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The Psychological
Therapies
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History of Insane Treatment
Maltreatment of the insane throughout the ages
was based on irrational views. Many patients
were subjected to strange, debilitating and
downright dangerous treatments.
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History of Insane Treatment
Pinel in France and Dix in America founded
humane movements to care for the mentally
sick.
Philippe Pinel (1745-1826)
Dorthea Dix (17451826)
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Therapies
Psychotherapy involves an emotionally
charged, confiding interaction between a trained
therapist and a mental patient.
Biomedical therapy uses drugs or other
procedures that act on the patient’s nervous
system curing him of psychological disorders.
An eclectic approach uses various forms of
healing techniques depending on the client’s
unique problems.
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Psychological Therapies
We will look at four major forms of
psychotherapy based on different theories on
human nature:
1. Psychoanalytical theory
2. Humanistic theory
3. Behavioral theory
4. Cognitive theory
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Psychoanalysis
The first formal psychotherapy to emerge was
psychoanalysis developed by Sigmund Freud.
Sigmund Freud's famous couch
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Psychoanalysis: Aims
Since psychological problems originate from
repressed impulses and conflicts in childhood,
the aim of psychoanalysis is to bring repressed
feelings into conscious awareness where the
patient can deal with them.
When energy devoted to id-ego-superego
conflict is released, the patient’s anxiety
lessens.
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Psychoanalysis: Methods
Dissatisfied with hypnosis, Freud developed the
method of free association to unravel the
unconscious mind and its conflicts.
The patient lies on a couch and speaks
whatever comes to his mind.
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Psychoanalysis: Methods
During free association, the patient edits his
thoughts to resist his feelings and to express his
emotions. Such resistance becomes important
in the analysis of conflict-driven anxiety.
Eventually the patient opens up and reveals his
innermost private thoughts to the therapist,
developing positive or negative feelings
(transference) towards him.
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Psychoanalysis: Criticisms
1. Psychoanalysis is hard to refute because it
cannot be proven or disproven.
2. Psychoanalysis takes a long time and is
very expensive.
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Current Psychodynamic
Therapies
Influenced by Freud, in a face-to-face setting,
psychodynamic therapists understand
symptoms and themes across important
relationships in a patient’s life.
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Psychodynamic Therapies
Interpersonal psychotherapy, a variation of
psychodynamic therapy is effective in treating
depression. It focuses on symptom relief here
and now, not overall personality change.
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Humanistic Therapies
Humanistic therapists aims to boost selffulfillment by helping people grow in selfawareness and self-acceptance.
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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.
Person-Centered Therapy
Developed by Carl Rogers, person-centered
therapy is a form of humanistic therapy.
The therapist listens to the needs of the patient
in an accepting and non-judgmental way,
addressing his problems in a productive way
and building his or her self-esteem.
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Humanistic Therapy
The therapist engages in active listening and
echoes, restates, and clarifies patient’s thinking,
acknowledging expressed feelings.
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Behavior Therapy
Therapy that applies learning principles to the
elimination of unwanted behaviors.
To treat phobias or sexual disorders behavior
therapists do not delve deeply below the
surface looking for inner causes.
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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.
Classical Conditioning Techniques
Counterconditioning: a procedure that
conditions new responses to stimuli that trigger
unwanted behaviors.
It is based on classical conditioning and
includes exposure therapy and aversive
conditioning.
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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.
drink.
drug.
alcohol.
nauseous response to the drug.
nauseous response to the sight of the
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.
Exposure Therapy
Exposes patients to
things they fear and
avoid. Through
repeated exposures
anxiety lessens
because they habituate
to the things feared.
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Exposure Therapy
Exposure therapy involves exposing people to
(fear of driving) objects in real or virtual
environments.
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Systematic Desensitization
A type of exposure therapy that associates a
pleasant, relaxed state with gradually increasing
anxiety-triggering stimuli commonly used to treat
phobias.
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Aversive Conditioning
A type of
counterconditioning
that associates an
unpleasant state with
an unwanted behavior.
With this technique,
temporary conditioned
aversion to alcohol
has been reported.
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Operant Conditioning
Operant conditioning procedures enable
therapists to use behavior modification in which
desired behavior is rewarded and undesired
behaviors are not or are punished.
A number of withdrawn, uncommunicative
3year-old autistic children have been
successfully trained by giving and withdrawing
reinforcements for desired and undesired
behaviors.
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Token Economy
In institutional settings therapists may create a
token economy, where a patient exchanges a
token of some sort, earned for exhibiting the
desired behavior, for various privileges or
treats.
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Cognitive Therapy
Teaches people adaptive ways of thinking and
acting based on the assumption that thoughts
intervene between events and our emotional
reactions.
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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.”
Cognitive Therapy for Depression
Aaron Beck (1979) suggests that depressed
patients believe that they can never be happy
(thinking) and thus associate minor failings (e.g.
failing a test [event]) in life as major causes for
their depression.
Beck believes that cognitions such as “can never
be happy,” need to change in order for
depressed patients to recover. This change is
brought into patients by gentle questioning.
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Cognitive Therapy for Depression
Rabin et al., (1986)
trained depressed
patients to daily record
positive events and relate
how they contributed to
these events. Compared
to other depressed
patients, trained patients
showed lower depression
scores.
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Stress Inoculation Training
Meichenbaum (1977, 1985) trained people to
restructure their thinking in stressful situations.
“Relax, the exam may be hard, but it will be
hard for everyone else too. I studied harder
than most people. Besides, I don’t need a
perfect score to get a good grade.”
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Cognitive-Behavior Therapy
Cognitive therapists often combine the reversal
of self-defeating thinking with efforts to modify
behavior.
Cognitive-behavior therapy aims to alter the
way people act (behavior therapy) and alter the
way they think (cognitive therapy).
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Group Therapy
Group therapy normally consists of 6-9 people
and a 90-minute session which can help more
people and cost less. Clients benefit from
knowing others have similar problems.
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Family Therapy
Family therapy treats the family as a system.
Therapy guides family members toward positive
relationships and improved communication.
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