1. AP Psychology Alice F. Short Hilliard Davidson High School
Therapies Chapter 16
AP Psychology
Alice F. Short
Hilliard Davidson High School

2. Chapter Preivew Biological Therapies Psychotherapy
Sociocultural Approaches and Issues
Effectiveness of Psychotherapy
Therapies and Health and Wellness

3. Biological Therapies Biomedical Approach
reduce/eliminate symptoms by altering body functioning
Common Forms of Biological Therapy
drug therapy
electroconvulsive therapy (ECT)
psychosurgery

4. Drug Therapy
antianxiety drugs – commonly known as tranquilizers, drugs that reduce anxiety by making the individual calmer and less excitable
benzodiazepines – the antianxiety drugs that generally offer the greatest relief for anxiety symptoms
potentially addictive
bind to receptor cites of neurotransmitters that become overactive during anxiety
examples: Xanax, Valium, Librium
nonbenzodiazepine – buspirone (BuSpar) – used to treat generalized anxiety disorder

5. Drug Therapy antidepressant drugs – drugs that regulate mood
tricyclics – 3-ringed molecular structure
believed to work by increasing neurotransmitters, especially serotonin and norepinephrine
reduce symptoms of depression in percent
takes 2-4 weeks to improve mood
side effects: restlessness, faintness, trembling, sleepiness, memory difficulties
tetracyclics – 4-ringed molecular structure
a.k.a. noradrenergic and specific serotonergic antidepressants (NaSSAs)
increases norepinephrine and serotonin
example: Remeron (mertazapine) – most effective in reducing depression
monoamine oxidase (MAO) inhibitors
block the enzyme monoamine oxidase (which breaks down serotonin and norepinephrine
worse side effects: high blood pressure, stroke (esp. with fermented foods, drugs)
selective serotonin reuptake inhibitors (SSRIs)
interfere with the reabsorption of serotonin in the brain
examples: Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline)
fewer side effects, still: insomnia, anxiety, headache, diarrhea, impaired sexual functioning
Remeron (mertazapine) = most effective drug therapy for depression

6. Antidepressant Drugs
1996  2005 – number of Americans prescribed antidepressants doubled
anxiety disorders: generalized anxiety disorder, obsessive-compulsive disorder, social anxiety disorder
PTSD
Bipolar Disorder
lithium – the lightest of the solid elements in the periodic table of elements
effective dosage is precariously close to toxic levels
influences serotonin and norepinephrine (how unknown)
weight gain, going off drug
Risks of Antidepressants for Children
FDA hearings on risk of suicide (2004)
“Black Box” warning

7. Drug Therapy
antipsychotic drugs – powerful drugs that diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior, and produce better sleep patterns in individuals with a severe psychological disorder, especially schizophrenia
small dosages over time, may combine with vocation, family and social skills training
neuroleptics (side effect - tardive dyskinesia)
most used
ability to block dopamine action in the brain
tardive dyskinesia – a neurological disorder characterized by involuntary random movements of the facial muscles, tongue and mouth, as well as twitching of the neck, arms and legs
20% on neuroleptics develop (can develop w/o drugs
atypical antipsychotic medications (introduced 1990s)
lower side effects
affects dopamine and serotonin (mechanism unknown)
examples: Clozaril (clozapine), Risperdal (risperidone)

8. Drug Therapy

9. Biological Therapies electroconvulsive therapy (a.k.a. shock therapy)
small electric current produces a brief seizure
used to treat major depressive disorder which has not responded to other treatments
deep brain stimulation – a procedure for treatment-resistant depression that involves the implantation of electrodes in the brain that emit signals to alter the brains electrical circuitry
treatment-resistant depression, OCD
nucleus acumbens
improved dramatically, still memory loss and cognitive impairments
for acute depression, great risk of suicide

10. Biological Therapies
psychosurgery – a biological therapy, will irreversible effects, that involves removal or destruction of brain tissue to improve the individuals adjustments
prefrontal lobotomies
coined by Walter Freemen, “lobotomobile”
today: small lesion in amygdala or another part of the limbic system
OCD
major depression
bipolar disorders
not schizophrenia

11. Insight Therapies
insight therapies – encourage self-awareness as the key to psychological health
psychodynamic therapies
humanistic therapies

12. Psychotherapy
psychotherapy (face-to-face and cybertherapy) a nonmedical process that helps people with psychological disodres recognize and overcome psychological and interpersonal difficulties
32% in 1996  20% in 2005
Preview of Psychotherapies
psychodynamic therapies
humanistic therapies
behavior therapies
cognitive therapies
cybertherapy is also called e-therapy

