Chapter 2 Wood Power Point2

©2009 Pearson Education, Inc.©2009 Pearson Education, Inc.

Instructor Version


Chapter 14Chapter 14TherapiesTherapies

This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program.


Chapter 14 OverviewChapter 14 Overview

Insight TherapiesInsight Therapies Relationship TherapiesRelationship Therapies Behavior TherapiesBehavior Therapies Cognitive TherapiesCognitive Therapies Biomedical TherapiesBiomedical Therapies Evaluating the TherapiesEvaluating the Therapies The Therapeutic RelationshipThe Therapeutic Relationship


Insight Therapies

Approaches to psychotherapy Approaches to psychotherapy based on the notion that based on the notion that psychological well-being depends psychological well-being depends on self-understandingon self-understanding


Psychodynamic TherapiesPsychodynamic Therapies

Attempt to uncover repressed childhood Attempt to uncover repressed childhood experiences that are thought to cause the experiences that are thought to cause the patient’s current problemspatient’s current problems

Free association: Free association: Explores the unconscious Explores the unconscious by having patients reveal whatever thoughts, by having patients reveal whatever thoughts, feelings, or images come to mindfeelings, or images come to mind

Dream analysis: Dream analysis: Areas of emotional Areas of emotional concern repressed in waking life are concern repressed in waking life are sometimes expressed in symbolic form in sometimes expressed in symbolic form in dreamsdreams

Transference: Transference: Emotional reaction that Emotional reaction that occurs during psychoanalysis, in which the occurs during psychoanalysis, in which the patient displays feelings and attitudes toward patient displays feelings and attitudes toward the analyst that were present in another the analyst that were present in another significant relationshipsignificant relationship


Psychodynamic Therapies Psychodynamic Therapies cont…cont… Object relations therapyObject relations therapy

– Based on idea that early relationships Based on idea that early relationships form blueprints for future relationshipsform blueprints for future relationships

– Therapist helps clients restructure current Therapist helps clients restructure current relationships, changing maladaptive relationships, changing maladaptive patterns formed in early relationshipspatterns formed in early relationships

Interpersonal therapyInterpersonal therapy– Brief psychotherapy that helps clients Brief psychotherapy that helps clients

understand and cope with four understand and cope with four interpersonal problems associated with interpersonal problems associated with depressiondepression


Humanistic Therapies

Humanistic therapies Humanistic therapies assume that people assume that people have the ability and freedom to lead rational have the ability and freedom to lead rational lives and make rational choiceslives and make rational choices– Founded by Carl Rogers (1951)Founded by Carl Rogers (1951)

Therapists show empathy and create a Therapists show empathy and create a climate of climate of unconditional positive regardunconditional positive regard– Goal is to allow the client to direct the therapy Goal is to allow the client to direct the therapy

session and move toward session and move toward self-actualizationself-actualization– The patient’s realization of his inner potentialThe patient’s realization of his inner potential


Gestalt Therapy

Helps clients fully experience their Helps clients fully experience their feelings, thoughts, and actionsfeelings, thoughts, and actions– Emphasizes clients taking responsibility for Emphasizes clients taking responsibility for

their behavior, instead of blaming society or their behavior, instead of blaming society or parentsparents

– Goal is to help the client resolve past conflicts, Goal is to help the client resolve past conflicts, achieve a more integrated self, and become achieve a more integrated self, and become more self-acceptingmore self-accepting

Gestalt therapy is Gestalt therapy is directivedirective– Therapist actively directs the therapy sessionTherapist actively directs the therapy session– Provides answers and suggestions to the clientProvides answers and suggestions to the client


Relationship TherapiesRelationship Therapies

Therapies that attempt to Therapies that attempt to improve patients’ interpersonal improve patients’ interpersonal relationships or create new relationships or create new relationships to support patients’ relationships to support patients’ efforts to address psychological efforts to address psychological problemsproblems


Family Therapy and Couple Therapy

Family therapyFamily therapy– Parents and children enter therapy as a groupParents and children enter therapy as a group– Goal is to help family members heal wounds Goal is to help family members heal wounds

to the family, improve communication, and to the family, improve communication, and create more understanding within the familycreate more understanding within the family

