Download Treatment

Fundamentals of Psychology:
The Brain, The Person, The World
Stephen M. Kosslyn
Robin S. Rosenberg
Allyn & Bacon
Treatment
Chapter 12
Treatment Categories

There are two treatment categories for psychological disorders:
 biomedical and
 psychological therapies.

Psychotherapy is a general term for psychological treatments designed to help people resolve behavioral,
emotional, and Interpersonal problems.
Psychologically Based Therapies

Psychotherapy involves a special relationship between a distressed person and a therapist in which the therapist
helps the client make changes in his or her thinking, feeling, and behavior.
Psychotherapies

Among the licensed practitioners who provide therapy for psychological disorders are clinical psychologists and psychiatrists.
Behavior Therapies
A type of therapy that focuses on changing observable, measurable behaviors
Behavior therapists view maladaptive behaviors as learned and rely on classical and operant conditioning and
modeling to teach the client new behaviors.

The ABCs
 Antecedents
 Behavior
 Consequences
Behavior Therapy

Techniques based on classical conditioning
 Systematic desensitization

Progressive muscle relaxation
 Exposure

Techniques based on operant conditioning
 Behavior modification
 Self-monitoring

Observation learning
Behavior Therapy

Systematic desensitization
 is an effective treatment for phobias in which clients are taught relaxation techniques and then asked to imagine or
approach feared situations gradually.
Behavior Therapies

Modeling is also an effective treatment for phobias.

Aversion therapy reduces undesirable behaviors by pairing them with an aversive (unpleasant) stimulus.
Behavior Therapy

Extinction
 is an operant conditioning technique used to reduce the occurrence of maladaptive behaviors.
 Reinforcers are withheld after the maladaptive behavior has occurred.
Cognitive Therapy
A type of therapy that focuses on thoughts rather than feelings or behaviors
Cognitive therapies are designed to change the way the client thinks: Cognitive distortions

Albert Ellis

the founder of rational-emotive behavior therapy (REBT), assumes that people are disturbed by the way they Interpret events.
Cognitive Therapy

Therefore, the role of the therapist is to challenge the client's irrational beliefs.
Common Cognitive Distortions





Dichotomous thinking
Mental filter
Mind reading
Catastrophic exaggeration
Control beliefs
Cognitive Therapy Techniques

Rational-emotive therapy (Ellis)






Activating event
Beliefs
Consequences
Dispute
Effect
Further action
Cognitive Therapy Techniques

Aaron Beck’s cognitive therapy






Cognitive restructuring
Psycho-education
Daily record of dysfunctional beliefs
Identify automatic thoughts
Identify rational responses
Beck's cognitive therapy has been applied to depression with promising results.
Insight-Oriented Therapy
Psychoanalytic therapy
Aims to help the patient develop insight into unconscious feelings and conflicts

Psychoanalysis






First use of a “talking cure”
Developed by Sigmund Freud
Identify unconscious motivations
Free association
Dream analysis
Interpretation of resistance and transference
Insight-Oriented Therapy

Psychodynamic therapy






Similar to psychoanalytic therapy
Less frequent sessions
Lower emphasis on sexual drives
Interpretation
Resistance
Transference
Insight-Oriented Therapy

Humanistic therapy

Carl Rogers
 Emphasize the ability of each person to solve his or her problems.
 Client-centered therapy
 Incongruence


Real self
Ideal self
Insight-Oriented Therapy

Client-centered therapy
 Seeks to develop an accepting environment for the client.




Reflection
Empathy
Unconditional positive regard
Gestalt therapy
 helps clients develop self-acceptance, but Gestalt therapists are more directive than client-centered therapists.
Psychopharmacology: Schizophrenia

Antipsychotic medications
 Target positive symptoms
 Tardive dyskinesia

Atypical antipsychotics
 Newer
 Target positive and negative symptoms

Early treatment
Psychopharmacology: Mood Disorders






Tricyclic antidepressants (TCAs)
Monoamine oxidase inhibitors (MAOIs)
 Food interactions
Selective serotonin reuptake inhibitors (SSRIs)
 Prozac, Zoloft, Paxil
Serotonin/norepinephrine reuptake Inhibitors (SNRIs)
 Serzone, Effexor
St. John’s wort
Lithium
Psychopharmacology: Anxiety Disorders

Benzodiazepines
 Xanax, Valium
 Often for short periods

Antidepressants
 TCAs
 SSRIs
 SNRIs
Other Forms of Treatment

Electroconvulsive therapy (ECT)
 Used when medication and therapy is ineffective
 Fell out of favor
 Regaining popularity

Transcranial magnetic stimulation (TMS)
 New technique
 May replace ECT
Modalities





Individual therapy
Group therapy
Family therapy
Systems therapy
Self-help therapies
 Support groups
 Bibliotherapy
Group Therapies

Group therapy
 Is based on the assumptions that behavior does not occur In a vacuum and that behaviors learned in group settings are
more likely to generalize to everyday situations.

Marital therapy and family therapy are two forms of group therapy.
Psychotherapy Integration


Combining techniques
Technical eclecticism
The Effectiveness of Psychotherapy

After Eysenck concluded that psychotherapy clients are just as likely to improve without it, psychotherapists
sought to provide better information about the success of therapy.
The Effectiveness of Psychotherapy

The search for the keys to successful therapy has led researchers to focus on factors such as the therapist's
ability to communicate empathy, which can lead to improvement in distressed individuals.
The Effectiveness of Psychotherapy

Therapists are becoming increasingly aware of the influence of ethnic and cultural factors on psychotherapy.

Members of many ethnic groups drop out early from psychotherapy, in part because there is a dearth of
therapists who share their native language as well as a failure to provide appropriate forms of therapy.
Researching Psychotherapy


Outcome research
Issues






Random assignment
Specific disorders and exclusion criteria
Treatment represents stated approach
Outcome measures
Dropouts
Follow-ups
The Effectiveness of Psychotherapy

Current forms of psychotherapy are offered in fewer sessions than in the past.

Many symptoms, especially distress symptoms, respond quickly to treatment.

There is also a growing recognition that there are limits to what aspects of our behavior can be changed.
Researching Psychotherapy

Meta-analysis allows researchers to combine the results of a number of studies.

Using this technique, researchers have found that therapy does lead to greater improvement than no treatment
and that differences among the various forms of therapy are not great.
The Consumer Reports Study

Treatment outcome





54% “much better”
33% “somewhat better”
Active patients had better outcomes
When treatment duration was limited by insurance, patients did worse
No form of therapy did better than others
Psychotherapy vs. Medication

The decision to enter psychotherapy should involve asking questions about;
 the degree of distress one is experiencing
 one's ability to cope with that distress,
 the effect of the symptoms on oneself, one's family, and one's work.
Other Factors





Curative factor
Which therapy works best for which disorders?
Matching client to therapeutic approach
Treatment for an ethnically diverse population
How to pick a psychotherapist?
Psychotherapy vs. Medication




Depression
Anxiety disorders
Other disorders
Combining psychotherapy and medication
The Future of Therapy

Managed care

Brief therapy
Manual-based treatment
Cybertherapy
 Financial concerns

