapy Project

Published online by Cambridge University Press:  02 January 2018

David A. Shapiro  and
Jenny Firth
David A. Shapiro*
Affiliation:
Medical Research Council/Economic and Social Research Council Social and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield S10 2TN
Jenny Firth
Affiliation:
Medical Research Council/Economic and Social Research Council Social and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield S10 2TN
*
Correspondence
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Abstract

Prior research suggests that psychotherapeutic techniques which differ in their contents are quite similar in their outcomes. Outcome data are reported from a study designed to maximise sensitivity to technique effects on outcome in a clinically realistic setting, and to permit detailed analysis of the relations between content, immediate impact, and outcome of therapy. Forty professional and managerial workers with depression or anxiety received eight sessions of Prescriptive (cognitive/behavioural) and eight sessions of Exploratory (relationship-oriented) therapy in a crossover design, with each client seeing the same therapist throughout. Outcome was assessed by standard interview and questionnaire methods. The results favoured Prescriptive therapy, although this difference was of moderate extent. The outcome was largely unaffected by the order in which the two methods were offered.

Type
Papers
Information
The British Journal of Psychiatry , Volume 151 , Issue 6 , December 1987 , pp. 790 - 799
Copyright
Copyright © Royal College of Psychiatrists, 1987 

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References

Armitage, P. & Hills, M. (1982) The two-period crossover trial. The Statistician, 31, 119–131.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Moat, J. A., Earhaugh, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Moat, J. A. Earhaugh, J., Rush, A. J., Shaw, B. F. & Emery, G. (1980) Cognitive Therapy of Depression. New York: Wiley.Google Scholar
Bergin, A. E. A. Suinn, R. M. (1975) Individual psychotherapy and behavior therapy. Annual Review of Psychology, 26, 509–556.Google Scholar
Bergin, A. E. A. Suinn, R. M. & Lambert, M. J. (1978) The evaluation of therapeutic outcomes. In Handbook of Psychotherapy and Behavior Change: an Empirical Analysis, 2nd edn (eds S. L Garfield A A. E. Bergin). New York: John Wiley.Google Scholar
Bernstein, S. (1984) A case history demonstrating the complementary use of psychodynamic and behavioral techniques in psychotherapy. Psychotherapy, 21, 402–407.Google Scholar
Beutler, L. E. (1979) Toward specific psychological therapies for specific conditions. Journal of Consulting and Clinical Psychology, 47, 882–897.Google Scholar
Birk, L. (1979) Behavior therapy: integration with dynamic psychiatry. Behavior Therapy, 1, 522–526.CrossRefGoogle Scholar
Birk, L. & Brinkley-Birk, A. (1974) Psychoanalysis and behavior therapy. American Journal of Psychiatry, 131, 449–509.Google Scholar
Brady, J. P. (1968) Psychotherapy by combined behavioral and dynamic approach. Comprehensive Psychiatry, 9, 536–543.CrossRefGoogle ScholarPubMed
Brunink, S. A. & Schroeder, H. E. (1979) Verbal therapeutic behavior of expert psychoanalytically-oriented. Gestalt, and behavior therapists. Journal of Consulting and Clinical Psychology, 47, 567–574.Google Scholar
Cronbach, L. J. & Furby, L. (1970) How we should measure ‘change1 - Or should we? Psychological Bulletin, 74, 68–80.CrossRefGoogle Scholar
Derogatis, L. R., Lipman, R. S. & Covi, M. D. (1973) SCL-90, an out-patient rating scale: preliminary report. Psychopharmacology Bulletin, 9, 13–20.Google Scholar
DeRubeis, R., Hollon, S., Evans, M. & Bemis, K. (1982) Can psychotherapies for depression be discriminated? A systematic investigation of cognitive therapy and interpersonal therapy. Journal of Consulting and Clinical Psychology, 50, 744–756.Google Scholar
Elliott, R., James, E., Reimschuessel, C., Cislo, D. & Sack, N. (1985) Significant events and the analysis of immediate therapeutic impacts. Psychotherapy, 22, 620–630.Google Scholar
Ferner, J. D. (1980) Successful Time Management: a Self-teaching Guide. New York: Wiley.Google Scholar
