Therapy 101Therapy 101

PsychotherapyPsychotherapy

Literally:Literally:

Treatment of the PsycheTreatment of the PsycheMinds or personalities Minds or personalities

in distressin distress

PsychotherapyPsychotherapy is a process by which you examine is a process by which you examine

your thoughts, feelings, actions and your thoughts, feelings, actions and relationships, relationships,

evaluate where problems exist, and evaluate where problems exist, and learn how to make whatever changes learn how to make whatever changes

are necessary to achieve better life are necessary to achieve better life adjustment and satisfactionadjustment and satisfaction

Therapeutic Relationship

Varies with approachesVaries with approachesObjectiveObjectiveEthicalEthicalConfidentialConfidentialProfessionalProfessional

Patient/Therapist Relationship Terminology: Patient vs. ClientTerminology: Patient vs. Client

How well patients relate to therapists and vice How well patients relate to therapists and vice versa is important to the progress that they versa is important to the progress that they make in therapy.make in therapy. According to much of the research on According to much of the research on psychotherapy, a positive therapeutic psychotherapy, a positive therapeutic relationship may even be more important relationship may even be more important for recovery than the type of therapy for recovery than the type of therapy usedused..

Elements of Counseling RelationshipElements of Counseling RelationshipRapportRapport-the patient and therapist seem -the patient and therapist seem to "click with one another."to "click with one another." Trust-Trust-the patient views the therapeutic the patient views the therapeutic relationship as helpful and the therapist relationship as helpful and the therapist finds the patient interested in changing.finds the patient interested in changing. Confidentiality-Confidentiality- a therapist keeps what a therapist keeps what is said in therapy between himself and is said in therapy between himself and the patient except when the patient or the patient except when the patient or others are in danger. others are in danger.

Empathy-Empathy- an empathic therapist an empathic therapist tries to understand the situations tries to understand the situations and feelings through the patient 's and feelings through the patient 's eyes. eyes. Insight-Insight- the patient is able to the patient is able to understand how his/her illness, understand how his/her illness, attitudes and behaviors affect attitudes and behaviors affect his/her life, (i.e. self-understanding). his/her life, (i.e. self-understanding). Motivation-Motivation-the patient has a desire the patient has a desire to feel better and improve his/her to feel better and improve his/her situation. situation.

Therapeutic GoalsTherapeutic Goals

Fostering InsightFostering InsightEncouragementEncouragementReducing emotional discomfortReducing emotional discomfortProviding new informationProviding new informationFacilitating changeFacilitating change

Continuum of CareContinuum of Care

ConsultatioConsultationn OutpatienOutpatien

tt Intensive Intensive outpatientoutpatient

Day Day TreatmentTreatmentResidentialResidential

Supervised livingSupervised livingInpatient Inpatient HospitalizationHospitalization

One on one delivery of services One on one delivery of services focused on theoretical perspective focused on theoretical perspective and client needand client needBrief, solution focused therapyBrief, solution focused therapySupportive therapySupportive therapyMatch client needs with orientationMatch client needs with orientation

Individual TherapyIndividual Therapy

Group TherapySimultaneous treatment of serveral Simultaneous treatment of serveral individualsindividualsYalom’s theory of group therapyYalom’s theory of group therapyTherapist’s trainingTherapist’s trainingScreening of candidatesScreening of candidatesGroup compositionGroup compositionOpen, closed, size, other Open, closed, size, other considerationsconsiderations

Family TherapyFamily Therapy

Identifying and changing Identifying and changing patterns of family interactionpatterns of family interaction““Identified client”Identified client”Systems viewSystems viewStructural, strategic viewStructural, strategic viewVirginia SatirVirginia Satir

Family TherapyFamily TherapyFamily therapy focuses on change Family therapy focuses on change within the family, and recognizes than within the family, and recognizes than family relationships all have an impact family relationships all have an impact on the feelings and behavior of each of on the feelings and behavior of each of the members of a family.the members of a family. Instead of meeting with an individual, Instead of meeting with an individual, all or most family members are all or most family members are involved in the therapy process.involved in the therapy process.

