Download Basic Statistics for the Behavioral Sciences - Marie-Murphy

Chapter 13: Methods
of Therapy
Learning Outcomes-Monday
• Define psychotherapy and describe the history
of treatment of psychological disorders
• Describe traditional psychoanalysis and shortterm psychodynamic therapies
• Define humanistic therapy and contrast its
two main approaches
• Define behavior therapy and identify various
behavioral approaches to therapy
What is Psychotherapy?
Psychotherapy
• Systematic interaction between client and
therapist
• Based on psychological principles
• Influences clients’ thoughts, feelings, and
behavior
• Clients use it for psychological disorders,
adjustment problems, and/or personal growth
History of Therapies
• Asylums
• Mental Hospitals
• Community Mental Health Movement
The Unchaining of the Patients at La
Salpêtrière
Psychodynamic Therapies
http://www.youtube.com/watch?v=o
S_L8efaJ-E
Traditional Psychoanalysis
•
•
•
•
•
•
Insight
Catharsis
Free Association
Resistance
Transference
Dream Analysis
– Wish Fulfillment
Freud’s Consulting Room
Modern Psychodynamic Approaches
• Briefer, less intense, usually directive
• Ego analysis
– More focus on ego, less on the id
http://www.youtube.com/watch?v=yTHM2o3dvao
Humanistic Therapies
http://www.youtube.com/watch?v=R
X_Y3zUPzEo
Client-Centered Therapy
• Carl Rogers
• Provide insight into
parts of us we have
disowned so we may
feel whole
• Warm, therapeutic
atmosphere
– Unconditional positive
regard
– Empathy
– Genuineness
Truth or Fiction?
• Some psychotherapists let their clients take
the lead in psychotherapy.
Truth or Fiction?
• Some psychotherapists let their clients take
the lead in psychotherapy.
• TRUE!
Gestalt Therapy
• Fritz Perls
• Integrate conflicting parts of the personality
• Directive, focused on the here and now
• http://www.youtube.com/watch?v=NwM84A
gJFoA
Behavior Therapy
Behavior Therapy
• Apply principles of learning to directly
promote desired behavioral changes
– Conditioning and observational learning
– Discontinue self-defeating behaviors
Truth or Fiction?
• Some psychotherapists tell their clients exactly
what to do.
Truth or Fiction?
• Some psychotherapists tell their clients exactly
what to do.
• TRUE!
Fear-Reduction Methods
• Systematic desensitization
– Confront hierarchy of stimuli
– Counterconditioning
– http://www.youtube.com/watch?v=wE5FFjbTRk&list=PL3AC40D10064B1D57
• Virtual Therapy
• Modeling
– Observational learning
A Program Containing Images of the World
Trade Center Intended to Help People with PTSD
Eye-Movement Desensitization and
Reprocessing
• EMDR – used to treat stress disorders
• http://www.youtube.com/watch?v=bqbFIj5vw
mA
• Research does not explain why it works
– Are the eye movements necessary?
– May have to do with relationship with therapist
and exposure to trauma while believing it can be
managed
Aversive Conditioning
• Pair an aversive stimuli with the unwanted
impulse
– Used to eliminate unwanted habits and antisocial
behaviors
http://www.youtube.com/watch?v=5NaP19C0WOI
Truth or Fiction?
• Smoking cigarettes can be an effective method
for helping people stop smoking cigarettes.
Truth or Fiction?
• Smoking cigarettes can be an effective method
for helping people stop smoking cigarettes.
• TRUE!
