Understanding Psychology 5th Edition Morris and Maisto Rogers that calls for unconditional positive regard of the client by the therapist ... •Social stigma of having a mental disorder

©Prentice Hall 2003 13-1

Understanding Psychology6th Edition

Charles G. Morris and Albert A. Maisto

PowerPoint Presentation by

H. Lynn Bradman

Metropolitan Community College


Chapter 17

Therapies


Insight Therapies

• Insight therapy is a major category of treatment for psychological problems.

• Insight therapies have in common the goal of providing people with better awareness and understanding of their feelings, motivations, and actions in the hope that this will lead to better adjustment.


Insight Therapies

• Three examples of insight therapies are:

– Psychoanalysis

– Humanistic Therapies:

• Client-Centered Therapy

• Gestalt Therapy


Psychoanalysis (Based on Freud’s approach to Psychology)

• Based on the belief that anxiety and other problems are symptoms of inner conflicts stemming from childhood.

• Free association: A technique encouraging the patient to talk without inhibition about whatever thoughts or fantasies come to mind.


Psychoanalysis

• Transference: The patient’s carrying over to the analyst feelings held toward childhood authority figures.

• Insight: Awareness of previously unconscious feelings and memories and how they influence present feelings and behavior.


Client-Centered Therapy

• Nondirectional form of therapy developed by Carl Rogers that calls for unconditional positive regard of the client by the therapist with the goal of helping the client become fully functioning.


“Client” vs. “Patient”

• Rogers used the term client rather than patient to highlight the more active and equal role he assigned to the person seeking therapy.


Role of the Therapist

• Rogers emphasized understanding life from the client’s point of view.

• A therapist must be nondirective and reflect back to the client what he/she has said.


Gestalt Therapy

• A therapy emphasizing the wholeness of the personality and attempts to reawaken people to their emotions and sensations in the here and now.


Gestalt Therapy

• Fritz Perls encouraged face-to-face confrontations to help people become more genuine or “real” in their day-to-day interactions.

• The therapist is active and directive.


Behavior Therapies

• Behavior therapies are based on the belief that all behavior, normal and abnormal, is learned and that the goal of therapy is to teach people more satisfying ways of behaving

• For behaviorists, the focus of psychotherapy should be the problem behaviors themselves, not some deeper, underlying conflicts that are presumably causing those behaviors.


Behavior Therapies

• Therapeutic approaches based on the belief that all behavior is learned.

• The objective of therapy is to teach people new, more satisfying ways of behaving.

– Classical conditioning

– Operant conditioning

– Modeling


Use of Classical Conditioning

• Systematic desensitization:

– A technique for reducing fear and anxiety by gradually associating a new response (relaxation) with stimuli that have been causing the fear and anxiety.

• Flooding:

– A method of desensitization through intense and prolonged exposure to anxiety-producing stimuli.


Use of Classical Conditioning

• Aversive conditioning:

– Techniques aimed at eliminating undesirable behavior patterns by teaching the person to associate them with pain and discomfort.


Use of Operant Conditioning

• Behavior contracting:

– The client and therapist set behavioral goals and agree on reinforcements the client will receive upon reaching those goals.

• Token economies:

– Patients earn tokens (reinforcers) for desired behaviors and exchange them for desired items or privileges.


Modeling

• A behavior technique in which the person learns desired behaviors by watching others perform those behaviors.

– The “Super Nanny” models effective parenting techniques


Cognitive Therapies

• Cognitive therapies focus not so much on maladaptive behaviors as on maladaptive ways of thinking.

• By changing people's distorted, self-defeating ideas about themselves and the world, cognitive therapists hope to encourage better coping skills and adjustment.


Cognitive Therapies

• Emphasize changing clients’ perceptions of their life situation as a way of modifying their behavior.

– Stress-inoculation therapy

– Rational-emotive therapy (RET)

– Beck’s cognitive therapy


Stress-Inoculation Therapy

• Trains clients to cope with stressful situations by learning a more useful pattern of self-talk.

• Works by turning the client’s own thought patterns into a kind of vaccine against stress-induced anxiety. (Thinking about deep breathing and relaxation instead of panic, for example).

• Clients practice new coping strategies with the therapist.


Rational-Emotive Therapy (RET)

• A directive therapy based on the idea that clients’ psychological distress is caused by irrational and self-defeating beliefs and the therapist’s job is to challenge such dysfunctional beliefs.

• Irrational/self-defeating beliefs involve absolutes, for example “musts” and “shoulds” that allow no room for mistakes.


A,B C Model

• RET employs the ‘ABC framework’

(A) activating events

(B) our beliefs about them

(C) the cognitive, emotional or behavioral consequences of our beliefs

Negative event--- Rational Belief---Healthy Negative Emotion

Negative event---Irrational Belief---Unhealthy Negative Emotion


Beck’s Cognitive Therapy

• Identifying and changing inappropriately negative and self-critical patterns of thought.

• Therapists try to help clients examine each dysfunctional thought in a supportive but objectively scientific manner.



• It is important to make sure that the client is interpreting what is going on around them accurately.

• People under stress tend to be focused on a negative issue, they may not be thinking properly.

• They can also ‘read into’ situations things which in reality are not there, it is their own interpretations which are faulty.



• What is the evidence supporting the conclusion currently held by the client?

• What is another way of looking at the same situation but reaching another conclusion?

• What will happen if, indeed, the current conclusion/opinion is correct?


Group Therapies

• Based on the idea that psychological problems are at least partly interpersonal and are therefore best approached in a group.

