89
ABNORMAL PSYCHOLOGY IN A CHANGING WORLD, NINTH EDITION Jeffrey S. Nevid/Spenver A. Rathus/Beverly Greene Chapter 2 Contemporary Perspectives on Abnormal Behavior and Methods of Treatment © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Nevid Pptch2 QBS

Embed Size (px)

DESCRIPTION

Psychology Clinic PowerPoint Presentation of LVL 2

Citation preview

Page 1: Nevid Pptch2 QBS

ABNORMAL PSYCHOLOGY IN A CHANGING WORLD, NINTH EDITION

Jeffrey S. Nevid/Spenver A. Rathus/Beverly Greene

Chapter 2

Contemporary Perspectives on Abnormal Behavior and Methods of Treatment

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 2: Nevid Pptch2 QBS

The Biological Perspective• The biological perspective, inspired by scientists and

physicians since the time of Hippocrates, focuses on the biological underpinnings of abnormal behavior and the use of biologically based approaches, such as drug therapy, to treat psychological disorders.

• The biological perspective gave rise to the development of the medical model, which remains today a powerful force in contemporary understandings of abnormal behavior.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 3: Nevid Pptch2 QBS

The Nervous System

• The nervous system is made up of neurons, nerve cells that transmit signals or “messages” throughout the body.

• Dendrites – The rootlike structures at the ends of neurons that receive messages from other neurons.

• Axon – The long, thin part of a neuron along which nerve impulses travel.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 4: Nevid Pptch2 QBS

The Nervous System• Terminals – The small branching structures at the

tips of axons.• Neurotransmitters – Chemical substances that

transmit messages from one neuron to another.• Synapse – The junction between one neuron and

another across which neurotransmitters pass.• Receptor site – A part of a dendrite on a receiving

neuron that is structured to receive a neurotransmitter.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 5: Nevid Pptch2 QBS

The Anatomy of a Neuron

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 6: Nevid Pptch2 QBS

Transmission of Neural Impulses

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 7: Nevid Pptch2 QBS

Neurotransmitter Functions and Relationships

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 8: Nevid Pptch2 QBS

The Nervous System

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 9: Nevid Pptch2 QBS

Central Nervous System

• Medulla – An area of the hindbrain involved in regulation of heartbeat, respiration, and blood pressure.

• Pons – A structure in the hindbrain involved in body movements, attention, sleep, and respiration.

• Cerebellum – A structure in the hindbrain involved in motor behavior, coordination, and balance.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 10: Nevid Pptch2 QBS

Central Nervous System• Reticular activating system – Brain structure

involved in processes of attention, sleep, and arousal.

• Thalamus – A structure in the forebrain involved in relaying sensory information to the cortex and in processes related to sleep and attention.

• Hypothalamus – A structure in the forebrain involved in regulating body temperature, emotion, and motivation.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 11: Nevid Pptch2 QBS

Central Nervous System• Limbic system – A group of forebrain structures involved in

emotional processing, memory, and basic drives such as hunger, thirst, and aggression.

• Basal ganglia – An assemblage of neurons at the base of the forebrain involved in regulating postural movements and coordination.

• Cerebrum – The large mass of the forebrain, consisting of the two cerebral hemispheres, responsible for higher mental functions.

• Cerebral cortex – The wrinkled surface area of the cerebrum responsible for processing sensory stimuli and controlling higher mental functions, such as thinking and use of language.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 12: Nevid Pptch2 QBS

The Geography of the Brain

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 13: Nevid Pptch2 QBS

Cerebral Cortex• Each hemisphere is divided into four lobes.• Occipital lobe – Primarily involved in processing visual

stimuli.• Temporal lobe – Involved in processing sounds or

auditory stimuli.• Parietal lobe – Involved in processing sensations of

touch, temperature, and pain. • Frontal lobe – Controls muscle movement and includes

the prefrontal cortex that regulates higher mental functions such as thinking, problem-solving, and use of language.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 14: Nevid Pptch2 QBS

Peripheral Nervous System• Somatic nervous system – The division of the peripheral

nervous system that relays information from the sense organs to the brain and transmits messages from the brain to the skeletal muscles.

