Download Aversion Therapy

1. Geraldo, a high school senior, is so fearful of asking a girl out that he
hasn't had a date in over three years. He has recently contacted a
psychotherapist for help in overcoming his fear. Describe how a
humanistic therapist and a psychoanalyst would treat Geraldo's
problem. (Objectives 1 & 2)
2. Describe how a therapist might apply operant conditioning
techniques to help Rosemary overcome a compulsive habit of eating
too much junk food. Be clear about the exact procedures that would be
used. (Objective 3)
3. One of your best friends feels that he fails at everything he does and
that his life isn't worth living. When you suggest that he talk to a
psychotherapist, your friend responds, “Talking won't help. The more I
talk about myself, the more I think about my problems. The more I
think about my problems, the more depressed I get.” What procedures
would a cognitive therapist use to help your friend overcome his
negative feelings? (Objective 4)
Geraldo, a high school senior, is so fearful of
asking a girl out that he hasn't had a date in
over three years. He has recently contacted a
psychotherapist for help in overcoming his
fear. Describe how a humanistic therapist
and a psychoanalyst would treat Geraldo's
problem. (Objectives 1 & 2)
Describe how a therapist might apply operant
conditioning techniques to help Rosemary
overcome a compulsive habit of eating too
much junk food. Be clear about the exact
procedures that would be used. (Objective 3)
Unit 13:
Treatment of Psychological
Disorders
Treatment
Psychoanalysis
Behavioral
Humanistic
Cognitive
Psychotherapy
Treatment
• History of treatment
– Philippe Pinel
– Dorothea Dix
• Psychotherapy
– treatment involving
psychological techniques
– consists of interactions
between a trained therapist &
someone seeking to
overcome psychological
difficulties or achieve personal
growth.
• Eclectic approach
The Psychological Therapies
Psychoanalysis
Psychotherapy
Treatment
Psychoanalysis
• Sigmund Freud
• Freud believed the patient’s free associations,
resistances, dreams, & transferences – and the
therapist’s interpretations of them – released
previously repressed feelings, allowing the patient
to gain self-insight.
– Childhood impulses &conflicts
Psychoanalysis
Methods
–Free association
–Resistance
• Blocking anxiety-laden
material
• Interpretation
– Dream analysis
–Transference
• in psychoanalysis, the patient’s transfer to the analyst
of emotions linked with other relationships (such as
love or hatred for a parent).
Psychoanalysis
Psychodynamic Therapy
• Psychodynamic therapy
– therapy deriving from the psychoanalytic tradition that
views individuals as responding to unconscious
forces and childhood experiences, and that seeks
to enhance self-insight.
–Similarities with psychoanalysis
–Differences with psychoanalysis
patients
past unconscious
hidden
determinants
curing illness
resistance
Psychoanalysis
transference
interpret
Psychodynamic
Psychotherapy
Humanistic
promoting
growth
conscious
“How does
that make
you feel?”
present &
future
personal
insight
client-centered
responsibility
clients
active listening
UPR
Humanistic Therapies
• Insight therapies
– increasing the client’s awareness of underlying motives and
defenses
• focus more on:
–the present rather than the past
–conscious rather than the unconscious
–taking immediate responsibility
–promoting growth instead of curing
Humanistic Therapies
• Client-centered therapy (person-centered)
–Nondirective therapy
–Genuineness, acceptance, and empathy
–Active listening
I know how you feel….
• Paraphrase
What is an example of that?….
