Download Psych 2 - Huber Heights City Schools

CHAPTER 17
Therapy and Change
Chapter 17 Section 1
What is Psychotherapy?
Psychotherapy involves three things:
1. verbal interaction between a therapist and client
2. the development of a supportive and trusting relationship
3. an analysis by the therapist of the client’s problems including suggestions for
overcoming those problems.
I.
The Nature of Psychotherapy
A. Functions of Psychotherapy
1. One of the functions is to help people realize that they are responsible for their
own problems & that, even more importantly, they are the only ones who can
really solve these problems.
2. People adopt techniques that, at the time, may be appropriate but lead to
trouble in the long run.
3. The major task of a therapist is to help people
examine their way of living, to understand how their
present way of living causes problems and to start
living in new, more beneficial ways.
B. Main Kinds of Therapy
1. There are many different kinds of therapy such as psychoanalysis, humanistic,
cognitive, behavioral and biological.
2. Each one is based on different theories about how human personality works.
3. Some therapists stick to one style while others used an eclectic approach which
combines different methods from many kinds of therapy.
C. Goals of Therapy
1. The primary goal of psychotherapy is to strengthen the patient’s control over his
or her life.
2. One of the most important factors in effective treatment is the patient’s belief or
hope that they can change.
II.
Who are Therapists?
A. What Makes a Good Therapist?
1. Many people turn to a friend for advice but professional therapists are more
skillful in encouraging the person to examine uncomfortable feelings and
problems.
2. There are three characteristics found in effective therapists.
a. Therapist needs to be psychologically healthy
b. Therapist must have empathy which is a capacity for warmth &
understanding.
c. A good therapist must be experienced in dealing with people and
understanding their complexities.
III. Group Therapies
A. Patients work together with the aid of a leader to resolve interpersonal problems.
1. There are several advantages to this type of therapy.
a. Chance to see people with similar problems & can see what other people
think of them and how this may differ from their own views of themselves.
b. One therapist can help a large number of people at a reduced cost.
B.
Family therapy is an example of group therapy that focuses on the interaction
among family members.
C. Self-help groups are voluntary groups composed of people who share a particular
problem & are often conducted without the active participation of a professional
therapist.
1. Self-help groups range from alcoholism, overeating and drug addiction to child
abuse, widowhood, single parenting and more.
2. The best known self-help group is Alcohol Anonymous which was founded in
1935.
Chapter 17 Section 2
Psychoanalysis & Humanistic
Therapy
I.
What is Psychoanalysis?
A. Psychoanalysis is based on the theories of Sigmund Freud which stated that
psychological disturbances are due to anxiety caused by hidden conflicts among the
unconscious components of one’s personality.
B.
The job of the psychoanalyst is to help make the patients aware of the unconscious
impulses, desires and fears that are causing the anxiety.
C. Free Association
1. Psychoanalysis is a slow process & uses free association where the patient
freely talks about everything that comes to mind
2. The psychoanalyst often says nothing for long periods of time occasionally
making remarks or asks questions that guide the patient.
3. Resistance happens when the patient is reluctant to reveal painful feelings and
unconsciously holds them back. The analyst will point out what is
happening & wait for the patient to continue.
D.
Dream Analysis
1.
E.
Freud believed that dreams express unconscious thoughts & feelings
therefore psychoanalysts interpret the patient’s dreams to find
unconscious meanings.
Transference
1.
At some point the analyst may begin to appear in the patient’s
associations & dreams and, as a result, may begin feeling toward the
analysts the way they feel towards other important figures in their life.
a.
2.
Anger towards parents = anger towards anaylst
Once a patient understands transference, they become more aware of
hidden feelings and motivations.
II.
Humanistic Therapy
A.
The goal of humanistic therapy is to help people fulfill their human potential & is
known as client-centered therapy.
B.
Based on the theories of Carl Rogers, this therapy depends on the person’s own
motivation toward growth & self-actualization.
1.
C.
D.
The term client is used instead of patient because the term patient suggests
inferiority or passivity & client implies an equal relationship between the
therapist & the individual.
There are three therapeutic components to this relationship
1.
Positive regard – the therapist’s ability to demonstrate caring and respect for
the client.
2.
Empathy – the ability to understand what the client is feeling.
3.
Genuineness – the therapist’s ability to act toward the client in a real and
nondefensive manner.
Client-centered therapists assume that people are basically good & that they are
capable of handling their own lives.
1.
One of the goals of therapy is to help the client to stop viewing themselves
according to the standards of others & recognize their own strength &
confidence.
E. Techniques of Client-Centered Therapy
1. Client-centered therapy is nondirective because the therapist does not direct
it. The client is encouraged to speak freely about any troubling matters &
the topics are entirely up to the client
2. The therapist listens & encourages conversation but tries to avoid giving
opinions.
3. The therapist uses active listening to echo back the feelings the client has
expressed to help acknowledge and clarify the speaker’s thoughts &
concerns.
