Presentation on theme: "Abnormal Psychology Chapter 10"— Presentation transcript:
1 Abnormal Psychology Chapter 10 The scientific study of mental disorders and their treatmentPrepared by J. W. Taylor V
2 Abnormal Psychology College reading: 363 – 365 general info about disorders and DSM 5 –375 – 380 schizophreniaREADING QUIZ SOON….
3 This unit is about…The Diagnosis and Classification of Mental DisordersThree Major Categories of Mental DisordersThe Treatment of Mental Disorders
4 What is abnormal behavior? Write 3 characteristics
5 Criteria for a Behavior/Thought Process to be a “Disorder” 1. Is the behavior/thought process atypical?2. Is the behavior/thought process maladaptive?3. Is the behavior/thought process personally distressing?4. Is the behavior/though process irrational?
7 Perceptual Bias of Labeling Problem: when we classify mental disorders we label people, and this biases our perception of these people in terms of the labelsEx: the word “crazy” has strong connotations
8 Mental disorders fall into 4 major categories Anxiety disorders: highly anxious or fearful behavior Ex:Mood disorders: emotional extremes Ex:Schizophrenic disorders: disorganized thinking, disturbed perceptions, inappropriate actions/emotions Ex:personality disorders: inflexible, long-standing personality traits, impaired social functioning, deviate from cultural normsEx:
9 Diagnostic and Statistical Manual: Official book of mental disorders The DSM-IV, published in 1994 by the American Psychiatric Association, is the most widely used diagnostic system for disordersFirst appeared in At that time, 60 disorders.Now contains more than 300 disordersDSM-IV classification required by health insurance companies before they will pay for therapy
10 Three Major Categories of Clinical Disorders CategorySpecific Disorders within CategoryAnxiety disordersSpecific phobia, social phobia, agoraphobia, panic disorder with and without agoraphobia, generalized anxiety disorder, obsessive-compulsive disorderMood disordersMajor depressive disorder, bipolar disorderSchizophrenic disordersSchizophrenia (paranoid, disorganized, catatonic, undifferentiated, and residual subtypes)
11 By the way…Be wary of the medical school syndrome: the tendency to think that you have a disorder when you read about its symptomsIt’s normal to feel depressed, spazz out, have occasional OCD etc…Remember, to be abnormal your behavior must be:AtypicalMaladaptivePersonally distressingIrrational
12 Schizophrenic disorder What are 3 of Jani’s symptoms/behaviors?Describe how her behavior fits the definition of “abnormal”.Do you feel her parents are responding appropriately? Why/not?
13 Schizophrenic disorder Is NOT multiple personality disorderSchizophrenics have one personality, but it is disorganized and irrationalThey typicallyHave hallucinations (hear voices)Are delusional (irrational beliefs, ex: “I am a messenger of God”)Are paranoid (“the government is spying on me”)Have erratic emotional responses/violent outbursts
17 Pair assignment – profile of a schizophrenic Make a detailed profile of a person who is schizophrenicInclude their name, age, living conditions, personality and other personal identifying informationDescribe their schizophrenic symptoms. Be descriptive, and realistic (base on research)Describe any treatment, relapses, family response etc
18 Grading criteria BEST poster: all members get 11 points! Second best: all members get 10Third: 9And so onIt’s a competition!!
19 Schizophrenic Disorders More people are institutionalized with schizophrenia than any other disorderAbout 1% of the population suffers from schizophreniaThe onset tends to be in late adolescence or early adulthoodTends to strike men earlier and more severely, though both sexes are equally vulnerableHigher incidence in lower socioeconomic groups and for people who are single, separated or divorced rather than married