• Invite clarification
• Reflect feelings
That sounds frustrating…
–Unconditional positive regard
behavior mod
token
economy
Psychoanalysis
operant
conditioning
Behavioral
classical
conditioning
Psychodynamic
counterconditioning
Psychotherapy
exposure
desensitization
virtual reality
Humanistic
insight
client-centered
active listening
UPR
aversion
Behavior Therapies
• uses learning principles to get rid of
unwanted behaviors
–Classical conditioning techniques
–Operant conditioning techniques
Behavior Therapies
Classical Conditioning Therapies
• Counterconditioning
– evoke new responses to stimuli that are
triggering unwanted behaviors
– repeated exposure = less anxious
–Exposure therapies
• Systematic desensitization
– progressive relaxation
– anxiety hierarchy
• Virtual reality exposure therapy
–Aversive conditioning
Behavior Therapies
Sys. Des. =
substitute a
fearful/negative
response with a
relaxed/positive
response to a
HARMLESS
stimulus
Aversion Therapy
Aversion =
substitute a
positive
response with a
negative
/aversive
response to a
HARMFUL
stimulus
(alcohol)
Behavior Therapies
Aversion Therapy
Behavior Therapies
Aversion Therapy
Behavior Therapies
Operant Conditioning
• Behavior modification
• Token economy
• Criticisms?
operant
conditioning
Psychoanalysis
Behavioral
http://www.youtube.com/
watch?v=GVNgmJ4tIpo
Buckbeak
1st 3 minutes
Psychodynamic
classical
conditioning
http://www.youtube.com/w
atch?v=doxxfXqpKYA
Psychotherapy
Boggart’s
Wardrobe 4min
Cognitive
Humanistic
insight
client-centered
active listening
UPR
CognitiveBehavioral
(CBT)
Cognitive Therapies
Cognitive therapy
–Beck’s therapy for depression
• Catastrophizing beliefs
–CBT
• stress inoculation training
• re-label obsessive thoughts
• assertive
Assertiveness Test
Nonassertive
1.
2.
3.
4.
5.
6.
7.
8.
9.
B
A
C
B
C
A
B
C
B
Aggressive
A
C
B
A
B
C
A
A
C
Assertive
C
B
A
C
A
B
C
B
A
Cognitive Therapies
Cognitive Therapies
Cognitive Therapies
Cognitive Therapies
Cognitive Therapies
Cognitive Therapies
Behavioral
Psychoanalysis
Group Therapy
Psychodynamic
Psychotherapy
BioMedical
Humanistic
CognitiveBehavioral
(CBT)
Objective 5:
Group & Family Therapy
What are the aims & benefits of
group and family therapy?
Evaluating Psychotherapies
(#6)Is Psychotherapy Effective?
• Regression toward the mean
• Client’s perceptions
–
–
–
–
crisis
time & $
speak well of therapist
Mass. Study
• Clinician’s perceptions
– Feedback usually positive
• Outcome research –
– time heals
– Meta-analysis
– Those not in therapy often improve; those in therapy more
likely to improve
– Placebo treatments
(#7)The Relative Effectiveness of
Different Therapies
• Behavioral
– Bed wetting, phobias, compulsions
• Cognitive
– Depression
• Negative Symptoms of Schizophrenia /
change entire personality will see less
benefit from psychotherapy alone
The Relative Effectiveness of
Different Therapies
• Evidence-based practice
(#8)Evaluating Alternative Therapies
• Eye movement desensitization & reprocessing
(EMDR)
– anxious thoughts vanished as eyes darted about
– Unlock & reprocess previously frozen memories
– What is actually therapeutic is the combination of
exposure therapy - repeatedly associating w/ trauma
memories a safe context & a robust placebo effect.
• Light exposure therapy
– Seasonal affective Disorder (SAD)
– Morning bright light does dim symptoms as
effectively (for some) as antidepressant drugs or
CBT
(#9)Commonalities Among Psychotherapies
placebo
• Hope for demoralized people effect
• A new perspective on oneself &
plausible
the world explanation
• An empathic,
trusting, caring
relationship
communicate their
concern, show respect,
reassure
therapeutic alliance
Culture & Values in Psychotherapy (#10)
• Similarities between cultures
• Differences between cultures
–minorities reluctance to seek
therapy
–religion
• Albert Ellis & Allen Bergin
rational-emotive therapy
The Biomedical Therapies
Introduction
• Biomedical therapy
–Drugs
–Electroconvulsive therapy
–Magnetic impulses
–Psychosurgery
–Psychiatrist
Drug Therapies (#11)
• Psychopharmacology
• Factors to consider with drug
therapy
–Normal recovery rate of untreated
patients
–Placebo effect
• Double blind procedure
Drug Therapies
Drug Therapies
Drug Therapies
Drug Therapies
Drug Therapies
Antipsychotic Drugs
• Antipsychotic drugs
–Psychoses
–Chlorpromazine
(Thorazine)
–Dopamine block
–Tardive dyskinesia
–Atypical antipsychotics (clozapine)
• negative symptoms (& positive)
Drug Therapies
Antianxiety Drugs
• Antianxiety drugs
–Xanax, Ativan,
D-cycloserine
• acts upon a receptor that helps the
extinction of learned fears
–Physiological dependence?
