1. Copyright © 2014 Pearson Education, Inc. All rights reserved 1 Prepared by Chelsea Hansen, MA PowerPoint Presentation for Psychology for Living, 11 th Edition Steven J. Kirsh, Karen Grover Duffy, & Eastwood Atwater

2. Copyright © 2014 Pearson Education, Inc. All rights reserved. 2

3.  Insight Therapies – The Talking Cure Insight Therapies – The Talking Cure ◦ Psychoanalysis ◦ The Person-Centered Approach  Cognitive-Behavioral Therapies Cognitive-Behavioral Therapies ◦ Behavioral Therapies ◦ Cognitive Therapies  Other Approaches to Treatment Other Approaches to Treatment ◦ Family, Couples, and Relationship Therapy ◦ Biomedical Therapies ◦ Community-Based Services  How Well Does Therapy Work? How Well Does Therapy Work?  Finding Help Finding Help Copyright © 2014 Pearson Education, Inc. All rights reserved 3

4.  Psychotherapy — the helping process in which a trained, socially sanctioned therapist performs certain activities that facilitate a change in the client’s attitudes and behaviors  Therapist — a person trained to help people with psychological problems  Insight therapy — one type of therapy designed to bring change by increasing self understanding Copyright © 2014 Pearson Education, Inc. All rights reserved 4

5.  Psychoanalysis was founded by Sigmund Freud.  Psychoanalysis — a form of psychotherapy aimed at helping the person gain insight and mastery over unconscious conflicts  Psychoanalysis utilizes the processes of free association, resistance, transference, dream analysis, etc. Copyright © 2014 Pearson Education, Inc. All rights reserved 5

6.  A core element is the analysis of transference — the unconscious tendency of clients to project onto the therapist their feelings and fantasies, both positive and negative, about significant others in their childhood.  Other techniques include: › Free association — the client is asked to clear the mind of everyday thoughts, and then say whatever comes to mind regardless of how trivial it sounds. › Resistance — when an individual hesitates or is reluctant to talk about some painful experience, the experience is viewed as a critical area in need of better understanding.  Greatly criticized in the past, but shorter versions today are gaining some recognition from the psychological community. Copyright © 2014 Pearson Education, Inc. All rights reserved 6

7.  Person-centered therapy, developed by Carl Rogers, emphasizes the helper’s genuineness, acceptance, and empathic understanding of the client as necessary and sufficient conditions for producing therapeutic change.  Uses the processes of acceptance and empathy.  As clients are understood and accepted by the therapist, they come to accept themselves more fully and listen more accurately to their inner experiences. Copyright © 2014 Pearson Education, Inc. All rights reserved 7

8.  According to Rogers (1980), three conditions must be present for a growth-producing therapeutic climate: › Therapist must be genuine, or “congruent”: There should be a close match between what the therapist experiences and what is expressed to the clients. › Attitude of acceptance and caring: Therapists accept clients unconditionally (unconditional positive regard), so that they are free to feel what is going on at the moment. › Empathic understanding: The therapist accurately senses the feelings and personal meanings that the clients are experiencing. Copyright © 2014 Pearson Education, Inc. All rights reserved 8

9.  A large and diverse group of therapists characterize their orientation as either behavioral or cognitive. › Behavioral: attempt to modify maladaptive behavior › Cognitive: attempt to modify faulty thinking  These psychologists practice cognitive therapy, behavioral therapy, or cognitive- behavioral therapy, depending on whether they combine the two approaches. Copyright © 2014 Pearson Education, Inc. All rights reserved 9

10.  These therapies are based on operant and classical conditioning.  Behavioral therapy — discovering the factors that trigger and reinforce the problem behavior, specifying a target behavior to replace it, and then, by manipulating these factors, bringing out the desired behavior. Copyright © 2014 Pearson Education, Inc. All rights reserved 10

11.  Behavioral therapists help clients to develop the necessary skills or behaviors to cope more effectively with their life situations.  Behavioral therapists utilize a variety of methods of proven effectiveness, including desensitization, aversive counter conditioning, token economies, modeling, and social skills training. › Desensitization, developed by Joseph Wolpe, is a method of controlling anxiety by learning to associate an incompatible response, like relaxation, with the fear-provoking stimulus. Copyright © 2014 Pearson Education, Inc. All rights reserved 11

