The Psychological Therapies *

History of Insane Treatment Maltreatment of the insane throughout the ages was based on irrational views. Many patients were subjected to strange, debilitating and downright dangerous treatments. * Psychology 7e in Modules *

History of Insane Treatment Pinel in France and Dix in America founded humane movements to care for the mentally sick. Philippe Pinel (1745-1826) Dorthea Dix (1745-1826) * Psychology 7e in Modules *

Therapies Psychotherapy involves an emotionally charged, confiding interaction between a trained therapist and a mental patient. Biomedical therapy uses drugs or other procedures that act on the patient’s nervous system curing him of psychological disorders. ½ of psychologists describe themselves as eclectic. OBJECTIVE 52-1| Discuss some ways that psychotherapy and an eclectic approach to therapy differ. An eclectic approach uses various forms of healing techniques depending on the client’s unique problems. * Psychology 7e in Modules *

Psychological Therapies We will look at four major forms of psychotherapy based on different theories on human nature: Psychoanalytical theory Humanistic theory Behavioral theory Cognitive theory OBJECTIVE 52-2| Define psychoanalysis, and discuss the aims of this form of therapy. * Psychology 7e in Modules *

Psychoanalysis The first formal psychotherapy to emerge was psychoanalysis developed by Sigmund Freud. Edmund Engleman Although few modern psychologists practice traditional psychoanalysis, many incorporate his ideas re: the need for working through past experiences of childhood and anxieties generated by internal conflicts. They help individuals gain insight into the unconscious roots of problems and work through them. Sigmund Freud's famous couch * *

Psychoanalysis: Aims Since psychological problems originate from repressed impulses and conflicts in childhood, the aim of psychoanalysis is to bring repressed feelings into conscious awareness where the patient can deal with them. When energy devoted to id-ego-superego conflict is released, the patient’s anxiety lessens. * Psychology 7e in Modules *

Psychoanalysis: Methods Dissatisfied with hypnosis, Freud developed the method of free association to unravel the unconscious mind and its conflicts. The patient lies on a couch and speaks whatever comes to his mind. OBJECTIVE 52-3| Describe some of the methods used in psychoanalysis, and list some criticisms of this form of therapy. http://www.english.upenn.edu * Psychology 7e in Modules *

Psychoanalysis: Methods During free association, the patient edits his thoughts to resist his feelings and to express his emotions. Such resistance becomes important in the analysis of conflict-driven anxiety. Eventually the patient opens up and reveals his innermost private thoughts to the therapist, developing positive or negative feelings (transference) towards him. * Psychology 7e in Modules *

Psychoanalysis: Criticisms Psychoanalysis is hard to refute because it cannot be proven or disproven. Psychoanalysis takes a long time and is very expensive. A problem with psychoanalytic therapy is that it’s impossible to prove or disprove its assertions. A person who denies a therapists’ interpretation is being resistant; a person who believes it is confirming it. * Psychology 7e in Modules *

Current Psychodynamic Therapies Influenced by Freud, in a face-to-face setting, psychodynamic therapists understand symptoms and themes across important relationships in a patient’s life. OBJECTIVE 52-4| Contrast psychodynamic therapy and interpersonal therapy with traditional psychoanalysis. * Psychology 7e in Modules *

Psychodynamic Therapies Interpersonal psychotherapy, a variation of psychodynamic therapy is effective in treating depression. It focuses on symptom relief here and now, not overall personality change. * Psychology 7e in Modules *

Humanistic Therapies Humanistic therapists aims to boost self- fulfillment by helping people grow in self- awareness and self-acceptance. OBJECTIVE 52-5| Identify the basic characteristics of the humanistic therapies, and describe the specific goals and techniques of Carl Rogers’ client-centered therapy. * Psychology 7e in Modules *

Humanistic therapies differ from psychoanalytic therapies in all of the following ways, EXCEPT: A. psychoanalytic therapists are more likely to encourage the client to take immediate responsibility for feelings. B. humanistic therapists are more oriented to the present and future, rather than the past. C. psychoanalytic therapists are more likely to emphasize unconscious processes. D. humanistic therapists are more growth- oriented.

McKenzie’s therapist believes that active listening is an extremely important component of therapy. He is probably a: A. psychoanalyst. B. cognitive therapist. C. behavior therapist. D. client-centered therapist.

Client-centered therapists emphasize the importance of: A. exploring clients’ childhood relationships with other family members. B. interpreting the meaning of clients’ nonverbal behaviors. C. enabling clients to feel unconditionally accepted. D. helping clients identify a hierarchy of anxiety-arousing experiences.

Person-Centered Therapy Developed by Carl Rogers, person-centered therapy is a form of humanistic therapy. The therapist listens to the needs of the patient in an accepting and non-judgmental way, addressing his problems in a productive way and building his or her self-esteem. Carl Rogers emphasized the importance of understanding the client from his/her perspective and believed that allowing a client to fell he had been heard is innately therapeutic. Although Rogers did not suggest being totally nondirective, he did feel that a relationship involving, trust, empathy, genuineness and unconditional positive regard was in and of itself therapeutic. * *

Michael Rougier/ Life Magazine © Time Warner, Inc. Humanistic Therapy The therapist engages in active listening and echoes, restates, and clarifies patient’s thinking, acknowledging expressed feelings. Michael Rougier/ Life Magazine © Time Warner, Inc. *

Behavior Therapy Therapy that applies learning principles to the elimination of unwanted behaviors. To treat phobias or sexual disorders behavior therapists do not delve deeply below the surface looking for inner causes. OBJECTIVE 52-6| Explain how the basic assumption of behavior therapy differs from those of traditional psychoanalytic and humanistic therapies. * Psychology 7e in Modules *

If a therapist tells a client, “Rank order the things that frighten you from least to most,” the therapist is most likely practicing: A. Freudian therapy. B. systematic desensitization. C. Gestalt therapy. D. token economy.

