Chapter 13 Therapies
Chapter 13 Overview <ul><li>Insight therapies </li></ul><ul><li>Relationship therapies </li></ul><ul><li>Behavior therapie...
Insight Therapies <ul><li>Approaches to psychotherapy based on the notion that psychological well-being depends on self-un...
What are the basic techniques of psychodynamic therapies? <ul><li>Psychotherapies that attempt to uncover repressed childh...
What are the basic techniques of psychodynamic therapies? <ul><li>Object relations therapy </li></ul><ul><ul><li>Based on ...
What is the goal of the therapist in person-centered therapy? <ul><li>Humanistic therapies  assume that people have the ab...
What is the major emphasis of Gestalt therapy? <ul><li>Helps clients fully experience their feelings, thoughts, and action...
Relationship Therapies <ul><li>Therapies that attempt to improve patients’ interpersonal relationships or create new relat...
What are the goals of family and couple therapy? <ul><li>Family therapy </li></ul><ul><ul><li>Parents and children enter t...
What are some advantages of group therapy? <ul><li>A group of clients (usually seven to ten) meets regularly with one or m...
Behavior Therapies <ul><li>A treatment approach that is based on the idea that abnormal behavior is learned and that appli...
How do behavior therapists modify clients’ problematic behavior? <ul><li>Uses reinforcement to shape or increase frequency...
What behavior therapies are based on classical conditioning and social-cognitive theory? <ul><li>Systematic desensitizatio...
What behavior therapies are based on classical conditioning and social-cognitive theory? <ul><li>Flooding  is behavior the...
Cognitive Therapies <ul><li>Therapies that assume maladaptive behavior can result from irrational thoughts, beliefs, and i...
What is the aim of rational emotive therapy? <ul><li>Developed by Albert Ellis </li></ul><ul><li>A  directive  form of the...
How does Beck’s cognitive therapy help people overcome depression and panic disorder? <ul><li>Cognitive therapy ,   design...
Biomedical Therapies <ul><li>Therapies (drug, therapy electroconvulsive therapy, or psychosurgery) that are based on the a...
What are the advantages and disadvantages of using drugs to treat psychological disorders? <ul><li>Antipsychotic drugs </l...
What are the advantages and disadvantages of using drugs to treat psychological disorders? <ul><li>Antidepressant drugs </...
What are the advantages and disadvantages of using drugs to treat psychological disorders? <ul><li>Drugs can have unpleasa...
What is electroconvulsive therapy (ECT) used for? <ul><li>Electric current is administered to the right cerebral hemispher...
What is psychosurgery, and for what problems is it used? <ul><li>Brain surgery performed to alleviate serious psychologica...
Evaluating the Therapies <ul><li>Therapies share many similarities.  Therapists use a core set of techniques no matter whi...
What therapy, if any, is most effective in treating psychological disorders? <ul><li>Smith et al. (1980) analyzed 475 stud...
What therapy, if any, is most effective in treating psychological disorders? <ul><li>A large survey of psychotherapy clien...
The Therapeutic Relationship <ul><li>When establishing a relationship with a therapist, it is important to become familiar...
What distinguishes one type of therapist from another, and what ethical standards are shared by all types of therapists? <...
What distinguishes one type of therapist from another, and what ethical standards are shared by all types of therapists? <...
What are the characteristics of culturally sensitive therapy? <ul><li>An approach to therapy in which knowledge of clients...
Why is gender-sensitive therapy important? <ul><li>An approach to therapy that takes into account the effects of gender on...