• Antidepressant drugs
– Use with mood and anxiety disorders
– 4 weeks
– increase the availability of norepinephrine &
serotnin
• Neurogenesis – birth of new brain cells
– Fluoxetine (Prozac), Paxil
• Selective-serotonin-reuptake inhibitors
– Side effects of antidepressants
• aerobic exercise
• CT
Drug Therapies
Antidepressant Drugs
Drug Therapies
Antidepressant Drugs
Drug Therapies
Antidepressant Drugs
Drug Therapies
Mood-Stabilizing Medications
• Mood-stabilizing medications
–Lithium
• bipolar
Brain Stimulation (#12)
Electroconvulsive Therapy
• Electroconvulsive therapy (1938)
–Procedure
•
•
•
•
•
general anesthetic
muscle relaxant
30-60 seconds
no memory of treatment
3 sessions/wk 2-4 weeks
–Severe depression
–Problems/side effects
• 4 in 10 relapse
Brain Stimulation
Electroconvulsive Therapy
Brain Stimulation
Alternative Neurostimulation Therapies
• Magnetic Stimulation
–Repetitive transcranial magnetic
stimulations
(rTMS)
• left frontal lobe
• Deep-Brain
Stimulation
– excites neurons that inhibit negative emotionfeeding activity (frontal lobe & limbic system)
Brain Stimulation
Alternative Neurostimulation Therapies
Psychosurgery (#13)
–surgery that removes or destroys brain
tissue in an effort to change behavior
–Lobotomy
• History – 1930s
• Procedure – cut nerves connecting frontal
lobe w/ emotion controlling centers
–coma; eye socket; wiggle to severe
connection
• Side effects
• Use today
Therapeutic Life-Style Change (#14)
• Integrated biopsychosocial system
• Therapeutic life-style change
– Aerobic exercise
– Adequate sleep
– Light exposure
– Social connection
– Anti-rumination
– Nutritional supplements
Preventing Psychological
Disorders
Preventing Psychological Disorders
(#15)
• Resilience
• Preventing psychological disorders
While focusing on several intrusive thoughts that
had been bothering her recently, Jenny was
instructed by her therapist to report any ideas or
memories stimulated by these thoughts. Jenny’s
therapist was making use of a technique known
as:
A.
B.
C.
D.
active listening.
free association.
systematic desensitization.
transference.
Humanistic therapies differ from
psychoanalytic therapies in all of
the following ways, EXCEPT:
A. psychoanalytic therapists are more likely to
encourage the client to take immediate
responsibility for feelings.
B. humanistic therapists are more oriented to
the present and future, rather than the past.
C. psychoanalytic therapists are more likely to
emphasize unconscious processes.
D. humanistic therapists are more growthoriented.
McKenzie’s therapist believes that active
listening is an extremely important
component of therapy. He is probably a:
A.
B.
C.
D.
psychoanalyst.
cognitive therapist.
behavior therapist.
client-centered therapist.
Client-centered therapists
emphasize the importance of:
A. exploring clients’ childhood relationships
with other family members.
B. interpreting the meaning of clients’
nonverbal behaviors.
C. enabling clients to feel unconditionally
accepted.
D. helping clients identify a hierarchy of
anxiety-arousing experiences.
A therapist helps Rebecca overcome her fear
of water by getting her to swim in the
family’s backyard pool three times a day for
two consecutive weeks. The therapist’s
approach to helping Rebecca best illustrates:
A.
B.
C.