• Offer a circle of support for clients, shares insights into problems, and provides the opportunity to obtain psychotherapy at a lower cost.


Group Therapy

• Clients meet regularly to interact and help one another achieve insight into their feelings and behavior.

– Self-help groups

– Family therapy

– Couple therapy


Self-Help Groups

• As the cost of private psychotherapy has risen, self-help groups have become increasingly popular because of its low cost.

• In such groups, people share their concerns and feelings with others who are experiencing similar problems.

• Alcoholics Anonymous is a very effective self-help group.


Family Therapy

• The family is seen as partly responsible for the individual’s problems.

• Family therapy seeks to change all family members’ behaviors to the benefit of the family unit as well as the troubled individual.


Couple Therapy

• A form of group therapy intended to help troubled partners improve their problems of communication and interaction.

• Empathy training:

– Each person is taught to share inner feelings and to listen to and understand the partner’s feelings before responding to them.


Effectiveness of Psychotherapy

• Most researchers agree that psychotherapy helps about two-thirds of the people treated.

• Although there is some debate over how many untreated people also recover, the consensus is that those who get therapy are generally better off than those who don't.


Effectiveness of Psychotherapy

• Each kind of therapy, however, works better for some problems than for others.

• The general trend in psychotherapy is toward the use of whatever treatment works best for a particular problem.



Biological Treatments

• A group of treatment approaches, such as medication, electroconvulsive therapy, and psychosurgery.

• These treatments are sometimes used to treat psychological disorders in conjunction with, or instead of, psychotherapy.


Reasons for Use of Drug Therapy

• The development of several effective drugs.

• Drug therapies cost less than psychotherapy.

• Critics contend that drugs are used because of our society’s “pill mentality.”


Major Types of Psychoactive Drugs

• Drugs are the most common form of biological therapy.

• Antipsychotic drugs are valuable in treating schizophrenia.

• They do not cure the disorder, but they reduce its symptoms, although side effects can be severe.



• Antidepressant drugs alleviate depression, though some also have serious side effects.

• Many other types of medications are used to treat psychological disorders including:

– Antimanic drugs

– Antianxiety drugs

– Sedatives

– Psychostimultants for children with attention-deficit/hyperactivity disorder.



– Antipsychotics are drugs used to treat very severe psychological disorders, particularly schizophrenia.


Lithium Carbonate

• Lithium is a naturally occurring salt that is used to treat bipolar disorder.

• Lithium helps level out the extreme highs of mania and the extreme lows of depression.


Electroconvulsive Therapy (ECT)

• A mild electrical current is passed through the brain for a short period, often producing convulsions and temporary coma.

• ECT is used to treat severe, prolonged depression.

• The reason ECT works remains unknown.


Psychosurgery

• Brain surgery performed to change a person’s behavior and emotional state, for example prefrontal lobotomy.

• This therapy is rarely used today.


Caring for the Seriously Disturbed and Preventing

Disorders• In the past, institutionalization in large mental

hospitals was the most common approach to caring for people with serious mental disorders.

• Patients were given shelter and some degree of treatment, but a great many were never able to be released.


Caring for the Seriously Disturbed and Preventing

Disorders• Then, with the advent of antipsychotic drugs,

a trend began toward deinstitutionalization, or integrating people with serious mental disorders back into the community.


Deinstitutionalization

• The policy of treating people with severe psychological disorders in the community rather than in large public hospitals.


Problems with Deinstitutionalization

• Community mental-health centers are poorly funded or non-existent.

• Ex-patients are poorly prepared to live in the community.

• Not enough housing available.

• Social stigma of having a mental disorder.

• Large insurance companies discourage outpatient care.


Types of Mental Illness Prevention

• Primary prevention

• Secondary prevention

• Tertiary prevention


Primary Prevention

• Techniques and programs to improve the social environment so that new cases of mental disorders do not develop.


Secondary Prevention

• Programs to identify groups that are at high risk for mental disorders and to detect maladaptive behavior in these groups and treat it properly.


Tertiary Prevention

• Programs to help people adjust to community life after release from a mental hospital.


Client Diversity and Treatment

• Given that human beings differ as much as they do, it isn't surprising that a one-size-fits-all concept isn't always appropriate in the treatment of psychological problems.

• In recent years the special needs of women and people from other cultures have particularly occupied the attention of mental health professionals.


Gender Differences in Treatment

• Women are more likely than men to be in psychotherapy.

• Psychotherapy is more socially accepted for women than men.

• Traditionally, women have received a disproportionate share of drugs for psychological disorders.


Gender Differences in Treatment

• Because, in traditional therapy, women are often expected to conform to gender stereotypes in order to be pronounced “well,” many women have turned to “feminist therapists.”

• The American Psychological Association has issued guidelines to ensure that women receive treatment that is not tied to traditional ideas about appropriate behavior for the sexes.


Cultural Differences in Treatment

• Our ideas of what constitutes normal behavior may not be viewed as normal by another culture.

• Some psychological disorders only occur within a specific culture.

• When the client and therapist come from different cultural backgrounds or belong to different racial or ethnic groups, misunderstandings can arise in therapy.


Cultural Differences in Treatment

• The APA has issued guidelines to help psychologists deal more effectively with our ethnically and culturally diverse population.

• Following these guidelines is an important step toward avoiding cultural misunderstandings.

Documents

Understanding Psychology 5th Edition Morris and Maisto Rogers that calls for unconditional positive regard of the client by the therapist ... •Social stigma of having a mental disorder