Chapter Sixteen - Therapy PDF

Macduff Everton/The Image Bank/Getty Images Chapter Sixteen- Therapy Overview  Introduction to Therapy and the Psychological Therapies  Evaluating Psychotherapies  The Biomedical Therapies Macduff Everton/The Image Bank/Getty Images Understanding Differences  Both psychoanalytic and humanis...

Macduff Everton/The Image Bank/Getty Images Chapter Sixteen- Therapy Overview  Introduction to Therapy and the Psychological Therapies  Evaluating Psychotherapies  The Biomedical Therapies Macduff Everton/The Image Bank/Getty Images Understanding Differences  Both psychoanalytic and humanistic therapies are insight therapies—they attempt to improve functioning by increasing clients’ awareness of motives and defenses.  Behavior therapies are not insight therapies. Their goal is to apply learning principles to modify problem behaviors. Macduff Everton/The Image Bank/Getty Images Approach Differences  Psychotherapy  Involves psychological techniques derived from psychological perspectives; trained therapist uses psychological techniques to assist someone seeking to overcome difficulties or achieve personal growth  Biomedical therapy  Involves treatment with medical procedures; trained therapist, most often a medical doctor, offers medications and other biological treatments  Eclectic approach  Approach to psychotherapy that uses techniques from various forms of therapy Macduff Everton/The Image Bank/Getty Images Psychoanalysis and Psychodynamic Therapies  Psychoanalysis  Goals: To bring patients’ repressed feelings into conscious awareness; to help patients release energy devoted to id-ego-superego conflicts so they may achieve healthier, less anxious lives.  Techniques: Historical reconstruction, initially through hypnosis and later through free association; interpretation of resistance, transference Macduff Everton/The Image Bank/Getty Images Tetra Images/Getty Images Psychodynamic Therapy FACE-TO-FACE THERAPY In this type of therapy session, the couch has disappeared. But the influence of psychoanalytic theory may not have, especially if the therapist seeks information from the patient’s childhood and helps the patient reclaim unconscious feelings.  Goals: To help people understand current symptoms; to explore and gain perspective on defended-against thoughts and feelings  Techniques: Clientcentered face-to-face meetings; exploration of past relationship troubles to understand origins of current difficulties Macduff Everton/The Image Bank/Getty Images Humanistic Therapies  Humanistic perspective  Theme: Emphasis on people’s potential for selffulfillment; to give people new insights  Goals: To reduce inner conflicts that interfere with natural development and growth; help clients grow in self-awareness and self-acceptance promoting personal growth  Techniques: Client-centered therapy; focus on taking responsibility for feelings and actions and on present and future rather than past Macduff Everton/The Image Bank/Getty Images Michael Rougier/The LIFE Picture Collection/Getty Images ACTIVE LISTENING Carl Rogers (right) empathized with a client during this group therapy session. Humanistic Therapies  Rogers  Person-centered therapy focuses on person’s conscious selfperceptions; nondirective; active listening; unconditional positive regard  Most people possess resources for growth  Therapists foster growth by exhibiting genuineness, acceptance, and empathy Macduff Everton/The Image Bank/Getty Images Behavior Therapies  Classical conditioning techniques  Counterconditioning: Uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors  Exposure therapies: Treat anxieties by exposing people (in imagination or actual situations) to the things they fear and avoid  Systematic desensitization: Associates a pleasant, relaxed state with gradually increasing, anxietytriggering stimuli Macduff Everton/The Image Bank/Getty Images Behavior Therapies  Aversive conditioning  Goal: Substituting negative response for a positive response to a harmful stimulus; conditioning an aversion to something the person should avoid  Techniques: Unwanted behavior is associated with unpleasant feelings; ability to discriminate between aversive conditioning situation in therapy and all other situations can limit treatment effectiveness Macduff Everton/The Image Bank/Getty Images Aversion Therapy for Alcohol Abuse Therapists gave people with a history of alcohol abuse a mixed drink containing alcohol and a drug that produces severe nausea. After repeated treatments, some people developed at least a temporary conditioned aversion to alcohol. (Classical conditioning terms: US is unconditioned stimulus, UR is unconditioned response, NS is neutral stimulus, CS is conditioned stimulus, and CR is conditioned response.) Macduff Everton/The Image Bank/Getty Images Behavior Therapies  Operant conditioning therapy: Consequences drive behavior: voluntary behaviors are strongly influenced by their consequences  Behavior modification: Desired behavior reinforced; undesired behavior not reinforced, sometimes punished  Token economy: People earn a token for exhibiting a desired behavior and can later exchange the tokens for privileges or treats Macduff Everton/The Image Bank/Getty Images Cognitive Therapies  Cognitive therapies  Teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions  Beck’s therapy for depression  Gentle questioning seeks to reveal irrational thinking and then to persuade people to change their perceptions of their own and others’ actions as dark, negative, and pessimistic  People trained to recognize and modify negative self-talk Macduff Everton/The Image Bank/Getty Images A COGNITIVE PERSPECTIVE ON PSYCHOLOGICAL DISORDERS The person’s emotional reactions are produced not directly by the event but by the person’s thoughts in response to the event. Macduff Everton/The Image Bank/Getty Images Cognitive Therapies  Cognitive-behavioral therapy (CBT)  Is integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)  Aims to alter the way they act AND they way they think  Helps people learn to make more realistic appraisals Macduff Everton/The Image Bank/Getty Images Which Psychotherapies Work Best?  Some forms of psychotherapy work best for particular problems.  Behavior therapies: Bed-wetting, phobias, compulsions, marital problems, and sexual dysfunctions  Psychodynamic therapy: Depression and anxiety  Cognitive therapies: Anxiety, depression, and posttraumatic stress disorder  Evidence-based practice: Integration of best available research with clinicians’ expertise and patients’ characteristics, preferences, and circumstances Steve Szydlowski/KRT/Newscom Macduff Everton/The Image Bank/Getty Images A CARING RELATIONSHIP Effective counselor aboard a ship, form a bond of trust with the people they are serving. How Do Psychotherapies Help People?  Three basic benefits for all psychotherapies  Hope for demoralized people  New perspective for oneself and the world  Empathic, trusting, caring relationship (therapeutic alliance) Macduff Everton/The Image Bank/Getty Images Finding a Mental Health Professional  A person seeking therapy is encouraged to ask about  Treatment approach  Values  Credentials  Fees  An important consideration is whether the potential client feels comfortable and able to establish a bond with the therapist. Macduff Everton/The Image Bank/Getty Images The Biomedical Therapies and Preventing Psychological Disorders  Psychopharmacology  Includes study of drug effects on mind and behavior, has helped make drug therapy the most widely used biomedical therapy  Drug therapies  Are most widely used biomedical treatments  Include prescribed antidepressants for 27 million Americans  Involve placebo and double-blind techniques to evaluate drug effectiveness Macduff Everton/The Image Bank/Getty Images Drug Therapies  Antipsychotic drugs  Mimic certain neurotransmitters (e.g., block or increase activity of dopamine); reduce overreaction to irrelevant stimuli  May produce sluggishness, tremors, twitches and tardive dyskinesia; Thorazine  Successfully used with life-skills programs and family support to treat schizophrenia  Antianxiety drugs  Depress CNS activity; Xanax or Ativan  Used in combination with psychological therapy  May reduce symptoms without resolving underlying problems; withdrawal linked to increased anxiety and insomnia