Hope and Placebo in Counseling - Essay Example

Hope and Placebo in Counseling Student’s Name Institutional Affiliation Date Hope and Placebo in Counseling Introduction The placebo effect can be defined as the changes that are experienced by a person as a result of them being subjected to some levels of the placebo manipulation. The placebo itself is the procedure or substance which lacks the inherent power of producing a particular effect which is expected or sought (Kelley et al., 2009). On the other hand, in counseling, hope is considered as a dynamic process whereby a client and the counselor usually interact in particular ways which can be influencing mutually (Carroll et al., 2004). Hope and the placebo effects are excellent activators of self-healing. Therefore, counselors can use hope and placebo in shaping some positive expectations which also usually tends to impact the strength of the client in dealing with the negative symptoms (Kelley et al., 2009). The paper will, therefore, seek to evaluate hope and placebo as an effective approach in counseling which helps the client psychologically in dealing with negative health symptoms. There has been a significant amount of interest of the placebo effect in the clinical and the scientific communities for decades (Lambert, 2005). Many counselors and other medical practitioners have been utilizing placebos until the 1930s as a substitute for the inert treatment for the rather dangerous drugs or used to reassure the patients when there was the lack of actual treatment that existed at the time (Lambert, 2005). Therefore, during this period, the use of placebos could not be regarded as malicious but as a medical practice. It is important to mention some of the other names which are used to refer to the placebo effect which includes the meaning response, context effects, as well as the expectancy effects (Lambert, 2005). Various non-specific treatment aspects have the ability to determine the size and direction of the placebo effect as well as give hope to the clients. These aspects may entail different clinical interventions which include surgery, devices, pills, gestures, and words (Finniss et al., 2010). Each of these aspects can play a role in addressing got conveying the confidence of the practitioner regarding a given treatment, their professional status, as well as show the empathy with a given patient. It is argued that placebo is not just an inert pill (Finniss et al., 2010). This was followed by research which depicted that there is no difference between no treatment and the placebo treatment. However, the same study illustrated that there was a great difference between the negative and the positive statements regarding prognosis (Finniss et al., 2010). Additionally, it is evident that the words of a particular medical practitioner which they use with the aim of creating expectations are crucial to how the patient will deal with the symptoms of their illnesses (Finniss et al., 2010). Hope installation and maintenance are very critical to the counseling field because having faith in a given mode of treatment is considered to be therapeutically useful in itself (Kelley et al., 2009). Various studies have depicted the effect of having high expectations of assisting others before the beginning of counseling usually has a significant positive therapeutic effect (Kelley et al., 2009). Additionally, it has been argued that the placebo effects in counseling could be traced back to the verbal cues. Additionally, there is also a possibility of the placebo remedy by itself to possess a powerful influence. For instance, the more actively the placebo involves the patient or, the more invasive it becomes, then the higher the placebo effect (Kelley et al., 2009). Various legislations exist which address the issues to do with placebo and hope in counseling. Some of these regulations can be found in the Belmont Report, Declaration of Helsinki, and the Nuremberg Code (La Vaque & Rossiter, 2001). All of these documents have documented the frameworks which intend to guide on how to protect human participants in the process. This is because of some significant risks which are associated with the placebo controls. Following this, the medical practitioners and researchers are required to abide by these legislations as well as the ethical guidelines documented in the Office for Protection from Research Risk (OPRR) to ensure that the participants are always protected whatsoever (La Vaque & Rossiter, 2001). Various models and theories can be used to describe the use and effectiveness of hope and placebo in counseling some of which include the psychosocial model, expectancy theory, and the Pavlovian theory. The psychosocial model of placebo effect emphasizes the importance of evaluating the psychosocial context which exists around a patient (Pratt & Wilkinson, 2003). The placebo effect is considered to be a psychological phenomenon which can be attributed to various mechanisms some of which include one having the expectation of either conditioning or clinical improvement. Additionally, there is no one particular placebo effect, but rather they are several. Therefore, since the placebo effects are several, it becomes an aspect to be put into consideration when evaluating the placebo