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Chapter 12
Methods of Therapy
Module 12.1
Types of Psychotherapy
Module 12.1 Preview Questions
 What
is psychotherapy?
 What are the major types of mental health
professionals?
 What are the major types of
psychotherapy?
 What is eclectic therapy?
 What are group, family, and couple
therapy?
Module 12.1
Preview Questions (Cont’d)
 Does
 What
psychotherapy work?
cultural factors do therapists need to
consider when working with members of
diverse groups?
What Is Psychotherapy?
A
psychologically based form of treatment
used to help people better understand
their emotional or behavioral problems and
resolve them
 Often
called “talk therapy” because
consists of a series of verbal interactions
between therapist and client
Major Types of Mental Health
Professionals (see Table 12.1 for more details)
 Clinical
psychologists
 Counseling psychologists
 Psychiatrists
 Clinical or psychiatric social workers
 Psychoanalysts
 Counselors
 Psychiatric nurses
Contemporary Approaches to
Therapy

Psychological therapies- based on psychological
principles





Behavioral therapy
Cognitive therapy
Psychodynamic approach
Humanistic therapy
Biomedical therapies- treatments that focus on
altering the brain, especially with drugs,
psychosurgery, or electroconvulsive therapy
Psychodynamic Therapy
 Psychological
problems are rooted in
unconscious psychological conflicts dating
from childhood
 Gaining
insight into conflicts and working
through them are the key steps to
restoring psychological health
 Traditional
Freud
psychoanalysis developed by
Psychoanalytic Techniques
 Free
association
 Dream

analysis
Latent vs. manifest content
 Use
of interpretations to help the client
gain insight



Interpretation of client’s resistance
Analysis of the transference relationship
Problem of countertransference
Modern Psychodynamic
Approaches (More Ego, Less Id)
 Less
focus on sexual issues
 Focus


more on the:
Adaptive functioning of ego
Client’s current relationships
 Briefer,
more direct approach
Humanistic Therapy
 Humans
possess free will and can make
conscious choices that enrich their lives
 Emphasis
on the client’s subjective,
conscious experience
 Focus
past
is on the here-and-now, not the
Rogers’s Client-Centered
Therapy
 Psychological
problems stem from
blocked self-actualization
 Focus


of therapy is on the person:
Therapist strives to create warm, accepting
atmosphere for client
Nondirective approach
Client-Centered Therapy (Cont’d)
 Effective



therapists display:
Unconditional positive regard
Empathy
Genuineness
Perls’s Gestalt Therapy
 Important
to help clients blend conflicting
parts of personality into an integrated
whole or “Gestalt”
 Characteristics:



Direct, even confrontational, approach
Challenging of clients to express feelings
Use of role playing, such as empty chair
technique
Behavior therapies
 Classical


Systematic desensitization
Aversion therapy
 Operant



Conditioning Techniques
Conditioning Approaches
Contingency management
Social Learning Therapy
Token Economies
Behavior Therapy
 Application
of learning principles to help
person make adaptive changes in
behavior

Assumption that psychological problems are
learned
 Focus
is on changing problem behaviors,
not exploring client’s feelings
Behavior Therapy: Fear
Reduction
 Systematic

desensitization
Construction of a fear hierarchy
 Gradual
exposure (in-vivo experience)
 Modeling
 Virtual
reality therapy
Behavior Therapy: Aversive Conditioning
 Form
of classical conditioning
 Objects

paired with aversive stimuli
e.g., electric shock, nausea-inducing drug
 Effects
often temporary
Other Behavior Therapy
Methods
 Operant


Conditioning Methods
Reinforcement and punishment
Token economy
 Cognitive-Behavioral

Therapy (CBT)
Combines behavioral techniques with
cognitive techniques
Cognitive Therapy
 Focus
on helping people to change how
they think
 Assumption that distorted thinking
underlies:



Emotional problems
Self-defeating behaviors
Maladaptive behaviors
 Focus
on present, not distant past
Ellis’s Rational-Emotive
Behavior Therapy (REBT)
 Irrational

beliefs lead to problems
Often take the form of “shoulds” and “musts”
 Encourages
clients to replace irrational
beliefs with rational alternatives
Beck’s Cognitive Therapy
 Goal
is to help clients identify and correct
errors in thinking

“Cognitive distortions”
 Clients

given homework assignments
e.g., Reality testing
 Although
similar to REBT, differs in
therapeutic style
Eclectic Therapy
 Draws
upon principles and techniques
representing different schools of therapy
 Most widely endorsed theoretical
orientation
 Some argue that therapeutic integration is
neither desirable nor achievable.
Continue
Group Therapy