Couple therapyCouple therapy– Goal is to help partners in an intimate Goal is to help partners in an intimate

relationship communicate and manage relationship communicate and manage conflicts more effectivelyconflicts more effectively

– May focus on behavioral change or partners’ May focus on behavioral change or partners’ emotional responses to each otheremotional responses to each other


Group Therapy

A group of clients (usually seven to ten) A group of clients (usually seven to ten) meets regularly with one or more meets regularly with one or more therapiststherapists

Provides client with a sense of Provides client with a sense of belonging and opportunity to belonging and opportunity to – Express feelingsExpress feelings– Get feedback from other group membersGet feedback from other group members– Give and receive emotional supportGive and receive emotional support

Self-help groupsSelf-help groups– People with similar problems who meet People with similar problems who meet

regularly, usually without a professional regularly, usually without a professional therapisttherapist


Behavior Therapies

A treatment approach that is based A treatment approach that is based on the idea that abnormal behavior is on the idea that abnormal behavior is learned and that applies the learned and that applies the principles of operant conditioning, principles of operant conditioning, classical conditioning, and/or classical conditioning, and/or observational learning to eliminate observational learning to eliminate inappropriate or maladaptive inappropriate or maladaptive behaviors and replace them with behaviors and replace them with more adaptive responsesmore adaptive responses


Behavior Modification Behavior Modification Techniques Based on Operant Techniques Based on Operant ConditioningConditioning

Uses reinforcement to shape or Uses reinforcement to shape or increase frequency of desirable increase frequency of desirable behaviorbehavior– Token economyToken economy

Extinguishes undesirable or Extinguishes undesirable or maladaptive behavior by terminating maladaptive behavior by terminating or withholding reinforcement that or withholding reinforcement that maintains the behaviormaintains the behavior– TimeoutTimeout


Behavior Modification Behavior Modification Techniques Based on Learning Techniques Based on Learning TheoriesTheories

Systematic desensitizationSystematic desensitization is is behavior therapy based on classical behavior therapy based on classical conditioning used to treat fearsconditioning used to treat fears

Client is trained to relax while being Client is trained to relax while being confronted with a graduated series of confronted with a graduated series of anxiety-producing situationsanxiety-producing situations

Eventually, client can stay relaxed Eventually, client can stay relaxed while confronting even the most while confronting even the most feared situationfeared situation


Behavior Modification Behavior Modification Techniques Based on Learning Techniques Based on Learning Theories cont…Theories cont…

Participant modeling Participant modeling is behavior is behavior therapy based on Albert Bandura’s therapy based on Albert Bandura’s principles of observational learningprinciples of observational learning

A model demonstrates appropriate A model demonstrates appropriate responses to a feared stimulus in responses to a feared stimulus in graduated stepsgraduated steps

Client then imitates the model with Client then imitates the model with encouragement of a therapistencouragement of a therapist

Using this technique, most specific Using this technique, most specific phobias can be extinguished in 3 to 4 phobias can be extinguished in 3 to 4 hourshours



Flooding Flooding is behavior therapy based is behavior therapy based on classical conditioningon classical conditioning

Used to treat phobias Client is exposed to the feared object

or event for an extended period Until their anxiety decreases



Exposure and response prevention Exposure and response prevention Exposes patients with obsessive-Exposes patients with obsessive-

compulsive disorder to stimuli that compulsive disorder to stimuli that trigger obsessions and compulsive trigger obsessions and compulsive ritualsrituals

Patients resist performing the Patients resist performing the compulsive rituals for progressively compulsive rituals for progressively longer periods of timelonger periods of time



Aversion therapyAversion therapy An aversive stimulus is paired with a An aversive stimulus is paired with a

harmful or socially undesirable harmful or socially undesirable behavior behavior

Until the behavior becomes associated Until the behavior becomes associated with pain or discomfortwith pain or discomfort


Cognitive TherapiesCognitive Therapies

Therapies that assume Therapies that assume maladaptive behavior can result maladaptive behavior can result from irrational thoughts, beliefs, from irrational thoughts, beliefs, and ideasand ideas