20 What does this graph tell us about schizophrenia?
21 SchizophreniaIs a psychotic disorder because it is characterized by a loss of contact with realitySchizophrenia means “split mind,” as mental functions do indeed become split from each other and detached from reality
22 Symptoms of Schizophrenia Positive symptoms are abnormal behaviors that exist, but should not. Added symptoms.Hallucinations (false sensory perceptions)Hallucinations tend to be auditory, such as hearing voices that are not realDelusions (false beliefs)Delusions of persecutions involve thoughts of conspiracy against youDelusions of grandeur involve believing that you are a person of great importance, such as Jesus Christ
23 Symptoms of Schizophrenia Negative symptoms refer to things that have been removedLoss of emotion, energy, social activity, even drives like hungerDisorganized symptoms include disorganized speech, disorganized behavior, and inappropriate emotionWhen the person’s speech is disorganized, it might be like a “word salad,” with unconnected words incoherently spoken together
24 Technical DefinitionAccording to the DSM-IV, schizophrenia is defined as the presence, most of the time during a one-month period, of at least two of the following symptomsHallucinationsDelusionsDisorganized speechDisorganized or catatonic behaviorAny negative symptoms (such as loss of emotion)
25 Catatonic schizophrenia This person might sit frozen in this position for hoursIs this a positive, negative or disorganized symptom?
26 Five Subtypes of Schizophrenic Disorder SymptomsDisorganizedDisorganized speech, disorganized behavior, or inappropriate emotionCatatonicExtreme movement symptoms ranging from excessive motor activity to posturing (immobility for long periods)ParanoidOrganized cognition and emotion, but with hallucinations and delusions that are usually concerned with persecutionUndifferentiatedMixed-bag category—symptoms fit the criteria of more than one of the above three types or none of themResidualThere has been a past schizophrenic episode, but presently only some negative symptoms and no positive symptoms (hallucinations and delusions)
27 SchizophrenicsWhat type of schizophrenic are these people? What are their symptoms?https://www.youtube.com/watch?v=bWaFqw8XnpA
28 Type I and Type IIAnother distinction is between Type I and Type II schizophreniaType I schizophrenia is characterized by positive symptomsType II schizophrenia is characterized by negative symptomsType I is more acute, as the person functioned normally before the disorder strikes and has a better chance of recovery because Type I can usually be alleviated with drugs, whereas Type II tends to stem from more permanent brain abnormalities
29 Causes of Schizophrenia Concordance rate is about 50%, although no particular genes have been identified, and it is possible different genes might be involved in the different types of schizophreniaOne hypothesis involves prenatal viral infectionsPeople are at increased risk if there was a flu epidemic during the middle of their fetal developmentIn the northern hemisphere, people born in the winter/spring months, January through April, following the fall/winter flu season, are more at risk than people born other months of the year
30 Causes of Schizophrenia A second hypothesis involves neurotransmittersSchizophrenics have elevated levels of dopamine activities in certain areas of their brainsA third hypothesis involves various brain abnormalities, especially among those with Type II schizophreniaShrunken cerebral tissue and enlarged fluid filled areasThe thalamus seems to be smaller and the frontal lobes less active in many schizophrenic brains
31 Causes of Schizophrenia A popular bio-psycho-social explanation is the vulnerability-stress-model that contends that genetic, prenatal, and postnatal biological factors render a person vulnerable to schizophrenia, but environmental stress determines whether it developsA person’s level of vulnerability interacts with the stressful social-cognitive events in their live to determine the likelihood of schizophreniaThe disorder does tend to strike in late adolescence and early adulthood, periods of unusually high stress levels
33 PerspectivesThe causes of abnormal behavior and thinking can be found in the four major research perspectivesBiologicalBehavioralCognitiveSocioculturalHowever, no one perspective adequately explains even one disorderThe biopsychosocial approach to explaining abnormality examines the interaction between biological, behavioral, cognitive, and social/cultural factors
34 TreatmentFortunately, schizophrenia can be successfully treated with antipsychotic medicationsIf the patient continues to take them, the disorders stays awayIf they stop, the symptoms returnProblem: many schizophrenics don’t identify as such, or are too paranoid to swallow pills
36 Look up:What is a personality disorder? Use your ipads. Share out.
37 Personality disorders Borderline personality:Sociopath/Antisocial personality:Narcissistic:Histrionic:,Schitzoid vs schizotypal:Passive aggressive behavior:
38 Personality disorder party! Complete worksheetWhat disorder does each person have?Underline the key words in their descriptionCreate a person with the disorder listed who is not present at the party (8 people come, but 9 disorders on back of sheet)Answer Q3 – are personality disorders easy to diagnose and treat?Dating – describe the relationship or fist date of two party goersDUE NEXT CLASS!
