1. Chapter 13 Overview Insight therapies Relationship therapies
Behavior therapies
Cognitive therapies
Biomedical therapies
Evaluating the therapies
The therapeutic relationship

2. Insight Therapies
Approaches to psychotherapy based on the notion that psychological well-being depends on self-understanding

3. What are the basic techniques of psychodynamic therapies?
Psychotherapies that attempt to uncover repressed childhood experiences that are thought to cause the patient’s current problems
Psychoanalysis is a technique developed by Freud
Free association
Explores the unconscious by having patients reveal whatever thoughts, feelings, or images come to mind
Dream analysis
Areas of emotional concern repressed in waking life are sometimes expressed in symbolic form in dreams
Transference
Emotional reaction that occurs during psychoanalysis, in which the patient displays feelings and attitudes toward the analyst that were present in another significant relationship

4. What are the basic techniques of psychodynamic therapies?
Object relations therapy
Based on idea that early relationships form blueprints for future relationships
Therapist helps clients restructure current relationships, changing maladaptive patterns formed in early relationships
Interpersonal therapy
Brief psychotherapy that helps clients understand and cope with four interpersonal problems associated with depression
Severe response to death of a loved one
Interpersonal role disputes
Difficulty adjusting to role transitions
Deficits in interpersonal skills

5. What is the goal of the therapist in person-centered therapy?
Humanistic therapies assume that people have the ability and freedom to lead rational lives and make rational choices
Founded by Carl Rogers (1951)
Therapists show empathy and create a climate of unconditional positive regard
Goal is to allow the client to direct the therapy session and move toward self-actualization
The patient’s realization of his inner potential

6. What is the major emphasis of Gestalt therapy?
Helps clients fully experience their feelings, thoughts, and actions
Emphasizes clients taking responsibility for their behavior, instead of blaming society or parents
Goal is to help the client resolve past conflicts, achieve a more integrated self, and become more self-accepting
Gestalt therapy is directive
Therapist actively directs the therapy session
Provides answers and suggestions to the client

7. Relationship Therapies
Therapies that attempt to improve patients’ interpersonal relationships or create new relationships to support patients’ efforts to address psychological problems

8. What are the goals of family and couple therapy?
Family therapy
Parents and children enter therapy as a group
Goal is to help family members heal wounds to the family, improve communication, and create more understanding within the family
Couple therapy
Goal is to help partners in an intimate relationship communicate and manage conflicts more effectively
May focus on behavioral change or partners’ emotional responses to each other

9. What are some advantages of group therapy?
A group of clients (usually seven to ten) meets regularly with one or more therapists
Provides client with a sense of belonging and opportunity to
Express feelings
Get feedback from other group members
Give and receive emotional support
Self-help groups
People with similar problems who meet regularly, usually without a professional therapist

10. Behavior Therapies
A treatment approach that is based on the idea that abnormal behavior is learned and that applies the principles of operant conditioning, classical conditioning, and/or observational learning to eliminate inappropriate or maladaptive behaviors and replace them with more adaptive responses

11. How do behavior therapists modify clients’ problematic behavior?
Uses reinforcement to shape or increase frequency of desirable behavior
e.g., Token economy
Extinguishes undesirable or maladaptive behavior by terminating or withholding reinforcement that maintains the behavior
e.g., Timeout

12. What behavior therapies are based on classical conditioning and social-cognitive theory?
Systematic desensitization is behavior therapy based on classical conditioning
Used to treat fears
Client is trained to relax while being confronted with a graduated series of anxiety-producing situations
Eventually, client can stay relaxed while confronting even the most feared situation
Participant modeling is behavior therapy based on Albert Bandura’s principles of observational learning
A model demonstrates appropriate responses to a feared stimulus in graduated steps
Client then imitates the model with encouragement of a therapist
Using this technique, most specific phobias can be extinguished in 3 to 4 hours

13. What behavior therapies are based on classical conditioning and social-cognitive theory?
Flooding is behavior therapy based on classical conditioning
Used to treat phobias by exposing clients to the feared object or event for an extended period, until their anxiety decreases
Exposure and response prevention is behavior therapy
Exposes patients with obsessive-compulsive disorder to stimuli that trigger obsessions and compulsive rituals, while patients resist performing the compulsive rituals for progressively longer periods of time
Aversion therapy is behavior therapy
An aversive stimulus is paired with a harmful or socially undesirable behavior until the behavior becomes associated with pain or discomfort

14. Cognitive Therapies
Therapies that assume maladaptive behavior can result from irrational thoughts, beliefs, and ideas

15. What is the aim of rational emotive therapy?
Developed by Albert Ellis
A directive form of therapy
Goal is to challenge and modify a client’s irrational beliefs about themselves and others
Which are believed to be the causes of personal distress