Occasionally, the non-custodial parents are also Occasionally, the non-custodial parents are also involved in family therapy, but this depends on the involved in family therapy, but this depends on the potential for divorced parents working together to potential for divorced parents working together to help their children resolve psychological problems. help their children resolve psychological problems. Family therapy is most frequently used when a child Family therapy is most frequently used when a child or adolescent is identified as having a psychological or adolescent is identified as having a psychological problemproblemFor example, a teen with chronic depression or For example, a teen with chronic depression or substance abuse problems might benefit from family substance abuse problems might benefit from family therapy to address the impact of their problem on therapy to address the impact of their problem on family relationships, while also receiving individual family relationships, while also receiving individual psychotherapy to directly address their personal psychotherapy to directly address their personal change issues. change issues.

Relationship counseling, couple Relationship counseling, couple therapytherapyFocus on interaction, Focus on interaction, communicationcommunicationDynamicsDynamicsLegal issuesLegal issuesProblem solvingProblem solvingTherapist’s mine field !Therapist’s mine field !

Marital Therapy

Relationship CounselingCouple Therapy

(Marriage Counseling)Couple therapy is often seen as somehow Couple therapy is often seen as somehow different from psychotherapy because one different from psychotherapy because one individual is not identified as having a specific individual is not identified as having a specific psychological problem.psychological problem. All psychological problems involve both All psychological problems involve both individual symptoms and changes in individual symptoms and changes in interpersonal relationships. interpersonal relationships. Couple therapy focuses on the problems Couple therapy focuses on the problems existing in the relationship between two people. existing in the relationship between two people.

These relationship problems always These relationship problems always involve individual symptoms and involve individual symptoms and problems, as well as relationship conflicts.problems, as well as relationship conflicts.

Changes may be different ways of Changes may be different ways of interacting within the relationship, or may interacting within the relationship, or may be individual changes related to other be individual changes related to other psychological problems. psychological problems. Couple therapy involves learning how to Couple therapy involves learning how to communicate more effectively, and how to communicate more effectively, and how to listen more closely. listen more closely.

Couples must learn how to avoid Couples must learn how to avoid competing with each other, and need to competing with each other, and need to identify common life goals and how to identify common life goals and how to share responsibilities within their share responsibilities within their relationship. relationship. Sometimes the process is very similar to Sometimes the process is very similar to individual psychotherapy, sometimes like individual psychotherapy, sometimes like mediation, and sometimes educational. mediation, and sometimes educational. The combination of the three is what The combination of the three is what makes it effective. makes it effective.

Who’s Who in Mental Health?Who’s Who in Mental Health?Psychiatrist (MD)

College, four years of medical College, four years of medical school, four years of a psychiatry school, four years of a psychiatry residency.residency.Diagnose and treat patients with Diagnose and treat patients with medication and/or therapy. Oversee medication and/or therapy. Oversee patient care.patient care.

Clinical PsychologistClinical Psychologist (Ph.D./PsyD)

College, five to seven years of graduate study, a written dissertation on a specialized topic, specialized clinical training.Diagnosis, psychological testing, and therapy. May refer people for medication but do not prescribe medication.

Counselor/TherapistCounselor/Therapist (MA/MS)

College, two year graduate study in College, two year graduate study in psychology or counseling.psychology or counseling.

Counseling or therapy, psychological Counseling or therapy, psychological testing.May refer people for medication but testing.May refer people for medication but do not prescribe medication.do not prescribe medication.

Psychiatric NursePsychiatric Nurse (RN/BSN)

RN: Two or three year hospital or community Two or three year hospital or community college program. college program. BSN: college degree in nursing. Psychiatric nurse certification: specialty Psychiatric nurse certification: specialty training in medication management and training in medication management and group therapy .group therapy .

Works in inpatient and outpatient settings. Works in inpatient and outpatient settings. Plans, implements, and evaluates patient Plans, implements, and evaluates patient care; monitors medications;and provides care; monitors medications;and provides individual and/or group therapyindividual and/or group therapy

Social Worker (MSW)Social Worker (MSW)

College, two years of graduate study College, two years of graduate study which includes clinical training.which includes clinical training.