effects (Pratt & Wilkinson, 2003). Precisely, the aspect of the placebo effect can just be conceptualized as a construct because there are various psychological and biological shifts which entail the placebo phenomenon (Pratt & Wilkinson, 2003). The expectancy theory describes that expectancy is just a consciously accessible belief regarding a given situation. According to this theory, the conditioning trials usually result in some expectation levels about what needs to take place in a particular stimulus (Kirsch, 2004). Therefore, this expectation is what accounts for the observed effects the placebo. This means that since client usually expects a suggested reaction, it is what often results in the actual generation of that particular response (Kirsch, 2004). Additionally, since expectations usually have some intentionality property or are usually anticipatory, then accessing this expectancy is what puts it within a given intentional state which means that the placebo effect can be regarded as intentional (Pollo et al., 2001). However, the criticism of this particular theory regarding the placebo effect is that it does not place the client’s body at the core of these placebo effects (Pollo et al., 2001). The Pavlovian theory seeks to explain the placebo effect by using the model of the original stimulus substitution. Various studies have depicted that indeed conditioning can also take place in human beings (Wagner & Brandon, 2001). This is following the findings that the unconditioned stimuli are the active medication, the techniques, and methods which are utilized to give treatments are the conditioned stimuli, and the conditioned response becomes the placebo effect (Wagner & Brandon, 2001). However, there is an assumption that the human conditioning fails to incorporate cognition which means that it takes place without the patient knowing it. Therefore, the patient’s placebo effect will be dependent on their learning history (Brandon et al., 2000). According to this theory, some of the other determinants of the placebo effects include the behaviors and the verbal suggestions which are manifested by the counselors. In the psychiatric research, the utilization of placebo has been an issue for a while. The Helsinki Declaration seems to be contradicting the use of placeboes if the effective treatment of the client’s condition is known (La Vaque & Rossiter, 2001). Also, according to studies, the use of placebo is accepted in the disorders which are associated or characterized by the fluctuating course with only minimal chances that a delay in the necessary treatment would result in permanent damage. It is evident that many of the psychiatric disorders usually have a fluctuating course (Carroll et al., 2004). Additionally, it is important to consider the public health implications when approving ineffective treatment. Following this, since the placebo use may reduce this particular risk, the approach is a greater good (Carroll et al., 2004). Various studies have undertaken to discuss the numerous benefits of using the placebo, but in the same light, it is also imperative to understand the potential risks of placebo (Kelley et al., 2009). Some of the primary risks which are associated with the utilization of placebo are grouped into the permanent serious harm, increased mortality, as well as the reversible but discomfort or severe harm. However, when the placebo is compared to some of the active treatments for the anti-depressants, studies have depicted that there are no enhanced suicide risks in the patients who are treated with the placebo (Kelley et al., 2009). The counterarguments about this use of placebo are that it usually associated with a substantial amount of burden against and compared to the other new treatments which make it not worth the risk of using it (Finniss et al., 2010). Some of the other situations, where the placebo controls have become controversial, involve the studies whereby a known effective therapy is or have the probability of being withheld. Other situations include when the disorder or the disease has detrimental implications for the health of the clients, and when the side effects of using placebo turn out to be intolerable for the clients (Finniss et al., 2010). According to research, the substitute for the active trials versus the placebo would be for a given new treatment to be compared to a treatment that is already established so that to determine the one that is most appropriate and efficient (Pollo et al., 2001). Following these concerns, it is paramount to also take into consideration that the placebo treatment is usually not the same and equal to non-treatment. A particular meta-analysis study portrayed that about 25% of research failed to differentiate placebo and the active antipsychotics (Pollo et al., 2001). Therefore, this suggests that despite the placebo being meant to be some inert procedure, it indeed has some impacts on these people who receive it (Pollo et al., 2001). Application of Placebo in Counseling The installation of hope usually provides some level of inspiration to help the patients to cope with the demands that are placed upon them actively. Following this, counselors are trained and therefore, understand the ways in which they can take to provide