• Autonomic nervous system – The division of the peripheral nervous system that regulates the activities of the glands and involuntary functions.

• Sympathetic – Pertaining to the division of the autonomic nervous system whose activity leads to heightened states of arousal.

• Parasympathetic – Pertaining to the division of the autonomic nervous system whose activity reduces states of arousal and regulates bodily processes that replenish energy reserves.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 15: Nevid Pptch2 QBS

Evaluating Biological Perspectives• For some disorders, biological processes play the direct

causative role.• For most disorders, the interaction of biological and

environmental factors needs to be examined.• Questions about the genetic bases of abnormal behavior touch

the long-standing nature versus nurture debate.• Scientists today are studying complex interactions between

genes and environmental factors to better understand the determinants of abnormal behavior patterns.

• Epigenetics – The field that focuses on how environmental factors influence genetic expression.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 16: Nevid Pptch2 QBS

The Psychological Perspective

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 17: Nevid Pptch2 QBS

Psychodynamic Models• Psychoanalytic theory – The theoretical model developed by Sigmund

Freud that is based on the belief that the roots of psychological problems involve unconscious motives and conflicts that can be traced back to childhood.– also called psychoanalysis.

• Conscious – To Freud, the part of the mind that corresponds to our present awareness.

• Preconscious – To Freud, the part of the mind that contains memories not in awareness but can be brought into awareness by focusing attention on them.

• Unconscious – To Freud, the part of the mind that lies outside the range of ordinary awareness and that contains instinctual urges.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 18: Nevid Pptch2 QBS

The Structure of the Mind

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 19: Nevid Pptch2 QBS

The Structure of Personality• Id – The original and unconscious psychic structure,

present at birth, that contains primitive instincts and is regulated by the pleasure principle.

• Pleasure principle – The governing principle of the id, involving demands for immediate gratification of needs.

• Ego – The psychic structure governed by the reality principle. It organizes reasonable ways of coping with frustration and seeks to curb the demands of the id.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 20: Nevid Pptch2 QBS

The Structure of Personality• Reality principle – The governing principle of

the ego, which involves considerations of social acceptability and practicality.

• Superego – The psychic structure that incorporates the values of the parents and important others and functions as a moral conscience.

• The superego serves as a conscience, or internal moral guardian, that monitors the ego and passes judgment on right and wrong.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 21: Nevid Pptch2 QBS

Defense Mechanisms• Defense mechanisms – The reality-distorting

strategies used by the ego to shield the self from awareness of anxiety-provoking impulses.

• These mechanisms enable us to constrain impulses from the id as we go about our daily business.

• Freud believed that slips of the tongue and ordinary forgetfulness could represent hidden motives that are kept out of consciousness by repression.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 22: Nevid Pptch2 QBS

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 23: Nevid Pptch2 QBS

Stages of Psychosexual Development• In Freud’s view, the stages of human development

are psychosexual in nature because they correspond to the transfer of libidinal energy from one erogenous zone to another.

• Freud proposed the existence of five psychosexual stages of development: oral (first year of life), anal (second year of life), phallic (beginning during the third year of life), latency (from around age 6 to age 12), and genital (beginning in puberty).

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 24: Nevid Pptch2 QBS

Stages of Psychosexual Development• Freud believed that phallic-stage children develop unconscious

incestuous desires for the parent of the opposite gender and begin to view the parent of the same sex as a rival.

• Freud dubbed this conflict the Oedipus complex after the legendary Greek king Oedipus, who unwittingly slew his father and married his mother.

• Fixation – In Freudian theory, a constellation of personality traits associated with a particular stage of psychosexual development, resulting from either too much or too little gratification at the stage.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 25: Nevid Pptch2 QBS

Other Psychodynamic Theorists

• Swiss psychiatrist Carl Jung developed his own psychodynamic theory called analytical psychology and believed that we not only have a personal unconscious but also inherit a collective unconscious.