Usually works in outpatient settings. Usually works in outpatient settings. Diagnosis, therapy, and medication Diagnosis, therapy, and medication management under the supervision management under the supervision of a physician.of a physician.

Therapist OrientationsTherapist Orientations

(APA Data, 1989)

Therapy TypesTherapy Types

Insight TherapiesInsight Therapies

Behavioral TherapiesBehavioral Therapies

Cognitive TherapiesCognitive Therapies

Biological TherapiesBiological Therapies

Not All Psychotherapy Is Psychoanalysis

Many people have misconceptions Many people have misconceptions about what psychotherapy is. Some about what psychotherapy is. Some people think psychotherapy involves people think psychotherapy involves laying on a couch and talking with a laying on a couch and talking with a psychoanalyst who just says "tell me psychoanalyst who just says "tell me more.". more.". Most therapies focus on reducing Most therapies focus on reducing symptoms quickly and returning the symptoms quickly and returning the patient to a relatively normal level of patient to a relatively normal level of functioning.functioning.

Insight TherapiesInsight TherapiesPsychodynamicPsychodynamic

Person-centered Therapy Person-centered Therapy

Gestalt Therapy Gestalt Therapy

Existential TherapyExistential Therapy

Comparing Major Therapies

PerceivedPerceivedCause of Cause of DisorderDisorder

GoalsGoals ofof TherapyTherapy

MethodsMethods usedused

PsychodynamicPsychodynamic

Cause Goals Methods

Unconscious Unconscious sexual and sexual and aggressive aggressive urges/conflictsurges/conflictsFixationsFixations

Bring Bring repressed repressed information information into into conscious conscious mindmind

Dream Dream InterpretationInterpretationFree Free AssociationAssociation

PsychodynamicPsychodynamicUsually lengthyFree Association and Dream AnalysisBarriers: Resistance, TransferenceExploring unconscious

PsychodynamicPsychodynamic

Free associationFree association

Analysis of ResistanceAnalysis of Resistance

Dream analysisDream analysis

Analysis of TransferenceAnalysis of Transference

PsychodynamicPsychodynamic

Minimizes patient responsibility

Neglects conscious motives and the present

Fairly costly

Psychoanalytic Orientation

The Nature of PsychoanalysisTechniques in psychoanalysis:Analysis of free associationsAnalysis of resistancesAnalysis of dreamsAnalysis of transferenceOffshoots of psychoanalysis

Freud’s Psychoanalysis

Psychoanalysis - an insight therapy based on the theory of Freud, emphasizing the revealing of unconscious conflicts.

Dream interpretationManifest content – the actual content of one’s dream.Latent content – the symbolic or hidden meaning of

dreams.Free association – Freudian technique in which a patient was encouraged to talk about anything that came to mind without fear of negative evaluations.

Freud’s PsychoanalysisResistance - occurring when a patient becomes reluctant to talk about a certain topic, either changing the subject or becoming silent.Transference - in psychoanalysis, the tendency for a patient or client to project positive or negative feelings for important people from the past onto the therapist.

Psychoanalysis TodayPsychodynamic therapy - a newer and more general term for therapies based on psychoanalysis, with an emphasis on transference, shorter treatment times, and a more direct therapeutic approach.Nondirective - therapy style in which the therapist remains relatively neutral and does not interpret or take direct actions with regard to the client, instead remaining a calm, nonjudgmental listener while the client talks.Directive - therapy in which the therapist actively gives interpretations of a client’s statements and may suggest certain behavior or actions. Psychoanalysis today is more directive.