this hope to the patients (Lambert & Barley, 2001). Additionally, the counselor needs to consider the emotional bond that exists between them and the client. When the counselor strives to enhance the therapeutic relationship between them and the patient, then they as well tend to improve the placebo’s response strength (Lambert & Barley, 2001). Counselors can also improve the therapeutic relationship through using the basic counseling skills like trustworthiness, unconditional positive regard, congruence, empathy, as well as active listening (Lambert & Barley, 2001). Thus, the counselors can oversee to achieve a strong placebo effect through strengthening their relationships with their client as there is a lot of power in a healthy therapeutic relationship. The counselors' interactions with their client, as well as their shared experiences, are another way in which placebo or expectancy may be influenced (Imel & Wampold, 2008). These interactions have the possibility of providing some non-specific benefits like improving the moods, reducing anxiety, and reducing stress. The counselor’s interaction and personality with the patient may result in some outcomes which are independent of any particular treatment (Imel & Wampold, 2008). This means that the counselors’ enthusiasm and positivity has a desirable outcome. This, therefore, means that just believing in the counseling process and the way it could result in the expected result, then the counselor increases the probability of their success of that counseling (Imel & Wampold, 2008). Counselors can be efficient in influencing the placebo effect in one way or the other through conducting their work with their patients by the utilization of enthusiastic and positive language, interaction and personality styles, and a healthy therapeutic alliance (Lambert, 2005). The placebo treatment works very well with the ability of the counselor’s positive approach to working with their patients. The counselors can, therefore, enhance the placebo response through increasing their patient’s confidence demeanor that a particular treatment will work (Lambert & Barley, 2001). Through starting the therapeutic work with a client from a rather positive standpoint, then a greater enthusiasm by the patient is achieved. Conclusion Hope and the placebo effects are regarded as great healing motivators. This is because they tend to bring about some positive influences on a patient which significantly helps them when they are dealing with negative symptoms. Some regulations regarding placebo effects can be found in the Belmont Report, Declaration of Helsinki, and the Nuremberg Code which guide the way the patients and participants need to be handled during the placebo trials. Some of the theories that can be used to explain the placebo effect include the Pavlovian theory, expectancy theory, and the psychosocial model. Hope and placebo can be used in counseling in various ways like strengthening the therapeutic relationship between counselor and client, enhancing their positive interactions and personality, as through increasing the confidence of the client in having a positive outcome from their treatment. References Brandon, S. E., Vogel, E. H., & Wagner, A. R. (2000). A componential view of configural cues in generalization and discrimination in Pavlovian conditioning. Behavioural brain research, 110(1): 67-72. Carroll, K. M., Fenton, L. R., Ball, S. A., Nich, C., Frankforter, T. L., Shi, J., & Rounsaville, B. J. (2004). Efficacy of Disulfiram and Cognitive Behavior Therapy in Cocaine-DependentOutpatients: A Randomized Placebo-Controlled Trial. Archives of general psychiatry, 61(3): 264-272. Finniss, D. G., Kaptchuk, T. J., Miller, F., & Benedetti, F. (2010). Biological, clinical, and ethical advances of placebo effects. The Lancet, 375(9715): 686-695. Imel, Z., & Wampold, B. E. (2008). The importance of treatment and the science of common factors in psychotherapy. Handbook of counseling psychology, 4, 249-266. Kelley, J. M., Lembo, A. J., Ablon, J. S., Villanueva, J. J., Conboy, L. A., Levy, R., ... & Riess, H. (2009). Patient and practitioner influences on the placebo effect in irritable bowel syndrome. Psychosomatic medicine, 71(7): 789-790. Kirsch, I. (2004). Conditioning, expectancy, and the placebo effect: comment on Stewart-Williams and Podd (2004). La Vaque, T. J., & Rossiter, T. (2001). The ethical use of placebo controls in clinical research: the Declaration of Helsinki. Applied psychophysiology and biofeedback, 26(1): 23-37. Lambert, M. J. (2005). Early response in psychotherapy: Further evidence for the importance of common factors rather than “placebo effects”. Journal of clinical psychology, 61(7): 855-869. Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, research, practice, training, 38(4): 357. Pollo, A., Amanzio, M., Arslanian, A., Casadio, C., Maggi, G., & Benedetti, F. (2001). Response expectancies in placebo analgesia and their clinical relevance. Pain, 93(1): 77-84. Pratt, R., & Wilkinson, H. (2003). A psychosocial model of understanding the experience of receiving a diagnosis of dementia. Dementia, 2(2): 181-199. Wagner, A. R., & Brandon, S. E. (2001). A componential theory of Pavlovian conditioning. Handbook of contemporary learning theories, 23-64. Read More