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Ch13 Wood 3e

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Ch13 Wood 3e

  1. 1. Chapter 13 Therapies
  2. 2. Chapter 13 Overview <ul><li>Insight therapies </li></ul><ul><li>Relationship therapies </li></ul><ul><li>Behavior therapies </li></ul><ul><li>Cognitive therapies </li></ul><ul><li>Biomedical therapies </li></ul><ul><li>Evaluating the therapies </li></ul><ul><li>The therapeutic relationship </li></ul>
  3. 3. Insight Therapies <ul><li>Approaches to psychotherapy based on the notion that psychological well-being depends on self-understanding </li></ul>
  4. 4. What are the basic techniques of psychodynamic therapies? <ul><li>Psychotherapies that attempt to uncover repressed childhood experiences that are thought to cause the patient’s current problems </li></ul><ul><li>Psychoanalysis is a technique developed by Freud </li></ul><ul><ul><li>Free association </li></ul></ul><ul><ul><ul><li>Explores the unconscious by having patients reveal whatever thoughts, feelings, or images come to mind </li></ul></ul></ul><ul><ul><li>Dream analysis </li></ul></ul><ul><ul><ul><li>Areas of emotional concern repressed in waking life are sometimes expressed in symbolic form in dreams </li></ul></ul></ul><ul><ul><li>Transference </li></ul></ul><ul><ul><ul><li>Emotional reaction that occurs during psychoanalysis, in which the patient displays feelings and attitudes toward the analyst that were present in another significant relationship </li></ul></ul></ul>
  5. 5. What are the basic techniques of psychodynamic therapies? <ul><li>Object relations therapy </li></ul><ul><ul><li>Based on idea that early relationships form blueprints for future relationships </li></ul></ul><ul><ul><li>Therapist helps clients restructure current relationships, changing maladaptive patterns formed in early relationships </li></ul></ul><ul><li>Interpersonal therapy </li></ul><ul><ul><li>Brief psychotherapy that helps clients understand and cope with four interpersonal problems associated with depression </li></ul></ul><ul><ul><ul><li>Severe response to death of a loved one </li></ul></ul></ul><ul><ul><ul><li>Interpersonal role disputes </li></ul></ul></ul><ul><ul><ul><li>Difficulty adjusting to role transitions </li></ul></ul></ul><ul><ul><ul><li>Deficits in interpersonal skills </li></ul></ul></ul>
  6. 6. What is the goal of the therapist in person-centered therapy? <ul><li>Humanistic therapies assume that people have the ability and freedom to lead rational lives and make rational choices </li></ul><ul><ul><li>Founded by Carl Rogers (1951) </li></ul></ul><ul><li>Therapists show empathy and create a climate of unconditional positive regard </li></ul><ul><ul><li>Goal is to allow the client to direct the therapy session and move toward self-actualization </li></ul></ul><ul><ul><ul><li>The patient’s realization of his inner potential </li></ul></ul></ul>
  7. 7. What is the major emphasis of Gestalt therapy? <ul><li>Helps clients fully experience their feelings, thoughts, and actions </li></ul><ul><ul><li>Emphasizes clients taking responsibility for their behavior, instead of blaming society or parents </li></ul></ul><ul><ul><li>Goal is to help the client resolve past conflicts, achieve a more integrated self, and become more self-accepting </li></ul></ul><ul><li>Gestalt therapy is directive </li></ul><ul><ul><li>Therapist actively directs the therapy session </li></ul></ul><ul><ul><li>Provides answers and suggestions to the client </li></ul></ul>
  8. 8. Relationship Therapies <ul><li>Therapies that attempt to improve patients’ interpersonal relationships or create new relationships to support patients’ efforts to address psychological problems </li></ul>
  9. 9. What are the goals of family and couple therapy? <ul><li>Family therapy </li></ul><ul><ul><li>Parents and children enter therapy as a group </li></ul></ul><ul><ul><li>Goal is to help family members heal wounds to the family, improve communication, and create more understanding within the family </li></ul></ul><ul><li>Couple therapy </li></ul><ul><ul><li>Goal is to help partners in an intimate relationship communicate and manage conflicts more effectively </li></ul></ul><ul><ul><li>May focus on behavioral change or partners’ emotional responses to each other </li></ul></ul>
  10. 10. What are some advantages of group therapy? <ul><li>A group of clients (usually seven to ten) meets regularly with one or more therapists </li></ul><ul><li>Provides client with a sense of belonging and opportunity to </li></ul><ul><ul><li>Express feelings </li></ul></ul><ul><ul><li>Get feedback from other group members </li></ul></ul><ul><ul><li>Give and receive emotional support </li></ul></ul><ul><li>Self-help groups </li></ul><ul><ul><li>People with similar problems who meet regularly, usually without a professional therapist </li></ul></ul>
  11. 11. Behavior Therapies <ul><li>A treatment approach that is based on the idea that abnormal behavior is learned and that applies the principles of operant conditioning, classical conditioning, and/or observational learning to eliminate inappropriate or maladaptive behaviors and replace them with more adaptive responses </li></ul>