• Archetypes – Primitive images or concepts that reside in the collective unconscious.

• Karen Horney (1885–1952) stressed the importance of child–parent relationships in the development of emotional problems.

• Ego psychology – Modern psychodynamic approach originated by Heinz Hartmann (1894–1970) that focuses more on the conscious strivings of the ego than on the hypothesized unconscious functions of the id.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 26: Nevid Pptch2 QBS

Other Psychodynamic Theorists

• Erik Erikson (1902–1994) focused on psychosocial development and attributed more importance to social relationships and formation of personal identity than to unconscious processes.

• Object-relations theory – The psychodynamic viewpoint developed by Margaret Mahler that focuses on the influences of internalized representations of the personalities of parents and other strong attachment figures (called “objects”).

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 27: Nevid Pptch2 QBS

Psychodynamic Views on Normality and Abnormality

• In the Freudian model, mental health is a function of the dynamic balance among the psychic structures of id, ego, and superego.

• Freud believed that the underlying conflicts that give rise to psychological disorders originate in childhood and are buried in the depths of the unconscious.

• Psychosis – A severe form of disturbed behavior characterized by impaired ability to interpret reality and difficulty meeting the demands of daily life.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 28: Nevid Pptch2 QBS

Learning Models• The behavioral perspective is identified with the Russian

physiologist Ivan Pavlov (1849–1936), the discoverer of the conditioned reflex, and the American psychologist John B. Watson (1878–1958), the father of behaviorism.

• Behaviorism – The school of psychology that defines psychology as the study of observable behavior and that focuses on the role of learning in explaining behavior.

• Watson and other behaviorists, such as Harvard University psychologist B. F. Skinner (1904–1990), believed that human behavior is the product of our genetic inheritance and environmental or situational influences.

Page 29: Nevid Pptch2 QBS

Learning Models

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 30: Nevid Pptch2 QBS

Role of Classical Conditioning• Conditioned response – In classical conditioning, a learned

response to a previously neutral stimulus.• Unconditioned stimulus – A stimulus that elicits an unlearned

response. • Unconditioned response – An unlearned response.• Conditioned stimulus – A previously neutral stimulus that

evokes a conditioned response after repeated pairings with an unconditioned stimulus that had previously evoked that response.

• Classical conditioning – A form of learning in which a response to one stimulus can be made to occur to another stimulus by pairing or associating the two stimuli.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 31: Nevid Pptch2 QBS

The Classical Conditioning Model

FIGURE 2.7 Schematic diagram of the process of classical conditioning.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 32: Nevid Pptch2 QBS

Role of Operant Conditioning• In operant conditioning, responses are acquired and

strengthened by their consequences.

• Operant conditioning – A form of learning in which behavior is acquired and strengthened when it is reinforced.

• Reinforcement – Changes in the environment (stimuli) that increase the frequency of the preceding behavior.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 33: Nevid Pptch2 QBS

Role of Operant Conditioning• Positive reinforcers – Reinforcers that, when

introduced, increase the frequency of the preceding behavior.

• Negative reinforcers – Reinforcers that, when removed, increase the frequency of the preceding behavior.

• Punishment – Application of aversive or painful stimuli that reduces the frequency of the behavior it follows.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 34: Nevid Pptch2 QBS

Social-Cognitive Theory• Social-cognitive theory – A learning-based theory

that emphasizes observational learning and incorporates roles for cognitive variables in determining behavior.

• Modeling – Learning by observing and imitating the behavior of others.

• Expectancies – Beliefs about expected outcomes.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 35: Nevid Pptch2 QBS

Humanistic Models• Self-actualization – In humanistic psychology, the

tendency to strive to become all that one is capable of being. The motive that drives one to reach one’s full potential and express one’s unique capabilities.

• Unconditional positive regard – Valuing other people as having basic worth regardless of their behavior at a particular time.

• Conditional positive regard – Valuing other people on the basis of whether their behavior meets one’s approval.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 36: Nevid Pptch2 QBS

Cognitive Models• Cognitive theorists study the cognitions—the thoughts,

beliefs, expectations, and attitudes—that accompany and may underlie abnormal behavior.

