Download Chapter 17: Therapy - Appoquinimink High School

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