PSYC 1113 Chapter 15


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  • Discovering Psy p 513 Table 14.1
  • Discovering Psy p515
  • Discovering PSY Figure 14.5 p534
  • PSYC 1113 Chapter 15

    1. 1. IntroChapter 15: Therapies
    2. 2. Reasons for Seeking Therapy• Psychological disorder—troublingthoughts, feelings, or behaviors that causepsychological discomfort or interfere with aperson’s ability to function• Troubled relationships—e.g., parent-childconflicts, unhappy marriage• Life transitions—e.g., death of a loved one,dissolving marriage, adjustment toretirement
    3. 3. Types of Therapy• Psychotherapy—use of psychologicaltechniques to treat emotional,behavioral, and interpersonal problems• Biomedical—use of medications andother medical therapies to treat thesymptoms associated withpsychological disorders
    4. 4. PsychoanalysisDeveloped by Sigmund Freud based onhis theory of personality
    5. 5. Causes of Psychological Problems• Undesirable urges and conflicts are“repressed” or pushed to the unconscious• Unconscious conflicts exert influence onbehaviors, emotions, and interpersonaldynamics• Understanding and insight into repressedconflicts leads to recognition andresolution
    6. 6. Techniques of Psychoanalysis• Free association—spontaneous report ofall mental images, thoughts, feelings as away of revealing unconscious conflicts• Resistance—patient’s unconsciousattempt to block revelation of unconsciousmaterial; usually sign that patient is closeto revealing painful memories
    7. 7. More Psychoanalytic Techniques• Dream interpretation—dreams are the“royal road to the unconscious”;interpretation often reveals unconsciousconflicts• Transference—process where emotionsoriginally associated with a significantperson are unconsciously transferred tothe therapist
    8. 8. Short-Term Dynamic Therapy• Interpersonal therapy (IPT)—focus oncurrent relationships; interpersonalproblems seen as core ofpsychological symptoms; highlystructured
    9. 9. Other Dynamic Therapies• Most therapies today are shorter-term• Based on goals that are specificand attainable• Therapists are more directivethan traditional psychoanalysis• Traditional psychoanalysis isseldom practiced today
    10. 10. Humanistic Therapies• Humanistic perspective emphasizes humanpotential, self-awareness, and free-will• Humanistic therapies focus on self-perception and individual’s consciousthoughts and perceptions• Client-centered (or person-centered) therapyis the most common form of humanistictherapy• Carl Rogers (1902–1987)—developed thistechnique
    11. 11. Client-Centered Therapy• Therapy is non-directive—therapist doesnot interpret thoughts, make suggestions,or pass judgment• Therapy focuses on client’s subjectiveperception of self and environment• Does not speak of “illness” or “cure”
    12. 12. Therapeutic Conditions• Genuineness—therapist openly sharesthoughts without defensiveness• Unconditional positive regard for client—no conditions on acceptance ofperson• Empathic understanding—creates apsychological mirror reflecting clientsthoughts and feelings
    13. 13. Applications of client-centeredtherapy• Motivational interviewing—only one ortwo sessions; help clients overcomereluctance to change; encourageclient’s self-motivating statements• Marital counseling, parenting,education, business, community andinternational relations
    14. 14. Behavior Therapy• Behavioristic perspective emphasizes thatbehavior (normal and abnormal) is learned• Uses principles of classical and operantconditioning to change maladaptivebehaviors• Behavior change does not require insightinto causes• Often called behavior modification
    15. 15. Systematic Desensitization• Based on classical conditioning• Uses three steps:– Progressive relaxation– Development of anxiety hierarchy andcontrol scene– Combination of progressive relaxationwith anxiety hierarchy
    16. 16. Sample Anxiety Hierarchy
    17. 17. Aversion Therapy for Alcoholism• Relatively ineffective, does not generalizevery well beyond therapy• Pairs an aversive stimulus with theundesired behavior
    18. 18. Token Economy• Based on operant conditioning• Used for behavior modification in groupsettings (prisons, classrooms, hospitals)• Has been successful with severelydisturbed people• Difficult to implement and administer
    19. 19. These graphs depict the changesin three specific sleep-relatedproblem behaviors of a 4 year-oldgirl over the course of behavioraltherapy. The intervention for eachproblem behavior was introducedseparately over several weeks.As you can see, behavior therapyproduced a rapid reduction in therate of each problem behavior.The green area shows themaintenance of desired behaviorchanges over a six-month follow-up.Source: Adapted from Ronen (1991).