• They focus on how reality is colored by our expectations, attitudes, and so forth, and how inaccurate or biased processing of information about the world—and our places within it—can give rise to abnormal behavior.

• Cognitive theorists believe that our interpretations of the events in our lives, and not the events themselves, determine our emotional states.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 37: Nevid Pptch2 QBS

Information-Processing Models• Information-processing theorists discuss human cognition in

terms such as input (sensory and perceptual processes), manipulation (interpreting or processing), storage (placing information in memory), retrieval (accessing information from memory), and output (acting on the information).

• Psychological disorders are seen as disturbances in these processes.

• People with schizophrenia, for example, frequently jump from topic to topic in a disorganized fashion, which may reflect problems in retrieving and manipulating information.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 38: Nevid Pptch2 QBS

Albert Ellis• Psychologist Albert Ellis (1977b, 1993), a prominent

cognitive theorist, believed that troubling events in themselves do not lead to anxiety, depression, or disturbed behavior.

• Ellis used an “ABC approach” to explain the causes of the misery. Being fired is an activating event (A). The ultimate outcome, or consequence (C), is emotional distress.

• But the activating event (A) and the consequences (C) are mediated by various beliefs (B).

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 39: Nevid Pptch2 QBS

Aaron Beck• Aaron Beck proposes that depression may result from errors in

thinking or “cognitive distortions,” such as judging oneself entirely on the basis of one’s flaws or failures and interpreting events in a negative light (through blue-colored glasses, as it were).

• Beck stresses the four basic types of cognitive distortions that contribute to emotional distress:1. Selective abstraction 2. Overgeneralization3. Magnification4. Absolutist thinking

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 40: Nevid Pptch2 QBS

The Sociocultural Perspective

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 41: Nevid Pptch2 QBS

Ethnicity and Mental Health• A recent analysis of ethnic group differences in rates of

mental disorders revealed an interesting pattern.

• Using data from a nationally representative sample of adult Americans, investigators found that traditionally disadvantaged groups (non-Hispanic Black Americans and Hispanic Americans) had either significantly lower rates of psychological disorders or comparable rates, as compared to European Americans (non-Hispanic Whites), but greater chronicity or persistence.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 42: Nevid Pptch2 QBS

FIGURE 2.8 Ethnicity and psychological disorders in the United States.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 43: Nevid Pptch2 QBS

Ethnicity and Mental Health• Native Americans are a traditionally disadvantaged

minority group with high rates of mental disorders (Gone & Trimble, 2012).– Most commonly alcohol dependence, posttraumatic

stress disorder, and depression (Beals et al., 2005).

• Compared to other Hawaiians, Native Hawaiians experience higher rates of mental health problems, including higher suicide rates among men, higher rates of alcoholism and drug abuse, and higher rates of antisocial behavior.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 44: Nevid Pptch2 QBS

Evaluating the Sociocultural Perspective• Social causation model – The belief that social

stressors, such as poverty, account for the greater risk of severe psychological disorders among people of lower socioeconomic status.

• Downward drift hypothesis – The theory that explains the linkage between low socioeconomic status and behavior problems by suggesting that problem behaviors lead people to drift downward in social status.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 45: Nevid Pptch2 QBS

The Biopsychosocial Perspective• The biopsychosocial perspective examines the contributions of

multiple factors representing biological, psychological, and sociocultural domains, as well as their interactions, in the development of psychological disorders.

• Even disorders that are primarily biological may be influenced by psychological factors, or vice-versa.

• For example, some phobias may be learned behaviors that are acquired through experiences in which particular objects became associated with traumatic or painful experiences. Yet, some people may inherit certain traits that make them susceptible to the development of acquired or conditioned phobias.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 46: Nevid Pptch2 QBS

The Diathesis-Stress Model• Diathesis-stress model – A model that posits that abnormal

behavior problems involve the interaction of a vulnerability or predisposition and stressful life events or experiences.

• Diathesis – A vulnerability or predisposition to a particular disorder.

