1. Chapter 14
psychological therapies

2. LO 14.1 Two Modern Ways to Treat Psychological Disorders
Treatment in the Past
LO 14.1 Two Modern Ways to Treat Psychological Disorders
AP: Identify Major Figures
Mentally ill people began to be confined to institutions called asylums in the mid-1500s
“Treatments” were harsh and often damaging
Philippe Pinel became famous for demanding that the mentally ill be treated with kindness, personally unlocking the chains of inmates in France

3. Therapy
LO 14.1 Two Modern Ways to Treat Psychological Disorders
AP: Central Characteristics of Psychotherapeutic Intervention
Therapy: treatment methods aimed at making people feel better and function more effectively
Two broad categories:
one based primarily in psychological theory and techniques
the other uses medical intervention to bring symptoms under control

4. LO 14.1 Two Modern Ways to Treat Psychological Disorders
Therapy
AP: Major Treatment Orientations
Evaluate Various Approaches to Explaining Psychological Disorders
LO 14.1 Two Modern Ways to Treat Psychological Disorders
Psychotherapy: therapy for mental disorders in which a person with a problem talks with a psychological professional
insight therapies: psychotherapies in which the main goal is helping people to gain insight with respect to their behavior, thoughts, and feelings
action therapy: psychotherapy in which the main goal is to change disordered or inappropriate behavior directly

5. LO 14.1 Two Modern Ways to Treat Psychological Disorders
Therapy
AP: Major Treatment Orientations
Evaluate Various Approaches to Explaining Psychological Disorders
LO 14.1 Two Modern Ways to Treat Psychological Disorders
Biomedical therapy: therapy for mental disorders in which a person with a problem is treated with biological or medical methods to relieve symptoms
Drugs
Surgeries
Electric shock treatments
Noninvasive stimulation techniques

6. Freud’s Psychoanalysis
LO 14.2 Elements of Freud’s Psychoanalysis and Psychoanalysis Today
AP: Identify Major Figures
Psychoanalysis: insight therapy based on the theory of Freud, emphasizing the revealing of unconscious conflicts
dream interpretation
manifest content: the actual content of one’s dream
latent content: the symbolic or hidden meaning of dreams

7. Freud’s Psychoanalysis
LO 14.2 Elements of Freud’s Psychoanalysis and Psychoanalysis Today
AP: Identify Major Figures
Psychoanalysis (cont’d)
free association: Freudian technique in which a patient is encouraged to talk about anything that comes to mind without fear of negative evaluations
resistance: occurs when a patient becomes reluctant to talk about a certain topic, either changing the subject or becoming silent
transference: the tendency for a patient or client to project positive or negative feelings for important people from the past onto the therapist

8. LO 14.2 Elements of Freud’s Psychoanalysis and Psychoanalysis Today
AP: Major Treatment Orientations
Directive: actively giving interpretations of a client’s statements in therapy, even suggesting certain behavior or actions
psychoanalysis today is generally directive
Psychodynamic therapy: a newer and more general term for therapies based on psychoanalysis
Emphasis on transference, shorter treatment times, and a more direct therapeutic approach

9. LO 14.2 Elements of Freud’s Psychoanalysis and Psychoanalysis Today
AP: Major Treatment Orientations/Effectiveness of Specific Treatments for Specific Problems
Interpersonal therapy (IPT): form of therapy for depression which incorporates multiple approaches and focuses on interpersonal problems

10. Rogers’s Person-Centered Therapy
LO 14.3 Basic Elements of Humanistic Therapies
AP: Identify Major Figures/Major Treatment Orientations
Person-centered therapy: a nondirective insight therapy in which the client does all the talking and the therapist listens
based on the work of Carl Rogers
nondirective: therapeutic style in which the therapist remains relatively neutral and does not interpret or take direct actions with regard to the client, instead remaining a calm, nonjudgmental listener while the client talks

11. Rogers’s Person-Centered Therapy
LO 14.3 Basic Elements of Humanistic Therapies
AP: Identify Major Figures/Major Treatment Orientations
Four elements:
authenticity: the genuine, open, and honest response of the therapist to the client
unconditional positive regard: the warmth, respect, and accepting atmosphere created by the therapist for the client in person-centered therapy
empathy: the ability of the therapist to understand the feelings of the client
reflection: the therapist restates what the client says rather than interpreting those statements