    20. 20. Cognitive Therapy• Based on the assumption thatpsychological problems are due tomaladaptive patterns of thinking• Therapy focuses on recognition andalteration of unhealthy thinking patterns
    21. 21. Rational Emotive Therapy• Developed by Albert Ellis• ABC model– Activating Event– Beliefs– Consequences• Identification and elimination of coreirrational beliefs
    22. 22. Aaron Beck’s Cognitive Therapy• Problems due to negative cognitive biasthat leads to distorted perceptions andinterpretations of events• Recognize the bias then test accuracy ofthese beliefs• Therapist acts as model and aims for acollaborative therapeutic climate
    23. 23. Cognitive-Behavioral TherapyIntegrates cognitive and behavioraltechniques. Based on theassumption that thoughts, moods,and behaviors are interrelated
    24. 24. Group and Family Therapy• Group therapy—one or more therapistsworking with several people at the sametime.• Family therapy—based on the assumptionthat the family is a system and treats thefamily as a unit.• Couple therapy—relationship therapy thathelps with difficulty in marriage or othercommitted relationships
    25. 25. Self-Help Groups• Format varies (structured andunstructured)• Many follow a 12-step approach• Have been shown to be very effective• More research needed: reasons foreffectiveness and kinds of people andproblems that benefit from this approach
    26. 26. Effectiveness of Psychotherapy• Most people do not seek help withproblems• Many people report spontaneousremission• Meta-analyses show that psychotherapy ismore effective than no treatment• Generally no differences among the typesof psychotherapy
    27. 27. The rates of improvementfor more than 2,000people in weeklypsychotherapy and for 500people who did not receivepsychotherapy. Clearly,psychotherapyaccelerates both the rateand the degree ofimprovement for thoseexperiencingpsychological problems.SOURCE: McNeilly & Howard,1991.
    28. 28. Eye movement desensitizationreprocessing (EMDR)•Developed by Francis Shapiro•Useful for anxiety and relieving traumaticmemories•Involves following finger waving whileholding mental image of disturbing event,situation, or memory•Lots of criticisms of this approach
    29. 29. •Therapeutic relationship—caring and mutuallyrespectful•Therapist characteristics—caring attitude,ability to listen, sensitive to cultural differences•Client characteristics—motivated, activelyinvolved, emotionally and socially mature•External circumstances—stable living situation,supportive family members can enhanceeffectiveness of therapyFactors in Successful Therapy
    30. 30. Cultural Values and Psychotherapy•Most Western psychotherapy focuses on theindividual, internal causes, burden on client•Collectivistic cultures have more focus on needs ofthe group, less internal causes, burden oncommunity•Native Americans use network therapy•Latino cultures: interdependence overindependence•Japanese psychotherapy uses Naikan therapy: self-absorption leads to suffering; replace self with others
    31. 31. Biomedical Therapies• Widespreaduse ofantipsychoticmedicationsbegan in themid-1950’s• Can be relatedto number ofpatients inmental hospitals
    32. 32. Typical Antipsychotic Medications• Typical antipsychotics– Effective against positive symptoms ofschizophrenia– Have uncomfortable side effects– Globally alter brain dopamine levels– Tardive dyskinesia—possible motor sideeffect that could be permanent with longterm drug use
    33. 33. Atypical Antipsychotic Medications• Atypical antipsychotics– Newer drugs that may also be effectiveagainst negative symptoms of schizophrenia– Affect levels of serotonin as well as dopamine– Have uncomfortable side effects– Symptoms return when medication isdiscontinued
    34. 34. Antianxiety medications• Benzodiazepines (Valium, Xanax)– reduce anxiety through increasing levelof GABA– side effects include decreasedcoordination, reaction time, alertness,addiction• Non-benzodiazepine—(Buspar)– may take a few weeks to work– does not reduce alertness
    35. 35. Lithium• Used to treat bipolar disorder (manic-depression)• Used to interrupt acute manic attacksand prevent relapse• Can have serious side effects andmust be closely monitored
    36. 36. Anti-Depressant Medication• First generation—tricyclics and MAOinhibitors– Effective for about 75% of patients– Produce troubling side effects• MAO inhibitors can have serious physiologicalside effects when taken with some commonfoods• Tricyclics caused weight gain, dry mouth,dizziness, sedation
    37. 37. Anti-Depressant Medication• Second generation—chemically differentbut no more effective than earlier drugs(Wellbutrin, Desyrel)• Selective serotonin reuptake inhibitors(SSRI)—have fewer undesirable sideeffects than earlier drugs (Prozac, Paxil,Zoloft)
    38. 38. Electroconvulsive Therapy• Used for severe depression• Very effective for quick relief of symptomsof severe depression (can be used untilmedication begins to work)• May have cognitive side effects such asmemory loss• Very controversial treatment