14. _______________ formed a large part of Freud’s psychoanalytic method.

a) Reflectionb) Empathyc) Dream interpretationd) Unconditional positive regard

14. _______________ formed a large part of Freud’s psychoanalytic method.

a) Reflectionb) Empathy

c) Dream interpretationd) Unconditional positive regard

HumanismHumanism

Only the client can judge if he or she is Only the client can judge if he or she is betterbetter

No way to independently verify No way to independently verify successsuccess

Person CenteredCauses Goals Methods

Incongruence Incongruence between real and between real and desired self. desired self. Overdependence Overdependence on positive on positive regard from regard from othersothers

Increase self Increase self acceptance acceptance and self and self understandingunderstandingEnhance Enhance personal personal growthgrowth

Empathy, Empathy, unconditionalunconditionalPositive Positive regardregardReflection of Reflection of feelingsfeelings

Person-Centered Therapy

A Humanistic therapy

Founded by Rogers

Uses mirroring & unconditional positive regard to promote self actualization

Therapist must genuinely like the client

Therapist must have empathy for the client

Person Centered (Nondirective)

Warm, supportive environmentWarm, supportive environmentUnconditional positive regardUnconditional positive regardReveal true feelings to achieve self-Reveal true feelings to achieve self-growthgrowthUnderstand past conditions of worthUnderstand past conditions of worthNeed for therapist to identify with client Need for therapist to identify with client (empathy)(empathy)

Gestalt Therapy

Founded by Perls

Therapist directs client to get in touch with feelings, resolve unfinished business

GestaltGestaltChallenge with questions, Challenge with questions, activities designed to activities designed to challengechallenge clients to clients to increase self-awarenessincrease self-awarenessRole playingRole playingConfrontation, but Confrontation, but encouraging, supportiveencouraging, supportive

Today’s View of Humanistic Therapy

Humanistic therapies are not based in experimental research and work best with intelligent, highly verbal persons.

Humanistic Orientation

Person-Centered Therapy; Carl Rogers

Reflection of feelings main techniqueUnconditional positive regard

Gestalt Therapy; Perls

Roger’s Person-Centered TherapyPerson-centered therapy - a nondirective insight therapy based on the work of Carl Rogers in which the client does all the talking and the therapist listens.Four Elements:

1. Reflection - therapy technique in which the therapist restates what the client says rather than interpreting those statements.

2. Unconditional positive regard - referring to the warmth, respect, and accepting atmosphere created by the therapist for the client in person-centered therapy.

3. Empathy - the ability of the therapist to understand the feelings of the client.

4. Authenticity - the genuine, open, and honest response of the therapist to the client.

What did Carl Rogers view as a cause of most personal problems and unhappiness?

a) reinforcement of maladaptive behavior patterns b) unrealistic modes of thought employed by many

peoplec) mismatch between an individual’s ideal self and real

selfd) unresolved unconscious conflicts occurring

between the id and superego

What did Carl Rogers view as a cause of most personal problems and unhappiness?

a) reinforcement of maladaptive behavior patterns b) unrealistic modes of thought employed by many peoplec) mismatch between an individual’s ideal self

and real selfd) unresolved unconscious conflicts occurring between the

id and superego

Gestalt Therapy form of directive insight therapy in which the therapist helps clients to accept all parts of their feelings and subjective experiences, using leading questions and planned experiences such as role-playing.Try to help clients deal with things in their past that they have denied and will use body language and other nonverbal cues to understand what clients are really saying.

Which of the following is a key component of Rogers’s person-

centered therapy?a) cognitionb) resistance

c) dream interpretationd) unconditional positive regard

Which of the following is a key component of Rogers’s person-centered therapy?

a) cognitionb) resistancec) dream interpretationd) unconditional positive regard

BehavioralBehavioralCauses Goals Methods

Learning Learning maladaptive maladaptive behaviors, behaviors, failure to failure to learn learn appropriate appropriate behaviorsbehaviors

Help acquire needed social skills,Extinguish maladaptive behaviors, Replace with Positive behaviors

Based on classical and operant conditioning:Exposure,ReinforcementFloodingModeling

BehavioralBehavioralUse learning principles to reduce Use learning principles to reduce or eliminate maladaptive or eliminate maladaptive behaviorsbehaviorsIgnores unconscious conflictsIgnores unconscious conflictsSystematic desensitization, Systematic desensitization, flooding, modeling, token flooding, modeling, token economy, aversive conditioningeconomy, aversive conditioning