4. Client-centered therapy is conducted in an atmosphere of emotional support
called unconditional positive regard.
a. The therapist never says what he or she thinks of the client or whether
what the client has said is good or bad. Instead the therapist show the
client that anything said is accepted without embarrassment, reservation
or anger.
b. This acceptance makes it easier for clients to explore thoughts about
themselves & their experiences & they are able to abandon old values
without fear of disapproval & can begin to seen themselves, situations &
relationships in a new light & with new confidance.
Chapter 17 Section 3
Cognitive & Behavior
Therapies
I.
Cognitive Therapy
A. The goal of cognitive therapies focuses on changing the way people think.
1. Basic assumptions that cognitive therapies share are that faulty cognitions – our
irrational or uninformed beliefs, expectations & ways of thinking – distort our
behaviors, attitudes and emotions.
2. To improve our lives, we must work to change our patterns of thinking.
B. Rational-Emotive Therapy
1. Albert Ellis developed a form of therapy called rational-emotive therapy (RET)
in 1973.
2. Ellis believed that people behave in deliberate & rational ways, given their
assumptions about life & emotional problems arise when an individual’s
assumptions are unrealistic.
3. The goal of RET is to correct these false & self-defeating beliefs.
4. RET therapists may use a number of techniques to help the client change their
way of thinking.
a. Role playing so that the person can see how their behavior affects their
relationships.
b. Modeling to demonstrate other ways of thinking & acting.
c. Humor to underline the absurdity of the belief.
5. Ellis liked to teach that behaviors are the result of the ABCs.
a. A refers to the Activating event
b. B refers to the person’s belief about the event
c. C refers to the Consequences that follow
6. Ellis claimed it is not the event that causes trouble but rather the way a person
thinking about the event.
C. Beck’s Cognitive Therapy
1. Aaron T. Beck introduced another form of cognitive therapy that is similar to
Ellis’s that focuses on illogical thought processes
2. Beck believed that people use maladaptive thought patterns which can cause a
distorted view of oneself & one’s world.
a. Overgeneralization – making blanket judgments about oneself (I’m a
failure)
b. Polarized thinking – categorizing information into two categories (most
people don’t like me)
c. Selective attention – focusing on only one detail of many (people always
criticize me)
3. The goal of the therapist is to demonstrate to the client that their automatic
thinking may be incorrect & that things are not as bad as they seem.
II. Behavior Therapies
A. Emphasis in behavior therapy is on one’s behavior rather than one’s thoughts.
B. The idea behind behavior therapy is that a disturbed person is one who has learned
to behave in an undesirable way & that any behavior that is learned can be
unlearned & the therapist’s job is to help the client learn new behaviors.
C. One technique used by behavior therapists is counterconditioning which pairs the
stimulus that triggers an unwanted behavior with a new, more desirable one.
1. Systematic desensitization is a counterconditioning technique use to overcome
irrational fears & anxieties the client has learned.
2. Flooding refers to another treatment in which a therapist exposes the client to a
feared object or situation.
3. Modeling is also used to teach a client to do something by watching someone
else do it.
D. Aversive conditioning makes an act so unpleasant so that they will be avoided such as
alcoholics given medication that will make them sick if they drink alcohol.
E. Operant conditioning is based on the assumption that behavior that is reinforced
tends to be repeated, whereas behavior that is not reinforced thends to be
extinguished.
F. In contingency management, the therapist & patient decide what old, undesirable
behavior needs to be eliminated & what new, desirable behavior needs to appear.
III. Cognitive-Behavior Therapy
A. Many therapists use a combination of cognitive therapy & behavioral therapy in
which a client’s thinking pattern is changed which then, in turn, changes a person’s
behavior.
Chapter 17 Section 4
Biological Approaches to Treatment
I.
Biological Therapy
A. Biological approaches to treatment assume there is an underlying physiological
reason fro the disturbed behavior, the faulty thinking & the inappropriate emotions
the person displays.
B. The most widely used biological therapy for psychological disorders is drug therapy
1. There are four main types of psychoactive medications
a. Antipsychotics drugs – medication to reduce agitation, delusions, &
hallucinations by blocking the activity of dopamine in the brain
b. Antidepressant drugs – medication to treat major depression by increasing
the amount of one or both of the neurotransmitters noradrenaline &
serotonin
c. Lithium Carbonate – a chemical used to counteract mood swings of bipolar
disorder
d. Antianxiety drugs – medication that relieves anxiety & panic disorders by
depressing the activity of the central nervous system
C. Electroconvulsive therapy has proved extremely effective in the treatment of severe
depression, acute mania & some types of schizophrenia.
1. ECT is a controversial treatment because it the past, it was not always used
judiciously
D. Psychosurgery is brain surgery that is performed to treat psychological disorders
1. The most common operation, prefrontal lobotomy, involves destruction of the front
portion of the brain which contains most of the nerve connections that control
emotions.
2. From the 30s to the 50s, lobotomies were performed on people who were
extremely violent or diagnosed with schizophrenia, depression, bipolar disorder
& OCD.
3. Today, less than 200 lobotomies are performed annually in the US.