12.  Cognitive therapies — focus on faulty cognitive processes as the crucial elements in maladaptive behaviors  For example, the central assumption of Aaron Beck’s cognitive therapy is that the emotional and behavioral problems result from the individual’s distorted thoughts and reactions to external events, rather than from the events themselves.  These therapies are meant to help clients think more rationally about themselves and their problems.  Therapists do not probe for deep-seated causes.  Cognitive-behavioral therapy combines elements from behavioral and cognitive therapies to replace maladaptive thoughts and modify behavior. Copyright © 2014 Pearson Education, Inc. All rights reserved 12

13.  Most practitioners today are eclectic — they use a variety of approaches.  They hope to find and match the best technique to each client, given the client’s uniqueness.  Therapy today is done in fewer sessions than in the past; this is most likely because of managed health care. Copyright © 2014 Pearson Education, Inc. All rights reserved 13

14.  Mutual-Help Groups (Self-Help Groups)  Group members share a common issue and meet regularly to discuss their concerns without the guidance of a professional. Copyright © 2014 Pearson Education, Inc. All rights reserved 14

15.  Relationship Therapy  Therapy that goes beyond an individual; intervention is typically complex because of the various relationships and alliances involved.  Relationship therapists try to help couples be more aware of how they treat each other, how they may unwittingly hurt one another, and how they can nurture each other better. Copyright © 2014 Pearson Education, Inc. All rights reserved 15

16.  Family Therapy  There are many different types of family therapy that vary in a number of ways.  In general, family therapy involves the larger family unit, including children and adolescents, on the assumption that the disturbance of one family member reflects problems in the overall family patterns. Copyright © 2014 Pearson Education, Inc. All rights reserved 16

17.  Biomedical therapies — strategies that rely on direct physiological intervention to treat the symptoms of psychological disorders  These treatments include: › Drugs › Electroconvulsive treatment › Psychosurgery Copyright © 2014 Pearson Education, Inc. All rights reserved 17

18.  The accumulation of evidence that many disorders are related to biochemical abnormalities, especially neurotransmitters— chemical substances involved in the transmission of neural impulses between neurons  Psychoactive drugs have especially become an indispensable part of treatment.  Each drug has its own advantages and disadvantages. Copyright © 2014 Pearson Education, Inc. All rights reserved 18

19.  Antianxiety drugs — used primarily for alleviating anxiety, including minor tranquilizers › Dangerous when combined with alcohol or other drugs  Antidepressants — used to treat depression or to elevate mood, usually by increasing the level of certain neurotransmitters such as norepinephrine and serotonin › Slow to work, taking 2-4 weeks  Lithium — a natural mineral salt and mood stabilizer used to treat people with bipolar disorder  Antipsychotic drugs — used to relieve the symptoms of psychoses, such as extreme agitation, hyperactivity, hallucinations, and delusions › Some patients develop tardive dyskinesia (jerking movements around the neck and face and involuntary protrusions of the tongue). Copyright © 2014 Pearson Education, Inc. All rights reserved 19

20.  ECT — the administration of an electric current to the patient’s brain to produce a convulsion  Commonly used to treat severely depressed patients  Generally requires multiple treatments (6-10) spread over several weeks  The most common side effect is memory loss, especially the recall of events just prior to the treatments. Copyright © 2014 Pearson Education, Inc. All rights reserved 20

21.  Psychosurgery — surgery designed to destroy or disconnect brain tissue in an attempt to regulate abnormal behavior › Example: frontal lobotomy — surgery of the frontal lobes of the brain intended to alter the emotion-controlling center of the brain  It remains a controversial treatment but is still utilized today as a treatment of last resort. Copyright © 2014 Pearson Education, Inc. All rights reserved 21

22.  Community-based services — mental health services located in the individual’s own community or nearby  Such services were promoted by the Community Mental Health Centers Act (1963).  Outpatient community services are heavily used today with the closing of so many psychiatric hospitals. Copyright © 2014 Pearson Education, Inc. All rights reserved 22

23.  A number of community-based resources have evolved to serve the needs of people, including: › Day hospitals — provide part-time care in a hospital setting for those with mental disorders › Halfway house (a.k.a. group homes and board- and-care homes) — a residence in which newly released patients and ex-addicts can live under supervision for a short period of time while they make the crucial transition in their lives from a setting with close supervision and other restrictions › Crisis intervention — immediate treatment for those who are in a state of acute crisis but do not need treatment for many sessions Copyright © 2014 Pearson Education, Inc. All rights reserved 23