39 Anxiety DisordersDisorders in which excessive anxiety leads to personal distress and atypical, maladaptive and irrational behaviorSpecific PhobiaSocial Phobia & AgoraphobiaPanic DisorderGeneralized Anxiety DisorderObsessive-Compulsive Disorder
40 Phobia: irrational fear A strong and persistent fear of specific objects/situations that is excessive or unreasonable (irrational)
41 Specific PhobiaFor example, there was woman with a specific phobia of birds.She became housebound because of her fear of encountering a bird. Any noises she heard within the house she thought were birds that had broken in to get her.When she did leave the house, she was careful not drive near any birds, because if she hit a bird, they would take revenge on her.She knew her fears were irrational, but she could not control their effects on her behavior and thinking.
42 Causes of Specific Phobias Classical conditioningIn Little Albert study, the infant was conditioned to fear white rats by pairing together a loud startling noise (an unconditioned stimulus) with a white rat (a conditioned stimulus)CREATE ANOTHER EXAMPLE: Biological predispositionsSome people are naturally more nervous and scaredCertain associations (such as taste and sickness) are easy to learn, while others (such as taste and electric shock) are much more difficult to learn
43 Phobia treatment Systematic desensitization Slow, progressive exposure to the stimulus that causes fearGradual exposure leads to lessening of fearStart with “safe” stimulus and build up
44 Social Anxiety/Phobia Fear or anxiety of social interactionHard time making eye contactNervous at parties, social eventsFeels extremely self conscious, awkwardAVOIDS social interaction because too difficult to deal withMuch stronger than introverted personality
47 AgoraphobiaA fear of being in places or situations from which escape might be difficult or embarrassingIncludes crowds, standing in line, traveling in a crowded bus, stuck in heavy trafficPeople avoid such situations, won’t leave home
48 Panic DisorderA condition in which a person experiences recurrent panic attacksSudden onsets of intense fearCan be triggered by stressful event (giving a speech) or NO apparent reasonSymptoms:Difficulty breathingChest painFeel like going to faintFEAR!! And PANIC!
49 Generalized Anxiety Disorder Excessive, global anxiety and worryGeneral sense of dread, fear, anxietyCannot controlPeriod of at least 6 monthsAnxiety not tied to any specific object or situation (not a phobic disorder)May be related to low GABA, a calming neurotransmitterPeople with generalized anxiety disorder may have problems with activation of GABA, allowing more and more neurons to get excited
50 Obsessive-Compulsive Disorder recurrent obsessions (thoughts) and/or compulsions (behaviors)cause significant distress and disruption in the person’s daily lifeAn obsession is a persistent intrusive thought, idea, impulse, or image that causes anxietyA compulsion is a repetitive and rigid behavior that a person feels compelled to perform to reduce anxiety
51 Obsessive-Compulsive Disorder Although it is not known for sure what causes OCD research suggests that neurotransmitter serotonin may be involvedAntidepressent drugs that increase serotonin activity (e.g., Prozac and Anafranil) help many obsessive-compulsive patients
52 Obsessive-Compulsive Disorder Two parts of the brain, the orbital region of the frontal cortex (the area just above our eyes) and the caudate nucleus (an area in the basal ganglia), have significantly higher than normal level of activity in obsessive-compulsive peopleThese two areas help filter out irrelevant information and disengaging attention, two central aspects of obsessive-compulsive disorder
55 Obsessive-Compulsive Disorder One strange case of obsessive-compulsive disorder highlights the importance of the frontal lobe regionA man with obsessive-compulsive disorder got severely depressed and attempted suicideHe shot himself in the head, but fortunately survived and was cured of his disorderThe bullet removed some his orbital front cortex and the disorder with it
56 Post Traumatic Stress Disorder (PTSD) severe anxiety disorder that can develop after exposure to any event that results in psychological traumaWarRapeFlashbacks and nightmares commonCan’t cope with life