Behavioral TherapyBehavioral Therapy

Problems arise from failure to learn adaptive behavior or learning of maladaptive behavior

Change through operant and classical conditioning techniques

Systematic Desensitization

Teach relaxationTeach relaxation

Create a hierarchy ranging from least to Create a hierarchy ranging from least to most feared stimulusmost feared stimulus

Work through hierarchy while Work through hierarchy while maintaining calmmaintaining calm

Exposure & Response Prevention

Exposing the person to the Exposing the person to the situation producing anxietysituation producing anxiety

Preventing the person from Preventing the person from performing their ritualsperforming their rituals

ModelingModeling

Providing a role model lacking the Providing a role model lacking the anxiety anxiety

Participant modeling works bestParticipant modeling works best

Behavioral Therapy and Classical ConditioningBehavior therapies - action therapies based on the principles of classical and operant conditioning and aimed at changing disordered behavior without concern for the original causes of such behavior.Behavior modification or applied behavior analysis – the use of learning techniques to modify or change undesirable behavior and increase desirable behavior.

Behavioral Therapy and Classical Conditioning

Systematic desensitization - behavior technique used to treat phobias, in which a client is asked to make a list of ordered fears and taught to relax while concentrating on those fears.

Counterconditioning - replacing an old conditioned response with a new one by changing the unconditioned stimulus.

Behavioral Therapy and Classical Conditioning

Aversion therapy - form of behavioral therapy in which an undesirable behavior is paired with an aversive stimulus to reduce the frequency of the behavior.Flooding - technique for treating phobias and other stress disorders in which the person is rapidly and intensely exposed to the fear-provoking situation or object and prevented from making the usual avoidance or escape response.

Menu

LO 15.8 Behavior therapists’ use of classical conditioning

Modeling - learning through the observation and imitation of others.

Participant modeling - technique in which a model demonstrates the desired behavior in a step-by-step, gradual process while the client is encouraged to imitate the model.

Reinforcement - the strengthening of a response by following it with a pleasurable consequence or the removal of an unpleasant stimulus.

Token economy - the use of objects called tokens to reinforce behavior in which the tokens can be accumulated and exchanged for desired items or privileges.Contingency contract – a formal, written agreement between the therapist and client (or teacher and student) in which goals for behavioral change, reinforcements, and penalties are clearly stated.

Extinction – the removal of a reinforcer to reduce the frequency of a behavior.

Time-out - an extinction process in which a person is removed from the situation that provides reinforcement for undesirable behavior, usually by being placed in a quiet corner or room away from possible attention and reinforcement opportunities.

Effectiveness of Behavioral TherapyBehavior therapies can be effective in treating specific problems, such as bedwetting, drug addictions, and phobias.Can help improve some of the more troubling behavioral symptoms associated with more severe disorders.

CognitiveCognitive

Causes Goals Methods

Irrational, negative assumptions and ideas about self and others

Change faulty, irrational, negative thinking

Identify negative thoughts and replace with rational thinking

Cognitive TherapiesCognitive Therapies

Rational Emotive Therapy (Ellis) Rational Emotive Therapy (Ellis)

Beck's cognitive therapyBeck's cognitive therapy

CognitiveCognitiveUses learning principles to Uses learning principles to challenge irrational thoughtschallenge irrational thoughtsCognitive distortions: Cognitive distortions: overgeneralization, black/white overgeneralization, black/white thinking, mind readingthinking, mind readingRational Emotive Rational Emotive Self defeating behaviors/thoughtsSelf defeating behaviors/thoughtsSubstitute more positiveSubstitute more positive

Rational Emotive Therapy

Attempts to modify the irrational Attempts to modify the irrational beliefs that cause distressbeliefs that cause distress

Confrontational and directiveConfrontational and directive

Common Irrational Beliefs

I must be perfect

Everyone must love me

The past determines the future

It is catastrophic when things don't go as planned

Common Irrational Beliefs

I have no control over my happiness I have no control over my happiness

Perfect solutions must be found for Perfect solutions must be found for life's problems life's problems