24.  Despite the variety of options available, community-based services often fall short of what is needed, mostly because of insufficient funding.  As a result, in many regions, the number of admissions to mental hospitals has increased rather than decreased, leading to a “revolving-door” syndrome, or transinstitutionalization. Copyright © 2014 Pearson Education, Inc. All rights reserved 24

25.  Is therapy better than no therapy? › Current research shows that after treatment, the average patient is better off than 75-80% of untreated patients. › This result is encouraging, especially as more and more people in need of therapy are finding ways to participate. › There is a move toward more evidence-based therapy — techniques proven effective through rigorous research methodologies. Copyright © 2014 Pearson Education, Inc. All rights reserved 25

26.  One important aspect of therapy is therapeutic alliance — the match or quality of fit between the client and the therapist.  Longer treatments provide better results.  Assigning projects (“homework”) between sessions also improves effectiveness.  Monitoring the effectiveness of therapy with assessments also improves results. Copyright © 2014 Pearson Education, Inc. All rights reserved 26

27.  There is little difference among types of psychotherapies; rather therapist and client characteristics seem more salient.  Therapist characteristics that enhance the effectiveness of therapy include: › flexibility › respectfulness › honesty › warmth › trustworthiness › emotional expressiveness Copyright © 2014 Pearson Education, Inc. All rights reserved 27

28.  Client characteristics that enhance the effectiveness of therapy include: › articulate › motivated › anxious to change › believe in psychological processes › match the therapist in terms of ethnicity, race, or gender Copyright © 2014 Pearson Education, Inc. All rights reserved 28

29.  Research indicates that: › Cognitive-behavioral techniques are very effective at treating anxiety, depression, and substance-abuse disorders. › However, a combination of medication and psychotherapy is the most effective treatment for depression. › Psychoactive medication is best for treating schizophrenia. Copyright © 2014 Pearson Education, Inc. All rights reserved 29

30.  When should you seek professional help?  General guide: When a problem interferes with your daily life, it is time to seek help. Copyright © 2014 Pearson Education, Inc. All rights reserved 30

31.  Many private therapists (counselors, psychologists, social workers) may be available in your community. Be sure you know the qualifications of any therapist!  The local or state psychological association can provide the names of practitioners.  Many hospitals, schools, and work sites employ therapists. Copyright © 2014 Pearson Education, Inc. All rights reserved 31

32.  Professional training and certification  Someone you are comfortable with Copyright © 2014 Pearson Education, Inc. All rights reserved 32

33.  Psychiatrists — medical doctors who specialize in the treatment of mental illness › Usually spend three to four years training in a clinical setting following their medical degree › Can treat the psychological disorders requiring drugs and hospitalization  Psychologists — receive clinical training in the methods of psychological assessment and treatment › Train in clinical, counseling, or school psychology program › May have a Ph.D., Ed.D., or Psy.D. degree Copyright © 2014 Pearson Education, Inc. All rights reserved 33

34.  Psychiatric (or clinical) social workers — receive supervised clinical training as part of their master’s degree program in the field of social work, and some earn a doctorate as well. They tend to be community-oriented and usually work as part of a clinical team, though many now enter private practice.  Counselors — receive training in personality theory and counseling skills, usually at the master’s-degree level. Their counseling emphasis tends to reflect their respective professional affiliations, depending on whether they are doing marriage counseling, career counseling, pastoral counseling (clergy), or some other type. Copyright © 2014 Pearson Education, Inc. All rights reserved 34

35.  Common benefits of therapy include: › hope for the future › caring for others › better understanding of personal problems › better relationships with others › positive personality changes Copyright © 2014 Pearson Education, Inc. All rights reserved 35

36.  There are no absolute guidelines for the length of therapy, and managed care has shortened the amount of time.  Two general guidelines for ending therapy: › Is the crisis or problem that brought you to therapy under control? › Can you maintain the gains acquired in therapy on your own? Copyright © 2014 Pearson Education, Inc. All rights reserved 36

37. This completes Chapter 15. You should now be able to: Define psychotherapy. Explain the role that culture plays in treatment. Summarize the main features of insight therapy. Compare psychoanalysis with modern psychodynamic therapy. Describe person-centered therapy. Compare cognitive, behavioral, and cognitive-behavioral therapies. Explain how to effectively use a token economy. Know about the various forms of multiperson therapy, such as family therapy. Discuss the importance of community-based services for comprehensive mental health care. Describe the major categories of biomedical therapy. Explain the effectiveness of psychotherapy. List the important questions that need to be asked when thinking about getting professional help. Copyright © 2014 Pearson Education, Inc. All rights reserved 37