  12. 12. How do behavior therapists modify clients’ problematic behavior? <ul><li>Uses reinforcement to shape or increase frequency of desirable behavior </li></ul><ul><ul><li>e.g., Token economy </li></ul></ul><ul><li>Extinguishes undesirable or maladaptive behavior by terminating or withholding reinforcement that maintains the behavior </li></ul><ul><ul><li>e.g., Timeout </li></ul></ul>
  13. 13. What behavior therapies are based on classical conditioning and social-cognitive theory? <ul><li>Systematic desensitization is behavior therapy based on classical conditioning </li></ul><ul><ul><li>Used to treat fears </li></ul></ul><ul><ul><ul><li>Client is trained to relax while being confronted with a graduated series of anxiety-producing situations </li></ul></ul></ul><ul><ul><ul><li>Eventually, client can stay relaxed while confronting even the most feared situation </li></ul></ul></ul><ul><li>Participant modeling is behavior therapy based on Albert Bandura’s principles of observational learning </li></ul><ul><ul><li>A model demonstrates appropriate responses to a feared stimulus in graduated steps </li></ul></ul><ul><ul><li>Client then imitates the model with encouragement of a therapist </li></ul></ul><ul><ul><li>Using this technique, most specific phobias can be extinguished in 3 to 4 hours </li></ul></ul>
  14. 14. What behavior therapies are based on classical conditioning and social-cognitive theory? <ul><li>Flooding is behavior therapy based on classical conditioning </li></ul><ul><ul><li>Used to treat phobias by exposing clients to the feared object or event for an extended period, until their anxiety decreases </li></ul></ul><ul><li>Exposure and response prevention is behavior therapy </li></ul><ul><ul><li>Exposes patients with obsessive-compulsive disorder to stimuli that trigger obsessions and compulsive rituals, while patients resist performing the compulsive rituals for progressively longer periods of time </li></ul></ul><ul><li>Aversion therapy is behavior therapy </li></ul><ul><ul><li>An aversive stimulus is paired with a harmful or socially undesirable behavior until the behavior becomes associated with pain or discomfort </li></ul></ul>
  15. 15. Cognitive Therapies <ul><li>Therapies that assume maladaptive behavior can result from irrational thoughts, beliefs, and ideas </li></ul>
  16. 16. What is the aim of rational emotive therapy? <ul><li>Developed by Albert Ellis </li></ul><ul><li>A directive form of therapy </li></ul><ul><li>Goal is to challenge and modify a client’s irrational beliefs about themselves and others </li></ul><ul><ul><li>Which are believed to be the causes of personal distress </li></ul></ul>
  17. 17. How does Beck’s cognitive therapy help people overcome depression and panic disorder? <ul><li>Cognitive therapy , designed by Aaron Beck, helps clients stop their negative thoughts as they occur and replace them with more objective thoughts </li></ul><ul><ul><li>Depression is treated by brief cognitive therapy, usually 10-20 sessions, and is more effective than antidepressant drugs </li></ul></ul><ul><ul><li>Panic disorder is treated by teaching clients to change the catastrophic interpretations of their symptoms to prevent them from escalating into panic, usually effective with 3 months of treatment </li></ul></ul>
  18. 18. Biomedical Therapies <ul><li>Therapies (drug, therapy electroconvulsive therapy, or psychosurgery) that are based on the assumption that psychological disorders are symptoms of underlying physical problems </li></ul>
  19. 19. What are the advantages and disadvantages of using drugs to treat psychological disorders? <ul><li>Antipsychotic drugs </li></ul><ul><ul><li>Prescribed primarily for schizophrenia </li></ul></ul><ul><ul><li>Used to treat symptoms such as hallucinations, delusions, and disorganized behavior </li></ul></ul><ul><ul><li>Work by inhibiting dopamine activity </li></ul></ul><ul><li>Lithium </li></ul><ul><ul><li>Used to treat bipolar disorder </li></ul></ul><ul><ul><li>Reduces both manic and depressive episodes </li></ul></ul><ul><li>Antianxiety drugs </li></ul><ul><ul><li>Benzodiazepines are effective for treating generalized anxiety disorder and panic disorder </li></ul></ul><ul><ul><ul><li>This family of minor tranquilizers includes Valium and Xanax </li></ul></ul></ul>
  20. 20. What are the advantages and disadvantages of using drugs to treat psychological disorders? <ul><li>Antidepressant drugs </li></ul><ul><ul><li>Act as mood elevators for people who are severely depressed </li></ul></ul><ul><ul><li>Selective serotonin reuptake inhibitors (SSRIs) </li></ul></ul><ul><ul><ul><li>Block the reuptake of serotonin , increasing its availability at the synapses of the brain </li></ul></ul></ul><ul><ul><ul><li>Are effective for treating major depression, OCD, social phobia, panic disorder, generalized anxiety disorder, and binge eating </li></ul></ul></ul>
