Chapter 12: Therapy

Chapter Outline Who Offers Therapies? Psychodynamic Therapies Behavior Therapies Cognitive Therapies Humanistic Therapies Biomedical Therapies

Learning Objectives Understand the different approaches to therapy. Understand the goals of each therapeutic approach. Understand benefits and drawbacks to each therapeutic approach.

Psychological and Biomedical Therapies Psychotherapy uses psychological methods that include a personal relationship between a trained therapist and a client. Biomedical therapies are treatments of psychological disorders by altering brain functioning with physical or chemical interventions. The following three mental health professions provide most of the therapy: Psychiatry Social work Psychology

Psychodynamic Therapies Founded by Sigmund Freud, asserts that all psychological disorders stem from unconscious forces Free association is the technique where clients say aloud whatever comes to mind. Transference occurs when a client develops feelings toward the therapist that may reflect feelings for others. Countertransference occurs when a therapist develops feelings for a client that may reflect feelings for others. Resistance is anything the client does to interfere with therapeutic progress. Psychodynamic therapy can be expensive and lengthy.

Behavior Therapies Behavior therapies apply learning principles to the elimination of unwanted behaviors. Counterconditioning is a procedure involving conditioning new responses to stimuli that trigger unwanted behavior. Systematic desensitization is a technique in which the client is gradually exposed to the feared object. Response prevention is a technique in which clients are exposed to a situation in which they exhibited a compulsive behavior but cannot engage in it.

Operant Conditioning Operant conditioning involves learning through reinforcement and punishment. Token economy involves reinforcing desirable behaviors with token that can be exchanged for other forms of reinforcement. It can be used to shape behavior.

Observational Learning Social learning theory explains that people learn social behaviors through observation and cognitive processing Modeling: technique in which desirable behaviors are demonstrated as a way of teaching them to clients Social skills training: technique in which clients are taught how to interact with others more comfortable and effectively

Cognitive Therapies Cognitive therapies focuses on identifying and then modifying dysfunctional patterns of thought. Rational-emotive behavior therapy: a therapy in which people are confronted with their irrational beliefs and persuaded to develop a more realistic way of thinking Cognitive-behavior therapy: a therapy that identifies then changes negative thinking and behavior by using cognitive and behavioral principles

Humanistic Therapies Humanistic therapies focus on helping people get in touch with their feelings. Client-centered therapy: a therapy in which the client directs the course of therapy Open-ended statements: a technique in which the therapist encourages the client to speak, without limiting the topic of conversation Reflection: a technique in which the therapist acknowledges an emotion that the client has expressed Paraphrasing: a technique in which the therapist summarizes the clients statements

Gestalt Therapy Gestalt therapy: a therapy that stresses awareness of feelings in the here and now It encourages clients to become aware of feelings and impulses they have disowned. Empty-chair technique: a technique in which an empty chair is placed in front of the client and that person is asked to imagine that an important person is there.

Other Forms of Psychotherapy Group therapy: simultaneous treatment of of several clients under the guidance of a therapist Family therapies: designed to constructively modify dysfunctional relationships among family members Couples therapy: designed to help couples improve the quality of their relationship

Biomedical Therapies (Slide 1 of 2) Antipsychotic drugs work by blocking dopamine receptors: Chlorpromazine Clozapine Risperidone Antidepressant drugs work by increasing norepinephrine and/or serotonin. MAOI SSRIs

Biomedical Therapies (Slide 2 of 2) Antianxiety drugs work by inhibiting GABA. Benzodiazepines Electroconvulsive therapy (ECT): a treatment where a brief electric shock is administered to the brain Psychosurgery destroys brain tissue thought to be the cause of the disorder. Deep brain stimulation: a technique using mild electrical stimulation to regions of the brain

Economic and Social Trends Managed healthcare had advantages and disadvantages for mental health treatment. Documentation of mental health treatment is increasing. Ethnic minorities in the U.S. are less likely to seek mental health treatment.