• In some cases, people with a diathesis for a particular disorder, say schizophrenia, will remain free of the disorder or will develop a milder form of the disorder if the level of stress in their lives remains low or if they develop effective coping responses for handling the stress they encounter.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 47: Nevid Pptch2 QBS

The Diathesis-Stress Model

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 48: Nevid Pptch2 QBS

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 49: Nevid Pptch2 QBS

Methods of Treatment

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 50: Nevid Pptch2 QBS

Types of Helping Professionals• Clinical psychologists – Have earned a doctoral degree in

psychology (either a Ph.D., or Doctor of Philosophy; a Psy.D., or Doctor of Psychology; or an Ed.D., or Doctor of Education) from an accredited college or university.

• Counseling psychologists – Also hold doctoral degrees in psychology and have completed graduate training preparing them for careers in college counseling centers and mental health facilities.

• Psychiatrists – Have earned a medical degree (M.D.) and completed a residency program in psychiatry.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 51: Nevid Pptch2 QBS

Types of Helping Professionals• Clinical or psychiatric social workers – Have earned a master’s degree

in social work (M.S.W.) and use their knowledge of community agencies and organizations to help people with severe mental disorders receive the services they need.

• Psychoanalysts – Typically are either psychiatrists or psychologists who have completed extensive additional training in psychoanalysis.

• Counselors – Have typically earned a master’s degree by completing a graduate program in a counseling field. Counselors work in many settings, including public schools, college testing and counseling centers, and hospitals and health clinics.

• Psychiatric nurses – Typically are R.N.s who have completed a master’s program in psychiatric nursing.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 52: Nevid Pptch2 QBS

Psychotherapy• Psychotherapy – A structured form of treatment

derived from a psychological framework that consists of one or more verbal interactions or treatment sessions between a client and a therapist.

• Psychotherapy is used to treat psychological disorders, to help clients change maladaptive behaviors or solve problems in living, or to help them develop their unique potentials.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 53: Nevid Pptch2 QBS

Psychodynamic Therapy• Psychoanalysis – The first method of

psychotherapy developed by Sigmund Freud.

• Psychodynamic therapy – Therapy that helps individuals gain insight into, and resolve, unconscious conflicts.

• Free association – The method of verbalizing thoughts as they occur without a conscious attempt to edit or censure them.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 54: Nevid Pptch2 QBS

Dream Analysis• In psychoanalytic theory, dreams have two levels of content:

1. Manifest content: The material of the dream the dreamer experiences and reports.2. Latent content: The unconscious material the dream symbolizes or represents.

• Freud believed dreams represented the “royal road to the unconscious.”

• Transference relationship – In psychoanalysis, the client’s transfer or generalization to the analyst of feelings and attitudes the client holds toward important figures in his or her life.

• Countertransference – In psychoanalysis, the transfer of feelings or attitudes that the analyst holds toward other persons in her or his life onto the client.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 55: Nevid Pptch2 QBS

Modern Psychodynamic Approaches• Like Freudian psychoanalysis, the newer psychodynamic

therapists explore their client’s psychological defenses and transference relationships – a process described as “peeling the onion” (Gothold, 2009).

• They focus more on the client’s present relationships and encourage the client to make adaptive behavior changes and treatment entails a more open dialogue.

• Many contemporary psychodynamic therapists draw more heavily on the ideas of Erik Erikson, Karen Horney, and other theorists than on Freud’s ideas.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 56: Nevid Pptch2 QBS

Behavioral Therapy• Behavior therapy – The systematic application of the

principles of learning to treat psychological disorders.

• Systematic desensitization – A behavior therapy technique for overcoming phobias by means of exposure to progressively more fearful stimuli while one remains deeply relaxed.

• Gradual exposure – A behavior therapy technique for overcoming fears through direct exposure to increasingly fearful stimuli.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 57: Nevid Pptch2 QBS

Behavioral Therapy• Modeling – A behavior therapy technique for helping

an individual acquire a target behavior by observing a therapist or another individual demonstrate the behavior and then imitating it.

