Download Chapter 17: Treatment

Chapter 15: Therapy
Insight Therapies
A variety of individual psychotherapies designed to give people a better awareness and
understanding of their feelings, motivations, and actions in the hope that this will help
them adjust.
•
•
•
psychoanalysis
client-centered therapy
gestalt therapy
Psychoanalysis
•
•
•
•
Based on the belief that anxiety and other problems are symptoms of inner conflicts
stemming from childhood
free association: A technique that encourages the patient to talk without inhibition
about whatever thoughts or fantasies come to mind
transference: The patient’s carrying over to the analyst feelings held toward childhood
authority figures
insight: Awareness of previously unconscious feelings and memories and how they
influence present feelings and behavior
Client-Centered Therapy
•
Nondirectional form of therapy developed by Carl Rogers that calls for unconditional
positive regard of the client by the therapist with the goal of helping the client become
fully functioning
“Client” vs. “Patient”
•
Rogers used the term client rather than patient to highlight the more active and equal
role he assigned to the person seeking therapy
Role of the Therapist
•
•
Rogers emphasized understanding life from the client’s point of view
A therapist must be nondirective and reflect back to the client what he/she has said
Gestalt Therapy
•
A therapy that emphasizes the wholeness of the personality and attempts to reawaken
people to their emotions and sensations in the here-and-now
•
•
Fritz Perls encouraged face-to-face confrontations to help people become more
genuine or “real” in their day-to-day interactions
The therapist is active and directive
Behavior Therapies
•
•
•
•
Therapeutic approaches that are based on the belief that all behavior is learned, and
that the objective of therapy is to teach people new, more satisfying ways of behaving
classical conditioning
operant conditioning
modeling
Use of Classical Conditioning
•
•
•
systematic desensitization: A technique for reducing fear and anxiety by gradually
associating a new response (relaxation) with stimuli that have been causing the fear
and anxiety
flooding: A method of desensitization through intense and prolonged exposure to
anxiety-producing stimuli
aversive conditioning: Techniques aimed at eliminating undesirable behavior patterns
by teaching the person to associate them with pain and discomfort
Use of Operant Conditioning
•
•
behavior contracting: The client and therapist set behavioral goals and agree on
reinforcements the client will receive upon reaching those goals
token economy: Patients earn tokens (reinforcers) for desired behaviors and exchange
them for desired items or privileges
Modeling
•
A behavior therapy in which the person learns desired behaviors by watching others
perform those behaviors
Cognitive Therapies
•
•
•
•
Emphasize changing clients’ perceptions of their life situation as a way of modifying
their behavior
stress-inoculation therapy
rational-emotive-therapy
Beck’s cognitive therapy
Stress-Inoculation Therapy
•
•
Trains clients to cope with stressful situations by learning a more useful pattern of
self-talk
Stress-inoculation therapy works by turning the client’s own thought patterns into a
kind of vaccine against stress-induced anxiety
Rational-Emotive Therapy (RET)
•
A directive therapy based on the idea that clients’ psychological distress is caused by
irrational and self-defeating beliefs and the therapist’s job is to challenge such
dysfunctional beliefs
•
Irrational/self-defeating beliefs involve absolutes (e.g., “musts” and “shoulds”) that
allow no room for mistakes
Beck’s Cognitive Therapy
•
•
Therapy that depends on identifying and changing inappropriately negative and selfcritical patterns of thought
Therapists try to help clients examine each dysfunctional thought in a supportive but
objectively scientific manner
Group Therapy
•
•
•
Clients meet regularly to interact and help one another achieve insight into their
feelings and behavior
family therapy
couple therapy
Advantages of Group Therapy
•
•
•
•
•
Allows client and therapist to see how client acts around others
Offers a client social support
Can help the client learn new behaviors
Interaction with others may lead to insight into one’s own behavior
Less expensive than individual therapy
Family Therapy
•
•
The family is seen as partly responsible for the individual’s problems
Family therapy seeks to change all family members’ behaviors to the benefit of the
family unit as well as the troubled individual
Couple Therapy
•
•
A form of group therapy intended to help troubled partners improve their problems of
communication and interaction
empathy training: Each person is taught to share inner feelings and to listen to and
understand the partner’s feelings before responding to them
Effectiveness of Psychotherapy
•
•
•
Therapy benefits two-thirds of the people undergoing it
Only 1 out of 3 people improve without therapy
In general, no one therapy appears to be more effective than another
Biological Treatments
•
•
A group of treatment approaches, such as medication, electroconvulsive therapy, and
psychosurgery
These treatments are sometimes used to treat psychological disorders in conjunction
with, or instead of, psychotherapy
Reasons for Use of Drug Therapy
 The development of several effective drugs
 Drug therapies cost less than psychotherapy
 Critics contend that drugs are used because of our society’s “pill mentality”
Classes of Drugs Used for Therapy
•
•
antipsychotics: Drugs (e.g., Thorazine) used to treat very severe psychological
disorders, particularly schizophrenia
antidepressants: Drugs (e.g., MAO inhibitors, Prozac) used to combat depression
Lithium Carbonate
•
•
Lithium is a naturally occurring salt that is used to treat bipolar disorder
Lithium helps level out the extreme highs of mania and the extreme lows of depression
Electroconvulsive Therapy (ECT)
•
A mild electrical current is passed through the brain for a short period, often producing
convulsions and temporary coma; used to treat severe, prolonged depression
•
The reason ECT works remains unknown
Psychosurgery
•
•
Brain surgery performed to change a person’s behavior and emotional state (e.g.,
prefrontal lobotomy)
This therapy is rarely used today
Deinstitutionalization
•
The policy of treating people with severe psychological disorders in the community
rather than in large public hospitals
Problems with Deinstitutionalization
 Community mental-health centers are poorly funded or non-existent
 Ex-patients are poorly prepared to live in the community
 Not enough housing available
 Social stigma of having a mental disorder
 Large insurance companies discourage outpatient care
Types of Mental Illness Prevention
•
•
•
primary prevention
secondary prevention
tertiary prevention
Primary Prevention
•
Techniques and programs to improve the social environment so that new cases of
mental disorders do not develop
Secondary Prevention
•
Programs to identify groups that are at high risk for mental disorders and to detect
maladaptive behavior in these groups and treat it properly
Tertiary Prevention
•
Programs to help people adjust to community life after release from a mental hospital
Gender Differences in Treatment
•
•
•
Women are more likely than men to be in psychotherapy
Psychotherapy is more socially accepted for women than men
Traditionally, women have received a disproportionate share of psychotropic drugs
Cultural Differences in Treatment
•
•
Our ideas of what constitutes normal behavior may not be viewed as normal by
another culture
Some psychological disorders only occur within a specific culture