Happiness just happensHappiness just happens

Beck’s Cognitive Therapy

Automatic Thoughts: Thoughts people have about life and the self that may be unreasonable but are accepted as accurate

Automatic thoughts create depression and anxiety

Goal: teach patients to stop the thoughts

Beck’s Cognitive Therapy

Also involves negative views of past, present, and future experiences

Highly effective treatment for depression & anxiety

Cognitive Orientation

Rational-Emotive Therapy: Albert Ellis

Goal is changing irrational beliefsA-B-C Theory of Emotion

Cognitive TherapyGoal is changing negative beliefs about the world, the self and the future

The A-B-C Theory of Emotion

Cognitive TherapyCognitive therapy - therapy in which the focus is on helping clients recognize distortions in their thinking and replace distorted, unrealistic beliefs with more realistic, helpful thoughts.Cognitive Distortions based on Beck’s Cognitive Therapy:

Arbitrary inference – distortion of thinking in which a person draws a conclusion that is not based on any evidence.Selective thinking - distortion of thinking in which a person focuses on only one aspect of a situation while ignoring all other relevant aspects.

Cognitive Distortions:Overgeneralization - distortion of thinking in which a person draws sweeping conclusions based on only one incident or event and applies those conclusions to events that are unrelated to the original.Magnification and minimization - distortions of thinking in which a person blows a negative event out of proportion to its importance (magnification) while ignoring relevant positive events (minimization).Personalization - distortion of thinking in which a person takes responsibility or blame for events that are unconnected to the person.

Cognitive-behavioral therapy (CBT) - action therapy in which the goal is to help clients overcome problems by learning to think more rationally and logically.Three goals:

Relieve the symptoms and solve the problems.To develop strategies for solving future problems.To help change irrational, distorted thinking.

Rational-Emotive TherapyRational-emotive behavior therapy (REBT) - cognitive-behavioral therapy in which clients are directly challenged in their irrational beliefs and helped to restructure their thinking into more rational belief statements.

Success of CBT

CBT has seemed successful in treating depression, stress disorders, and anxiety.Criticized for focusing on the symptoms and not the causes of disordered behavior.

Biomedical

Causes Goals Methods

Genetic inheritance,Biochemical abnormality within the brain

Eliminate or control biological causes.Restore balance of neurotransmitters

Medication,Medication,PsychosurgeryPsychosurgeryECTECT

BiomedicalBiomedicalDrug therapiesDrug therapiesAntianxiety agentsAntianxiety agentsAntipsychotic agentsAntipsychotic agentsAntidepressantsAntidepressants

Electro convulsive therapy (ECT)Electro convulsive therapy (ECT)PsychosurgeryPsychosurgery

Biological TherapiesBiological TherapiesPsychoactive drugs highly successful in reducing in-patient population

Mental Hospital

Population

Antipsychotic DrugsAntipsychotic Drugs

Neuroleptics -- phenothiazine, butyrophenones

Neuroleptics may cause Tardive dyskinesia

Clozapine and risperidoneClozapine has a risk of producing blood clots

AntidepressantsAntidepressantsTricyclicsTricyclics

Serotonin Selective Reuptake InhibitorsSerotonin Selective Reuptake InhibitorsSSRIs (Prozac, Anafranil) have fewer side SSRIs (Prozac, Anafranil) have fewer side

effects effects

MAO inhibitorsMAO inhibitorsMAO inhibitors can't be taken with certain MAO inhibitors can't be taken with certain

foodsfoods

Antimania Drugs

Lithium Carbonate evens out the Lithium Carbonate evens out the mood swings of bipolar patientsmood swings of bipolar patients

Must be carefully monitoredMust be carefully monitored

TranquilizersTranquilizers

Benzodiazapines (Librium, Valium, Benzodiazapines (Librium, Valium, Xanax)Xanax)

Xanax more effective but somewhat Xanax more effective but somewhat addictive addictive

Electroconvulsive Therapy

An effective treatment for depression & An effective treatment for depression & mania not responsive to drugsmania not responsive to drugs

