*

The Psychological Therapies

Rg13a

*

History of Insane Treatment

Maltreatment of the insane throughout the ages was based on irrational views. Many patients were subjected to strange, debilitating and

downright dangerous treatments.

*

History of Insane Treatment

Pinel in France and Dix in America founded humane movements to care for the mentally

sick.

Philippe Pinel (1745-1826)

Dorthea Dix (1745-1826)

*

Therapies

Psychotherapy involves an emotionally charged, confiding interaction between a trained

therapist and a mental patient.

Biomedical therapy uses drugs or other procedures that act on the patient’s nervous

system curing him of psychological disorders.

An eclectic approach uses various forms of healing techniques depending on the client’s

unique problems.

*

Psychological Therapies

We will look at four major forms of psychotherapy based on different theories on

human nature:

1.Psychoanalytical theory

2. Humanistic theory

3.Behavioral theory

4.Cognitive theory

Your therapist asks you to try to remember your dreams. He also

encourages you to review incidents in early childhood. Your therapist is most

likely practicing:

A. Freudian therapy.

B. cognitive therapy.

C. behavior therapy.

D. humanistic therapy.

While focusing on several intrusive thoughts that had been bothering her recently, Jenny was instructed by her therapist to report any

ideas or memories stimulated by these thoughts. Jenny’s therapist was making use

of a technique known as:

A. active listening.

B. free association.

C. systematic desensitization.

D. transference.

*

Psychoanalysis

The first formal psychotherapy to emerge was psychoanalysis developed by Sigmund Freud.

Sigmund Freud's famous couch

Edmund Engleman

*

Psychoanalysis: Aims

Since psychological problems originate from repressed impulses and conflicts in childhood, the aim of psychoanalysis is to bring repressed feelings into conscious awareness where the

patient can deal with them.

When energy devoted to id-ego-superego conflict is released, the patient’s anxiety

lessens.

*

Psychoanalysis: Methods

Dissatisfied with hypnosis, Freud developed the method of free association to unravel the

unconscious mind and its conflicts.

The patient lies on a couch and speaks whatever comes to his mind.

http://www.english.upenn.edu

*

Psychoanalysis: Methods

During free association, the patient edits his thoughts to resist his feelings and to express his emotions. Such resistance becomes important

in the analysis of conflict-driven anxiety.

Eventually the patient opens up and reveals his innermost private thoughts to the therapist,

developing positive or negative feelings (transference) towards him.

*

Psychoanalysis: Criticisms

1.Psychoanalysis is hard to refute because it cannot be proven or disproven.

2.Psychoanalysis takes a long time and is very expensive.

*

Current Psychodynamic Therapies

Influenced by Freud, in a face-to-face setting, psychodynamic therapists understand

symptoms and themes across important relationships in a patient’s life.

*

Psychodynamic Therapies

Interpersonal psychotherapy, a variation of psychodynamic therapy is effective in treating depression. It focuses on symptom relief here

and now, not overall personality change.

*

Humanistic Therapies

Humanistic therapists aims to boost self-fulfillment by helping people grow in self-

awareness and self-acceptance.

Humanistic therapies differ from psychoanalytic therapies in all of

the following ways, EXCEPT:A. psychoanalytic therapists are more likely

to encourage the client to take immediate responsibility for feelings.

B. humanistic therapists are more oriented to the present and future, rather than the past.

C. psychoanalytic therapists are more likely to emphasize unconscious processes.

D. humanistic therapists are more growth-oriented.

McKenzie’s therapist believes that active listening is an extremely

important component of therapy. He is probably a:

A. psychoanalyst.

B. cognitive therapist.

C. behavior therapist.

D. client-centered therapist.

Client-centered therapists emphasize the importance of:

A. exploring clients’ childhood relationships with other family members.

B. interpreting the meaning of clients’ nonverbal behaviors.

C. enabling clients to feel unconditionally accepted.

D. helping clients identify a hierarchy of anxiety-arousing experiences.

*

Person-Centered Therapy

Developed by Carl Rogers, person-centered therapy is a form of humanistic therapy.

The therapist listens to the needs of the patient in an accepting and non-judgmental way,

addressing his problems in a productive way and building his or her self-esteem.