• Token economy – Behavioral treatment program in which a controlled environment is constructed such that people are reinforced for desired behaviors by receiving tokens that may be exchanged for desired rewards.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 58: Nevid Pptch2 QBS

Humanistic Therapy• Humanistic therapists focus on clients’ subjective,

conscious experiences.

• Like behavior therapists, humanistic therapists also focus more on what clients are experiencing in the present—the here and now—than on the past.

• The major form of humanistic therapy is person-centered therapy (also called client-centered therapy), which was developed by the psychologist Carl Rogers.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 59: Nevid Pptch2 QBS

Person-Centered Therapy• Person-centered therapy – The establishment of a

warm, accepting therapeutic relationship that frees clients to engage in self-exploration and achieve self-acceptance.

• Person-centered therapy is nondirective.• The therapist uses reflection—the restating or

paraphrasing of the client’s expressed feelings without interpreting them or passing judgment on them.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 60: Nevid Pptch2 QBS

Person-Centered Therapy• Unconditional positive regard – The expression of

unconditional acceptance of another person’s intrinsic worth.

• Empathy – The ability to understand someone’s experiences and feelings from that person’s point of view.

• Genuineness – The ability to recognize and express one’s true feelings.

• Congruence – The fit between one’s thoughts, behaviors, and feelings.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 61: Nevid Pptch2 QBS

Cognitive Therapy

• Cognitive therapy – A form of therapy that helps clients identify and correct faulty cognitions (thoughts, beliefs, and attitudes) believed to underlie their emotional problems and maladaptive behavior.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 62: Nevid Pptch2 QBS

Rational Emotive Behavior Therapy• Albert Ellis believed that negative emotions such as anxiety

and depression are caused by the irrational ways in which we interpret or judge negative events, not by negative events themselves.

• Rational emotive behavior therapy (REBT) – A therapeutic approach that focuses on helping clients replace irrational, maladaptive beliefs with alternative, more adaptive beliefs.

• Rational emotive behavior therapists help clients substitute more effective interpersonal behavior for self-defeating or maladaptive behavior.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 63: Nevid Pptch2 QBS

Beck’s Cognitive Therapy• Psychiatrist Aaron Beck and his colleagues developed

cognitive therapy, which, like REBT, focuses on people’s faulty thoughts and beliefs.

• Cognitive therapists encourage clients to recognize and change errors in their thinking, called cognitive distortions, such as tendencies to magnify negative events and minimize personal accomplishments, that affect their moods and impair their behavior.

• Cognitive therapists have clients record the thoughts that are prompted by upsetting events and note the connections between their thoughts and their emotional responses.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 64: Nevid Pptch2 QBS

Cognitive-Behavioral Therapy• Cognitive-behavioral therapy (CBT) – A learning-based

approach to therapy incorporating cognitive and behavioral techniques.

• CBT attempts to integrate therapeutic techniques that help individuals make changes not only in their overt behavior but also in their underlying thoughts, beliefs, and attitudes.

• CBT draws on the assumption that thinking patterns and beliefs affect behavior and that changes in these cognitions can produce desirable behavioral and emotional changes.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 65: Nevid Pptch2 QBS

Overview of Major Types of Psychotherapy

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 66: Nevid Pptch2 QBS

Eclectic Therapy• Eclectic therapy – An approach to psychotherapy that

incorporates principles or techniques from various systems or theories.

• An eclectic therapist might use behavior therapy techniques to help a client change specific maladaptive behaviors, for example, along with psychodynamic techniques to help the client gain insight into the childhood roots of the problem.

• Some therapists are technical eclectics.

• Other eclectic therapists are integrative eclectics.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 67: Nevid Pptch2 QBS

FIGURE 2.10 Therapeutic orientations of clinical psychologists.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 68: Nevid Pptch2 QBS

Group, Family, and Couple Therapy• Group therapy – A form of therapy in which a group

of clients meets together with a therapist.

• Family therapy – A form of therapy in which the family, not the individual, is the unit of treatment.

