Download Evaluation of behavior therapies

CHAPTER 15
Treatment of
Psychological Disorders
Introductory Definitions
• Psychotherapy: techniques employed to
improve psychological functioning &
promote adjustment to life
• Three major approaches to therapy:
– Insight (personal understanding)
– Behavior (maladaptive behaviors)
– Biomedical (mental illness & medical
treatments, such as drugs)
Four Major Forms of Insight
Therapy
• Psychoanalysis/
psychodynamic
• Cognitive
• Group,
Family,
& Marital
• Humanistic
Insight Therapies:
Psychoanalysis/Psychodynamic
• Psychoanalysis:
Freudian therapy
designed to bring
unconscious conflicts
into consciousness
Insight Therapies:
Psychoanalyis/Psychodynamic
•
Five major techniques of
psychoanalysis:
Insight Therapies:
Psychoanalysis/Psychodynamic
• Evaluation of psychoanalysis: limited
applicability & lack of scientific credibility
• Psychodynamic Therapy: briefer, more
directive, contemporary form of
psychoanalysis focusing on conscious
processes & current problems
Insight Therapies: Cognitive
• Cognitive Therapy: focuses on
changing faulty thought processes
& beliefs
– Improvement comes from insight into negative
self-talk (internal dialogue)
– Cognitive Restructuring: process of challenging
& changing destructive thoughts & maladaptive
behaviors
Insight Therapies:
Cognitive (Continued)
•
Albert Ellis’s RationalEmotive Therapy
(RET): eliminates
emotional problems
through rational
examination of
irrational beliefs
Ellis’s Rational-Emotive Therapy
(RET)
Beck’s Cognitive-Behavior Therapy
• Aaron Beck’s form of CognitiveBehavior Therapy works to
change destructive thoughts &
behaviors
• Depressive thought patterns:
– selective perception
– overgeneralization
– magnification
– all-or-nothing thinking
Insight Therapies:
Cognitive (Continued)
• Evaluation of cognitive therapy
Pro: Considerable success with a range of
problems
Con: Criticized for overemphasizing
rationality, ignoring unconscious dynamics,
minimizing importance of the client’s past, &
progress only comes from behavioral
change—not thought processes
Insight Therapies: Humanistic
• Humanistic therapy: seeks to
maximize personal growth
through affective restructuring
(emotional readjustment)
• Key assumption: Problems =
blockage or disruption of
normal growth potential, which
leads to a defective selfconcept
Insight Therapies: Humanistic (Cont.)
• Rogers’s Client-Centered Therapy:
provides accepting atmosphere &
encourages healthy emotional experiences
• Techniques include:
– empathy
– unconditional positive regard
– genuineness
– active listening
Insight Therapies:
Humanistic (Continued)
• Evaluation of humanistic therapy
Pro: Empirical evidence of efficacy
Con: Outcomes such as selfactualization & self-awareness
difficult to test scientifically; research
on specific techniques has had
mixed results
Insight Therapies:
Group, Family, & Marital Therapies
• Group Therapy: a number of
people meet together to work
toward therapeutic goals
• Family & Marital Therapies:
work to change maladaptive
family patterns
Behavior Therapies
• Behavior Therapy: group of techniques based on
learning principles used to change maladaptive
behaviors
• Three foundations of
behavior therapy:
– classical conditioning
– operant conditioning
– observational learning
Behavior Therapies:
Classical Conditioning
– Aversion Therapy: pairs an aversive (unpleasant)
stimulus with a maladaptive behavior
Pause & Reflect:
Critical Thinking
Classical Conditioning:
Systematic Desensitization
• Systematic Desensitization:
gradual process of extinguishing
a learned fear (or phobia) by
working through a hierarchy of
fearful stimuli while remaining
relaxed
• Virtual reality therapy offers a
type of systematic
desensitization with “virtual” vs.
real-life therapeutic
experiences.
Behavior Therapies:
Classical Conditioning & Driving Phobia
Behavior Therapies:
Operant Conditioning
• Operant conditioning uses techniques to
increase ADAPTIVE behaviors:
• Shaping: rewards successive
approximations of target behavior
through role-playing, behavior
rehearsal, etc.
• Tokens: symbolic rewards used to
immediately reinforce desired behavior
Behavior Therapies:
Observational Learning
• Modeling: watching &
imitating models that
demonstrate
desirable behaviors
Behavior Therapies (Continued)
• Evaluation of behavior therapies:
Pro: Strong evidence for success with a
wide range of problems
Con: Questioned & criticized for
generalizability & questionable ethics
Biomedical Therapies
• Biomedical Therapy: uses physiological
interventions, such as drugs, to reduce or
alleviate symptoms of psychological disorders
• Three forms of biomedical therapy:
– Psychopharmacology
– Electroconvulsive therapy (ECT)
– Psychosurgery
Biomedical Therapies:
Psychopharmacology
• Four major categories of drugs:
1. Antianxiety (increases relaxation;
reduces anxiety & muscle tension)
2. Antipsychotic (treats hallucinations
& other symptoms of psychosis)
3. Mood Stabilizer (treats manic
episodes & depression)
4. Antidepressant (treats symptoms of
depression)
Biomedical Therapies (Continued)
• Electroconvulsive Therapy (ECT): based
on passing electrical current through the
brain; used almost exclusively when other
methods have failed
• Psychosurgery: operative procedures on
the brain designed to relieve severe mental
symptoms that have not responded to
other forms of treatment
Evaluating Biomedical Therapies
• Psychopharmacology: enormously
beneficial, but several problems (e.g., side
effects, dependency, etc.)
• Electroconvulsive Therapy (ECT) &
Psychosurgery: controversial & generally
used as a last resort
Therapy Essentials:
Five Common Goals
Cultural Issues in Therapy
• Cultural similarities in therapy:
naming the problem
qualities of the therapist
establishing credibility
familiar framework
applying techniques that bring relief
special time & place
Cultural Issues in Therapy (Cont.)
• Cultural differences:
– Therapies in individualistic cultures
emphasize independence, the self, &
control over one’s life.
– Therapies in collectivist cultures
emphasize interdependence.
Cultural Issues in Therapy (Cont.)
•
Key considerations for women & therapy:
1. higher rates of diagnosis &
treatment of mental disorders
2. stresses of poverty
3. stresses of multiple roles
4. stresses of aging
5. violence against women
Therapy & Critical Thinking:
Institutionalization
• Institutionalization—criteria for
involuntary commitment:
– dangerous to self or others
– believed to be in serious need of
treatment
– no reasonable alternatives
Therapy & Critical Thinking:
Institutionalization (Continued)
• Deinstitutionalization:
discharging as many people
as possible from state hospitals
& discouraging admissions
• Community services such as community
mental health (CMH) centers work to cope
with problems of deinstitutionalization.