12. Rogers’s Person-Centered Therapy
LO 14.3 Basic Elements of Humanistic Therapies
AP: Major Treatment Orientations
Motivational interviewing (MI)
In contrast to client-centered therapy, MI has specific goals:
To reduce ambivalence about change
To increase intrinsic motivation to bring that change about
Four principles:
Express empathy
Develop discrepancy between client’s present behaviors, values
Roll with resistance
Support the client’s self-efficacy

13. LO 14.3 Basic Elements of Humanistic Therapies
Gestalt Therapy
AP: Major Treatment Orientations
Strategies for Resilience and Competence
LO 14.3 Basic Elements of Humanistic Therapies
Gestalt therapy: form of directive insight therapy in which the therapist helps clients accept all parts of their feelings and subjective experiences, using leading questions and planned experiences such as role-playing

14. Today’s View of Humanistic Therapy
AP: Major Treatment Orientations
Evaluate Various Approaches to Explaining Psychological Disorders
LO 14.3 Basic Elements of Humanistic Therapies
Humanistic therapies are not based in experimental research and work best with intelligent, highly verbal persons

15. Behavioral Therapy and Classical Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Behavior therapies: action therapies based on the principles of classical and operant conditioning and aimed at changing disordered behavior without concern for the original causes of such behavior

16. Behavioral Therapy and Classical Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Behavior modification or applied behavior analysis: use of learning techniques to modify or change undesirable behavior and increase desirable behavior

17. Behavioral Therapy and Classical Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Identify Major Figures/Major Treatment Orientations
Systematic desensitization (Wolpe, 1958): behavioral technique used to treat phobias, in which a client is asked to make a list of ordered fears and taught to relax while concentrating on those fears
The patient confronts each item from his/her hierarchy of fears until the phobia is gone

19. Behavioral Therapy and Classical Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Aversion therapy: form of behavioral therapy in which an undesirable behavior is paired with an aversive stimulus to reduce the frequency of the behavior

20. Behavioral Therapy and Classical Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Exposure therapy: behavioral techniques that introduce the client to situations (under carefully controlled conditions) that are related to their anxieties or fears
flooding: technique for treating phobias and other stress disorders in which the person is rapidly and intensely exposed to the fear-provoking situation or object and prevented from making the usual avoidance or escape response

21. Behavioral Therapy and Classical Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Exposure therapy (cont’d)
Eye-movement desensitization reprocessing (EMDR): controversial therapy for posttraumatic stress disorder and similar anxiety problems in which the client is directed to move the eyes rapidly back and forth while thinking of a disturbing memory
needs more controlled studies

22. Behavioral Therapy and Operant Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Modeling: learning through the observation and imitation of others
participant modeling: technique in which a model demonstrates the desired behavior in a step-by-step, gradual process while the client is encouraged to imitate the model

23. Behavioral Therapy and Operant Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Reinforcement: the strengthening of a response by following it with a pleasurable consequence or the removal of an unpleasant stimulus
Token economy: the use of tokens to reinforce behavior in which the tokens can be accumulated and exchanged for desired items or privileges

24. Behavioral Therapy and Operant Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Reinforcement (cont’d)
contingency contract: a formal, written agreement between the therapist and client (or teacher and student) in which goals for behavioral change, reinforcements, and penalties are clearly stated

25. Behavioral Therapy and Operant Conditioning
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations
Extinction: the removal of a reinforcer to reduce the frequency of a behavior
time-out: an extinction process in which a person (usually a child) is removed from the situation that provides reinforcement for undesirable behavior, usually by being placed in a quiet corner or room away from possible attention and reinforcement opportunities

26. Effectiveness of Behavioral Therapy
LO 14.4 Behavior Therapists’ Use of Classical and Operant Conditioning
AP: Major Treatment Orientations/Evaluate Various Approaches to Explaining Psychological Disorders
Behavior therapies can be effective in treating specific problems, such as bedwetting, drug addictions, and phobias
Behavior therapies can also help improve some of the more troubling behavioral symptoms associated with more severe disorders

27. LO 14.5 Goals of Cognitive Therapies
Cognitive Therapy
LO 14.5 Goals of Cognitive Therapies
AP: Major Treatment Orientations/Identify Major Figures
Cognitive therapy: therapy in which the focus is on helping clients recognize distortions in their thinking and replace distorted, unrealistic beliefs with more realistic, helpful thoughts
Developed by Aaron T. Beck