• Couple therapy – A form of therapy that focuses on resolving conflicts in distressed couples.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 69: Nevid Pptch2 QBS

Group Therapy

• What are some of the advantages of group therapy over individual therapy?

• What are some of the disadvantages?

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 70: Nevid Pptch2 QBS

Family Therapy

• In family therapy, the family, not the individual, is the unit of treatment. Family therapists help family members communicate more effectively with one another—for example, to air their disagreements in ways that are not hurtful to individual members. Family therapists also try to prevent one member of the family from becoming the scapegoat for the family’s problems.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 71: Nevid Pptch2 QBS

Evaluating Methods of Psychotherapy• Reviews of the scientific literature often utilize a statistical technique

called meta-analysis, which averages the results of a large number of studies to determine an overall level of effectiveness.

• In the most frequently cited meta-analysis of psychotherapy research, M. L. Smith and Glass (1977) analyzed the results of some 375 controlled studies comparing various types of therapies (psychodynamic, behavioral, humanistic, etc.) against control groups.

• The results of their analyses showed that the average psychotherapy client in these studies was better off than 75% of the clients who remained untreated.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 72: Nevid Pptch2 QBS

Evaluating Methods of Psychotherapy• Although evidence supports the effectiveness of

psychotherapy, researchers lack clarity about why it works—that is, what factors or processes account for therapeutic change (Carey, 2011).

• Suggests the effectiveness of different forms of psychotherapy may have more to do with the common features.

• Nonspecific treatment factors – Factors not specific to any one form of psychotherapy, such as therapist attention and support, and creating positive expectancies of change.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 73: Nevid Pptch2 QBS

Empirically Supported Treatments (ESTs)

• Another approach to determining whether particular therapies are effective in treating particular problems is known as empirically supported treatments or ESTs.

• Efficacy studies speak to the issue of whether a treatment works better than control conditions.

• Effectiveness studies examine whether particular treatments are effective when used by practitioners.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 74: Nevid Pptch2 QBS

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 75: Nevid Pptch2 QBS

Multicultural Issues in Psychotherapy

• Normal and abnormal behaviors occur in a context of culture and community.

• Therapists need to be sensitive to cultural differences and how they affect the therapeutic process.

• We must also recognize that just because a given therapy works with one population does not mean that it will necessarily work with another population.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 76: Nevid Pptch2 QBS

African Americans• The cultural history of African Americans must be understood

in the context of persistent racial discrimination.• Therapists need to be aware of the tendency of African

American clients to minimize their vulnerability by being less self-disclosing (Sanchez-Hucles, 2000).

• Therapists must be aware of the cultural characteristics such as strong kinship bonds, strong religious and spiritual orientation, multigenerational households, adaptability and flexibility of gender roles, and distribution of child-care responsibilities among different family members.

• Therapists must recognize how stereotypes can become destructive to the therapeutic relationships they form with African American clients.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 77: Nevid Pptch2 QBS

Asian Americans• Culturally sensitive therapists not only understand the

beliefs and values of other cultures but also integrate this knowledge within the therapy process.

• Generally speaking, Asian cultures, including Japanese culture, value restraint in talking about oneself and one’s feelings.

• Public expression of emotions is also discouraged in Asian cultures, which may inhibit Asian clients from revealing their feelings in therapy.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 78: Nevid Pptch2 QBS

Hispanic Americans• Although Hispanic American subcultures differ in various

respects, many share certain cultural values and beliefs, such as the importance placed on the family and kinship ties, as well as on respect and dignity (Calzada, Fernandez, & Cortes, 2010).

• Therapists need to recognize that the traditional Hispanic American value of interdependency within the family may conflict with the values of independence and self-reliance that are stressed in the mainstream U.S. culture.

• Therapists should also be trained to reach beyond the confines of their offices to work within the Hispanic American community itself, in settings that have an impact on the daily lives of Hispanic Americans.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 79: Nevid Pptch2 QBS

Native Americans• Native Americans remain underserved, partly as a result of

underfunding and the cultural gap between providers and recipients.