People brought together to explore and resolve
problems
Advantages:
 Less costly
 Helps with interpersonal problems, social skills
 Share coping strategies
Drawbacks:
 No individual attention
 Reluctance to disclose personal problems to
group
 Feelings of inhibition
Family Therapy
 Helps
troubled families learn to
communicate better and resolve their
differences
 Family,
not the individual, is the unit of
treatment
 Individual
problems symptomatic of family
system breakdown
Couples Therapy
 The
couple is the unit of the treatment
 Goal


is to build healthier relationships:
Acquire more effective communication and
problem-solving skills
Resolve power struggles
 Aim
is to help open channels of
communication between partners
Nonspecific Factors Accounting
for the Benefits of Psychotherapy
 Interpersonal

Therapeutic alliance
 Expectation


relationship with therapist
of improvement
Self-fulfilling prophecy
Placebo or expectancy effects
Multicultural Issues
 Members
of ethnic and racial minorities
may have different customs, beliefs, and
philosophies
 Culturally
sensitive therapists need to
respect and understand the customs,
cultures, and values of the people they
treat
Module 12.2
Biomedical Therapies
Module 12.2 Preview Questions
 What
are the major types of psychotropic or
psychiatric drugs?
 What are the advantages and
disadvantages of psychiatric drugs?
 What is ECT, and how is it used?
 What is psychosurgery?
 What are community-based mental health
centers?
 How successful is the policy of
deinstitutionalization?
How Is the Biomedical Approach
Used to Treat Mental Disorders?

Biomedical therapies seek to alter the structure
of function of the brain through drugs, surgery,
or electromagnetic stimulation

Psychopharmacotherapy- treatment of mental
disorders with medication

Three major groups of drugs
1.
2.
3.
Antipsychotic drugs
Antidepressant drugs
Antianxiety drugs
Drug Therapy: Antianxiety
Drugs
 Also
called minor tranquilizers
 Effects:



Reduces anxiety
Produces calmness
Reduces muscle tension
 Effect
on GABA receptors
 Examples:

Valium, Librium, Xanax
Drug Therapy: Antidepressants
 Increases
availability of
neurotransmitters

Serotonin, norepinephrine
 Major



types:
Tricyclics (e.g., Elavil)
MAO inhibitors (e.g., Nardil)
Selective serotonin-reuptake inhibitors
(e.g., Prozac, Zoloft)
 Used
to treat more than depression
(e.g., anxiety, bulimia, phobias, PTSD,
OCD)
Drug Therapy: Antipsychotics
 Sometimes
called major tranquilizers
 Used to treat schizophrenia and other
psychotic disorders
 Newer drugs block the action of dopamine
at receptor sites in brain
Other Psychiatric Drugs
 Mood

stabilizers to reduce mood swings
e.g., Lithium
 Stimulants
used to improve attention
spans and reduce disruptive behavior in
hyperactive children

e.g., Ritalin, Cylert
Evaluating Psychotropic Drugs
 Limitations:


May reduce or control symptoms, but not a
cure
Does not teach how to resolve problems or
develop necessary life skills
 Risks
of adverse side effects
 Some drugs can lead to psychological or
physical dependence
Evaluating Psychotropic Drugs
(Cont’d)
 Relapses
common when taking drugs is
stopped
 May be seen as a “quick fix”
 Useful for temporary relief

Usually used in tandem with psychotherapy
Electroconvulsive Therapy (ECT)
 Electric
current is passed through head
 Can produce dramatic relief from severe
depression
 High rates of relapse in weeks and months
following treatment
 May produce permanent memory loss
 Many view as treatment of last resort
Psychosurgery
 Involves
surgically altering the brain to
control deviant or violent behavior
 Prefrontal lobotomy a widely practiced
form in the past
 More sophisticated techniques have been
introduced in recent years.

But still, procedures rarely used and only as
a treatment of last resort
Community-Based Care
 Social

policy of deinstitutionalization
Resulted in the back wards of many mental
hospitals being vacated
 Community-based
mental health centers
offer a variety of services
 Has deinstitutionalization been
successful?

A work in progress
Module 12.3
Getting Help
Choosing a Therapist

Seek recommendations from respected sources

Seek a referral from a local medical center or
local community mental health center

Seek consultation from college counseling
center or health services

Contact professional organizations for
recommendations
Choosing a Therapist (Cont’d)
 Use
local Yellow Pages, but be careful
 Check
 Ask
 Ask
for proper licensing
about type of therapy being provided
about provider’s background &
experience
Working with the Therapist
 Discuss
diagnosis and treatment plan
before committing
 Ask
about costs and insurance
 Find
out about policies for missed or
canceled sessions
 If
medication is to be prescribed, inquire
about delay, side effects
Working with Therapist (Cont’d)
 Openly
discuss concerns about treatment
 Request
 Be
a second opinion if in doubt
wary of online therapy services