Classical Conditioning Techniques Counterconditioning: a procedure that conditions new responses to stimuli that trigger unwanted behaviors. It is based on classical conditioning and includes exposure therapy and aversive conditioning. OBJECTIVE 52-7| Define counterconditioning, and describe the techniques used in exposure therapies and aversive conditioning. * Psychology 7e in Modules *

Jon’s therapist laces his alcoholic drink with a drug that makes Jon sick. After getting sick a few times, just the sight of the drink makes Jon nauseous. In this example, the conditioned stimulus is the: A. drug. B. alcohol. C. nauseous response to the drug. D. nauseous response to the sight of the drink.

A therapist helps Rebecca overcome her fear of water by getting her to swim in the family’s backyard pool three times a day for two consecutive weeks. The therapist’s approach to helping Rebecca best illustrates: A. stress inoculation training. B. aversive conditioning. C. exposure therapy. D. humanistic therapy.

Exposure Therapy Exposes patients to things they fear and avoid. Through repeated exposures anxiety lessens because they habituate to the things feared. The Far Side © 1986 FARWORKS. Reprinted with Permission. All Rights Reserved. *

Both Photos: Bob Mahoney/ The Image Works Exposure Therapy Exposure therapy involves exposing people to (fear of driving) objects in real or virtual environments. Both Photos: Bob Mahoney/ The Image Works N. Rown/ The Image Works *

Systematic Desensitization A type of exposure therapy that associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli commonly used to treat phobias. *

Aversive Conditioning A type of counterconditioning that associates an unpleasant state with an unwanted behavior. With this technique, temporary conditioned aversion to alcohol has been reported. Note study regarding aversive conditioning (Wiens and Menustik, 1983) in which alcohol was paired with sickness. Even though the patients received several follow-up sessions to boost learning, after 1 year, 63% were abstinent; after 3 years, only 33% were. Probably relates to the fact that in this situation, the aversive stimulus was avoidable (if they didn’t want to get sick, they wouldn’t take the drug that would cause the sickness). * *

Operant Conditioning Operant conditioning procedures enable therapists to use behavior modification in which desired behavior is rewarded and undesired behaviors are not or are punished. A number of withdrawn, uncommunicative 3- year-old autistic children have been successfully trained by giving and withdrawing reinforcements for desired and undesired behaviors. OBJECTIVE 52-8| State the main premise of therapy based on operant conditioning principles, and describe the views of proponents and critics of behavior modification. * Psychology 7e in Modules *

Token Economy In institutional settings therapists may create a token economy, where a patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats. Critics of behavior modification question whether the desired behavior will continue when reinforcement if no longer available, as well as whether or not it is ethical for one human being to control the behavior of another through operant conditioning techniques. * *

Cognitive Therapy Teaches people adaptive ways of thinking and acting based on the assumption that thoughts intervene between events and our emotional reactions. *

A cognitive therapist would be most likely to say: A. “That sounds quite frustrating. It isn’t easy to be in a situation like that.” B. “Can you think of a more positive interpretation of what happened?” C. “Just say whatever comes to mind, no matter how trivial or irrelevant it might seem.” D. “Next time you start to feel anxious, you can use the relaxation techniques we’ve been working on.”

Cognitive Therapy for Depression Aaron Beck (1979) suggests that depressed patients believe that they can never be happy (thinking) and thus associate minor failings (e.g. failing a test [event]) in life as major causes for their depression. Beck believes that cognitions such as “can never be happy,” need to change in order for depressed patients to recover. This change is brought into patients by gentle questioning. OBJECTIVE 52-9| Contrast cognitive therapy and cognitive-behavior therapy, and give some examples of cognitive therapy for depression. * Psychology 7e in Modules *

Cognitive Therapy for Depression Rabin et al., (1986) trained depressed patients to daily record positive events and relate how they contributed to these events. Compared to other depressed patients, trained patients showed lower depression scores. * Psychology 7e in Modules *

Stress Inoculation Training Meichenbaum (1977, 1985) trained people to restructure their thinking in stressful situations. “Relax, the exam may be hard, but it will be hard for everyone else too. I studied harder than most people. Besides, I don’t need a perfect score to get a good grade.” * Psychology 7e in Modules *

Cognitive-Behavior Therapy Cognitive therapists often combine the reversal of self-defeating thinking with efforts to modify behavior. Cognitive-behavior therapy aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy). *

© Mary Kate Denny/ PhotoEdit, Inc. Group Therapy Group therapy normally consists of 6-9 people and a 90-minute session which can help more people and cost less. Clients benefit from knowing others have similar problems. OBJECTIVE 52-10| Discuss the rationale and benefits of group therapy, including family therapy. © Mary Kate Denny/ PhotoEdit, Inc. * Psychology 7e in Modules *

Family Therapy Family therapy treats the family as a system. Therapy guides family members toward positive relationships and improved communication. * Psychology 7e in Modules *