Rational Emotive TherapyRational Emotive Therapy

Developed by Albert EllisDeveloped by Albert Ellis A A directivedirective form of psychotherapy form of psychotherapy Goal is to challenge and modify a Goal is to challenge and modify a

client’s irrational beliefs about client’s irrational beliefs about themselves and othersthemselves and others

Irrational beliefs are believed to be the Irrational beliefs are believed to be the causes of personal distresscauses of personal distress


Figure 14.1 The ABCs of Rational Emotive Therapy


Cognitive Therapy

Designed by Aaron Beck, helps clients Designed by Aaron Beck, helps clients stop their negative thoughts as they stop their negative thoughts as they occur and replace them with more occur and replace them with more objective thoughtsobjective thoughts

DepressionDepression is treated by brief cognitive is treated by brief cognitive therapy, usually 10-20 sessions, and is therapy, usually 10-20 sessions, and is more effective than antidepressant drugsmore effective than antidepressant drugs

Panic disorderPanic disorder is treated by teaching is treated by teaching clients to change the catastrophic clients to change the catastrophic interpretations of their symptoms to interpretations of their symptoms to prevent them from escalating into panic, prevent them from escalating into panic, usually effective with 3 months of usually effective with 3 months of treatmenttreatment


Biomedical Therapies

Therapies (drug, therapy Therapies (drug, therapy electroconvulsive therapy, or electroconvulsive therapy, or psychosurgery) that are based on psychosurgery) that are based on the assumption that psychological the assumption that psychological disorders are symptoms of disorders are symptoms of underlying physical problemsunderlying physical problems


Drug Therapy

Antipsychotic drugsAntipsychotic drugs– Prescribed primarily for Prescribed primarily for schizophreniaschizophrenia – Used to treat symptoms such as Used to treat symptoms such as

hallucinations, delusions, and disorganized hallucinations, delusions, and disorganized behaviorbehavior

– Work by inhibiting Work by inhibiting dopaminedopamine activity activity LithiumLithium

– Used to treat Used to treat bipolar disorderbipolar disorder– Reduces both manic and depressive Reduces both manic and depressive

episodesepisodes Antianxiety drugsAntianxiety drugs

– BenzodiazepinesBenzodiazepines are effective for treating are effective for treating generalized anxiety disordergeneralized anxiety disorder and and panic panic disorderdisorder


Figure 14.2 Decrease in Patient Populations in State and County Mental Hospitals (1950-2000)


Drug Therapy cont…

Antidepressant drugsAntidepressant drugs Act as mood elevators for people who are Act as mood elevators for people who are

severely depressedseverely depressed Selective serotonin reuptake Selective serotonin reuptake

inhibitors (SSRIs)inhibitors (SSRIs) Block the reuptake of Block the reuptake of serotoninserotonin, increasing , increasing

its availability at the synapses of the brainits availability at the synapses of the brain Are effective for treating Are effective for treating major major

depression, OCD, social phobia, panic depression, OCD, social phobia, panic disorder, generalized anxiety disorder, disorder, generalized anxiety disorder, and binge eatingand binge eating


Drug Therapy cont…

Drugs can have unpleasant or dangerous Drugs can have unpleasant or dangerous side effectsside effects

It is difficult to establish proper dosagesIt is difficult to establish proper dosages Drugs do not cure psychological Drugs do not cure psychological

disorders so relapse is likely if drug disorders so relapse is likely if drug therapy is discontinuedtherapy is discontinued

Availability of Availability of antipsychotic drugsantipsychotic drugs led led to a trend away from hospitalization, to a trend away from hospitalization, which may have increased homelessness which may have increased homelessness among people with among people with schizophreniaschizophrenia


Electroconvulsive therapy (ECT)

Electric current is administered to the Electric current is administered to the right cerebral hemisphereright cerebral hemisphere– While patient is under anesthesiaWhile patient is under anesthesia– Usually reserved for severely depressed Usually reserved for severely depressed

patients who are suicidalpatients who are suicidal ECTECT was misused and overused in the was misused and overused in the

1940s and 1950s, leading to a bad 1940s and 1950s, leading to a bad reputationreputation

But it can be a highly effective treatment for But it can be a highly effective treatment for major depressionmajor depression


Psychosurgery

Brain surgery performed to alleviate Brain surgery performed to alleviate serious psychological disorders or serious psychological disorders or unbearable chronic painunbearable chronic pain

