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Psychology, 4/e by Saul Kassin CHAPTER 17: Treatment Psychology, 4/e by Saul Kassin Treatment Psychological Therapies Perspectives on Psychotherapy Medical Interventions Psychology, 4/e by Saul Kassin Psychological Therapies Professionals Involved in Therapy Clinical Psychologists Ph.D. in psychology, conducts testing, diagnosis, treatment, and research Counseling Psychologists Ph.D. in counseling, help people with marital, family, and minor adjustment problems Psychiatrists M.D., does a residency in psychiatry and can prescribe medications Psychiatric Social Workers Master’s degree in social work with special training in counseling Psychology, 4/e by Saul Kassin Psychological Therapies Psychoanalytic Therapies Uncovering, resolving unconscious conflicts Orthodox Psychoanalysis Free association Dream Analysis Resistance Transference Brief Psychoanalytic Therapy Psychology, 4/e by Saul Kassin Psychological Therapies Psychoanalytic Therapies Free association A basic technique of psychoanalysis in which the patient says whatever comes to mindfreely and without censorship Resistance The tendency for patients to actively block, or “resist,” psychologically painful insights Transference The tendency of patients to displace intense feelings for others onto the therapist Psychology, 4/e by Saul Kassin Psychological Therapies Behavioral Therapies Behavioral-therapy or Cognitive-behavioral Therapy Techniques used to modify disordered thoughts, feelings, and behaviors through the principles of learning Classical Conditioning Techniques Flooding, Systematic Desensitization, Aversion Therapy Operant-Conditioning Techniques Reward and Punishment, Token Economy, Biofeedback, Social Skills Training Psychology, 4/e by Saul Kassin Psychological Therapies Behavioral Therapies Classical-Conditioning Techniques Flooding • Technique in which the patient is saturated with a fear-provoking stimulus until the anxiety is extinguished Systematic Desensitization • Technique used to treat anxiety disorders by pairing gradual exposure to an anxiety-provoking situation with relaxation Aversion Therapy • Technique for classically conditioned people to react with aversion to alcohol and other harmful substances Psychology, 4/e by Saul Kassin Psychological Therapies Behavioral Therapies Therapeutic Effects of Exposure & Response Prevention These are BaselineInstruction-Response Prevention (RP) cycles from a woman with a hand-washing compulsion. After a few cycles, the woman was washing less often and getting fewer urges to wash. Psychology, 4/e by Saul Kassin Hand Washing Urges Psychological Therapies Behavioral Therapies Aversion Therapy to Treat Alcoholism Alcohol is paired with a chemical that causes nausea and vomiting. Person should learn to associate alcohol with nausea. Psychology, 4/e by Saul Kassin Psychological Therapies Behavioral Therapies Operant-Conditioning Techniques Reward and Punishment • Token Economy Biofeedback • Procedure in which people learn to control physiological responses with the help of “feedback” about their internal states Social Skills Training • Used to teach interpersonal skills through modeling, rehearsal, and reinforcement (e.g., assertiveness training) Psychology, 4/e by Saul Kassin Psychological Therapies Behavioral Therapies Biofeedback and the Tension Headache Sensors on the head detect muscle activity. System converts signal to visual display. Patient watches the display, learns to relax forehead muscles. Psychology, 4/e by Saul Kassin Psychological Therapies Cognitive Therapies Cognitive Therapy A form of psychotherapy in which people are taught to think in more adaptive ways Rational-Emotive Behavior Therapy • A form of cognitive therapy in which people are confronted with their irrational, maladaptive beliefs Beck’s Cognitive Therapy • Uses a gentler, more collaborative approach to cognitive therapy Psychology, 4/e by Saul Kassin Psychological Therapies Cognitive Therapies Ellis’ A-B-C Theory of Emotional Distress Emotional distress is caused by irrational thoughts and self-defeating beliefs. Activating Event - Beliefs - Consequences Emotional consequences then help sustain the irrational beliefs. Psychology, 4/e by Saul Kassin Psychological Therapies Humanistic Therapies Removing impediments to personal growth Person-Centered Therapy Involves a warm and accepting environment to foster self-insight and acceptance Founded by