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Chapter 16: Therapy 1 Treating Psychological Disorders ______________________ and that therapy takes a long Objective 16-1: Discuss how psychotherapy, biomedical time and is very ______________________ . therapy, and an eclectic approach to therapy differ. 10. Therapists who are influenced by Freud's 1. Mental health therapies are classified as either psychoanalysis but who talk to the patient face to face are ______________________ therapies or ______________________ therapists. In addition, they ______________________ therapies. work with patients only ______________________ (how 2. Some therapists blend several psychotherapy techniques long?) and for only a few weeks or months. These and so are said to take an ______________________ therapists focus on ______________________ across approach. important relationships. 11. A brief alternative to psychodynamic therapy that has The Psychological Therapies Objective 16-2:Discuss the goals and techniques of psychoanalysis, and describe how they have been adapted in psychodynamic therapy. 3. The goal of Freud's psychoanalysis, which is based on his personality theory, is to help the patient gain proven effective with ______________________ patients is ______________________ ______________________ . 12. While this approach aims to help people gain ______________________ into the roots of their difficulties, it focuses on ______________________ ______________________ rather than on past hurts. ______________________ . 4. Freud assumed that many psychological problems originate in childhood impulses and conflicts that have been ______________________ . 5. Psychoanalysts attempt to bring APPLICATIONS: 13. During a session with his psychoanalyst, Jamal hesitates while describing a highly embarrassing thought. In the psychoanalytic framework, this is an example of a. transference. ______________________ feelings into b. insight. ______________________ awareness where they can be c. mental repression. dealt with. d. resistance. 6. Freud's technique in which a patient says whatever 14. During psychoanalysis, Jane has developed strong comes to mind is called ______________________ feelings of hatred for her therapist. The analyst interprets ______________________ . Jane's behavior in terms of a ______________________ 7. When, in the course of therapy, a person omits shameful of her feelings toward her father. or embarrassing material, ______________________ is a. projection c. regression occurring. Insight is facilitated by the analyst's b. resistance d. transference ______________________ of the meaning of such omissions, of dreams, and of other information revealed during therapy sessions. 8. When strong feelings, similar to those experienced in other important relationships, are developed toward the therapist, ______________________ has occurred. 9. Today, psychoanalysis (is/is not) commonly practiced in the United States. Critics point out that psychoanalysts' interpretations are hard to ______________________ 15. Ernesto is seeing a psychodynamic therapist. Unlike a psychoanalyst, his therapist does not talk about ______________________ , ______________________, and ______________________ , but rather about themes across important ______________________ . 16. Isadora's psychoanalyst would be most likely to interpret her fear of intimate relationships in terms of ______________________ ______________________. 2 Chapter 16: Therapy Objective 16-3:Identify the basic themes of humanistic Contrast the assumptions of the behavior therapies with therapy, and describe the specific goals and techniques of those of psychodynamic and humanistic therapies. Rogers' client-centered approach. 17. Humanistic therapies attempt to help people meet their potential for ______________________ . Like psychodynamic therapies, humanistic therapies attempt to reduce inner conflicts by providing clients with new ______________________ . List several ways that humanistic therapy differs from 23. One cluster of behavior therapies is based on the psychodynamic therapy. principles of ______________________ ______________________ , as developed in Pavlov's experiments. This technique, in which a new, incompatible response is substituted for a maladaptive one, is called ______________________ . Two examples of this technique are 18. The humanistic therapy based on Rogers' theory is ______________________ ______________________ and called ______________________ - ______________________ ______________________ . ______________________ therapy, which is described as 24. The most widely used types of behavior therapies are therapy because the therapist (interprets/ does not the ______________________ ______________________ interpret) the person's problems. developed by ______________________ . In systematic 19. To promote growth in clients, Rogerian therapists desensitization, he assumed that one cannot simultaneously exhibit ______________________ , be ______________________ and relaxed. ______________________, and ______________________. 25. The first step in systematic desensitization is the 20. Rogers' technique of echoing, restating, and clarifying construction of a ______________________ of anxiety- what a person is saying is called ______________________ arousing stimuli. The second step involves training in ______________________ . Given a nonjudgmental ______________________ ______________________ . In environment that provides ______________________ the final step, the person is trained to associate the ______________________ ______________________, ______________________ state with the patients are better able to accept themselves as they are and ______________________-arousing stimuli. to feel valued and whole. 