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Chapter 17: Therapy The Psychological Therapies Psychological therapy, or psychotherapy, is an emotionally charged, confiding interaction between a trained therapist and someone suffering from psychological difficulties. The major psychotherapies derive from the familiar psychoanalytic, humanistic, behavioral, and cognitive perspectives on psychology. Psychoanalysis Those influenced by the psychoanalytic perspective try to help people gain insight into the unconscious origins of their disorders and to work through the accompanying feelings. To do so, an analyst may draw on techniques such as free association and dream analysis, and interpret resistance and the transference to the therapist of long-repressed feelings. Traditional psychoanalysis, which is no longer practiced widely, is criticized for assuming repression, for after-the-fact interpretations, and for being time-consuming and costly. The more common psychodynamic therapy is influenced by the psychoanalytic perspective’s concern for providing insight into childhood experiences and defense mechanisms. But it offers a briefer treatment form and often incorporates other techniques into the therapy sessions. Humanistic Therapies Unlike psychoanalysts, humanistic therapists focus on clients’ current conscious feelings and on their taking responsibility for their own growth. Carl Rogers, in his client-centered therapy, used active listening to express genuineness, acceptance, and empathy. Behavior Therapies Behavior therapists do not attempt to explain the origin of problem behaviors or to promote self-awareness. Instead, they attempt to modify the problem behaviors themselves. Thus, they may countercondition behaviors through exposure therapies or aversive conditioning. Or they may apply operant conditioning principles with behavior modification techniques, such as token economies. Cognitive Therapies The cognitive therapies, such as Aaron Beck’s cognitive therapy for depression, aim to change self-defeating thinking by training people to look at themselves in new, more positive ways. Group and Family Therapies Many therapeutic techniques can also be applied in a group context. Self-help and support groups, such as AA, engage many millions of people. Family therapy treats the family as an interactive system from which problems may arise. Evaluating Psychotherapies Is Psychotherapy Effective? Because the positive testimonials of clients and therapists cannot prove that therapy is actually effective, psychologists have conducted hundreds of studies of psychotherapy’s outcomes. Meta-analyses of these studies reveal that (1) people who remain untreated often improve; (2) those who receive psychotherapy are more likely to improve, regardless of what kind of therapy they receive and for how long; (3) people with clear-cut specific problems often receive the greatest benefits from therapy; but (4) placebo treatments or the sympathy and friendly counsel of paraprofessionals also tend to produce more improvement than occurs when people receive no treatment. The Relative Effectiveness of Different Therapies Although no one type of therapy can be said to be most effective overall, some therapies are particularly well-suited to specific disorders. Behavioral conditioning, for example, is effective in treating phobias and compulsions. Evaluating Alternative Therapies Of the alternative therapies considered—EMDR and light exposure therapy—only light exposure therapy has held up under scientific testing. Commonalities Among Psychotherapies All types of psychotherapy seem to offer three benefits: new hope, a fresh perspective, and an empathic, trusting, caring relationship. Culture and Values in Psychotherapy Therapists do, however, differ in the values that influence their aims. This makes it important for people seeking therapy to find someone they are comfortable with. Cultural and value difference can affect the client-therapist bond. The Biomedical Therapies Drug Therapies The most widely used biomedical therapies are the antipsychotic, antianxiety, and antidepressant drugs. A few drugs, such as lithium for bipolar disorder, have proven very effective in double-blind studies, though many drugs are hardly more effective than placebo treatments and some have serious side effects. Brain Stimulation Electroconvulsive Therapy (ECT) is a biomedical therapy in which a brief electric current is sent through the brain of an anesthetized patient. Although controversial, ECT remains an effective, last-resort treatment for many people with severe depression who have not responded to drug therapy. Researchers are also exploring newer alternatives, such as magnetic brain stimulation. Psychosurgery Although radical psychosurgical procedures such as lobotomy were once popular, neurosurgeons now rarely perform brain surgery to alleviate specific problems. Even when MRI-guided precision surgery is considered, it is a treatment of last resort because its effects are irreversible. Preventing Psychological Disorders Advocates of preventive mental health argue that many psychological disorders could be prevented. Their aim is to change oppressive, esteem-destroying environments into more benevolent, nurturing environments that foster individual growth and self-confidence. Myers, Myers Psychology Eighth Edition © 2006 Worth Publishers