CHAPTER 15: THERAPY

Psychology in Action (9e)

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

Humanistic

Group, Family, & Marital

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, & more modern form of psychoanalysis focusing on conscious processes & current problems

Insight Therapies: Cognitive

Cognitive Therapy: focuses on faulty thinking & beliefs

Improvement comes from insight into negative self-talk (internal dialogue)

Cognitive Restructuring: process of changing destructive thoughts or inappropriate interpretations

Insight Therapies: Cognitive (Continued)

Albert Ellis’s Rational-Emotive Behavior Therapy (REBT): eliminates emotional problems through rational examination of irrational beliefs

Aaron Beck’s form of Cognitive-Behavior Therapy works to change both thoughts & behaviors

Ellis’s Rational-Emotive Behavior Therapy (REBT)

Beck’s Cognitive-Behavior Therapy

Depressive thought patterns: selective perceptionovergeneralizationmagnificationall-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 past, etc.

Insight Therapies: Humanistic

Humanistic therapy: maximizes personal growth through affective restructuring (emotional readjustment)

Key assumption: Problems = blockage or disruption of normal growth potential, which leads to a defective self-concept.

Insight Therapies: Humanistic (Cont.)

Rogers’s Client-Centered Therapy: emphasizes client’s natural tendency to become healthy & productive

Techniques include:empathyunconditional positive regardgenuinenessactive listening

Insight Therapies: Humanistic (Continued)

Evaluation of humanistic therapy

Pro: Evidence for success

Con: Basic tenets, such as self-actualization, difficult to test scientifically

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 & couple interaction patterns

Behavior TherapiesBehavior Therapy: group of

techniques based on learning principles used to change maladaptive behaviors

Three foundations of behavior therapy:classical conditioningoperant conditioningobservational learning

Behavior Therapies: Classical Conditioning

Systematic Desensitization: gradual process of extinguishing a learned fear (or phobia) by working through a hierarchy of fearful stimuli while remaining relaxed

Behavior Therapies: Classical Conditioning & Driving Phobia

Behavior Therapies: Classical Conditioning

Aversion Therapy: pairing an aversive (unpleasant) stimulus with a maladaptive behavior

Behavior Therapies: Operant Conditioning

Operant conditioning techniques used to INCREASE adaptive behaviors:

Shaping: successive approximations of target behavior are rewarded; includes role-playing, behavior rehearsal, assertiveness training

Tokens: symbolic rewards used to immediately reinforce desired behavior

Behavior Therapies: Operant Conditioning

Operant conditioning techniques used to DECREASE maladaptive behaviors:

Extinction: withdrawal of attention

Punishment: adding or taking

away something (e.g., time-out)

Behavior Therapies: Observational Learning

©John Wiley & Sons, Inc. 2010

Modeling: watching & imitating models that demonstrate desirable behaviors

Participant Modeling: combining live modeling with direct & gradual practice

Behavior Therapies (Continued)

Evaluation of behavior therapies:

Pro: Strong evidence for success with a wide range of problems

Con: Questioned & criticized for generalizability & ethics

Biomedical Therapies

Biomedical Therapy: uses physiological interventions, such as drugs, to treat psychological disorders

Three forms of biomedical therapy:PsychopharmacologyElectroconvulsive 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)

Psychopharmacology—How Antidepressants Work

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

Therapy & Critical ThinkingTherapy Essentials--Five Common Goals

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.