26. For those who are unable to visually imagine an 21. Three tips for listening more actively in your own anxiety-arousing situation, or too afraid or embarrassed to relationships are to ______________________ , do so, ______________________ ______________________ , ________________ and ______________________ ______________________. ________________ Objective 16-4:Explain how the basic assumption of ________________ behavior therapy differs from those of psychodynamic and therapy offers a promising alternative. humanistic therapies, and describe the techniques used in 27. In aversive conditioning, the therapist attempts to exposure therapies and aversive conditioning. substitute a (positive/ negative) response for one that is 22. Behavior therapy applies principles of currently (positive/negative) to a harmful stimulus. In this ______________________ to eliminate troubling behaviors. technique, a person's unwanted behaviors become Chapter 16: Therapy 3 associated with ______________________ feelings. In the State some responses of proponents of behavior long run, aversive conditioning (does/ does not) work. modification. APPLICATIONS: 28. To help Sam quit smoking, his therapist blew a blast of smoke into Sam's face each time Sam inhaled. Which technique is the therapist using? a. exposure therapy b. behavior modification c. systematic desensitization d. aversive conditioning 29. To help him overcome his fear of flying, Duane's therapist has him construct a hierarchy of anxiety-triggering stimuli and then learn to associate each with a state of deep relaxation. Duane's therapist is using the technique called a. systematic desensitization. b. aversive conditioning. c. transference. d. free association. STUDY TIP: Each type of behavior therapy discussed is derived from principles of either classical conditioning or operant conditioning. Recall from Chapter 6 that classical conditioning is based on the formation of a learned association between two stimulus situations or events. Operant conditioning is based on the use of reinforcement and punishment to modify Several problem behaviors are described in the chart below. Test your understanding of behavior therapy by completing the chart and explaining how you would treat the problem behavior using one of the behavior therapies. Be sure to identify any reinforcers, conditioned stimuli, and unconditioned stimuli that you would Objective 16-5:State the main premise of therapy based on use. The first example is completed for you. (next page) operant conditioning principles, and describe the views of proponents and critics. Objective 16-6: Discuss the goals and techniques of 30. Reinforcing desired behaviors and withholding cognitive therapy and of cognitive-behavioral therapy. reinforcement for undesired behaviors are key aspects of 33. Therapists who teach people new, more constructive ______________________ ______________________ . ways of thinking are using ______________________ 31. Therapies that influence behavior by controlling its therapy. One such therapy, created by consequences are based on principles of ______________________ and called ______________________ conditioning. One application of ______________________ - ______________________ this form of therapy to institutional settings is the therapy, vigorously challenges people's illogical, self- ______________________ ______________________ , in defeating attitudes. which desired behaviors are rewarded. 34. One variety of cognitive therapy attempts to reverse the State two criticisms of behavior modification. ______________________ beliefs often associated with ______________________ by helping clients see their irrationalities. This therapy was developed by ______________________ . 35. Training people to restructure their thinking in stressful situations is the goal of ______________________ ______________________ training. Students trained to ______________________ their negative thoughts are less 4 Chapter 16: Therapy likely to experience future depression. Rachel, who is a behavior therapist, Ben is more likely to 36. An integrative therapy that combines an attack on a. base his therapy on principles of operant negative thinking with efforts to modify behavior is known conditioning. as ______________________-______________________ b. base his therapy on principles of classical therapy. conditioning. 37. This type of therapy is an effective treatment program for anxiety and mood disorders, because they share a common problem: ______________________ ______________________ . c. address clients' attitudes as well as behaviors. d. focus on clients' unconscious urges. 43. A patient in a hospital receives poker chips for making her bed, being punctual at meal times, and maintaining her physical appearance. The poker chips can be exchanged for privileges, such as television viewing, snacks, and APPLICATIONS (review of all psychotherapies): 38. Given that Don Carlo's therapist attempts to help him by offering genuineness, acceptance, and empathy, she is probably practicing ______________________ therapy. 39. To help Sam lose weight by eating fewer sweets, his magazines. This is an example of the a. psychodynamic therapy technique called systematic desensitization. b. behavior therapy technique called token economy. c. cognitive therapy technique called token economy. therapist laced a batch of cookies with a nausea- d. humanistic therapy technique called systematic producing drug. Which technique is the therapist using? desensitization. ______________________ ______________________ 40. B.J.'s therapist interprets her psychological problems in 44. After Darnel dropped a pass in an important football game, he became depressed and vowed to quit the team terms of repressed impulses. Which type(s) of therapy is because of his athletic incompetence. The campus she using? ______________________ psychologist used gentle questioning to reveal to Darnel 41. Leota is startled when her therapist says that she needs to that his thinking was irrational: his "incompetence" had focus on eliminating her problem behavior rather than earned him an athletic scholarship. The psychologist's gaining insight into its underlying cause. Most likely, response was most typical of a _ therapist. Leota has consulted a ___________________ therapist. a. behavior a. behavior c. cognitive b. psychodynamic b. humanistic d. psychoanalytic c. client-centered 42. Ben is a cognitive-behavioral therapist. Compared with d. cognitive Chapter 16: Therapy 5 Objective 16-7:Discuss the aims and benefits of group and ______________________ groups. One such group is family therapy. ______________________ ______________________ . List several advantages of group therapy. STUDY TIP/APPLICATION: To organize your thinking about the modern psychological therapies discussed in this chapter, complete the chart on the next page. For each category of therapy, state the assumed underlying cause of psychological disorders, the overall goal of therapy, and the role of the therapist. To help you get started, the first example is already filled in . 