Firth, J. A., Shapiro, D. A. & Parry, G. (1986) The impact of research on the practice of psychotherapy. British Journal of Psychotherapy, 2, 169–179.Google Scholar
Frank, J. D. (1979) The presetat status of outcome studies. Journal of Consulting and Clinical Psychology, 47, 310–316.Google Scholar
Goldberg, D. P. (1972) The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press.Google Scholar
Goldberg, D. P., Hobson, R. F., Maguire, G. P., Margison, F. R., O'Dowd, T., Osborn, M. S. & Moss, S. (1984) The clarification and assessment of a method of psychotherapy. British Journal of Psychiatry, 144, 567–575.Google Scholar
Goldfried, M. R. & Merbaum, M. (1973) Behavior Change Through Self-control. New York: Holt, Rinehart & Winston.Google Scholar
Gomes-Schwartz, B. (1978) Effective ingredients in psychotherapy: prediction of outcome from process variables. Journal of Consulting and Clinical Psychology, 46, 1023–1035.Google Scholar
Hackman, J. R. & Suttle, J. L. (1977) Improving Life at Work: Behavioral Science Approaches to Organizational Change. Santa Monica: Goodyear.Google Scholar
Haardy, G. E. & Shapiro, D. A. (1985) Therapist verbal response modes in prescriptive vs. exploratory psychotherapy. British Journal of Clinical Psychology, 24,Google Scholar
Hill, C. E., Thames, T. B. & Rardin, D. K. (1979) Comparison of Rogers, Peris, and Ellis on the Hill Counselor Verbal Response Category System. Journal of Consulting and Clinical Psychology, 46, 198–208.Google Scholar
Hills, M. & Armitaoe, P. (1979) The two-period cross-over clinical trial. British Journal of Clinical Pharmacology, 8, 7–20.Google Scholar
Hobson, R. F. (1985) Forms of Feeling. London: Tavistock.Google Scholar
Jacobson, N. S., Follette, W. C. & Revenstorf, D. (1984) Psychotherapy outcome research: methods for reporting variability and evaluating clinical significance. Behavior Therapy, 15, 336–352.Google Scholar
Kanfer, F. H. & Goldstein, A. P. (eds) (1975) Helping People Change. New York: Pergamon.Google Scholar
Kazdin, A. E. (1980) Research Design in Clinical Psychology. New York: Harper & Row.Google Scholar
Klein, D. F., Zitrin, C. M., Woerner, M. G. & Ross, D. C. (1983) Treatment of phobias: Behavior therapy and supportive psychotherapy: are there any specific ingredients? Archives of General Psychiatry, 40, 139–145.Google Scholar
Levin, S. M., Hirsch, I. S., Shucar, G. & Kapche, R. (1968) Treatment of homosexuality and heterosexual anxiety with avoidance conditioning and systematic desensitization: data and case report. Psychotherapy, 5, 160–168.Google Scholar
Llewelyn, S. P. & Hume, W. J. (1979) The patient's view of therapy. British Journal of Medical Psychology, 55, 307–317.Google Scholar
Luborsky, L. (1984) Principles of Psychoanalytic Psychotherapy: a Manual for Supportive-Expressive Treatment. New York: Basic Books.Google Scholar
Luborsky, L., Singer, B. & Luborsky, L. (1975) Comparative studies of psychotherapies: is it true that “Everyone has won and all must have prizes”? Archives of General Psychiatry, 32, 995–1008.CrossRefGoogle Scholar
Luborsky, L., Singer, B., Luborsky, L., Woody, G. E., McLellan, A. T., O'Brien, C. P. & Rosenzweic, J. (1982) Can independent judges recognise different psychotherapies? An experience with manual-guided therapies. Journal of Consulting and Clinical Psychology, 50, 49–62.CrossRefGoogle ScholarPubMed
Macuire, G. P., Goldberg, D. P., Hobson, R. F., Margison, F. R., Moss, S. & O'Dowd, T. (1984) Evaluating the teaching of a method of psychotherapy. British Journal of Psychiatry, 144, 576–580.Google Scholar
Margison, F. & Hobson, R. F. (1983) A Conversational Model of Psychotherapy: Videotape Teaching Package. London: Tavistock.Google Scholar
Marmor, J. (1979) Short-term dynamic psychotherapy. American Journal of Psychiatry, 136, 149–155.Google Scholar
McLean, P. D. & Haxstian, A. R. (1979) Clinical depression: comparative efficacy of outpatient treatments. Journal of Consulting and Clinical Psychology, 47, 818–836.Google Scholar
Meichenbaum, D. (1977) Cognitive-Behavior Modification: an Integrative Approach. New York: Plenum.Google Scholar
Meltzoff, J. & Kornreich, M. (1970) Research in Psychotherapy. New York: Atherton Press.Google Scholar