61 What were some of the keywords/concepts you noticed in the online test?
62 Bipolar Disorder I and II Mood DisordersDramatic changes in a person’s emotional state that are irrational and maladaptiveClinical DepressionBipolar Disorder I and IICyclothymia
63 Clinical DepressionOne or more major depressive episodes, lasting 2 weeks or longerSymptoms includeFeelings of intense hopelessnessLow self-esteem and worthlessnessExtreme fatigue/lack of energyDramatic changes in eating and sleeping behaviorInability to concentrateDiminished interest in family, friends, and activities
64 Note: sadness and downward mood following stressful life events (such as a death in the family) are understandable and normal, and are usually self-correctingSuch feelings do not necessarily indicate a major depressive disorder
65 Who gets clinically depressed? Women suffer from major depressive disorder twice as often as menMiddle aged (45-65 y o) most likely time of lifeStates in the deep south highest rates
66 Cause of clinical depression Low serotonin and norepinephrineBiological predispositionFor identical twins, the concordance rate is 50%, much higher than for fraternal twins and rate of occurrence in the general population
67 Major Depressive Disorder Non-genetic factors are also important“Pessimistic explanatory style” a person explains events in terms of causes that areinternal (their own fault),stable (here to stay),global (applies to all aspects of their life)
69 Bipolar DisorderThe person’s mood takes dramatic swings between depression and maniarecurrent cycles
70 Mania!!!!!A manic episode is a period of at least a week of abnormally:elevated moodinflated self-esteemgrandiose delusionsdecreased need for sleepconstant talking, distractibilityrestlessness, excess energypoor judgmentImpulsivity (will go shopping or gambling)
71 Bipolar DisorderIn bipolar I disorder, the person has both major manic and depressive episodes (clinical depression)In bipolar II disorder, the person has full-blown depressive episodes, but the manic episodes are milder; hypomaniaCyclothymia is a milder cycling from depression to mania
72 Doc trailer about bipolar disorder Another one:Second one not as good
74 Psychiatrist vs psychologist Psychiatrist – has medical degree (MD). Can prescribe medications, ex: xanax, prozac.Psychologist – has PhD or Masters degree. Cannot prescribe drugs. Practices talk therapy, ex: cognitive therapy, client centered therapy.
75 Case worker and client role play Pair up. One of you will be clinical psychologist/psychiatrist, other will be patientPatient is seeing therapist for first time.Record your “session”.Therapist must:Diagnose mood disorder by asking questionsDetermine course of treatment (type, time frame, name of meds if prescribed) research this on iPadYour skit must be at least 2 minutes long – detailed!A mood disorderClinical depressionBipolar 1Bipolar 2Cyclothymia
76 Find your partner: Pair up with same number/face card Red card – psychologist/psychiatristInterview your patient to diagnose them and determine treatmentYou must distinguish between BP I, BP II and cyclothymiaBlack card – patientDecide which mood disorder you have, then answer Q’s accordingly. Psychologist must diagnose you.
77 Some things you can discuss: Eating habits (eating schedule, type of food eaten, health awareness)Overall physical health (Exercise? Self harm or kind to self? Body type, hair style and grooming habits, general physical description).Medications (name, dose, schedule of when taken, side effects)Other treatments (psychologist therapy, self-help books, support groups, self-medicating, lifestyle modifications, diary writing…)Relationships (describe nature of relationships with significant other, parents, children, colleagues, strangers… give specific examples).Home (size, how much stuff, messy or cluttered? Organized or not? Quiet or noisy?)
78 The Treatment of Mental Disorders Biomedical TherapiesPsychotherapies
79 Early treatments for mental illness (circa 1950)
80 Two Major Types of Therapy Biomedical TherapyInvolves the use of biological interventions, such as drugsPsychotherapyInvolves the use of psychological interventions
81 Treatment concept chart – group activity Read each person’s illness and underline keywordsWrite neatly what they suffer fromCan be specific: “phobia of spiders”Or general: “schizophrenia”Think about what treatments would best serve each person
82 Mental illness treatment Cut the paper into people and treatmentsMake a large “map” of mental illness treatment using the people and therapy types providedThe format/arrangement of the papers is up to youConnect the people and their treatmentsAdd: (use your ipad to research)A statistic about the treatmentWhy it’s effectiveOne criticism of this treatment type
83 Content to know for abnormal psych test (next class) Definition of abnormal (4 things)Schizophrenia – positive and negative symptoms, types of schizophreniaAnxiety disorders – characterized by fear or dread. Know the different types, treatmentsPersonality disorders – characterized by social and emotional expression outside the range of normal. Know the different typesMood disorder – characterized by irrational changes in emotional state. Depression, BP I and BP II, cyclothymia. Know treatments.Therapies – know diff between psychiatrist and psychologist, systematic desensitization, different talk therapies, group therapy, medications, ECT.