28. LO 14.5 Goals of Cognitive Therapies
Cognitive Therapy
LO 14.5 Goals of Cognitive Therapies
AP: Major Treatment Orientations/Identify Major Figures
Cognitive distortions:
arbitrary inference: drawing a conclusion without any evidence
selective thinking: focusing on only one aspect of a situation while ignoring all other relevant aspects
overgeneralization: drawing sweeping conclusions based on only one incident or event and applying those conclusions to events that are unrelated to the original

29. LO 14.5 Goals of Cognitive Therapies
Cognitive Therapy
LO 14.5 Goals of Cognitive Therapies
AP: Major Treatment Orientations/Identify Major Figures
Cognitive distortions (cont’d):
magnification and minimization: blowing a negative event out of proportion (magnification) while ignoring relevant positive events (minimization)
personalization: taking responsibility or blame for events that are unconnected to the person

30. Cognitive-Behavioral Therapies
LO 14.5 Goals of Cognitive Therapies
AP: Major Treatment Orientations/Identify Major Figures
Cognitive-behavioral therapy (CBT): action therapy in which the goal is to help clients overcome problems by learning to think more rationally and logically

31. Cognitive-Behavioral Therapies
LO 14.5 Goals of Cognitive Therapies
AP: Major Treatment Orientations/Identify Major Figures
Three goals:
Relieve the symptoms and solve the problems.
Help develop strategies for solving future problems.
Help change irrational, distorted thinking.

32. Rational Emotive Therapy
LO 14.5 Goals of Cognitive Therapies
AP: Major Treatment Orientations/Identify Major Figures
Rational emotive behavior therapy (REBT): cognitive-behavioral therapy in which clients are directly challenged in their irrational beliefs and helped to restructure their thinking into more rational belief statements
Proposed by Albert Ellis

33. LO 14.5 Goals of Cognitive Therapies
Success of CBT
AP: Major Treatment Orientations
Evaluate Various Approaches to Explaining Psychological Disorders
LO 14.5 Goals of Cognitive Therapies
CBT has seemed successful in treating depression, stress disorders, and anxiety.
CBT has been criticized for focusing on the symptoms, not the causes, of disordered behavior.

35. LO 14.6 Types of Group Therapy
AP: Compare Treatment Formats
Family counseling (family therapy): family members meet together with a counselor or therapist to resolve problems that affect the entire family

36. LO 14.6 Types of Group Therapy
AP: Compare Treatment Formats
Self-help group (support group): a group composed of people who have similar problems and who meet together without a therapist or counselor for the purpose of discussion, problem solving, and social and emotional support

37. When Is Group Therapy Useful?
AP: Compare Treatment Formats
Effectiveness of Specific Treatments for Specific Problems
LO 14.6 Types of Group Therapy
Group therapy is most useful to persons who:
cannot afford individual therapy
may obtain a great deal of social and emotional support from other group members

38. LO 14.6 Types of Group Therapy
AP: Compare Treatment Formats/
Effectiveness of Specific Treatments for Specific Problems
LO 14.6 Types of Group Therapy
Advantages:
low cost
exposure to other people with similar problems; social interaction with others
social and emotional support from people with similar disorders or problems

39. LO 14.6 Types of Group Therapy
AP: Compare Treatment Formats/
Effectiveness of Specific Treatments for Specific Problems
LO 14.6 Types of Group Therapy
Disadvantages:
need to share the therapist’s time with others in the group
lack of a private setting in which to reveal concerns
inability of people with severe disorders to tolerate being in a group

40. Effectiveness of Psychotherapy
LO 14.7 The Effectiveness of Psychotherapy
AP: Effectiveness of Specific Treatments for Specific Problems
Psychotherapy is more effective than no treatment at all
Between 75 and 90 percent of people who receive therapy feel it has helped them
the longer a person stays in therapy, the greater the improvement

41. Effectiveness of Psychotherapy
LO 14.7 The Effectiveness of Psychotherapy
AP: Effectiveness of Specific Treatments for Specific Problems
Some types of psychotherapy are more effective for certain types of problems, and no one psychotherapy method is effective for all problems
effective therapy should be matched to the particular client and the particular problem

42. Effectiveness of Psychotherapy
LO 14.7 The Effectiveness of Psychotherapy
AP: Effectiveness of Specific Treatments for Specific Problems
Common factors approach: modern approach to eclecticism focusing on factors seen as the source of success

43. Effectiveness of Psychotherapy
LO 14.7 The Effectiveness of Psychotherapy
AP: Effectiveness of Specific Treatments for Specific Problems
Common factors approach
therapeutic alliance: the relationship between therapist and client that develops as a warm, caring, accepting relationship characterized by empathy, mutual respect, and understanding
protected setting
opportunity for catharsis
learning and practice of new behaviors
positive experiences for the client