May cause temporary memory lossMay cause temporary memory loss

Works by altering neurotransmitter Works by altering neurotransmitter balancebalance

PsychosurgeryPsychosurgery

Lobotomies done from 1935-1955Lobotomies done from 1935-1955

Cingulotomies and other Cingulotomies and other microsurgeries sometimes done todaymicrosurgeries sometimes done today

Lobotomy Site

Portions of the Portions of the frontal lobefrontal lobeare separated from are separated from the the thalamusthalamus

PsychosurgeryPsychosurgery

Negatives:

Results are unpredictable

Consequences are irreversible

Biopsychological Orientation

PsychosurgeryPrefrontal lobotomy

Electroconvulsive TherapyBrief electric current induces brain seizuresProduces retrograde amnesia

Drug TherapyAntianxiety Drugs e.g., Valium, Xanax Work by stimulating GABA

Antidepressant Drugs e.g., tricyclic antidepressants and SSRIs

Antimania drugs e.g., lithium Can produce dangerous side effects

Antipsychotic drugs e.g., thorazine Motor side effects

Drug Treatments

Biomedical therapies – therapies that directly affect the biological functioning of the body and brain.Psychopharmacology - the use of drugs to control or relieve the symptoms of psychological disorders.

Antipsychotic drugs - drugs used to treat psychotic symptoms such as delusions, hallucinations, and other bizarre behavior.

Antianxiety drugs - drugs used to treat and calm anxiety reactions, typically minor tranquilizers.Antimanic drugs - used to treat bipolar disorder and include lithium and certain anticonvulsant drugs.Antidepressant drugs - drugs used to treat depression and anxiety.

Electroconvulsive TherapyElectroconvulsive therapy (ECT) - form of biomedical therapy to treat severe depression in which electrodes are placed on either one or both sides of a person’s head and an electric current is passed through the electrodes that is strong enough to cause a seizure or convulsion.

Bilateral ECT - electroconvulsive therapy in which the electrodes are placed on both sides of the head.Unilateral ECT - electroconvulsive therapy in which the electrodes are placed on only one side of the head and the forehead.

PsychosurgeryPsychosurgery - surgery performed on brain tissue to relieve or control severe psychological disorders.

Prefrontal lobotomy - psychosurgery in which the connections of the prefrontal lobes of the brain to the rear portions are severed.Bilateral cingulotomy - psychosurgical technique in which an electrode wire is inserted into the cingulated gyrus area of the brain with the guidance of a magnetic resonance imaging machine for the purpose of destroying that area of brain tissue with an electric current.

Danger of Treating Children with Antidepressants

All but one antidepressant drug has been associated with an increased risk of suicide when used to treat depression in children and adolescents.

Prozac, the one safe antidepressant for children and adolescents, has been found to be more effective when combined with psychotherapy.

Clicker Review

Therapy

Lulu sees a professional once a month to manage the medication she is taking to help alleviate the symptoms of her anxiety disorder. The type of therapy Lulu is undergoing is called ______________.

a) psychotherapyb) biomedical therapyc) physical therapyd) electroconvulsive shock therapy

Lulu sees a professional once a month to manage the medication she is taking to help alleviate the symptoms of her anxiety disorder. The type of therapy Lulu is undergoing is called ______________.

a) psychotherapy

b) biomedical therapyc) physical therapyd) electroconvulsive shock therapy

The psychoanalytic patient who lets her thoughts flow without interruption or fear of negative criticism from her therapist is using ______.

a) dream interpretation

b) positive transference

c) regressiond) free association

The psychoanalytic patient who lets her thoughts flow without interruption or fear of negative criticism from her therapist is using ______.

a) dream interpretation

b) positive transference

c) regression

d) free association

The therapist’s feeling of respect and affection for the client that exists without any strings attached, no matter what the client may say or do, is called __________.

a) conditions of worthb) empathyc) catharsisd) unconditional positive regard

The therapist’s feeling of respect and affection for the client that exists without any strings attached, no matter what the client may say or do, is called __________.

