ISSUES IN PSYCHOTHERAPY: A CRITICAL APPROACH
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Ref No: 3311
Table of Contents
Introduction
This critical review discusses a research based incentral aspects of psychotherapy performed by Fiorella Monti, Lorenzo Tonetti, and Pio Enrico Ricci Bitti at the University of Bologna, Province of Bologna, Italy. The chosen research was published in 2014 in The British Journal of Guidance & Counselling. The journal is an established paradigm of ongoing efforts to promote theoretical and practical research of superior quality in the interacting fields of psychotherapy and counselling.
The paper, titled “Comparison of Cognitive-Behavioural Therapy and Psychodynamic Therapy in the Treatment of Anxiety among University Students: An Effectiveness Study”, was a thorough investigation into the therapeutic efficacy of two recognized and established types of psychotherapy, namely psychodynamic therapy (PDT) cognitive-behavioural therapy (CBT). These methods are practiced by mental health professionals the world over to effectively treat various kinds of psychological conditions, some of which are depression, panic disorder, post-traumatic stress disorder (PTSD), and particularly, anxiety (Hofmann et al., 2014; Shedler, 2012).
The chief outcome of the selected research was that both CBT and PDT were demonstrably found to cause a substantial decrease in the levels of anxiety experienced by the students. From an introspection of this data, the authors were led to form the conclusion that both forms of psychotherapy, although significantly diverse from one another, were successful psychotherapy measures in the treatment of university students suffering from anxiety. Moreover, the study found that no noteworthy variations were apparent between the 2 therapy groups as far as gender, mean age, issues presented at the initial consultation, and the individual GAS results were concerned.
Background information
The focus of the study under scrutiny was on anxiety amongst university-going students. Several relevant studies undertaken in recent years have recognised that psychological conditions are becoming more severe and more prevalent amongst university students worldwide (Baykan & Naçar, 2012; Shamsuddin et al., 2013). With the growing numbers of students besieged with mental health problems and the struggle to cope with them alongside academics and extracurricular activities, there is a proportionally growing demand for the effective counselling services being provided (Murdock, 2016).
This need gave rise to the concern about whether students were being offered beneficial psychological and emotional support by their university counsellingcentresto appease their psychological distress (McLeod, 2014). Although numerous studies have been performed to evaluate the efficiency of student counselling, the primary consideration remains that these researches were orchestrated outside of Italy,therefore prompting the need to a study to be conducted within the country to more accurately portray the estimated efficiency of counselling for its national institutes.
This emphasison university students was preferred for two primary reasons. Firstly, the effective results of treatment with CBT and PDT in the resolution or abatement of various psychological disorders, while having been demonstrated and compared within the adult populations often been compared in adult populations (Driessen et al., 2013), have hardly been concentrated upon in comparative or observational studies in the context of university student counselling. Secondly, anxiety is among the chief difficulties undergone by students who approach universitycounselling services for assistance. This finding was further confirmed by the authors whilst conducting the consultation phase (Regehr, Glancy & Pitts, 2013).
The conduction of the selected research served more than one purpose. Psychological distress in university students poses as apublic health issue because it significantly intrudes with the processes of social and academic growth (Richardson, Abraham & Bond, 2012). Psychotherapyfacilities for university students offer an exclusiveprospect to support students in acknowledging and easing their distress. This is especially beneficial at their current stage of life, which is largelyregarded as aperiod in life with the greatest onset of psychologicalconditions. Speaking from an economic viewpoint, university counselling facilities must establish the efficacy of their therapeutic treatment methods, seeing as how the financially backing organisations will apportion their inadequate monetary resources on the foundation of successful treatment outcomes and efficiency criteria.
The University of Bologna, which was the centre of the research conduction, inaugurated its guidance and counselling facility in 1985, thus establishing itself as one of the pioneer psychiatric support institutions of its kind in all of Italy. The counsellingservices are provided for free for all students of the university who approach the centre. This counselling is classically administered in two distinct phases, the first being 4 sittings long psychosomatic consultation phase, and the second being the course of psychotherapy itself. The need for the second phase is understandable, determined by the first phase.
