T001/Discussion Board 300 words

Module 3: Discussion - Discussion Group 3 1 Decisions and Therapeutic Efficacy of the counseling psychologist is one of great responsibility. Like a physician, the psychologist is perceived by the patient to be an *expert* in the field. Also like the physician, the psychologist is ethically bound to “do no harm” when providing treatment. Therefore, clinical decisions about the treatment approach to use with a client, and whether or not to continue the treatment over time, carry significant weight. Yet, frequently, there are vulnerable clients—who trust the counseling expert—subjected to a treatment approach for which there is little or no evidence of efficacy. For example, it is a common assumption that a strong relationship between the counselor and client (known as “therapeutic alliance”) will improve treatment outcomes, and clinicians typically spend the first sessions of therapy establishing rapport. However, several meta-analyses found that therapeutic alliance accounts for only about 6% of the variance in the outcomes of therapy, with several longitudinal studies suggesting that greater treatment effectiveness early on in therapy may produce stronger therapeutic alliance, as opposed to stronger alliance producing greater treatment effectiveness (see Waller & Turner, 2016, for a review). Other examples of therapies that lack evidence of effectiveness but are still being used include facilitated communication for individuals with Autism, recovered memory techniques for possible victims of sexual abuse, “gay therapy” to reverse homosexuality, and boot camps for adolescents with conduct disorder (Lilienfeld, 2007). In fact, most of these therapies cause harm to the client. Using counseling therapy as the context, discuss the *cognitive errors* that can arise on the part of *both* the therapist and the client. Use specific hypothetical examples to make your points, and cite your text or other readings for support. In addition to decisions made prior to treatment, think about how perceptions of the client’s therapy progress and eventual therapy outcomes are influenced by past experiences and subsequently serve to influence future decisions.