LobotomyLobotomy CingulotomyCingulotomy Psychosurgery Psychosurgery is controversial, and is controversial, and

is considered experimental and a last is considered experimental and a last resortresort– Because results are unpredictable and Because results are unpredictable and

permanentpermanent


Evaluating the Therapies

Therapies share many similarities. Therapies share many similarities. Therapists use a core set of Therapists use a core set of

techniques no matter which techniques no matter which perspective of therapy session they perspective of therapy session they adopt, but at the same time, each adopt, but at the same time, each therapeutic approach has elements therapeutic approach has elements that distinguish it from others.that distinguish it from others.


Evaluating the Therapies cont…

Smith et al. (1980) analyzed 475 Smith et al. (1980) analyzed 475 studies with 25,000 clientsstudies with 25,000 clients– Found that psychotherapy was better than Found that psychotherapy was better than

no treatmentno treatment– But no one type of psychotherapy was But no one type of psychotherapy was

more effective than anothermore effective than another Eysenck (1994) reanalyzed the same Eysenck (1994) reanalyzed the same

studiesstudies– Reported that Reported that behavior therapybehavior therapy has a has a

slight advantage over other types of slight advantage over other types of therapiestherapies


Consumer ReportsConsumer Reports SurveySurvey Overall, clients believed that they Overall, clients believed that they

benefited substantially from benefited substantially from psychotherapypsychotherapy

Clients were equally satisfied with Clients were equally satisfied with therapy provided by psychologists, therapy provided by psychologists, psychiatrists, and social workerspsychiatrists, and social workers

The longer clients stayed in therapy, the The longer clients stayed in therapy, the more they improvedmore they improved

Clients believed that antidepressant and Clients believed that antidepressant and antianxiety drugs helped them; but antianxiety drugs helped them; but overall psychotherapy alone worked as overall psychotherapy alone worked as well as psychotherapy plus drugswell as psychotherapy plus drugs


The Therapeutic The Therapeutic RelationshipRelationship

When establishing a relationship When establishing a relationship with a therapist, it is important to with a therapist, it is important to become familiar with the various become familiar with the various professionals who offer professionals who offer therapeutic services. therapeutic services.


Choosing a Therapist

A A PsychologistPsychologist– Has an advanced degree, usually a doctorate, Has an advanced degree, usually a doctorate,

in psychologyin psychology– Clinical psychologistsClinical psychologists generally diagnose generally diagnose

and treat psychological disordersand treat psychological disorders– Counseling psychologistsCounseling psychologists generally provide generally provide

therapy for normal problems of life, such as therapy for normal problems of life, such as divorcedivorce

A A PsychiatristPsychiatrist– Is a medical doctorIs a medical doctor– Can prescribe drug therapyCan prescribe drug therapy


Choosing a Therapist cont…

Therapists are forbidden to engage Therapists are forbidden to engage in any kind of intimate relationship in any kind of intimate relationship with a client or anyone close to the with a client or anyone close to the clientclient

They are prohibited from providing They are prohibited from providing therapy to former intimate partnerstherapy to former intimate partners

They are obligated to use tests that They are obligated to use tests that are reliable and validare reliable and valid– And they must have appropriate And they must have appropriate

training for all tests that are usedtraining for all tests that are used


Culturally Sensitive Therapy

An approach to therapy in which An approach to therapy in which knowledge of clients’ cultural knowledge of clients’ cultural backgrounds guides the choice of backgrounds guides the choice of therapeutic interventionstherapeutic interventions

This approach emphasizes that This approach emphasizes that cultural variables may influence the cultural variables may influence the diagnosis and treatment of diagnosis and treatment of psychological disorderspsychological disorders


Gender-Sensitive TherapyGender-Sensitive Therapy

An approach to therapy that takes into An approach to therapy that takes into account the effects of gender on both account the effects of gender on both the therapist’s and the client’s the therapist’s and the client’s behaviorbehavior

This approach emphasizes how a This approach emphasizes how a therapist’s gender biases may affect therapist’s gender biases may affect the techniques that they choose and the techniques that they choose and their assessments of clients’ progresstheir assessments of clients’ progress

Business

Chapter 2 Wood Power Point2