Download Understanding Psychology 5th Edition Morris and

Understanding Psychology
6th Edition
Charles G. Morris and Albert A. Maisto
PowerPoint Presentation by
H. Lynn Bradman
Metropolitan Community College
©Prentice Hall 2003
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Chapter 17
Therapies
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Insight Therapies
• Insight therapy is a major category of
treatment for psychological problems.
• Insight therapies have in common the goal of
providing people with better awareness and
understanding of their feelings, motivations,
and actions in the hope that this will lead to
better adjustment.
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Insight Therapies
• Three examples of insight therapies are:
– Psychoanalysis
– Humanistic Therapies:
• Client-Centered Therapy
• Gestalt Therapy
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Psychoanalysis (Based on Freud’s
approach to Psychology)
• Based on the belief that anxiety and other
problems are symptoms of inner conflicts
stemming from childhood.
• Free association: A technique encouraging
the patient to talk without inhibition about
whatever thoughts or fantasies come to mind.
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Psychoanalysis
• 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.
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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.
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“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.
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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.
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Gestalt Therapy
• A therapy emphasizing the wholeness of the
personality and attempts to reawaken people
to their emotions and sensations in the here
and now.
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Gestalt Therapy
• 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.
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Behavior Therapies
• Behavior therapies are based on the belief
that all behavior, normal and abnormal, is
learned and that the goal of therapy is to
teach people more satisfying ways of
behaving
• For behaviorists, the focus of psychotherapy
should be the problem behaviors themselves,
not some deeper, underlying conflicts that are
presumably causing those behaviors.
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Behavior Therapies
• Therapeutic approaches based on the belief
that all behavior is learned.
• The objective of therapy is to teach people
new, more satisfying ways of behaving.
– Classical conditioning
– Operant conditioning
– Modeling
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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.
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Use of Classical Conditioning
• Aversive conditioning:
– Techniques aimed at eliminating undesirable
behavior patterns by teaching the person to
associate them with pain and discomfort.
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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 economies:
– Patients earn tokens (reinforcers) for desired
behaviors and exchange them for desired items or
privileges.
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Modeling
• A behavior technique in which the person
learns desired behaviors by watching others
perform those behaviors.
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Cognitive Therapies
• Cognitive therapies focus not so much on
maladaptive behaviors as on maladaptive
ways of thinking.
• By changing people's distorted, self-defeating
ideas about themselves and the world,
cognitive therapists hope to encourage better
coping skills and adjustment.
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Cognitive Therapies
• Emphasize changing clients’ perceptions of
their life situation as a way of modifying their
behavior.
– Stress-inoculation therapy
– Rational-emotive therapy (RET)
– Beck’s cognitive therapy
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Stress-Inoculation Therapy
• Trains clients to cope with stressful situations
by learning a more useful pattern of self-talk.
• Works by turning the client’s own thought
patterns into a kind of vaccine against stressinduced anxiety. (Thinking about deep
breathing and relaxation instead of panic, for
example).
• Clients practice new coping strategies with
the therapist.
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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, for example “musts” and “shoulds”
that allow no room for mistakes.
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A,B C Model
• REBT employs the ‘ABC framework’
(A) activating events
(B) our beliefs about them
(C) the cognitive, emotional or behavioral consequences of our
beliefs
Negative event--- Rational Belief---Healthy Negative Emotion
Negative event---Irrational Belief---Unhealthy Negative Emotion
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Beck’s Cognitive Therapy
• Depends on identifying and changing
inappropriately negative and self-critical
patterns of thought.
• Therapists try to help clients examine each
dysfunctional thought in a supportive but
objectively scientific manner.
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Beck’s Cognitive Therapy
• It is important to make sure that the client is
interpreting what is going on around them
accurately.
• People under stress tend to be focused on a
negative issue, they may not be thinking
properly.
• They can also ‘read into’ situations things
which in reality are not there, it is their own
interpretations which are faulty.
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Beck’s Cognitive Therapy
•
•
•
What is the evidence supporting the
conclusion currently held by the client?
What is another way of looking at the same
situation but reaching another conclusion?
What will happen if, indeed, the current
conclusion/opinion is correct?