84 Suggested answers…Joan (mood swing drug)+ Tom (self help group, AA) Melissa (anti-depressant, perhaps ECT) Barry (psychosurgery?) Archie (cognitive therapy) Anna (psychoanalysis) Susan (behavior therapy) Lyle (humanistic/existential therapy) Martha and Joe (marital therapy) Sharon (group therapy) Willy (anti-anxiety drug) Harry (anti-psychotic drug) The Smiths (family therapy & child therapy) Sam (ECT)
85 Different Types of Mental Health Professionals Credential and Job DescriptionClinical psychologistDoctoral degree in clinical psychology; provides therapy for people with mental disordersCounseling psychologistDoctoral degree in psychological or educational counseling; counsels people with milder problems such as academic, job, and relationship problemsPsychiatristMedical degree with residency in mental health; provides therapy for people with mental disorders; only therapist who can prescribe drugs or other biomedical treatmentPsycho- analystAny of the above credentials, but with training from a psychoanalytic institute; provides psychoanalytic therapy for psychological disordersClinical social workerMaster’s or doctoral degree in social work with specialized training in counseling; helps with social problems (e.g., family problems)
86 Biomedical TherapiesThe earliest use to biomedical therapy may date to the Stone Age, when trephination was usedHere, a trephine (a stone tool) was used to cut away a section of the person’s skull, supposedly to let evils spirits causing the disorder to exist the bodyIn the early 1800s, the “tranquilizing chair” was used, in which the patient was strapped into a chair, with their head enclosed inside a box for a long periods of timeSuch restriction was designed to calm the person
87 Biomedical TherapiesEven modern biomedical therapies are not without controversyDirect biological interventions have a downside in that they involve potential dangers and possible serious side effectsHigh levels of some drugs can be toxic and potentially fatal if not monitored carefully
88 Electro- convulsive Therapy Biomedical TherapiesDrug TherapyElectro- convulsive TherapyPsycho- surgery
89 Drug Therapy Lithium Antianxiety Drugs Antidepressants Antipsychotic Drugs
90 LithiumNot a drug, but rather a naturally occurring metallic element (a mineral salt) that is used to treat bipolar disorderAround 1950, John Cade, a psychiatrist, injected guinea pigs with a mixture of uric acid, which he thought was the cause of manic behavior, and mixed lithium with it so that the acid more easily liquefiedInstead of becoming manic, the guinea pigs became lethargic, and later tests with human showed that lithium stabilized the mood of bipolar patientsLithium levels in the blood must be monitored carefully because of possible toxic effectsBecause of lithium’s side effects, anticonvulsant drugs are now sometimes prescribed for people with bipolar disorder
91 Antidepressant DrugsMonoamine oxidase (MAO) inhibitors break down neurotransmitters such as serotonin and norepinephrine in the synaptic gapThis means that MAO inhibitors increase the availability of these neurotransmitters by preventing their breakdownCan have very dangerous side effects, particularly interactions with several different foods and drinks that lead to high blood pressure and possibly deathTricyclics are agonists for norepinephrine, serotonin, and dopamine and make these neurotransmitters more available by blocking their reuptake during synaptic gap activity
92 Antidepressant DrugsThe most common anti-depressant drugs are selective serotonin reuptake inhibitors (SSRIs)They selectively block the reuptake of serotonin in the synaptic gap, keeping the serotonin active and increasing its availabilityExamples include Prozac, Zoloft, and PaxilVery mild side effectsUsually required 3-6 weeks to being to see mood improvement
93 Antidepressant Drugs Neurogenesis is the growth of new neurons The neurogenesis theory of depression assumes that neurogenesis in the hippocampus stops during depression, and neurogenesis resumes, the depression liftsResearch has shown that SSRIs lead to increased neurogenesis in other animalsIt takes about 3-6 weeks for new cells to mature, the same timeframe it takes SSRI patients to improveThis means that, in the case of the SSRIs, the increased serotonin activity may be responsible for getting neurogenesis going again and lifting our moods
94 Antidepressant DrugsThere is controversy about the effectiveness of antidepressant drugsSome research suggests a placebo effect, improvements due to expectations of getting betterWhy would placebo effects make people feel better?It may also be the case that positive thinking, in the form of a strong placebo effect, might also get neurogenesis going again