16. How does Beck’s cognitive therapy help people overcome depression and panic disorder?
Cognitive therapy, designed by Aaron Beck, helps clients stop their negative thoughts as they occur and replace them with more objective thoughts
Depression is treated by brief cognitive therapy, usually sessions, and is more effective than antidepressant drugs
Panic disorder is treated by teaching clients to change the catastrophic interpretations of their symptoms to prevent them from escalating into panic, usually effective with 3 months of treatment

17. Biomedical Therapies
Therapies (drug, therapy electroconvulsive therapy, or psychosurgery) that are based on the assumption that psychological disorders are symptoms of underlying physical problems

18. What are the advantages and disadvantages of using drugs to treat psychological disorders?
Antipsychotic drugs
Prescribed primarily for schizophrenia
Used to treat symptoms such as hallucinations, delusions, and disorganized behavior
Work by inhibiting dopamine activity
Lithium
Used to treat bipolar disorder
Reduces both manic and depressive episodes
Antianxiety drugs
Benzodiazepines are effective for treating generalized anxiety disorder and panic disorder
This family of minor tranquilizers includes Valium and Xanax

19. What are the advantages and disadvantages of using drugs to treat psychological disorders?
Antidepressant drugs
Act as mood elevators for people who are severely depressed
Selective serotonin reuptake inhibitors (SSRIs)
Block the reuptake of serotonin, increasing its availability at the synapses of the brain
Are effective for treating major depression, OCD, social phobia, panic disorder, generalized anxiety disorder, and binge eating

20. What are the advantages and disadvantages of using drugs to treat psychological disorders?
Drugs can have unpleasant or dangerous side effects
It is difficult to establish proper dosages
Drugs do not cure psychological disorders
So relapse is likely if drug therapy is discontinued
Availability of antipsychotic drugs led to a trend away from hospitalization, which may have increased homelessness among people with schizophrenia

21. What is electroconvulsive therapy (ECT) used for?
Electric current is administered to the right cerebral hemisphere
While patient is under anesthesia
Usually reserved for severely depressed patients who are suicidal
ECT was misused and overused in the 1940s and 1950s, leading to a bad reputation
But it can be a highly effective treatment for major depression

22. What is psychosurgery, and for what problems is it used?
Brain surgery performed to alleviate serious psychological disorders or unbearable chronic pain
Lobotomy
Severs neural connections between frontal lobes and deeper centers involved in emotion
No longer performed, because it leaves patients in permanent deteriorated condition
Cingulotomy
Destroys cingulum
Can help in extreme cases of OCD
Psychosurgery is controversial, and is considered experimental and a last resort
Because results are unpredictable and permanent

23. Evaluating the Therapies
Therapies share many similarities. Therapists use a core set of techniques no matter which perspective of therapy session they adopt, but at the same time, each therapeutic approach has elements that distinguish it from others.

24. What therapy, if any, is most effective in treating psychological disorders?
Smith et al. (1980) analyzed 475 studies with 25,000 clients
Found that psychotherapy was better than no treatment
But no one type of psychotherapy was more effective than another
Eysenck (1994) reanalyzed the same studies
Reported that behavior therapy has a slight advantage over other types of therapies

25. What therapy, if any, is most effective in treating psychological disorders?
A large survey of psychotherapy clients conducted by Consumer Reports found that
Overall, clients believed that they benefited substantially from psychotherapy
Clients were equally satisfied with therapy provided by psychologists, psychiatrists, and social workers
The longer clients stayed in therapy, the more they improved
Clients believed that antidepressant and antianxiety drugs helped them; but overall psychotherapy alone worked as well as psychotherapy plus drugs

26. The Therapeutic Relationship
When establishing a relationship with a therapist, it is important to become familiar with the various professionals who offer therapeutic services.

27. What distinguishes one type of therapist from another, and what ethical standards are shared by all types of therapists?
A Psychologist
Has an advanced degree, usually a doctorate, in psychology
Clinical psychologists generally diagnose and treat psychological disorders
Counseling psychologists generally provide therapy for normal problems of life, such as divorce
A Psychiatrist
Is a medical doctor
Can prescribe drug therapy

28. They are prohibited from providing therapy to former intimate partners
What distinguishes one type of therapist from another, and what ethical standards are shared by all types of therapists?
Therapists are forbidden to engage in any kind of intimate relationship with a client or anyone close to the client
They are prohibited from providing therapy to former intimate partners
They are obligated to use tests that are reliable and valid
And they must have appropriate training for all tests that are used

29. What are the characteristics of culturally sensitive therapy?
An approach to therapy in which knowledge of clients’ cultural backgrounds guides the choice of therapeutic interventions
This approach emphasizes that cultural variables may influence the diagnosis and treatment of psychological disorders

30. Why is gender-sensitive therapy important?
An approach to therapy that takes into account the effects of gender on both the therapist’s and the client’s behavior
This approach emphasizes how a therapist’s gender biases may affect the techniques that they choose and their assessments of clients’ progress