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Therapy
Chapter 15
Psychological Therapies
1.
2.
3.
4.
Psychoanalytic theory
Humanistic theory
Behavioral theory
Cognitive theory
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Psychoanalytic Therapy
• Goal: to bring unconscious conflicts, traumas,
worries into the conscious so they can be
faced and resolved
Psychoanalytic Therapy
• Psychoanalysis: Freud’s Therapy
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Free association
Dream interpretation
Transference
http://www.youtube.com/watch?v=oS_L8efaJ-E
Psychoanalysis: Criticisms
1. cannot be proven or disproven.
2. takes a long time and is very expensive
–
http://www.youtube.com/watch?v=Ss8fYIKlRdo
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Psychoanalytic Therapies
Interpersonal psychotherapy
•effective in treating depression
•focuses on symptom relief here and now
•Relationships the patient has
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Humanistic Therapies
•client-centered therapy
–Carl Rogers
–Provide unconditional acceptance and high regard
–Increase self-esteem
–http://www.youtube.com/watch?v=m30jsZx_Ngs&f
eature=related
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Humanistic Therapy
active listening - echoes, restates, and clarifies
the patient’s thinking, acknowledging expressed
feelings
Michael Rougier/ Life Magazine © Time Warner, Inc.
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Behavior Therapy
Therapy that applies learning principles to the
elimination of unwanted behaviors.
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Behavioral Therapy
•Counterconditioning
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Exposure Therapy
The Far Side © 1986 FARWORKS. Reprinted with Permission. All Rights Reserved.
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Systematic Desensitization
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Aversive Conditioning
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Operant Conditioning
•behavior modification
–desired behaviors are rewarded and
undesired behaviors are either
unrewarded or punished
–Successful in treating
uncommunicative patients
•Autistic children
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Token Economy
•patients exchange a token of some sort, earned
for exhibiting the desired behavior, for various
privileges or treats.
–institutional settings
–schizophrenic patients
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Cognitive Therapy
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Cognitive Therapy
Cognitive Therapy
Stress Inoculation Training
Meichenbaum (1977, 1985) trained people to
restructure their thinking in stressful situations.
“Relax, the exam may be hard, but it will be hard for
everyone else too. I studied harder than most
people. Besides, I don’t need a perfect score to get a
good grade.”
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Cognitive Therapy
• Cognitive-Behavioral Therapy (CBT)
– Therapists attempt to change the way people
think as well as their behavior
– Highly structured and focused on concrete
problems
– Clients have specific therapy goals
– Clients are given “homework”
Group Therapy, Family Therapy
• Group Therapy
– Several unrelated people meet with a therapist to discuss some
aspect of their psychological functioning
– Often centers on a common difficulty
– Help people realize that others have the same problem
– People with the same problem exchange advice about how to
deal with things
© Mary Kate Denny/ PhotoEdit, Inc.
Group Therapy, Family Therapy
• Family Therapy
– Involves two or more family members, one (or more) of
whose problems led to treatment
• Family is viewed as a unit so if one person has psychological issues,
the entire family needs therapy to improve the situation
Evaluating Therapies
Who do people turn to for help with
psychological difficulties?
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Is Psychotherapy Effective?
It is difficult to gauge the effectiveness of
psychotherapy because there are different levels
upon which its effectiveness can be measured.
1.
2.
3.
Does the patient sense improvement?
Does the therapist feel the patient has improved?
How do friends and family feel about the patient’s
improvement?
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Client’s Perceptions
1. Clients enter therapy in crisis, but
crisis may subside over the natural
course of time (regression to
normalcy).
2. Clients may need to believe the
therapy was worth the effort.
3. Clients generally speak kindly of
their therapists.
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Choosing the Right Therapist
• You should feel comfortable with your therapist
• Therapists should have appropriate training and
credentials and should be licensed by appropriate
state and local agencies
• You should feel that you are making progress after
therapy has begun, despite occasional setbacks
• The therapist should be monitoring your progress
and making sure that you are improving, adjusting
treatment accordingly
Clinician’s Perceptions
1. Clinicians are aware of failures, but they
believe failures are the problem of other
therapists.