• Mental health professionals can help Native Americans if they work within a context that is relevant and sensitive to Native Americans’ customs, culture, and values (Gone & Trimble, 2012).

• Many Native Americans expect that the therapist will do most of the talking and they will play a passive role in treatment.

• There may also be differences in nonverbal expression that can impede effective communication between the therapist and the client (Renfrey, 1992).

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 80: Nevid Pptch2 QBS

Barriers to Use of Mental Health Services by Ethnic Minorities

Barriers that exist for ethnic minorities include the following:

1. Cultural mistrust2. Mental health literacy3. Institutional barriers4. Cultural barriers5. Language barriers6. Economic and accessibility barriers

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 81: Nevid Pptch2 QBS

Biomedical Therapies• There is a growing emphasis in American psychiatry on

biomedical therapies, especially the use of psychotropic drugs (also called psychiatric drugs).

• Psychopharmacology – The field of study that examines the effects of therapeutic or psychiatric drugs.

• Today, roughly one in five adult Americans takes psychotropic drugs (Smith, 2012).

• Psychosurgery has been all but eliminated as a form of treatment because of serious harmful effects of earlier procedures.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 82: Nevid Pptch2 QBS

Drug Therapy• Different classes of psychotropic drugs are used in treating

many types of psychological disorders.

• But all the drugs in these classes act on neurotransmitter systems in the brain, affecting the delicate balance of chemicals that ferry nerve impulses from neuron to neuron.

• The major classes of psychiatric drugs are antianxiety drugs, antipsychotic drugs, and antidepressants, as well as lithium, which is used to treat mood swings in people with bipolar disorder.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 83: Nevid Pptch2 QBS

Antianxiety Drugs

• Antianxiety drugs – Drugs that combat anxiety and reduce states of muscle tension by reducing central nervous system activity.

• They include mild tranquilizers, such as diazepam (Valium) and alprazolam (Xanax), as well as hypnotic sedatives, such as triazolam (Halcion).

• Rebound anxiety – The experiencing of strong anxiety following withdrawal from a tranquilizer.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 84: Nevid Pptch2 QBS

Antipsychotic Drugs

• Antipsychotic drugs – Drugs used to treat schizophrenia or other psychotic disorders.

• The use of neuroleptics has greatly reduced the need for more restrictive forms of treatment for severely disturbed patients, such as physical restraints and confinement in padded cells, and has lessened the need for long-term hospitalization.

• Neuroleptics are not without their problems, including potential side effects such as muscular rigidity and tremors.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 85: Nevid Pptch2 QBS

Antidepressants• Antidepressants – Drugs used to treat depression

that affect the availability of neurotransmitters in the brain.

• The third class of antidepressants, selective serotonin-reuptake inhibitors, or SSRIs, have more specific effects on serotonin function in the brain.

• Drugs in this class include fluoxetine (Prozac) and sertraline (Zoloft).

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 86: Nevid Pptch2 QBS

Electroconvulsive Therapy• Electroconvulsive therapy (ECT) – A treatment in

which an electric shock is sent through the patient’s brain, sufficient to induce convulsions.

• People with major depression show significant improvement following ECT.

• ECT is associated with memory loss for events occurring around the time of treatment and high relapse rates.

• ECT is generally considered a treatment of last resort after less intrusive methods have been tried and failed.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 87: Nevid Pptch2 QBS

Psychosurgery• Psychosurgery is yet more controversial than ECT and is

rarely practiced today.

• Although no longer performed today, the most common form of psychosurgery was the prefrontal lobotomy.

• This procedure involved surgically severing nerve pathways linking the thalamus to the prefrontal lobes of the brain.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 88: Nevid Pptch2 QBS

Evaluation of Biological Approaches• There is little doubt that biological treatments have helped

many people with severe psychological problems.

• On the other hand, some forms of psychotherapy may be as effective as drug therapy in treating anxiety disorders and depression.

• Although we continue to learn more about the biological foundations of abnormal behavior patterns, the interface between biology and behavior can be construed as a two-way street.

© 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Page 89: Nevid Pptch2 QBS

The End