1. Therapies PowerPoint by Prentice Hall, Inc
Therapies PowerPoint by Prentice Hall, Inc., modified by Stephen Landman, Ph.D.

2. Insight Therapies Insight therapies
Provide people with better awareness and understanding of their feelings, motivations, and actions
Psychoanalysis
Client-Centered Therapy
Gestalt Therapy

3. Freud’s method of psychotherapy
Psychoanalysis
Hidden feelings and motives are made conscious for better adaptation.
Freud’s method of psychotherapy
Based on the belief that anxiety and other problems are symptoms of inner conflicts stemming from childhood
Free association: A technique encouraging the patient to talk without inhibition about whatever thoughts or fantasies come to mind
Transference: transferring feelings toward authority figures from childhood to therapist
Insight: becoming aware of what was formerly outside of awareness

4. Psychoanalysis (continued)
Freudian therapist = “psychoanalyst”
Symptoms are caused by unconscious conflicts
Goal of Psychoanalysis = Insight, which causes symptoms to disappear
Task of psychoanalyst is to make timely interpretations
Freud interpreted:
Free Association – (reason for use of the couch)
Dreams
Transference
Catharsis = “Emotional Insight” (also called “abreaction”)

5. Client-Centered Therapy (person-centered therapy)
Carl Rogers
Problems stem from conditional love from parents
Calls for unconditional positive regard
Conditional positive regard
Love and acceptance comes from conforming to what others want
Unconditional positive regard
True acceptance regardless of actions
Nondirective
“Reflection of Feeling”
Nondirectional form of therapy developed by Carl Rogers that calls for unconditional positive regard of the client by the therapist with the goal of helping the client become fully functioning

6. Gestalt Therapy
To help people be more genuine in day-to-day interactions
Focus on here-and-now, and whole person
Therapy is active, directive
Empty chair technique

7. Behavior Therapies Focus on behavior change, rather than insight
Belief that all behavior is learned. Uses principles of learning for treatment.
Maladaptive behaviors themselves are the focus of the therapy; they are not “symptoms” of an underlying problem.
Based on the belief that all behavior, normal and abnormal, is learned and that the goal of therapy is to teach people more satisfying ways of behaving
For behaviorists, the focus of psychotherapy should be the problem behaviors themselves, not some deeper, underlying conflicts that are presumably causing those behaviors

8. Behavior Therapy (continued)
Examples:
Desensitization – uses classical conditioning of Pavlov
Token Economy – uses operant conditioning of Skinner
Aversive therapy – classical conditioning (Antabuse for alcholism, slap a car to teach dog not to chase cars)
Behavioral marriage counseling
Behavioral Contracting
Modeling
Many other applications exist

9. Cognitive Therapies
Changing clients’ perceptions of themselves and the world
One method: Rational-emotive therapy Albert Ellis, Ph.D.
Irrational ideas, common in society, cause problems.
Client needs to understand how the ideas are irrational and what self-talk is associated with them, and then needs to change to using rational self-talk instead.
Ellis uses “counterpropaganda” to counter the irrational propaganda the client has been affected by.
Cognitive therapies focus not so much on maladaptive behaviors as on maladaptive ways of thinking
By changing people's distorted, self-defeating ideas about themselves and the world, cognitive therapists hope to encourage better coping skills and adjustment
Stress-inoculation therapy
Trains clients to cope with stressful situations by learning a more useful pattern of self-talk
Works by turning the client’s own thought patterns into a kind of vaccine against stress-induced anxiety
Rational-emotive therapy (RET)
A directive therapy based on the idea that clients’ psychological distress is caused by irrational and self-defeating beliefs and the therapist’s job is to challenge such dysfunctional beliefs
Irrational/self-defeating beliefs involve absolutes, for example “musts” and “shoulds” that allow no room for mistakes
Beck’s cognitive therapy
Depends on identifying and changing inappropriately negative and self-critical patterns of thought
Therapists try to help clients examine each dysfunctional thought in a supportive but objectively scientific manner

10. Cognitive-Behavioral Therapy widely used today
Combines cognitive therapy and behavior therapy methods – not one specific technique
Supported by much research as being effective for wide range of problems (eating disorders, personality disorders, depression, pain disorders)
Short term
Structured and goal-directed
An educational model - Client does homework

11. Group Therapies Many advantages to group approach Types Family therapy
Increased feedback on how a person affects others
Modeling
Learning from others’ mistakes
Laboratory for trying new behaviors
Social support
Realizing that one is not alone
Social skills and communication practice
Opportunity to be helpful to others
Cost effective
Types
Family therapy
Couple therapy
Self-help groups (not technically a therapy group)
Advantages
Based on the idea that psychological problems are at least partly interpersonal and are therefore best approached in a group
Offer a circle of support for clients, shares insights into problems, and provides the opportunity to obtain psychotherapy at a lower cost
Family therapy
The family is seen as partly responsible for the individual’s problems
Family therapy seeks to change all family members’ behaviors to the benefit of the family unit as well as the troubled individual
Couple therapy
A form of group therapy intended to help troubled partners improve their problems of communication and interaction
Empathy training:
Each person is taught to share inner feelings and to listen to and understand the partner’s feelings before responding to them
Self-help groups
As the cost of private psychotherapy has risen, self-help groups have become increasingly popular because of its low cost
In such groups, people share their concerns and feelings with others who are experiencing similar problems
Alcoholics Anonymous is a very effective self-help group