D.
stress inoculation training.
aversive conditioning.
exposure therapy.
humanistic therapy.
A cognitive therapist would be most
likely to say:
A. “That sounds quite frustrating. It isn’t easy
to be in a situation like that.”
B. “Can you think of a more positive
interpretation of what happened?”
C. “Just say whatever comes to mind, no matter
how trivial or irrelevant it might seem.”
D. “Next time you start to feel anxious, you can
use the relaxation techniques we’ve been
working on.”
For which of the following disorders
is psychotherapy most likely to be
effective in the long run?
A.
B.
C.
D.
generalized anxiety disorder
major depressive disorder
chronic schizophrenia
phobias
Researchers have sought to answer the
question, “Does psychotherapy work?”
Generally speaking, the answer seems to
be:
A. yes, people in therapy improve more than people in
control groups.
B. yes, but people in therapy improve at the same rate as
people who are receiving placebo treatments.
C. no, therapy does not provide any benefits; people who
just let time pass improve at the same rate as people in
therapy.
D. no one really knows, because so far the only method
used to answer this question has been interviewing
former therapy clients.
The effectiveness of psychotherapy
shows little if any connection to:
A. the level of training and experience of the
therapist.
B. the length of time a client has experienced
symptoms of disorder prior to therapy.
C. the particular disorder experienced by a
client.
D. the extent to which the process depends on
changing clients’ personalities.
The placebo effect best illustrates the
importance of _______ in therapeutic
success.
A.
B.
C.
D.
active listening
psychopharmacology
behavior modification
cognitive processes
If a therapist tells a client, “Rank
order the things that frighten you
from least to most,” the therapist is
most likely practicing:
A.
B.
C.
D.
Freudian therapy.
systematic desensitization.
Gestalt therapy.
token economy.
Jon’s therapist laces his alcoholic drink
with a drug that makes Jon sick. After
getting sick a few times, just the sight of
the drink makes Jon nauseous. In this
example, the conditioned stimulus is the:
A.
B.
C.
D.
drug.
alcohol.
nauseous response to the drug.
nauseous response to the sight of the drink.
Your therapist asks you to try to
remember your dreams. He also
encourages you to review incidents in
early childhood. Your therapist is most
likely practicing:
A.
B.
C.
D.
Freudian therapy.
cognitive therapy.
behavior therapy.
humanistic therapy.
In your therapy session you often review
your current behaviors as compared to
what you think you should be doing. Your
therapist is kind and listens to your ideas,
even if you think they are silly. Your
therapist is most likely practicing:
A.
B.
C.
D.
Freudian therapy.
Jungian therapy.
cognitive therapy.
humanistic therapy.
Samuel receives some very bad
news, and feels quite low. As time
passes, you would expect:
A. his emotions to return to their usual state.
B. his emotions to stay low until something unusually
good happens to him.
C. him to become much happier than usual, since people
typically bounce back and forth between emotional
extremes.
D. him to stay emotionally low unless he goes in for
psychotherapy.
QUIZ
Thursday 4/4
Definition
Slides
Eclectic Approach
= an approach to psychotherapy that,
depending on the client’s problems, uses
techniques from various forms of therapy.
Psychotherapy
= treatment involving psychological
techniques; consists of interactions
between a trained therapist and someone
seeking to overcome psychological
difficulties or achieve personal growth.
Psychoanalysis
= Sigmund Freud’s therapeutic technique.
Freud believed the patient’s free
associations, resistances, dreams, and
transferences – and the therapist’s
interpretations of them – released
previously repressed feelings, allowing the
patient to gain self-insight.
Resistance
= in psychoanalysis, the blocking from
consciousness of anxiety-laden material.
Interpretation
= in psychoanalysis, the analyst’s noting
supposed dream meanings, resistances,
and other significant behaviors and events
in order to promote insight.
Transference
= in psychoanalysis, the patient’s transfer to
the analyst of emotions linked with other
relationships (such as love or hatred for a
parent).
Psychodynamic Therapy
= therapy deriving from the psychoanalytic
tradition that views individuals as
responding to unconscious forces and
childhood experiences, and that seeks to
enhance self-insight.
