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chapter 13 Therapies PowerPoint by Prentice Hall, Inc., modified by Stephen Landman, Ph.D. chapter 13 Insight Therapies Insight therapies Provide people with better awareness and understanding of their feelings, motivations, and actions • Psychoanalysis • Client-Centered Therapy • Gestalt Therapy chapter 13 Psychoanalysis Hidden feelings and motives are made conscious for better adaptation. Freud’s method of psychotherapy chapter 13 Psychoanalysis (continued) Freudian therapist = “psychoanalyst” Symptoms are caused by unconscious conflicts Goal of Psychoanalysis = Insight, which causes symptoms to disappear Task of psychoanalyst is to make timely interpretations Freud interpreted: 1. Free Association – (reason for use of the couch) 2. Dreams 3. Transference Catharsis = “Emotional Insight” (also called “abreaction”) chapter 13 Client-Centered Therapy (person-centered therapy) Carl Rogers Problems stem from conditional love from parents Calls for unconditional positive regard • Conditional positive regard – Love and acceptance comes from conforming to what others want • Unconditional positive regard – True acceptance regardless of actions Nondirective “Reflection of Feeling” chapter 13 Gestalt Therapy To help people be more genuine in day-today interactions Focus on here-and-now, and whole person Therapy is active, directive Empty chair technique chapter 13 Behavior Therapies Focus on behavior change, rather than insight Belief that all behavior is learned. Uses principles of learning for treatment. Maladaptive behaviors themselves are the focus of the therapy; they are not “symptoms” of an underlying problem. chapter 13 Behavior Therapy (continued) Examples: • Desensitization – uses classical conditioning of Pavlov • Token Economy – uses operant conditioning of Skinner • Aversive therapy – classical conditioning (Antabuse for alcholism, slap a car to teach dog not to chase cars) • Behavioral marriage counseling • Behavioral Contracting • Modeling Many other applications exist chapter 13 Cognitive Therapies Changing clients’ perceptions of themselves and the world One method: Rational-emotive therapy Albert Ellis, Ph.D. • • • Irrational ideas, common in society, cause problems. Client needs to understand how the ideas are irrational and what self-talk is associated with them, and then needs to change to using rational self-talk instead. Ellis uses “counterpropaganda” to counter the irrational propaganda the client has been affected by. chapter 13 Cognitive-Behavioral Therapy widely used today •Combines cognitive therapy and behavior therapy methods – not one specific technique •Supported by much research as being effective for wide range of problems (eating disorders, personality disorders, depression, pain disorders) •Short term •Structured and goal-directed •An educational model - Client does homework chapter 13 Group Therapies Many advantages to group approach Increased feedback on how a person affects others Modeling Learning from others’ mistakes Laboratory for trying new behaviors Social support Realizing that one is not alone Social skills and communication practice Opportunity to be helpful to others Cost effective Types Family therapy Couple therapy Self-help groups (not technically a therapy group) chapter 13 Effectiveness of Psychotherapy Success rate Eysenck (1952): About two-thirds get better with or without therapy. He was criticizing psychodynamic therapy, claiming behavior therapy to be superior. Smith & Glass (1977) Meta-analysis of psychotherapy outcome studies concludes that therapy is better than no therapy. chapter 13 Which Therapy is Best? Truax and Carkhuff (1967) found that characteristics of therapist are crucial. Effective therapists are characterized by warmth, genuiness, and empathy. Most therapists are “eclectic”, drawing form various approaches, rather than strictly following one method. chapter 13 Which Type of Therapy is Best? No apparent difference in effectiveness Possible explanations: All offer an explanation for problems All offer hope All provide a therapeutic alliance with a therapist chapter 13 Biological Treatments Drug therapy Major types • Antipsychotic drugs • Antidepressant drugs • Lithium & Other Mood Stabilizers Electroconvulsive therapy Transcranial magnetic stimulation (new treatment for depression) Psychosurgery chapter 13 Institutionalization In past, institutionalization was most common approach Antipsychotic drugs reduced this practice Deinstitutionalization This approach has own problems Alternative forms of treatment chapter 13 Prevention Forms of prevention Primary prevention • Efforts to reduce new cases of mental disorders Secondary prevention • Identifying at-risk groups Tertiary prevention • Helping people adjust after hospital release chapter 13 Client Diversity and Treatment Gender and treatment Rates of treatment for females is higher Form of treatment can be gender biased Culture and treatment What constitutes normal can be culturebound