45. Although ______________________ therapy does not provide the same degree of therapist involvement with each client, it does save time and money and permits therapeutic benefits from ______________________ interaction. 46. The type of group interaction that focuses on the fact that we live and grow in relation to others is ______________________ ______________________ . 47. In this type of group, therapists focus on improving ______________________ within the family. 48. Many people also participate in ______________________- ______________________ and 6 Chapter 16: Therapy Evaluating Psychotherapies 57. A statistical technique that makes it possible to combine Objective 16-8: Discuss whether psychotherapy works as the results of many different psychotherapy outcome interpreted by clients, clinicians, and outcome research. studies is called ______________________ . Overall, the 50. A majority of psychotherapy clients express results of such analyses indicate that psychotherapy (satisfaction/ dissatisfaction) with their therapy. is(somewhat effective/ ineffective). Give three reasons that client testimonials are not Objective 16-9: Describe which psychotherapies are most persuasive evidence for psychotherapy's effectiveness. effective for specific disorders. 51. Clinicians tend to (overestimate/underestimate) the 58. Comparisons of the effectiveness of different forms of effectiveness of psychotherapy. therapy reveal (clear/no clear) differences, that the type of 52. One reason clinicians' perceptions of the effectiveness of therapy provider (matters greatly / does not matter), and psychotherapy are inaccurate is that clients justify entering that whether therapy is provided by an individual therapist therapy by emphasizing their ______________________ or within a group (makes a difference/ does not make a and justify leaving therapy by emphasizing their difference). ______________________ . 59. Some forms of therapy are best for particular problems, 53. (Thinking Critically) Clients' and therapists' though there is often an overlapping or perceptions of therapy's effectiveness may be inflated by ______________________ —of disorders. With phobias, their ______________________ that a treatment works. compulsions, and other specific behavior problems, This phenomenon is called the ______________________ ______________________ ______________________ ______________________ . therapies have been the most effective. Other studies have Another phenomenon that may inflate their perceptions of demonstrated that anxiety, post-traumatic stress disorder, therapy's effectiveness is the phenomenon called and depression may be effectively treated with ______________________ ______________________ ______________________ or ______________________ - ______________________ ______________________ , ______________________ therapy. which is the tendency for ______________________ events 60. As a rule, psychotherapy is most effective with or emotions to return to their ______________________ problems that are (specific/nonspecific). state. 61. Clinical decision making that integrates research with 54. In hopes of better assessing psychotherapy's clinical expertise and patient preferences and characteristics effectiveness, psychologists have turned to is called ______________________- ______________________ research studies. ______________________ ______________________ . 55. The debate over the effectiveness of psychotherapy began with a study by ______________________ ; it APPLICATION: showed that the rate of improvement for those who 62. Your best friend Armand wants to know which type of received therapy (was/was not) higher than the rate for those who did not. 56. In the best studies of the effectiveness of therapy, researchers randomly assign people on a waiting list to therapy or no therapy and later evaluate everyone. These are ______________________ ______________________ trials. therapy works best. You should tell him that a. psychotherapy does not work. b. behavior therapy is the most effective. c. cognitive therapy is the most effective. d. no one type of therapy is consistently the most successful. Chapter 16: Therapy 7 Objective 16-10: Discuss how alternative therapies fare c. "You'd be better off with a prescription for lithium." under scientific scrutiny. d. "It might be worth a try. There is some evidence 63. Today, many forms of ______________________ that morning light exposure produces relief." ______________________ are touted as effective treatments for a variety of complaints. Objective 16-11:Describe the three elements shared by all 64. Aside from testimonials, there is very little evidence forms of psychotherapy. based on ______________________ research for such 68. All forms of psychotherapy offer three benefits: therapies. ______________________ for demoralized people; a new 65. In one popular alternative therapy, a therapist triggers ______________________ on oneself; and a relationship eye movements in patients while they imagine that is ______________________ , ______________________ ______________________ . ______________________ , and ______________________. This therapy, called ______________________ 69. The emotional bond between therapist and client—the ______________________ ______________________ ______________________ ______________________—is ______________________ ______________________, has a key aspect of effective therapy. In one study of depression proven (completely ineffective/ somewhat effective) as a treatment, the most effective therapists were those who treatment for nonmilitary ______________________- were perceived as most ______________________ and ______________________ ______________________ ______________________ . ______________________ . However, skeptics point to Objective 16-12:Discuss how culture, gender, and values evidence that ______________________ influence the therapist-client relationship. ______________________ is just as effective as triggered 70. Generally speaking, psychotherapists' personal values eye movements in producing beneficial results. The key (do/ do not) influence their therapy. This is particularly seems to be in the person's ______________________ significant when the therapist and client are from different traumatic memories and in a ______________________ ______________________ or are different effect. ______________________ . Another area of potential value 66. For people who suffer from the wintertime form of conflict is ______________________ . depression called ______________________ 71. In North America, Europe, and Australia, most ______________________ ______________________, therapists reflect their culture's ______________________ . timed ______________________ 72. Differences in values may help explain the reluctance of ______________________ therapy may be beneficial. some ______________________ populations to use mental health services. APPLICATION: Objective 16-13: Identify some guidelines for selecting a 67. A close friend who for years has suffered from wintertime therapist. depression is seeking your advice regarding the 73. The American Psychological Association suggests that a effectiveness of light exposure therapy. What should you person should seek help when he or she has feelings of tell your friend? ______________________ , a deep and lasting a. "Don't waste your time and money. It doesn't ______________________ , ______________________ , work." behavior, disruptive ______________________ , sudden b. "A more effective treatment for seasonal affective ______________________ shifts, and disorder is eye movement desensitization and ______________________ rituals, for example. reprocessing." 8 Chapter 16: Therapy APPLICATION: 81. Xanax and Ativan are classified as 74. Seth enters therapy to talk about some issues that have ______________________ drugs. been upsetting him. The therapist prescribes some 82. These drugs depress activity in the medication to help him. The therapist is most likely a ______________________ ______________________ a. clinical psychologist. ______________________ . b. psychiatrist. 83. When used in combination with c. psychiatric social worker. d. clinical social worker. The Biomedical Therapies ______________________ ______________________ these drugs can help people cope with frightening situations. 84. Antianxiety drugs have been criticized for merely Objective 16-14: Identify and describe the drug therapies, reducing ______________________ , rather than resolving and explain how double-blind studies help researchers underlying ______________________ . These drugs can evaluate a drug's effectiveness. also cause ______________________ 75. As noted earlier, therapy involving changing the brain's ______________________ . functioning is referred to as ______________________ 85. Drugs that are prescribed to alleviate depression are therapy. The most widely used biomedical treatments are called ______________________ drugs. They are the ______________________ therapies. Thanks to these increasingly being used to treat ______________________ therapies, the number of residents in mental hospitals has disorders such as ______________________- (increased/decreased) sharply. ______________________ disorder. These drugs work by 76. The field that studies the effects of drugs on the mind increasing levels of the neurotransmitters and behavior is ______________________ . ______________________ or ______________________ . 77. To guard against the ______________________ effect 86. One example of this type of drug is and normal ______________________ , neither the patients ______________________ , which works by blocking the nor the staff involved in a study may be aware of which reabsorption and removal of ______________________ condition a given individual is in; this is called a from synapses and is therefore called a ______________________-______________________ ______________________ - ______________________ - procedure. ______________________ - ______________________ 78. One effect of drugs such as is to help those experiencing drug. Increased serotonin promotes (positive/negative) symptoms of schizophrenia by ______________________ , the development of new brain decreasing their responsiveness to irrelevant stimuli. cells. Drugs that work by blocking the reabsorption or Schizophrenia patients who are apathetic and withdrawn may be more effectively treated with atypical antipsychotics such as ______________________ . 79. The antipsychotic drugs work by blocking the receptor sites for the neurotransmitter ______________________ . 80. Long-term use of antipsychotic drugs can produce ______________________ ______________________ which involves involuntary movements of the muscles of the ______________________ , ______________________, and ______________________ . breakdown of norepinephrine and serotonin are called ______________________ - ______________________ drugs. These drugs have (more/fewer) side effects. Chapter 16: Therapy 9 87. Also effective in calming anxious people and energizing a. antipsychotic depressed people is ______________________ , which has b. mood-stabilizing positive side effects. Even better is to use antidepressant c. antidepressant drugs, which work (bottom-up / top-down), in conjunction d. anticonvulsive with ______________________ ______________________ therapy, which works (bottom- 94. A psychiatrist has diagnosed a patient as having bipolar disorder. It is likely that she will prescribe a. an antipsychotic drug. up / top-down). b. lithium. 