2. If a client seeks another clinician, the
former therapist is more likely to argue
that the client has developed another
psychological problem.
3. Clinicians are likely to testify to the
efficacy of their therapy regardless of
the outcome of treatment.
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Outcome Research
Research shows that treated patients were 80%
better than untreated ones.
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The Relative Effectiveness of Different
Therapies
Which psychotherapy would be most effective
for treating a particular problem?
Disorder
Therapy
Depression
Behavior, Cognition, Interpersonal
Anxiety
Cognition, Exposure, Stress Inoculation
Bulimia
Cognitive-behavior
Phobia
Behavior
Bed Wetting
Behavior Modification
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Eye Movement Desensitization and
Reprocessing (EMDR)
In EMDR therapy, the therapist attempts to
unlock and reprocess previous frozen traumatic
memories by waving a finger in front of the
eyes of the client.
EMDR has not held up under scientific testing.
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Light Exposure Therapy
Courtesy of Christine Brune
Seasonal Affective
Disorder (SAD), a
form of depression,
has been effectively
treated by light
exposure therapy. This
form of therapy has
been scientifically
validated.
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Commonalities Among Psychotherapies
Three commonalities shared by all forms of
psychotherapies are the following:
© Mary Kate Denny/ PhotoEdit, Inc.
1. A hope for demoralized
people.
2. A new perspective.
3. An empathic, trusting
and caring relationship.
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The Biomedical Therapies
1. Drug Therapies
2. Brain Stimulation
3. Psychosurgery
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Drug Therapies
With the advent of drugs, hospitalization in mental institutions
has rapidly declined.
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Double-Blind Procedures
To test the effectiveness of a drug, patients are tested with the drug and a placebo.
Two groups of patients and medical health professionals are unaware of who is
taking the drug and who is taking the placebo.
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Antipsychotic Drugs
Classical antipsychotics [chlorpromazine
(Thorazine)]: Remove a number of positive
symptoms associated with schizophrenia such
as agitation, delusions, and hallucinatio
Atypical antipsychotics [clozapine (Clozaril)]:
Remove negative symptoms associated with
schizophrenia such as apathy, jumbled thoughts,
concentration difficulties, and difficulties in
interacting with others.
ns.
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Atypical Antipsychotic
Clozapine (Clozaril) blocks receptors for
dopamine and serotonin to remove the negative
symptoms of schizophrenia.
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Antianxiety Drugs
Antianxiety drugs (Xanax and Ativan) depress the
central nervous system and reduce anxiety and tension
by elevating the levels of the Gamma-aminobutyric acid
(GABA) neurotransmitter.
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Drug Therapy
• Antidepressant Drugs
– Medications used in cases of severe depression to
improve the moods of patients
• Work by changing the concentration of specific
neurotransmitters in the brain
– Tricyclic drugs
– MAO inhibitors
– Selective serotonin reuptake inhibitors (SSRIs)
» Prozac
How Prozac Works
Effectiveness of Drug in Treating Mood
Disorders
• Results are about the same with MAOIs,
tricyclics, and SSRIs
– About 50% improve, compared to 25% of controls
• do not prevent future episodes
Antidepressant Drugs
Antidepressant drugs like Prozac, Zoloft, and Paxil are
Selective Serotonin Reuptake Inhibitors (SSRIs) that
improve the mood by elevating levels of serotonin by
inhibiting reuptake.
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Mood-Stabilizing Medications
For Bipolar Disorder
Lithium Carbonate, a common salt,
It moderates the levels of norepinephrine and
glutamate neurotransmitters.
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Brain Stimulation
Electroconvulsive Therapy
(ECT)
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Alternatives to ECT
Repetitive Transcranial
Magnetic Stimulation
(rTMS)
http://www.pbs.org/wgbh/nova/body
/george-uses-tms.html
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Psychosurgery
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