Psychology Second Edition Chapter 15 Therapy Copyright 2020

Psychology Second Edition Chapter 15 Therapy Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Learning Objectives (1 of 4) • 15. 1 a Discuss historical trends in the treatment of disorders, including the supernatural, medical, and psychological models. 15. 1 b Discuss the current treatment approaches. Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Learning Objectives (2 of 4) • 15. 2 a Describe the use of drugs for treating psychological disorders. 15. 2 b Discuss nondrug-related biological treatments for mental illness, including neurosurgery and electric and magnetic therapies. Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Learning Objectives (3 of 4) • 15. 3 a Discuss how the psychodynamic approaches to psychotherapy are useful in helping clients gain insight into their feelings and problems. 15. 3 b Describe the humanistic approaches including client-centered and Gestalt therapies. 15. 3 c Identify a variety of behavioral therapies and explain how they are used to change unwanted behaviors. 15. 3 d Discuss cognitive therapies aimed at altering maladaptive thoughts. Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Learning Objectives (4 of 4) • 15. 4 a Describe the benefits of group therapies, such as self-help groups and family therapy. 15. 4 b Give examples of alternative therapies and discuss their potential risks. 15. 4 c Discuss the effectiveness of treatment, including both traditional and nontraditional approaches to therapy. 15. 4 d Identify the factors that are important for therapists to consider when treating clients who have a cultural background different from their own. Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Historical Trends and Models (1 of 3) • The supernatural model – view that supernatural forces were responsible for abnormal behavior • Trephination – drilling holes into the skull to treat abnormal behaviors • Abnormality was seen as a combination of both moral and religious problems Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Historical Trends and Models (2 of 3) • The medical model – psychological abnormalities are caused by illness or bodily dysfunction – Not widely used until 1800 s – Many treatments cruel and ineffective due to misinformation about anatomy and physiology Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Historical Trends and Models (3 of 3) • Psychological model – psychological disorders caused by problems in the mind – Psychological disorders are the result of societal stress – Treated by changing aspects of the person's environment and thought processes Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Current Treatment Approaches (1 of 3) • Evidence-based treatment (EBT) • Emphasis on using scientific evidence to guide approaches to treatment • Person who needs treatment works with a trained professional on specific goals Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Current Treatment Approaches (2 of 3) • Therapists receive specialized training in therapeutic techniques and procedures • Psychologists, psychiatrists, social workers, nurses, or other mental health professionals • Appropriate licensing and credentials mandatory Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Current Treatment Approaches (3 of 3) Factors to consider when choosing a therapist***: • Location and Cost • Training and Experience • Comfort Level Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Biological Therapies • Medical approaches to the treatment of mental disorders • Assumes mental disorders are medical problems • Includes the use of drugs, neurosurgery, and different ways of stimulating the brain Drug Therapy*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Drug Therapies (1 of 5) • Most common form of treatment for psychological disorders • Psychotropic drugs – medications capable of affecting the mind, emotions, and behaviors • Most commonly administered as pills – antipsychotic drugs, antidepressant drugs, and antianxiety drugs Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Drug Therapies (2 of 5) • Antipsychotic drugs – used to help people suffering from a psychosis – Useful in treating psychotic symptoms such as delusional thinking, hallucinations, or paranoia – Commonly used to treat schizophrenia – work by changing the balance of neurotransmitter chemicals in brain – Most interfere with the release of dopamine Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Drug Therapies (3 of 5) • Antidepressant drugs – medications used to treat symptoms related to mood disorders – Balance neurotransmitters serotonin, norepinephrine, and dopamine in brain – Most popular antidepressants are serotonin reuptake inhibitors (SSRIs) – block receptors that normally absorb serotonin Short Video on SSRI’s*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Drug Therapies (4 of 5) • Antianxiety drugs – medications used to reduce fear, nervousness, and panic – Treatment for generalized anxiety disorder, panic disorder, and phobias – Can be physically addictive and have severe side effects Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Drug Therapies (5 of 5) • Not considered a “cure” • Provide symptom relief • Limitations: – side effects – drug addiction – Noncompliance Psychotropic medication in the media*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Neurosurgery (1 of 2) • Neurosurgery for psychiatric disorders – surgery performed on the brain to eliminate psychiatric symptoms • Prefrontal lobotomy*** – surgery in which the connections between the frontal lobes and the lower centers of the brain are severed Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Neurosurgery (2 of 2) • Modern methods safer, more exact, and more diverse • Deep lesioning – precise destruction of certain areas of the brain to reduce severe symptoms Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Electric and Magnetic Therapies (1 of 2) Stimulate areas of the brain in an effort to improve psychological symptoms • Electro-convulsive therapy (ECT) – passing electrical current through the brain to intentionally cause a seizure – Effective for severe depression – Seizures may rebalance hormones and chemicals in the brain How does ECT work? *** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Psychotherapies • Psychotherapies – strategies based on belief that psychological disturbances are the result of unconscious conflicts, faulty thinking patterns, or self-defeating learned behaviors – “Talk therapies” aimed to change the psychological processing of the mind – Typically involve regular meetings with a therapist – May also involve behavioral techniques Crash Course: Psychotherapy*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Psychodynamic Therapies • Gaining insight into unconscious conflicts is critical to resolving psychological problems • Talking with a therapist to “working through” both conscious and unconscious problems and conflicts Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Psychoanalysis • Psychoanalysis – Freud’s therapy involving a variety of methods to uncover the unconscious – Assumes hidden conflicts and unfulfilled wishes from childhood are driving forces behind emotional problems – Goal is to bring unconscious desires, conflicts, repressed feelings and memories to awareness Who was Freud? *** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Psychoanalysis Techniques • Free association – client asked to say anything that comes to mind • Dream interpretation – therapist assigns meaning to dreams • Transference – clients “transfer” feelings and desires in relationships with significant adults from childhood onto therapist Psychoanalysis Techniques*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Brief psychodynamic therapy (BPT) • Shorter version of psychoanalysis – Therapists take a more active role – May probe clients with direct questions – Less time spent on exploring childhood experiences – More focused on current problems and relationships Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Humanistic Therapies (1 of 4) • Goal is to help individuals find meaning, self-acceptance, and personal growth*** • Assumptions: – humans born motivated to reach full potential – problems develop when people aren’t reaching their potential or don’t live up to the view they have of themselves Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Humanistic Therapies (2 of 4) • Client-centered therapy – assumes clients more equipped to solve own problems through conversation and insight • Responsibility for treatment placed on client • Therapist’s role is to help clients help themselves – ask questions and provide a positive and supportive environment Overview of Client-centered Therapy*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Humanistic Therapies (3 of 4) Goals of client centered therapists: 1. Congruence – openness and genuineness on the part of therapist 2. Unconditional positive regard – clients accepted without judgment, criticism, or disapproval 3. Empathy – understanding of and sensitivity to clients’ feelings and situation Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Humanistic Therapies (4 of 4) • Gestalt therapy – helps people to see themselves as “whole, ” by exploring and accepting their “parts, ” including inconsistencies, problems, and negative emotions – Interested in helping clients gain greater awareness, acceptance, and personal growth – Therapists take a more active role and confront or challenge clients Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Behavior Therapies • Behavioral therapies – principles of learning are applied to change unwanted behaviors – Insight not necessary to change behavior – No emphasis on the origins or causes of behavior • Most common behavior therapies include exposure, aversion, and operant therapies • Highly effective in treating depression, anxiety disorders, eating disorders, and chronic pain disorders Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Exposure Therapies (1 of 2) • Exposure therapies – client directly confronted with frightening stimuli in order to reduce anxiety – Used to treat anxiety disorders, especially phobias and PTSD – Treatment of PTSD using Virtual Reality*** – Exposure treatment for clown phobia*** – Basic approach for exposure therapy, snakes*** – Exposure therapy for snake phobia (longer video)*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Exposure Therapies (2 of 2) • Flooding – person is placed in an environment filled with the thing the person is scared of • Systematic desensitization – clients slowly and with increasing intensity exposed to their fear – Relaxation Training – Anxiety Hierarchy – Gradual Exposure Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Aversion Therapies • Aversion therapies – pairing of unwanted behavior with something aversive or uncomfortable • Goal is association of old behavior with something bad to stop it • Used to treat sexual deviance and substance abuse disorders • Friends and aversion therapy*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Operant Therapies B. F. Skinner (1953) • Behavior could be modified by the use of reinforcement and punishment • Contingency management programs – rewards and punishments dependent upon the client's behavior • Behavior contract – written agreement that outlines roles, responsibilities, rules, behaviors, and consequences Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Cognitive Therapies (1 of 3) Cognitive–behavioral therapies • Focus on the role of thoughts in behavior • Help clients change irrational or destructive beliefs and ideas • Often combined with techniques designed to change behavior patterns that accompany dysfunctional thoughts Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Cognitive Therapies (2 of 3) • Rational-emotive therapy (RET) – cognitive therapy that helps clients overcome destructive beliefs, feelings, and behaviors – Goal is to encourage clients to challenge irrational and dysfunctional thoughts and feelings and replace them with healthier ones • ABC Framework – Activating events (A) Beliefs about the event (B) emotional or behavioral consequences (C) Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Cognitive Therapies (3 of 3) • Aaron Beck (1976) • Beck’s cognitive therapy – therapy in which clients are encouraged to examine their own habitual beliefs – Also asked to complete assignments or gather real world evidence that refutes these beliefs Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Group Therapy (1 of 2) • Treatment of more than one person at the same time • Benefits – Cost – less expensive – Social support – shared experiences, reduced feelings of isolation, and coping strategies – Social skills training – opportunity to practice social interaction skills in a supportive environment Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Group Therapy (2 of 2) • Family and couples therapy – all members of the family or both partners in a romantic relationship come in for treatment • Self-help groups – groups of people who meet to work through shared problems and goals • Community prevention programs – on preventing and reducing psychological problems in larger populations (communities) – Primary prevention – programs designed to stop disorders by eliminating the potential causes of the disorders – Secondary prevention – reducing the severity of a problem Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Bibliotherapy • Bibliotherapy – a therapist’s selection of reading material for a client that has relevance to that person’s life situation • Many psychologists believe bibliotherapy can be an important and effective part of the process • Can be effective in treating alcoholism, anxiety disorders, stress disorders, depression Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Technology-Based Therapies • Telecounseling – telephone communication to provide mental health education and services • E-therapies – Internet and/or computer-based therapies • Cybertherapy – use of simulations and virtual humans to assist in therapeutic ways • Media counseling – psychologist offering advice to a guest on radio/TV Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Alternative Medicine • Complementary and alternative medicine (CAM) – medical practices and products currently not part of conventional medicine – Examples: yoga, massage, herbal supplements, acupuncture • Commonly used to treat anxiety and depression Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Efficacy of Treatments • Efficacy study – well-controlled treatment protocol in which clients seen for a fixed number of sessions are compared to a control group • Effectiveness or Efficiency Studies – studies that attempt to evaluate the effectiveness of therapy in real-world settings • Therapeutic alliance – relationship between therapist and client – more important than the specific type of therapy Quick video about how to approach treatment*** Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

Therapy and Culture • Positive alliance between therapist and client is the foundation of good therapy • Therapists need training in multicultural awareness and sensitivity • Cultural competence – generic set of skills and knowledge that allow therapist to work in any cross-cultural therapy environment – needed for psychotherapists to work effectively with clients from a different cultural background Copyright © 2020, 2016 Pearson Education, Inc. All Rights Reserved

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