88. Although people with depression often improve after c. an antianxiety drug. one month on antidepressants, studies demonstrate that a d. a drug that blocks receptor sites for serotonin. large percentage of the effectiveness is due to ______________________ ______________________ or a ______________________ ______________________ . 89. To treat the emotional highs and lows of ______________________ disorder, a ______________________ - ______________________ drug such as the simple salt ______________________ is often prescribed. 90. Another effective drug in the control of mania was originally used to treat epilepsy; it is ______________________ . Objective 16-15: Describe the use of brain stimulation techniques and psychosurgery in treating specific disorders. 95. The therapeutic technique in which the patient receives an electric shock to the brain is referred to as ______________________ therapy, abbreviated as ______________________ 96. ECT is most often used with patients suffering from severe ______________________ . Research evidence (confirms/does not confirm) ECT's effectiveness with such patients. 97. The mechanism by which ECT works is ______________________ . APPLICATIONS: 91. In an experiment testing the effects of a new antipsychotic drug, neither Dr. Cunningham nor her patients know whether the patients are in the experimental or the control group. This is an example of 98. A gentler procedure called ______________________ ______________________ ______________________ ______________________ aims to treat depression by presenting pulses through a magnetic coil held close to a a. outcome research. person's skull above the right eyebrow. Unlike ECT, this b. within-subjects research. procedure produces no ______________________ . c. the double-blind procedure. ______________________ loss, or other side effects. d. the single-blind procedure. Although how it works is unclear, one explanation is that it 92. Linda's doctor prescribes medication that blocks the energizes the brain's left ______________________ activity of dopamine in her nervous system. Evidently, ______________________ , which is relatively inactive in Linda is being treated with an ______________________ depressed patients. drug. 99. Another treatment being investigated for treatment of a. antipsychotic c. antidepressant patients with depression is ______________________ - b. antianxiety d. anticonvulsive ______________________ stimulation of a neural hub that 93. Abraham's doctor prescribes medication that increases the availability of norepinephrine or serotonin in his nervous system. Evidently, Abraham is being treated with an ______________________ drug. bridges the frontal lobes to the limbic system. 100. The biomedical therapy in which a portion of brain tissue is removed or destroyed is called 10 Chapter 16: Therapy ______________________ . 107. Psychotherapies and biomedical therapies locate the 101. In the 1930s, Moniz developed an operation called the cause of psychological disorders within the ______________________ . In this procedure, the ______________________ . An alternative viewpoint is that ______________________ lobe of the brain is disconnected many psychological disorders are responses to ___________ from the rest of the brain. _________________________________________________ 102. Today, most psychosurgery has been replaced by the 108. According to this viewpoint, it is not just the use of ______________________ or some other form of ______________________ who needs treatment but also treatment. the person's ______________________ ______________________ . APPLICATION: 109. One advocate of ______________________ mental 103. In concluding her talk titled "Psychosurgery Today," health, George Albee, believes that many social stresses Ashley states that undermine people's sense of ______________________ , a. "Psychosurgery is still widely used throughout the ______________________ , ______________________ , world." and ______________________ . These stresses include b. "Electroconvulsive therapy is the only remaining ______________________ , work that is psychosurgical technique that is widely practiced." c. "With advances in psychopharmacology, psychosurgery has largely been abandoned." d. "Although lobotomies remain popular, other psychosurgical techniques have been abandoned." Objective 16-16: Describe how, by taking care of themselves with a healthy lifestyle, people might find some ______________________ , constant ______________________ , ______________________ , ______________________ , and ______________________. 110. Albee's views remind us that disorders are not just biological and not just environmental or psychological because we are all an ______________________ ______________________ system. relief from depression, and explain how this reflects our being biopsychosocial systems. 104. A recent approach to therapy promotes ______________________ ______________________ change, which includes regular aerobic exercise, adequate sleep, light exposure, social connection, anti-rumination, APPLICATION: 111. A psychotherapist who believes that the best way to treat psychological disorders is to prevent them from developing would be MOST likely to view disordered behavior as a. maladaptive thoughts and actions. and nutritional supplementation. b. expressions of unconscious conflicts. 105. The relative success of this ______________________ c. conditioned responses. approach seems to confirm that everything psychological is d. an understandable response to stressful social also biological and that we are all social creatures. conditions. Preventing Psychological Disorders Objective 16-17: Explain the rationale of preventive mental health programs. 106. Lifestyle changes may also help prevent some disorders by building an individual's ______________________ .