Aversive Conditioning
Operant Conditioning
• Token economy
http://www.youtube.com/watch?v=tfSZ87HkTO
o
• Successive approximation
http://www.youtube.com/watch?v=sOP6mwg5i
Aw
• Biofeedback training
http://www.youtube.com/watch?v=TR50BRecpb
g
Social Skills Training
• Decrease social anxiety and build social skills
through operant conditioning techniques
– Self-monitoring, behavior rehearsal, and feedback
http://www.youtube.com/watch?v=M2Upy0zbgy4
Cognitive Therapies
Learning Outcomes - Wednesday
• Define cognitive therapy and describe Beck’s
approach and REBT
• Identify various types of group therapy and
discuss their advantages and disadvantages
• Explain whether psychotherapy works and
who benefits from it
• Describe methods of biological therapy - their
benefits and side effects
Cognitive Therapy
• Changing beliefs, attitudes, and automatic
types of thinking that create and compound
problems
– Awareness of current cognitions
CBT:
http://www.youtube.com/watch?v=5juIXl9KGRc
Aaron Beck’s Cognitive Therapy
• Client confronts feelings and beliefs that make
no sense
• Become aware of cognitive errors
Rational Emotive Behavior Therapy
• Albert Ellis
• Challenge irrational beliefs
– Need for love and approval of others
– Need to prove oneself to be thoroughly
competent, adequate, achieving
– Ellis:
http://www.youtube.com/watch?v=0KS9NezArg0
Cognitive-Behavioral Therapy
• Integration of behavioral and cognitive
therapies
Group Therapies
Group Therapies
• Advantages
– Economical
– More experiences for client to draw upon
– Social support of the group
– Affiliation with people with similar problems
– Improvement provides hope for others
– Practice social skills in safe environment
• Disadvantages
– Unable to express feelings to group
Group Therapies
• Couple therapy
– Improve communication and manage conflict
– Cognitive behavioral approach
• Family therapy
– Systems approach
• Self-help and support groups
– Alcoholics Anonymous (AA)
Does Psychotherapy Work?
Truth or Fiction?
• There is no scientific evidence that
psychotherapy helps people with
psychological disorders.
Truth or Fiction?
• There is no scientific evidence that
psychotherapy helps people with
psychological disorders.
• FICTION!
Effectiveness of Psychotherapy
• Meta-analysis
– People who obtain psychotherapy of clientcentered therapies fare better than those who do
not
– Must consider type of therapy; type of problem;
and type of patient
Effectiveness of Psychotherapy
• Cognitive therapies
– Best used for anxiety and depression
– Also used with personality disorders
Evidence –Based Practices
• Use of random controlled experiments (RCEs)
– May favor cognitive-behavioral therapies
– May not capture the complexity of clients in
community settings
Examples of Evidence-Based Practices
Ethnicity and Psychotherapy
• Ethnic minority groups in US less likely than
European Americans to seek therapy
– Not aware of helpfulness of therapy
– Lack of information on services
– Distrust of professionals
– Language barriers
Ethnicity and Psychotherapy
• Ethnic minority groups in US less likely than
European Americans to seek therapy
– Reluctance to open up to strangers
– Cultural inclinations toward other approaches
– Negative experiences
Ethnicity and Psychotherapy
• African Americans – reluctant to seek help;
suspicious of therapist
• Asian Americans – stigmatize people with
disorders therefore deny problems
• Latino/Latina Americans – value of family
interdependence conflicts with goal for selfreliance
• Native Americans – Disruption of traditional
culture
Biological Therapies
Drug Therapy
• Antianxiety Drugs
– Rebound anxiety
• Antipsychotic Drugs
• Antidepressants
– Selective serotonin-reuptake inhibitors
• Mood stabilizers
Other Biological Therapies
• Electroconvulsive Therapy
– Side effects include memory problems
• Psychosurgery
– Prefrontal lobotomy
– Pioneered by Antonio Egas Moniz
Electroconvulsive Therapy
Truth or Fiction?
• The originator of a surgical technique to
reduce violence learned that it was not always
successful when one of his patients shot him.
Truth or Fiction?
• The originator of a surgical technique to
reduce violence learned that it was not always
successful when one of his patients shot him.
• TRUE!
Does Biological Therapy Work?
• Drug therapies have been effective
– Must consider side effects
• Psychotherapy and pharmacotherapy
– Depression
– Schizophrenia
• ECT as last resort