*

Humanistic Therapy

The therapist engages in active listening and echoes, restates, and clarifies patient’s thinking,

acknowledging expressed feelings.

Michael Rougier/ Life Magazine © Time Warner, Inc.

*

Behavior Therapy

Therapy that applies learning principles to the elimination of unwanted behaviors.

To treat phobias or sexual disorders behavior therapists do not delve deeply below the

surface looking for inner causes.

If a therapist tells a client, “Rank order the things that frighten you from least to most,” the therapist

is most likely practicing:A. Freudian therapy.

B. systematic desensitization.

C. Gestalt therapy.

D. token economy.

*

Classical Conditioning Techniques

Counterconditioning: a procedure that conditions new responses to stimuli that trigger

unwanted behaviors.

It is based on classical conditioning and includes exposure therapy and aversive

conditioning.

Jon’s therapist laces his alcoholic drink with a drug that makes Jon sick. After getting sick a few times, just the

sight of the drink makes Jon nauseous. In this example, the

conditioned stimulus is the:A. drug.

B. alcohol.

C. nauseous response to the drug.

D. nauseous response to the sight of the drink.

A therapist helps Rebecca overcome her fear of water by getting her to swim in

the family’s backyard pool three times a day for two consecutive weeks. The

therapist’s approach to helping Rebecca best illustrates:

A. stress inoculation training.

B. aversive conditioning.

C. exposure therapy.

D. humanistic therapy.

*

Exposure Therapy

Exposes patients to things they fear and

avoid. Through repeated exposures

anxiety lessens because they habituate

to the things feared.

The Far Side © 1986 FARWORKS. Reprinted with Permission. All Rights Reserved.

*

Exposure Therapy

Exposure therapy involves exposing people to (fear of driving) objects in real or virtual

environments.

N. Rown/ The Image Works

Both Photos: Bob Mahoney/ The Image Works

*

Systematic Desensitization

A type of exposure therapy that associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli commonly used to treat

phobias.

*

Aversive Conditioning

A type of counterconditioning that associates an

unpleasant state with an unwanted behavior.

With this technique, temporary conditioned

aversion to alcohol has been reported.

*

Operant Conditioning

Operant conditioning procedures enable therapists to use behavior modification in which

desired behavior is rewarded and undesired behaviors are not or are punished.

A number of withdrawn, uncommunicative 3-year-old autistic children have been

successfully trained by giving and withdrawing reinforcements for desired and undesired

behaviors.

*

Token Economy

In institutional settings therapists may create a token economy, where a patient exchanges a token of some sort, earned for exhibiting the

desired behavior, for various privileges or treats.

*

Cognitive Therapy

Teaches people adaptive ways of thinking and acting based on the assumption that thoughts intervene between events and our emotional

reactions.

A cognitive therapist would be most likely to say:

A. “That sounds quite frustrating. It isn’t easy to be in a situation like that.”

B. “Can you think of a more positive interpretation of what happened?”

C. “Just say whatever comes to mind, no matter how trivial or irrelevant it might seem.”

D. “Next time you start to feel anxious, you can use the relaxation techniques we’ve been working on.”

*

Cognitive Therapy for Depression

Aaron Beck (1979) suggests that depressed patients believe that they can never be happy

(thinking) and thus associate minor failings (e.g. failing a test [event]) in life as major causes for

their depression.

Beck believes that cognitions such as “can never be happy,” need to change in order for depressed

patients to recover. This change is brought into patients by gentle questioning.

*

Cognitive Therapy for Depression

Rabin et al., (1986) trained depressed

patients to daily record positive events and relate how they contributed to these events. Compared

to other depressed patients, trained patients showed lower depression

scores.

*

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.”

*

Cognitive-Behavior Therapy

Cognitive therapists often combine the reversal of self-defeating thinking with efforts to modify

behavior.

Cognitive-behavior therapy aims to alter the way people act (behavior therapy) and alter the

way they think (cognitive therapy).

*

Group Therapy

Group therapy normally consists of 6-9 people and a 90-minute session which can help more

people and cost less. Clients benefit from knowing others have similar problems.

© Mary Kate Denny/ PhotoEdit, Inc.

*

Family Therapy

Family therapy treats the family as a system. Therapy guides family members toward positive

relationships and improved communication.