Mintz, J., Luborsky, L. & Christolph, P. (1979) Measuring the outcomes of psychotherapy: findings of the Penn Psychotherapy Project. Journal of Consulting and Clinical Psychology, 47, 319–334.CrossRefGoogle ScholarPubMed
Mulhall, D. (1976) Systematic self-assessment by PQRST. Psychological Medicine, 6, 591–597.Google Scholar
O'Malley, P. M. & Bachman, J. G. (1979) Self-esteem and education: sex and cohort comparisons among high school seniors. Journal of Personality and Social Psychology, 37, 1153–1159.Google Scholar
Paul, G. L. (1967) Strategy of outcome research in psychotherapy. Journal of Consulting Psychology, 31, 109–118.Google Scholar
Rachman, S. & Wilson, G. T. (1980) The Effects of Psychological Therapy, 2nd edn. New York: Pergamon Press.Google Scholar
Roback, H. B. (1971) The comparative influence of insight and non-insight psychotherapies on therapeutic outcome: a review of the experimental literature. Psychotherapy: Theory, Research and Practice, 8, 23–35.Google Scholar
Rosenberg, M. (1965) Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press.Google Scholar
Shapiro, D. A. (1985) Recent applications of meta-analysis in clinical research. Clinical Psychology Review, 5, 13–34.Google Scholar
Shapiro, D. A. & Shapiro, D. (1977) The ‘double standard’ in evaluation of psychotherapies. Bulletin of the British Psychological Society, 30, 209–210.Google Scholar
Shapiro, D. A., Shapiro, D. & Shapiro, D. (1982) Meta-analysis of comparative therapy outcome studies: a replication and refinement. Psychological Bulletin, 92, 581–604.Google Scholar
Shapiro, D. A., Shapiro, D., Shapiro, D. & Shapiro, D. (1983) Comparative therapy outcome research: methodological implications of meta-analysis. Journal of Consulting and Clinical Psychology, 51, 42–53.CrossRefGoogle ScholarPubMed
Shapiro, D. A., Shapiro, D., Shapiro, D., Shapiro, D., Barkham, M. & Irving, D. L. (1984) The reliability of a modified helper behavior rating system. british journal of medical psychology, 57, 45–48.CrossRefGoogle Scholar
Sloane, R. B., Staples, F. R., Cristol, A. H., Yorkston, N. J. & Whipple, K. (1975) Psychotherapy versus Behavior Therapy. Cambridge, MA: Harvard University Press.Google Scholar
Smith, M. L. & Glass, G. V. (1977) Meta-analysis of psychotherapy outcome studies. American Psychologist, 32, 752–760.Google Scholar
Smith, M. L., Glass, G. V. & Miller, T. I. (1980) The Benefits of Psychotherapy. Baltimore: Johns Hopkins University Press.Google Scholar
Snaith, R. P. (1974) Psychotherapy based on relaxation techniques. British Journal of Psychiatry, 124, 473–481.Google Scholar
Stiles, W. B. (1979) Verbal response modes and psychotherapeutic technique. Psychiatry, 42, 49–62.Google Scholar
Stiles, W. B. (1980) Measurement of the impact of psychotherapy sessions. Journal of Consulting and Clinical Psychology, 48, 176–185.Google Scholar
Stiles, W. B. (1984) Client disclosure and psychotherapy session evaluations. British Journal of Clinical Psychology, 23, 311–312.Google Scholar
Stiles, W. B. & Sultan, F. E. (1979) Verbal response mode use by clients in psychotherapy. Journal of Consulting and Clinical Psychology, 47, 611–613.Google Scholar
Stiles, W. B., Sultan, F. E., Shapiro, D. A. & Elliott, R. K. (1986) Are all psychotherapies equivalent? American Psychologist, 41, 165–180.Google Scholar
Strupp, H. H. (1955) An objective comparison of Rogerian and psychoanalytic techniques. Journal of Consulting Psychology, 19, 1–7.Google Scholar
Strupp, H. H. (1957) A multidimensional analysis of therapist activity in analytic and client-centered therapy. Journal of Consulting Psychology, 21, 301–308.Google Scholar
Taylor, M. (1979) Coverdate on Management. London: Hememann.Google Scholar
Wachtel, P. (1977) Psychoanalysis and Behavior Therapy. New York: Basic Books.Google Scholar
Waskow, I. E. (1979) Presidential Address. Oxford: Society for Psychotherapy Research.Google Scholar
Waskow, I. E. & Parloff, M. B. (eds) (1975) Psychotherapy Change Measures. Rockville, Md: National Institute of Mental Health.Google Scholar
Weissman, M. M. & Paykel, E. S. (1974) The Depressed Woman. London: University of Chicago Press.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
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