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Module 24
Therapies
HISTORICAL BACKGROUND
• Definition of Psychotherapy
– three basic characteristics
1. verbal interaction between therapist and client
2. development of a supportive relationship in which a
client can bring up and discuss traumatic or
bothersome experiences that may have led to current
problems
3. analysis of the client’s experiences and/or suggested
ways for the client to deal with or overcome his or her
problems
HISTORICAL BACKGROUND (CONT.)
• Early Treatments
– 1400 to 1700, people who today would be diagnosed
as schizophrenics were considered insane and called
lunatics
– late 1800s, Dr. Benjamin Rush, (considered the father
of American Psychiatry), developed the “tranquilizing
chair”
– believed that mental disorders were caused by too
much blood to the brain
HISTORICAL BACKGROUND (CONT.)
• Reform movement
– Moral therapy, popular in the early 1800s
• belief that mental patients could be helped to
function better by providing humane treatment in a
relaxed and decent environment
• late 1800s, moral therapy was abandoned
• 1930s, Sigmund Freud had developed
psychoanalysis
• early 1950s, wretched conditions and inhumane
treatment of patients persisted
• mid 1950s, two dramatic changes happened:
discovery of antipsychotic drugs, and development
of community mental health centers
HISTORICAL BACKGROUND (CONT.)
• Phenothiazines and deinstitutionalization
– Phenothiazines
• discovered in the early 1950s, block or reduce the
effects of the neurotransmitter dopamine and
reduce schizophrenic symptoms, such as
delusions and hallucinations
• chlorpromazine (Thorazine)
– Deinstitutionalization
• refers to the release of mental patients from mental
hospitals and their return to the community to
develop more independent and fulfilling lives
HISTORICAL BACKGROUND (CONT.)
• Community mental health centers
– offer low-cost or free mental health care to members
of the surrounding community, especially the
underprivileged
– provide briefer forms of therapy that are needed in
emergencies and focus on the early detection and
prevention of psychological problems
QUESTIONS ABOUT PSYCHOTHERAPY
• Are there different kinds of therapists?
– Psychiatrists
• go to medical school, receive an M.D. degree, and
then take a psychiatric residency, which involves
additional training in pharmacology, neurology,
psychopathology, and psychotherapeutic
techniques
– Clinical psychologists
• go to graduate school in clinical psychology and
earn a doctorate degree (Ph.D., Psy.D., or Ed.D.)
– Counseling psychologists
• go to graduate school in psychology or education
and earn a doctorate degree (Ph.D., Psy.D., or
ed.D)
QUESTIONS ABOUT PSYCHOTHERAPY
(CONT.)
• Are there different approaches?
– Insight therapy
• therapist and client talk about the client’s
symptoms and problems with the goal of reaching
or identifying the cause of the problem
– Cognitive-behavior therapy
• involves the application of principles of learning
• therapist focuses on the client’s problem, identifies
specific thoughts and behaviors that need to be
changed and provides techniques based on
learning principles to make desired changes
QUESTIONS ABOUT PSYCHOTHERAPY
(CONT.)
• Are there different approaches?
– Eclectic approach
• involves combining and using techniques and
ideas from many different therapeutic approaches
– Medical therapy
• involves the use of various psychoactive drugs to
treat mental disorders by changing biological
factors, such as the levels of neurotransmitters
INSIGHT THERAPIES
• Psychoanalysis
– focuses on the idea that each of us has an
unconscious part that contains ideas, memories,
desires, or thoughts, that have been hidden or
repressed because they are psychologically
dangerous or threatening to our self-concept
• Unconscious conflicts
– chief reason for the development of psychological
problems (paranoia) and physical symptoms (loss of
feeling in a hand)
INSIGHT THERAPIES (CONT.)
• Psychoanalysis
– Three techniques
• free association, dream interpretation, and analysis
of slips of the tongue
– Transfer
• patient reacts to the therapist as a substitute
parent, lover, sibling, or friend and projects strong
emotions onto the therapist
INSIGHT THERAPIES (CONT.)
• Techniques to reveal the unconscious
– Neuroses
• maladaptive thoughts and actions that arise from
some unconscious thought or conflict and indicate
feelings of anxiety
– Free association
• technique that encourages clients to talk about any
thoughts or images that enter their heads
• assumption is that this kind of free-flowing,
uncensored talking will provide clues to
unconscious material
INSIGHT THERAPIES (CONT.)
• Techniques to reveal the unconscious
– Dream interpretation
• psychoanalytic technique based on the assumption
that dreams contain underlying, hidden meanings
and symbols that provide clues to unconscious
thoughts and desires
INSIGHT THERAPIES (CONT.)
• Problems during therapy
– Transference
• process by which a client expresses strong
emotions toward the therapist because the
therapist substitutes for someone important in the
client’s life, such as the client’s mother or father
– Resistance
• characterized by the client’s reluctance to work
through or deal with feelings or to recognize
unconscious conflicts and repressed thoughts
– Short-term dynamic psychotherapy
• emphasizes a limited time for treatment (3-20
sessions) and focuses on limited goals, such as
solving a relatively well-defined problem
INSIGHT THERAPIES (CONT.)
• Client-centered therapy
– also called person-centered therapy
– assumes that each person has an actualizing
tendency, which is a tendency to develop one’s full
potential
• Therapist’s traits:
– Empathy
• ability to understand what the client is saying and
feeling
– Positive regard
• ability to communicate caring, respect, and regard
for the client
– Genuineness
• ability to be real and nondefensive in interactions
with the client
INSIGHT THERAPIES (CONT.)
• Cognitive therapy
– developed by Aaron Beck
– assumes that we have automatic negative thoughts
that we typically say to ourselves without much notice
– repeating these automatic negative thoughts causes
distortion in how we perceive and interpret our world
and influences how we behave and feel
BEHAVIOR THERAPY
• Definition
– Also called behavior modification
• uses the principles of classical and operant
conditioning to change disruptive behaviors and
improve human functioning
• focuses on changing particular behaviors rather
than the underlying mental events or possible
unconscious factors
– Systematic desensitization
• technique of behavior therapy in which the client is
gradually exposed to the feared object while
simultaneously practicing relaxation
BEHAVIOR THERAPY
• Cognitive-behavior therapy
– combines the cognitive therapy technique of changing
negative, unhealthy, or distorted thought patterns,
with behavior therapy
– technique of changing maladaptive or disruptive
behaviors by learning and practicing new skills, to
improve functioning
BEHAVIOR THERAPY
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