12. Effectiveness of Psychotherapy
Success rate
Eysenck (1952): About two-thirds get better with or without therapy. He was criticizing psychodynamic therapy, claiming behavior therapy to be superior.
Smith & Glass (1977) Meta-analysis of psychotherapy outcome studies concludes that therapy is better than no therapy.
Most researchers agree that psychotherapy helps about two-thirds of the people treated
Although there is some debate over how many untreated people also recover, the consensus is that those who get therapy are generally better off than those who don't
Each kind of therapy, however, works better for some problems than for others
The general trend in psychotherapy is toward eclecticism, the use of whatever treatment works best for a particular problem
Consumer Reports study
180,000 readers, 7,000 responded
Most report an improvement
No difference between types of therapy
Long-term therapy better than short-term (Fig 13-1)

13. Which Therapy is Best?
Truax and Carkhuff (1967) found that characteristics of therapist are crucial. Effective therapists are characterized by warmth, genuiness, and empathy.
Most therapists are “eclectic”, drawing form various approaches, rather than strictly following one method.

14. Which Type of Therapy is Best?
No apparent difference in effectiveness
Possible explanations:
All offer an explanation for problems
All offer hope
All provide a therapeutic alliance with a therapist

15. Biological Treatments
Drug therapy
Major types
Antipsychotic drugs
Antidepressant drugs
Lithium & Other Mood Stabilizers
Electroconvulsive therapy
Transcranial magnetic stimulation (new treatment for depression)
Psychosurgery
A group of treatment approaches, such as medication, electroconvulsive therapy, and psychosurgery
These treatments are sometimes used to treat psychological disorders in conjunction with, or instead of, psychotherapy
Drug therapy
The development of several effective drugs; Drug therapies cost less than psychotherapy
Critics contend that drugs are used because of our society’s “pill mentality”
Drugs are the most common form of biological therapy
Antipsychotic drugs are valuable in treating schizophrenia
They do not cure the disorder, but they reduce its symptoms, although side effects can be severe
Antidepressant drugs alleviate depression, though some also have serious side effects
Lithium is a naturally occurring salt that is used to treat bipolar disorder
Lithium helps level out the extreme highs of mania and the extreme lows of depression
Many other types of medications are used to treat psychological disorders including:
Antimanic drugs, Antianxiety drugs, Sedatives, Psychostimultants for children with attention-deficit/hyperactivity disorder
ECT
A mild electrical current is passed through the brain for a short period, often producing convulsions and temporary coma
ECT is used to treat severe, prolonged depression
The reason ECT works remains unknown
Psychosurgery
Brain surgery performed to change a person’s behavior and emotional state, for example prefrontal lobotomy
This therapy is rarely used today

16. Institutionalization
In past, institutionalization was most common approach
Antipsychotic drugs reduced this practice
Deinstitutionalization
This approach has own problems
Alternative forms of treatment
In the past, institutionalization in large mental hospitals was the most common approach to caring for people with serious mental disorders
Patients were given shelter and some degree of treatment, but a great many were never able to be released
Then, with the advent of antipsychotic drugs, a trend began toward deinstitutionalization, or integrating people with serious mental disorders back into the community
Deinstitutionalization
The policy of treating people with severe psychological disorders in the community rather than in large public hospitals
Problems
Community mental-health centers are poorly funded or non-existent
Ex-patients are poorly prepared to live in the community
Not enough housing available
Social stigma of having a mental disorder
Large insurance companies discourage outpatient care
Alternative forms of treatment
Avoiding hospitalization through a number of different types of programs involving skilled workers in different therapy settings
Is often effective and less expensive than hospitalization

17. Prevention Forms of prevention Primary prevention
Efforts to reduce new cases of mental disorders
Secondary prevention
Identifying at-risk groups
Tertiary prevention
Helping people adjust after hospital release
Primary prevention
Techniques and programs to improve the social environment so that new cases of mental disorders do not develop
Secondary prevention
Programs to identify groups that are at high risk for mental disorders and to detect maladaptive behavior in these groups and treat it properly
Tertiary prevention
Programs to help people adjust to community life after release from a mental hospital

18. Client Diversity and Treatment
Gender and treatment
Rates of treatment for females is higher
Form of treatment can be gender biased
Culture and treatment
What constitutes normal can be culture-bound
Given that human beings differ as much as they do, it isn't surprising that a one-size-fits-all concept isn't always appropriate in the treatment of psychological problems
In recent years the special needs of women and people from other cultures have particularly occupied the attention of mental health professionals
Women are more likely than men to be in psychotherapy
Psychotherapy is more socially accepted for women than men
Traditionally, women have received a disproportionate share of drugs for psychological disorders
Because, in traditional therapy, women are often expected to conform to gender stereotypes in order to be pronounced “well,” many women have turned to “feminist therapists”
The American Psychological Association has issued guidelines to ensure that women receive treatment that is not tied to traditional ideas about appropriate behavior for the sexes
Our ideas of what constitutes normal behavior may not be viewed as normal by another culture
Some psychological disorders only occur within a specific culture
When the client and therapist come from different cultural backgrounds or belong to different racial or ethnic groups, misunderstandings can arise in therapy
The APA has issued guidelines to help psychologists deal more effectively with our ethnically and culturally diverse population
Following these guidelines is an important step toward avoiding cultural misunderstandings