The research was published in the British Journal of Guidance & Counselling, a recognized and time-honoured scholarly journal that necessitates authentic research, findings, and analysis, prior to publication. Studies are not required to implement a specific pre-set criteria for article layout of thetype of research methodology opted for, however it does necessitate that the particular methodology that is selected is clearly justified. The journal has also fixed a high set of criteria regarding the detailed discussions of the implications and recommendations from the perspective study’s findings to aid future practice. This following of this criteria is obligatory to ensure relevance to the journal. Additionally, a thorough review of relevant literature and acute consideration of new concepts is a prerequisite for all pending submissions. All submitted manuscripts are then also contingent on a primary review by the Editor, and then, if approved, are further subject to double-blindpeer reviews by uninvolved reputable authorities of the field. It was therefore found that the quality of the journal in which the article was published was inarguably satisfactory.
Review of the literature
This study was carried out in the time period from January 2008 through October 2010. Initially, a total number of 40 students were admitted into a CBT course whereas 29 students were selected for PDT sessions at the university’s own counsellingcentre.
Five students from the PDT course and 10 from the CBT grouping opted out of psychotherapy in the duration of the research, leading to inconclusive hence excluded results. Therefore, ultimatelythe sample comprised of 30 patients (24 females) who successfully finished the CBT course at the counsellingcentre, and 24 (20 females) who finished the PDT sessions. The students were from both bachelor’s as well as master’s programs, in unequal numbers. The students belong to both humanities and scientific backgrounds. It needs to be pointed out here that the samples did not consist of equal numbers of students, nor were the students belonging to similar levels of study (bachelors or masters). While this provides a more diverse sample group, it could have implications of minimizing the significance of the results of the study as some aspects of the students are not comparable. The gender of the students who were selected as participants in this research was also overwhelmingly female therefore there was not enough male representation in the sample size to demonstrate credible outcomes in male students undergoing psychotherapy.
The project was initiated with the carrying out of a psychological consultation phase where the therapists gauged the overall functioning of the university students by implementing the Global Assessment Scale (GAS). The GAS was a revised and streamlined update of the Global Assessment of Functioning Scale (GAF) presented in a paper by Endicott et al (1976). This numeric scale is utilized by psychiatric professionals and general practitioners alike to subjectively score the multifaceted functioning of individuals. Marks are allotted from a scale of 100 (exceptionally well-functioning) to 1 (gravely compromised). Utilization of the GAS to indicate symptoms or level of functionality has been demonstrated to perform well as aworldwidegauge of mental health problems and psychosocial debilitations (Pedersen & Karterud, 2012).
The Symptom Questionnaire (SQ) was also utilized and filled out. SQ is able to perceive the vicissitudes stirring throughout psychotherapy treatment. Additionally, it is of interest that SQ was at one point used to equate the efficacy of dissimilarmethods of psychotherapy. SQ’s Italian version was authorised for the purposes of this study. The SQ was opted for as it successfully accounted for characteristics of psychological disquietude as well as welfare(Jason et al., 2015). Furthermore, SQ was applied rather than a measure that specifically evaluates anxiety since anxiety was not the unanimous prominent presentation in every student at the consultation.
The SQ is 92 questions long self-rating scale with a yes or no configuration. It is composed of 4 distress sub-ranges (hostility-irritability, anxiety, somatization, and depression,) and 4 wellness sub-ranges (sociability, relaxation, bodily health, and contentment). The summation of both sets of scores results in the final marks and hence the patient outcome. Patients filled out the SQ survey twice, once at the commencement of psychotherapy and once following course conclusion.The overwhelming majority of the students that were patients of the 2 therapies were revealed to be afflicted with anxiety.
To ascertain whether both crowds of students were corresponding preceding treatment, the socio-and graphic stats and the overall scores of the SQ scale evaluated at the initiation of the treatment were matchedto the results upon successful completion of PDT and CBT. With regards to sex, mean age and GASprior to treatment commencement, no momentousvariance was seen between either of the psychotherapy groups………………………………….continued
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