Carl Rogers Therapists show empathy, unconditional positive regard, and use reflection Gestalt Therapy Therapy in which clients are aggressively prompted to express their feelings Founded by Fritz Perls Psychology, 4/e by Saul Kassin Psychological Therapies Humanistic Therapies Group-Therapy Approaches Group Therapy The simultaneous treatment of several clients in a group setting Each approach to psychotherapy has a form of group therapy, e.g., transactional analysis is used by psychoanalysts. Family Therapy Form of psychotherapy that treats the members of a family as an interactive system Psychology, 4/e by Saul Kassin Perspectives on Psychotherapy The Bottom Line: Does Psychotherapy Work? The Benefits of Psychotherapy Based on the results of 475 studies (Smith et al., 1980), the average psychotherapy client shows more improvement than 80% of those in the no-treatment control group. Psychology, 4/e by Saul Kassin Perspectives on Psychotherapy Improvement in Psychotherapy: The More The Better? With additional therapy sessions, the percentage of people who improve increases up to 26 sessions. Rate of improvement then levels off. At one session per week, six months appears to be the ideal of amount of time. Psychology, 4/e by Saul Kassin Perspectives on Psychotherapy Are Some Therapies Better Than Others? All approaches are equally effective. However for some disorders, certain types of therapy tend to be more successful. Examples: behavioral therapy for phobias, person-centered therapy for raising self-esteem, and cognitive therapy for depression There is no universal “best” type of therapy. Psychology, 4/e by Saul Kassin Perspectives on Psychotherapy What are the Active Ingredients? Three common, nonspecific factors are apparent in all types of psychotherapy. Supportive Relationship A Ray of Hope • Placebo Effect (the curative effect of an inactive treatment that results simply from the patient’s belief in its therapeutic value) operates but it is not as effective as real psychotherapy. Opportunity to Open Up Psychology, 4/e by Saul Kassin Perspectives on Psychotherapy What is the Future of Psychotherapy? Orientations of Psychotherapists Eclectic: Borrowing ideas and techniques from different approaches Psychology, 4/e by Saul Kassin Medical Interventions Drug Therapies Psychopharmacology The study of the effects of drugs on psychological processes and disorders Psychology, 4/e by Saul Kassin Medical Interventions Drug Therapies Antipsychotic Drugs & Hospitalization Trends Psychology, 4/e by Saul Kassin Medical Interventions Types of Drug Treatments I Antianxiety Drugs Tranquilizing medications used in the treatment of anxiety Trade names: Librium, Valium, Xanax, BuSpar Antidepressants Drugs that relieve depression by increasing the supply of norepinephrine, serotonin, or dopamine Trade names: Tofranil, Prozac Psychology, 4/e by Saul Kassin Medical Interventions Types of Drug Treatments II Mood Stabilizer Calms mania; may reduce bipolar mood swings Trade Name: Lithium Carbonate • A drug used to control mania and mood swings in people with bipolar disorder Antipsychotic Drugs Drugs used to control the positive symptoms of schizophrenia and other psychotic disorders Trade names: Thorazine, Clozaril, Risperdal Psychology, 4/e by Saul Kassin Medical Interventions Perspectives on Drug Therapies Drugs have helped numerous people who once lived in psychiatric institutions. People may not respond well to psychotherapy. However, some drugs produce unpleasant or dangerous side effects and may lead to a physical and/or psychological addiction. Thus, patients become passive in the healing process. Neither psychotherapy nor drug therapy has been found to be generally more effective. Psychology, 4/e by Saul Kassin Medical Interventions Electroconvulsive Therapy (ECT) Electric-shock treatments that often relieve severe depression by triggering seizures in the brain Psychosurgery The surgical removal of portions of the brain for the purpose of treating psychological disorders Psychology, 4/e by Saul Kassin How To: Beating the Winter Blues Seasonal Differences in SAD Seasonal Affective Disorder (SAD) is depression linked to certain times of year. Symptoms are lethargy, withdrawal, increases in sleeping and eating People with SAD feel even worse than most people do in the winter. Light therapy can ease their suffering. Psychology, 4/e by Saul Kassin Where People Turn for Help Psychology, 4/e by Saul Kassin