95 Antianxiety Drugs Drugs that treat anxiety problems and disorders Benzodiazepines reduce anxiety by stimulating receptor sites for GABA and also increasing the receptivity of these sites, which increases GABA activityExamples of benzodiazepines include Valium and Xanax
96 Antipsychotic Drugs Drugs that reduce psychotic symptoms Early antipsychotic drugs (e.g., Thorazine and Stelazine) greatly reduced the positive symptoms of schizophrenia, but had little impact on the negative symptomsGreatly reduced the need to institutionalize people with schizophreniaProduced side effects in motor movement caused by their antagonistic effect on dopamine
97 Antipsychotic DrugsNew-generation antipsychotic drugs (e.g., Clozaril amd Risperdal) are more selective in where in the brain they reduce dopamine activityConsequently, they do not produce the severe movement side effects, such as tardive dyskinesia, in which the person has uncontrollable facial tics, grimaces and other involuntary movements of the lips, jaw, and tongue
98 Electroconvulsive Therapy (ECT) A biomedical therapy for severe depression that involves electrically inducing a brief brain seizureElectrodes are placed on one or both sides of the head, and a very brief electrical shock is administered causing a brain seizure that leads the patient to convulse for a few minutesPatients are given anesthetics, so they are not conscious during the procedure, and muscle relaxants to minimize the convulsions
99 Electroconvulsive Therapy (ECT) We really do not understand why ECT works in treating depressionOne explanation is that the electric shock increases the activity of serotonin and norepinephrine, which improves moodECT may also increase neurogenesis, which it has been demonstrated to do in ratsECT does not lead to any type of detectable brain damage or long-term cognitive impairment, but there is memory loss for events prior to and following the therapy?
100 PsychosurgeryThe destruction of specific areas in the brain to treat the symptoms of disordersA lobotomy, the most famous type of psychosurgery, involves cutting the neurological connections between the frontal lobes to lower areas of the brainWas the common means to “treat” schizophrenia in the 1940s and 1950s, until drugs became available
101 PsychosurgeryPsychosurgery still exists but not in terms of frontal lobe lobotomiesFor instance, cingulatomies, in which dime-sized holes are surgically burnt in specific areas of the frontal lobes (the cingulate gyrus) are sometimes performed on severely depressed or obsessive-compulsive patients who have not responded to other types of treatment
102 Psychotherapies Psychoanalysis Behavioral Humanistic Cognitive Four major typesPsychoanalysisBehavioralHumanisticCognitive
103 PsychotherapiesPsychoanalysis and humanistic therapies are called insight therapies because they stress that a person achieve understanding of the causes of their behavior and thinkingBehavioral and cognitive therapies are usually referred to as actions therapies because they stress that the actions of the person must change for therapy to be effective
104 PsychoanalysisA style of psychotherapy originally developed by Sigmund Freud in which the therapist helps the person gain insight into the unconscious sources of their problemsPsychoanalysts must collect data from a multitude of sources
105 PsychoanalysisFree association is a technique in which the patient spontaneously describes, without editing, all thoughts, feelings, or images that come to mindThe assumption is that free association will provide clues to the unconscious conflicts leading to a person’s problemsA resistance is a patient’s unwillingness to discuss particular topicsWhen a resistance is hit, it may provide clues into unconscious conflicts
106 PsychoanalysisDream interpretation also provides clues into unconscious conflictsDreams have two levels of meaning:The manifest content is the surface, literally meaning of the dream; it is what the dream reports when awakeningThe latent content is the underlying, true meaning of the dream and is of primary interest to the psychoanalystWhen we dream, we are not inhibited, and this dreams allow us the chance to symbolically experience our unconscious conflicts
107 PsychoanalysisTransference occurs when the patient acts toward the therapist as she did or does toward important figures in her life, such as her parentsTransference is like a reenactment of earlier or current conflicts with important figures in the patient’s life
108 PsychoanalysisPsychoanalysis requires a lot of time because the therapist must piece together clues with only vague circumstantial evidenceCritics question the validity of psychoanalysis’ main construct, unconscious conflicts and their impact on behavior and thinking?