a) conditions of worthb) empathyc) catharsisd) unconditional positive regard

14.56. What do behavior therapists see as the cause of abnormal or undesirable behaviors?

a) learningb) unconscious conflictsc) distortions in thinkingd) discrepancy between the real self and ideal

self

14.56. What do behavior therapists see as the cause of abnormal or undesirable behaviors?

a) learningb) unconscious conflictsc) distortions in thinkingd) discrepancy between the real self and ideal

self

14.67. Every time Jarrad opens his cigarette case or uses his lighter, he gets a painful electric shock. Jarrad’s friends and family have been asked not to give him any cigarettes or light any cigarettes for him, so he must use his own lighter if he wants to smoke. Eventually, Jarrad loses his desire to smoke, thanks to ______.a) negative transferenceb) behavioral contractingc) systematic desensitizationd) aversion conditioning

14.67. Every time Jarrad opens his cigarette case or uses his lighter, he gets a painful electric shock. Jarrad’s friends and family have been asked not to give him any cigarettes or light any cigarettes for him, so he must use his own lighter if he wants to smoke. Eventually, Jarrad loses his desire to smoke, thanks to ______.a) negative transferenceb) behavioral contractingc) systematic desensitization

d) aversion conditioning

14.61. Which method of treating phobias involves progressive relaxation and exposure to the feared object?

a) extinction b) punishment c) token economy d) systematic desensitization

14.61. Which method of treating phobias involves progressive relaxation and exposure to the feared object?

a) extinction b) punishment c) token economy

d) systematic desensitization

Estella is afraid of cats. To help her overcome her fear, her mother calmly pets and strokes a cat while Estella is watching. Her mother encourages her to imitate her behavior. Estella’s mother is using_________.

a) reinforcementb) token economy c) modelingd) punishment

Estella is afraid of cats. To help her overcome her fear, her mother calmly pets and strokes a cat while Estella is watching. Her mother encourages her to imitate her behavior. Estella’s mother is using_________.

a) reinforcementb) token economy

c) modelingd) punishment

Which of the following is one of the criticisms of behavior therapy?

a) It focuses on the underlying cause of behavior and not the symptoms.b) Therapy typically lasts for several years and is very expensive.c) It focuses too much on the past.d) It only relieves some symptoms but does not treat the overall disorder.

Which of the following is one of the criticisms of behavior therapy?

a) It focuses on the underlying cause of behavior and not the symptoms.b) Therapy typically lasts for several years and is very expensive.c) It focuses too much on the past.d) It only relieves some symptoms but does not treat the overall disorder.

Therapy that depends on identifying and changing distorted thinking and unrealistic beliefs is ______ therapy.

a) cognitiveb) psychoanalyticc) behaviord) person-centered

Therapy that depends on identifying and changing distorted thinking and unrealistic beliefs is ______ therapy.

a) cognitiveb) psychoanalyticc) behaviord) person-centered

Which of the following is a basic goal of cognitive-behavioral therapy?

a) to help clients uncover unconscious conflicts and sexual urgesb) to help clients develop a closer match between real and ideal selvesc) to help clients change irrational thoughts to rational thoughtsd) to help clients complete unfinished business and become whole

Which of the following is a basic goal of cognitive-behavioral therapy?

a) to help clients uncover unconscious conflicts and sexual urgesb) to help clients develop a closer match between real and ideal selvesc) to help clients change irrational thoughts to rational thoughtsd) to help clients complete unfinished business and become whole

Which of the following is an advantage of cognitive and cognitive-behavioral therapies?

a) Clients do not need to be verbal.b) They treat the underlying cause of the problem.c) They are less expensive and short term than typical insight therapies.d) The therapist decides which of the client’s beliefs are rational and which are irrational.

Which of the following is an advantage of cognitive and cognitive-behavioral therapies?

a) Clients do not need to be verbal.b) They treat the underlying cause of the problem.c) They are less expensive and short term than typical insight therapies.d) The therapist decides which of the client’s beliefs are rational and which are irrational.

The EndThe End