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Group Therapies
• Based on the idea that psychological
problems are at least partly interpersonal and
are therefore best approached in a group.
• Offer a circle of support for clients, shares
insights into problems, and provides the
opportunity to obtain psychotherapy at a
lower cost.
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Group Therapy
• Clients meet regularly to interact and help
one another achieve insight into their feelings
and behavior.
– Self-help groups
– Family therapy
– Couple therapy
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Self-Help Groups
• As the cost of private psychotherapy has
risen, self-help groups have become
increasingly popular because of its low cost.
• In such groups, people share their concerns
and feelings with others who are experiencing
similar problems.
• Alcoholics Anonymous is a very effective selfhelp group.
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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.
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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.
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Effectiveness of
Psychotherapy
• Most researchers agree that psychotherapy
helps about two-thirds of the people treated.
• Although there is some debate over how
many untreated people also recover, the
consensus is that those who get therapy are
generally better off than those who don't.
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Effectiveness of
Psychotherapy
• Each kind of therapy, however, works better
for some problems than for others.
• The general trend in psychotherapy is toward
eclecticism, the use of whatever treatment
works best for a particular problem.
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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.
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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.”
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Major Types of Psychoactive
Drugs
• Drugs are the most common form of
biological therapy.
• Antipsychotic drugs are valuable in treating
schizophrenia.
• They do not cure the disorder, but they
reduce its symptoms, although side effects
can be severe.
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Major Types of Psychoactive
Drugs
• Antidepressant drugs alleviate depression,
though some also have serious side effects.
• Many other types of medications are used to
treat psychological disorders including:
–
–
–
–
Antimanic drugs
Antianxiety drugs
Sedatives
Psychostimultants for children with attentiondeficit/hyperactivity disorder.
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Major Types of Psychoactive
Drugs
– Antipsychotics are drugs used to treat very severe
psychological disorders, particularly schizophrenia.
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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.
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Electroconvulsive Therapy
(ECT)
• A mild electrical current is passed through the
brain for a short period, often producing
convulsions and temporary coma.
• ECT is used to treat severe, prolonged
depression.
• The reason ECT works remains unknown.
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Psychosurgery
• Brain surgery performed to change a person’s
behavior and emotional state, for example
prefrontal lobotomy.
• This therapy is rarely used today.
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Caring for the Seriously
Disturbed and Preventing
Disorders
• In the past, institutionalization in large mental
hospitals was the most common approach to
caring for people with serious mental
disorders.
• Patients were given shelter and some degree
of treatment, but a great many were never
able to be released.
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Caring for the Seriously
Disturbed and Preventing
Disorders
• Then, with the advent of antipsychotic drugs,
a trend began toward deinstitutionalization,
or integrating people with serious mental
disorders back into the community.
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Deinstitutionalization
• The policy of treating people with severe
psychological disorders in the community
rather than in large public hospitals.
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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.
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Types of Mental Illness
Prevention
• Primary prevention
• Secondary prevention
• Tertiary prevention
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Primary Prevention
• Techniques and programs to improve the
social environment so that new cases of
mental disorders do not develop.
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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.
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Tertiary Prevention
• Programs to help people adjust to community
life after release from a mental hospital.
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Client Diversity and
Treatment
• Given that human beings differ as much as
they do, it isn't surprising that a one-size-fitsall concept isn't always appropriate in the
treatment of psychological problems.
• In recent years the special needs of women
and people from other cultures have
particularly occupied the attention of mental
health professionals.
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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 drugs for
psychological disorders.
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Gender Differences in
Treatment
• Because, in traditional therapy, women are
often expected to conform to gender
stereotypes in order to be pronounced “well,”
many women have turned to “feminist
therapists.”
• The American Psychological Association has
issued guidelines to ensure that women
receive treatment that is not tied to
traditional ideas about appropriate behavior
for the sexes.
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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.
• When the client and therapist come from
different cultural backgrounds or belong to
different racial or ethnic groups,
misunderstandings can arise in therapy.
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Cultural Differences in
Treatment
• The APA has issued guidelines to help
psychologists deal more effectively with our
ethnically and culturally diverse population.
• Following these guidelines is an important
step toward avoiding cultural
misunderstandings.
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