44. Effectiveness of Psychotherapy
LO 14.7 The Effectiveness of Psychotherapy
AP: Effectiveness of Specific Treatments for Specific Problems
Evidence-based treatment (EBT) refers to techniques or interventions that have produced desired outcomes, or therapeutic change in controlled studies

45. Mental Health on Campus
LO 14.7 The Effectiveness of Psychotherapy
AP: Strategies for Resilience and Competence
Campus life is often very stressful
Many students arrive on campus already in therapy for a diagnosed disorder
Students should:
make use of the available resources on college campuses
counseling centers
exercise, eat well, get enough sleep and relaxation time

46. Culture and Psychotherapy
LO 14.7 The Effectiveness of Psychotherapy
AP: How Culture Influences Treatment/Identify Major Figures
When the cultures, ethnic groups, or genders of the therapist and the client differs, misunderstandings and misinterpretations can occur (e.g. Jones et al., 1987)
Four barriers to effective psychotherapy exist when culture the backgrounds of client and therapist differ (Sue & Sue, 2008):
culture-bound values
class-bound values
language
nonverbal communication

47. LO 14.7 The Effectiveness of Psychotherapy
Cybertherapy
LO 14.7 The Effectiveness of Psychotherapy
AP: Effectiveness of Specific Treatments for Specific Problems
Cybertherapy: psychotherapy that is offered on the Internet
also called online, Internet, or Web therapy or counseling
offers the advantages of anonymity and therapy for people who cannot otherwise get to a therapist
but you can’t be sure of the cybertherapist’s credentials, and there are no vocal/body cues for assessing emotions

48. Drug Treatments
LO 14.8 Types of Drugs Used to Treat Psychological Disorders
AP: Major Treatment Orientations
Biomedical therapies: therapies that directly affect the biological functioning of the body and brain

49. LO 14.8 Types of Drugs Used to Treat Psychological Disorders
Drug Treatments
LO 14.8 Types of Drugs Used to Treat Psychological Disorders
AP: Major Treatment Orientations
Psychopharmacology: the use of drugs to control or relieve the symptoms of psychological disorders
antipsychotic drugs: used to treat psychotic symptoms such as delusions, hallucinations, and other bizarre behavior
antianxiety drugs: used to treat and calm anxiety reactions
typically minor tranquilizers

50. LO 14.8 Types of Drugs Used to Treat Psychological Disorders
Drug Treatments
LO 14.8 Types of Drugs Used to Treat Psychological Disorders
AP: Major Treatment Orientations
Psychopharmacology (cont’d)
mood-stabilizing drugs: used to treat bipolar disorder
include lithium and certain anticonvulsant drugs
antidepressant drugs: used to treat depression and anxiety

52. Electroconvulsive Therapy
LO 14.9 Electroconvulsive Therapy and Psychosurgery
AP: Major Treatment Orientations
Electroconvulsive therapy (ECT): biomedical treatment in which electrodes are placed on either one or both sides of a person’s head and an electric current strong enough to cause a seizure or convulsion is passed through the electrodes
still used to treat severe depression

53. LO 14.9 Electroconvulsive Therapy and Psychosurgery
AP: Major Treatment Orientations
Psychosurgery: surgery performed on brain tissue to relieve or control severe psychological disorders
prefrontal lobotomy: the connections of the prefrontal lobes of the brain to the rear portions are severed

54. LO 14.9 Electroconvulsive Therapy and Psychosurgery
AP: Major Treatment Orientations
Psychosurgery (cont’d)
Bilateral anterior cingulotomy: an electrode wire is inserted into the anterior cingulated gyrus area of the brain for the purpose of destroying that area of brain tissue with an electric current
electrode is inserted with the guidance of a magnetic resonance imaging (MRI) machine

55. LO 14.9 Electroconvulsive Therapy and Psychosurgery
AP: Major Treatment Orientations
Emerging techniques
repetitive transcranial magnetic stimulation (rTMS): magnetic pulses are applied to the cortex
transcranial direct current stimulation (tDCS): uses scalp electrodes to pass very low amplitude direct currents to the brain

56. LO 14.10 How Might Computers Be Used in Psychotherapy?
Virtual Reality
LO How Might Computers Be Used in Psychotherapy?
Virtual reality is a software-generated three-dimensional simulated environment with can be used in the treatment of PTSD
like playing a video game
particularly useful as a delivery system for exposure therapy