109 Humanistic TherapyThe most influential humanistic therapy is Carl Rogers’s client-centered therapy, also called person-centered therapyA style of psychotherapy in which the therapist uses unconditional positive regard, genuineness, and empathy to help the person to gain insight into their true self-concept
110 Humanistic TherapyTo achieve this goal, the therapist is non-directiveThe therapist doesn’t attempt to steer the dialogue in a certain direction; rather, the client decides the direction of each sessionThe therapist’s job is to create the conditions that allow the client to gain insight into their true feelings and self-conceptThe therapist establishes an environment of acceptance by giving the client unconditional positive regard
111 Humanistic TherapyTo achieve this goal, the therapist is non-directiveThe therapist demonstrates genuineness by honestly sharing his own thoughts and feelings with the clientTo achieve empathetic understanding of the client’s feelings, the therapist uses active listening to gain a sense of the client’s feelings, and then uses mirroring to echo these feelings back to the client, so the client can gain a clearer image of their true feelings
112 Behavioral TherapyA style of psychotherapy in which the therapist uses the principles of classical and operant conditioning to change a person’s behavior from maladaptive to adaptiveThe assumption is that maladaptive behaviors are learned and must be unlearned for therapy to be effective
113 Behavioral TherapyIn counterconditioning, a maladaptive response is replaced by an incompatible adaptive responseSystematic desensitization is a counterconditioning procedure in which a fear response to an object or situation is replaced with a relaxation response in a series of progressively increasing fear-arousing steps
114 Behavioral TherapyFor example, a person with a specific phobia of spiders might find that planning a picnic to be a situation that evoked slight fear because of the possibility that a spider might be encountered on the picnicSeeing a picture of a spider might evoke more fear, and being in the same room with a spider would evoke even greater levels of fearOnce this “hierarchy” of fear-provoking situations is established, the patient starts working through the hierarchy and attempts to relax at each step
115 Behavioral TherapyIn flooding, another counterconditioning technique, the patient is immediately exposed to the feared object or situationBehavioral therapists also use operant conditioning to reinforce desired behaviors and extinguish undesirable behaviorsA token economy is an environment in which desired behaviors are reinforced with tokens (secondary reinforcers, such as stickers) which can be exchanged for rewards such as candy or television privilegesThis technique is often used with institutionalized patients, and has been fairly effective in managing people with autism, mental retardation, and some schizophrenic populations
116 Cognitive TherapyA style of psychotherapy in which the therapist changes the person’s thinking from maladaptive to adaptiveThe assumption is that the person’s through processes and beliefs are maladaptive and need to changeThe therapist identifies the irrational thoughts and unrealistic beliefs that need to change, and then helps the person to execute that change
117 Cognitive TherapyIn Ellis’s rational-emotive therapy, the therapist directly confronts and challenges the patient’s unrealistic thought and beliefs to show that they are irrationalSuch irrational thoughts are marked by words such as “must,” “always,” and “every”A rational-emotive therapist will show a person the irrationality of his thinking and how to make it more realistic
118 Cognitive TherapyThis is achieved by Ellis’s ABC modelA refers to the Activating event (e.g., failure to be perfect at everything)B refers to the person’s Belief about the event (e.g., feeling like a failure for normal levels of imperfection)C is the resulting emotional Consequence (e.g., depression)According to Ellis, A does not cause C; rather, B causes CRational-emotive therapy is very direct and confrontational is getting people to see the errors of their thinking
119 Cognitive TherapyA therapist using Beck’s cognitive therapy works to develop a warm relationship with the person and has a person carefully consider the objective evidence for their beliefs to see the errors in their thinkingFor instance, a student who failed a test may think she blew her chance to get into medical school, so the therapist would have the student examine statistics on how few students actually have a perfect GPA and the GPAs of students admitted to medical school
120 Is psychotherapy effective? Spontaneous remission is getting better with the passage of time without receiving any therapyThus, the effect of psychotherapy must be statistically significantly greater than that due to spontaneous remissionA meta-analysis (i.e., the pooling of results from a large number of studies into one analysis) of 475 studies involving different types of psychotherapy revealed that psychotherapy is indeed effectiveThe average psychotherapy client is better off than about 80% of people not receiving any therapyNo one particular type of psychotherapy, however, is superior to the others