Insight Therapies
= a variety of therapies that aim to improve
psychological functioning by increasing the
client’s awareness of underlying motives
and defenses.
Client-centered Therapy
= a humanistic therapy, developed by Carl
Rogers, in which the therapist uses
techniques such as active listening within
a genuine, accepting, empathic
environment to facilitate client’s growth.
(Also called person-centered therapy.)
Active Listening
= empathic listening in which the listener
echoes, restates, and clarifies. A feature
of Roger’s client-centered therapy.
Unconditional Positive Regard
= a caring, accepting, nonjudgmental
attitude, which Carl Rogers believed would
help clients to develop self-awareness and
self-acceptance.
Behavior Therapy
= therapy that applies learning principles to
the elimination of unwanted behaviors.
Counterconditioning
= a behavior therapy procedure that used
classical conditioning to evoke new
responses to stimuli that are triggering
unwanted behaviors; includes exposure
therapies and aversive conditioning.
Exposure Therapies
= behavioral techniques, such as systematic
desensitization, that treat anxieties by
exposing people (in imagination or
actuality) to the things they fear and avoid.
Systematic Desensitization
= a type of exposure therapy that associates
a pleasant relaxed state with gradually
increasing anxiety-triggering stimuli.
Commonly used to treat phobias.
Virtual Reality Exposure
Therapy
= an anxiety treatment that progressively
exposes people to simulations of their
greatest fears, such as airplane flying,
spiders, or public speaking.
Aversive Conditioning
= a type of counterconditioning that
associates an unpleasant state (such as
nausea) with an unwanted behavior (such
as drinking alcohol).
Token Economy
= an operant conditioning procedure in
which people earn a token of some sort for
exhibiting a desired behavior and can later
exchange the tokens for various privileges
or treats.
Cognitive Therapy
= therapy that teaches people new, more
adaptive ways of thinking and acting;
based on the assumption that thoughts
intervene between events and our
emotional reactions.
Cognitive-behavioral Therapy
= a popular integrative therapy that
combines cognitive therapy (changing selfdefeating thinking) with behavior therapy
(changing behavior).
Family Therapy
= therapy that treats the family as a system.
Views an individual’s unwanted behaviors
as influenced by, or directed at, other
family members.
Regression Toward the Mean
= the tendency for extreme or unusual
scores to fall back (regress) toward their
average.
Meta-analysis
= a procedure for statistically combining the
results of many different research studies.
Evidence-based Practice
= clinical decision-making that integrates the
best available research with clinical
expertise and patient characteristics and
preferences.
Biomedical Therapy
= prescribed medications or medical
procedures that act directly on the
patient’s nervous system.
Psychopharmacology
= the study of the effects of drugs on mind
and behavior.
Antipsychotic Drugs
= drugs used to treat schizophrenia and
other forms of severe thought disorder.
Tardive Dyskinesia
= involuntary movements of the facial
muscles, tongue, and limbs; a possible
neurotoxic side effect of long-term use of
antipsychotic drugs that target certain
dopamine receptors.
Antianxiety Drugs
= drugs used to control anxiety and
agitation.
Antidepressant Drugs
= drugs used to treat depression; also
increasingly prescribed for anxiety.
Different types work by altering the
availability of various neurotransmitters.
Electroconvulsive Therapy
(ECT)
= a biomedical therapy for severely
depressed patients in which a brief electric
current is sent through the brain of an
anesthetized patient.
Repetitive Transcranial
Magnetic Stimulation (rTMS)
= the application of repeated pulses of
magnetic energy to the brain; used to
stimulate or suppress brain activity.
Psychosurgery
= surgery that removes or destroys brain
tissue in an effort to change behavior.
Lobotomy
= a now-rare psychosurgical procedure once
used to calm uncontrollably emotional or
violent patients. The procedure cut the
nerves connecting the frontal lobes to the
emotion-controlling centers of the inner
brain.
Resilience
= the personal strength that helps most
people cope with stress and recover from
adversity and even trauma.