Hope installation and maintenance are very critical to the counseling field because having faith in a given mode of treatment is considered to be therapeutically useful in itself (Kelley et al., 2009). Various studies have depicted the effect of having high expectations of assisting others before the beginning of counseling usually has a significant positive therapeutic effect (Kelley et al., 2009). Additionally, it has been argued that the placebo effects in counseling could be traced back to the verbal cues.

Additionally, there is also a possibility of the placebo remedy by itself to possess a powerful influence. For instance, the more actively the placebo involves the patient or, the more invasive it becomes, then the higher the placebo effect (Kelley et al., 2009). Various legislations exist which address the issues to do with placebo and hope in counseling. Some of these regulations can be found in the Belmont Report, Declaration of Helsinki, and the Nuremberg Code (La Vaque & Rossiter, 2001).

All of these documents have documented the frameworks which intend to guide on how to protect human participants in the process. This is because of some significant risks which are associated with the placebo controls. Following this, the medical practitioners and researchers are required to abide by these legislations as well as the ethical guidelines documented in the Office for Protection from Research Risk (OPRR) to ensure that the participants are always protected whatsoever (La Vaque & Rossiter, 2001).

Various models and theories can be used to describe the use and effectiveness of hope and placebo in counseling some of which include the psychosocial model, expectancy theory, and the Pavlovian theory. The psychosocial model of placebo effect emphasizes the importance of evaluating the psychosocial context which exists around a patient (Pratt & Wilkinson, 2003). The placebo effect is considered to be a psychological phenomenon which can be attributed to various mechanisms some of which include one having the expectation of either conditioning or clinical improvement.

Additionally, there is no one particular placebo effect, but rather they are several. Therefore, since the placebo effects are several, it becomes an aspect to be put into consideration when evaluating the placebo effects (Pratt & Wilkinson, 2003). Precisely, the aspect of the placebo effect can just be conceptualized as a construct because there are various psychological and biological shifts which entail the placebo phenomenon (Pratt & Wilkinson, 2003). The expectancy theory describes that expectancy is just a consciously accessible belief regarding a given situation.

According to this theory, the conditioning trials usually result in some expectation levels about what needs to take place in a particular stimulus (Kirsch, 2004). Therefore, this expectation is what accounts for the observed effects the placebo. This means that since client usually expects a suggested reaction, it is what often results in the actual generation of that particular response (Kirsch, 2004). Additionally, since expectations usually have some intentionality property or are usually anticipatory, then accessing this expectancy is what puts it within a given intentional state which means that the placebo effect can be regarded as intentional (Pollo et al., 2001). However, the criticism of this particular theory regarding the placebo effect is that it does not place the client’s body at the core of these placebo effects (Pollo et al., 2001). The Pavlovian theory seeks to explain the placebo effect by using the model of the original stimulus substitution.

Various studies have depicted that indeed conditioning can also take place in human beings (Wagner & Brandon, 2001). This is following the findings that the unconditioned stimuli are the active medication, the techniques, and methods which are utilized to give treatments are the conditioned stimuli, and the conditioned response becomes the placebo effect (Wagner & Brandon, 2001).

Read More