  21. 21. What are the advantages and disadvantages of using drugs to treat psychological disorders? <ul><li>Drugs can have unpleasant or dangerous side effects </li></ul><ul><li>It is difficult to establish proper dosages </li></ul><ul><li>Drugs do not cure psychological disorders </li></ul><ul><ul><li>So relapse is likely if drug therapy is discontinued </li></ul></ul><ul><li>Availability of antipsychotic drugs led to a trend away from hospitalization, which may have increased homelessness among people with schizophrenia </li></ul>
  22. 22. What is electroconvulsive therapy (ECT) used for? <ul><li>Electric current is administered to the right cerebral hemisphere </li></ul><ul><ul><li>While patient is under anesthesia </li></ul></ul><ul><ul><li>Usually reserved for severely depressed patients who are suicidal </li></ul></ul><ul><li>ECT was misused and overused in the 1940s and 1950s, leading to a bad reputation </li></ul><ul><li>But it can be a highly effective treatment for major depression </li></ul>
  23. 23. What is psychosurgery, and for what problems is it used? <ul><li>Brain surgery performed to alleviate serious psychological disorders or unbearable chronic pain </li></ul><ul><li>Lobotomy </li></ul><ul><ul><li>Severs neural connections between frontal lobes and deeper centers involved in emotion </li></ul></ul><ul><ul><li>No longer performed, because it leaves patients in permanent deteriorated condition </li></ul></ul><ul><li>Cingulotomy </li></ul><ul><ul><li>Destroys cingulum </li></ul></ul><ul><ul><li>Can help in extreme cases of OCD </li></ul></ul><ul><li>Psychosurgery is controversial, and is considered experimental and a last resort </li></ul><ul><ul><li>Because results are unpredictable and permanent </li></ul></ul>
  24. 24. Evaluating the Therapies <ul><li>Therapies share many similarities. Therapists use a core set of techniques no matter which perspective of therapy session they adopt, but at the same time, each therapeutic approach has elements that distinguish it from others. </li></ul>
  25. 25. What therapy, if any, is most effective in treating psychological disorders? <ul><li>Smith et al. (1980) analyzed 475 studies with 25,000 clients </li></ul><ul><ul><li>Found that psychotherapy was better than no treatment </li></ul></ul><ul><ul><li>But no one type of psychotherapy was more effective than another </li></ul></ul><ul><li>Eysenck (1994) reanalyzed the same studies </li></ul><ul><ul><li>Reported that behavior therapy has a slight advantage over other types of therapies </li></ul></ul>
  26. 26. What therapy, if any, is most effective in treating psychological disorders? <ul><li>A large survey of psychotherapy clients conducted by Consumer Reports found that </li></ul><ul><ul><li>Overall, clients believed that they benefited substantially from psychotherapy </li></ul></ul><ul><ul><li>Clients were equally satisfied with therapy provided by psychologists, psychiatrists, and social workers </li></ul></ul><ul><ul><li>The longer clients stayed in therapy, the more they improved </li></ul></ul><ul><ul><li>Clients believed that antidepressant and antianxiety drugs helped them; but overall psychotherapy alone worked as well as psychotherapy plus drugs </li></ul></ul>
  27. 27. The Therapeutic Relationship <ul><li>When establishing a relationship with a therapist, it is important to become familiar with the various professionals who offer therapeutic services. </li></ul>
  28. 28. What distinguishes one type of therapist from another, and what ethical standards are shared by all types of therapists? <ul><li>A Psychologist </li></ul><ul><ul><li>Has an advanced degree, usually a doctorate, in psychology </li></ul></ul><ul><ul><li>Clinical psychologists generally diagnose and treat psychological disorders </li></ul></ul><ul><ul><li>Counseling psychologists generally provide therapy for normal problems of life, such as divorce </li></ul></ul><ul><li>A Psychiatrist </li></ul><ul><ul><li>Is a medical doctor </li></ul></ul><ul><ul><li>Can prescribe drug therapy </li></ul></ul>
  29. 29. What distinguishes one type of therapist from another, and what ethical standards are shared by all types of therapists? <ul><li>Therapists are forbidden to engage in any kind of intimate relationship with a client or anyone close to the client </li></ul><ul><li>They are prohibited from providing therapy to former intimate partners </li></ul><ul><li>They are obligated to use tests that are reliable and valid </li></ul><ul><ul><li>And they must have appropriate training for all tests that are used </li></ul></ul>
  30. 30. What are the characteristics of culturally sensitive therapy? <ul><li>An approach to therapy in which knowledge of clients’ cultural backgrounds guides the choice of therapeutic interventions </li></ul><ul><li>This approach emphasizes that cultural variables may influence the diagnosis and treatment of psychological disorders </li></ul>
  31. 31. Why is gender-sensitive therapy important? <ul><li>An approach to therapy that takes into account the effects of gender on both the therapist’s and the client’s behavior </li></ul><ul><li>This approach emphasizes how a therapist’s gender biases may affect the techniques that they choose and their assessments of clients’ progress </li></ul>

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