13. Psychodynamic Therapies
Emphasis of this Approach
unconscious mind
therapeutic interpretation
early childhood experiences
Goals of Therapy
recognize maladaptive coping strategies
identify sources of unconscious conflicts

14. Psychodynamic Therapies
Freudian Psychoanalysis – Freud’s therapeutic technique for analyzing an individual’s unconscious thoughts
free association – a psychoanalytic technique that involves encouraging individuals to say aloud whatever comes to mind, no matter who trivial or embarrassing
catharsis – the release of emotional tension a person experiences when reliving an emotionally charged and conflicting experience
interpretation – a psychoanalyst’s search for symbolic, hidden meanings in what the client says and does during therapy
dream analysis – a psychoanalytic technique for interpreting a person’s dreams
manifest content
latent content
transference – a client's relating to the psychoanalyst in ways the reproduce or relive important relationships in the individual’s life
resistance – a client’s unconscious defense strategies that interfere with the psychoanalysts understanding of the individuals problems
examples: showing up late/missing sessions, arguing, faking free associations
Contemporary Psychodynamic Therapies
still interested in childhood trauma
accord more power to the conscious mind and a person’s current relationships
less emphasis on sex
Heinz Kohut (1977) – therapist replaces unhealthy childhood relationship (empathic, understanding)

15. Humanistic Therapies
humanistic therapies – treatments, unique in their emphasis on people’s self-healing capacities, that encourage clients to understand themselves and to grow personally
self healing
conscious thoughts
self-fulfillment
goals of therapy
self-understanding
personal growth

16. Roger’s Client-Centered Therapy
client-centered therapy – also called Rogerian therapy or nondirective therapy, a form of humanistic therapy, developed by Rogers, in which the therapist provides a war, supportive atmosphere to improve the client’s self-concept and to encourage the client to gain insight into problems
identify and understand his or her own genuine feelings
warm, supportive atmosphere
active listening
reflective speech – a technique in which the therapist mirrors the client’s own feelings back to the client
Roger’s 3 essential elements to grow:
unconditional positive regard
empathy
genuineness

17. Behavior Therapies
behavior therapies – treatments, based on the behavioral and social cognitive theories of learning, that use principles of learning to reduce or eliminate maladaptive behavior
emphasis: overt behavior change rather than insights into self or into underlying causes
goal: reduce or eliminate maladaptive behaviors
common methods: classical and operant conditioning

18. Behavior Therapies Classical Conditioning Techniques Treating Phobias
systematic desensitization – a method of behavior therapy that treats anxiety by teaching the client to associate deep relaxation with increasingly intense anxiety-producing situations (p. 533)
develop hierarchy of fearful scenes
learn relaxation techniques
apply relaxation while imagining fearful scenes
Flooding
intense exposure to feared stimuli without allowing avoidance

19. Desensitization for Test Anxiety

20. Aversive Conditioning
noxious stimuli paired with conditioned stimulus

21. Behavior Therapies Operant Conditioning Techniques…
unlearning maladaptive behavior (e.g., OCD) through altered consequences.
Applied Behavior Analysis
positive reinforcement of adaptive behaviors
extinguish maladaptive behaviors
does not depend on gaining insight

22. Cognitive Therapies cognitive therapies Emphasis of this Approach
thoughts (cognitions) are the primary source of psychological problems
how we think controls how we feel
attempt to change the individual’s feelings and behaviors by changing cognitions
focus on overt problems (unlike Freud)
structured analysis and specific guidance (unlike Rogers)
Goals of Therapy
cognitive restructuring – a general concept for changing a pattern of thought that is presumed to be causing maladaptive behavior or emotion

23. Cognitive Therapies Albert Ellis’s Rational-Emotive Behavior Therapy
assertion that individuals develop a psychological disorder because of irrational and self-defeating beliefs
eliminate beliefs through rational examination
directive, persuasive, confrontational
musterbating
Beck’s Cognitive Therapy
illogical automatic negative thoughts
identify and challenge automatic thoughts
reflective, open-ended dialogue, less directive
Both are more effective in treating depression than drugs.

24. Cognitive Therapy Techniques
challenge idiosyncratic meanings
question the evidence
reattribution
examine options and alternatives
decatastrophize
fantasize consequences
examine advantages and disadvantages
turn adversity to advantage
guided association
scaling
thought stopping
distraction
labeling of distortions

25. Cognitive-Behavior Therapy
Albert Bandura and Self Efficacy
self-efficacy – concept that one can master a situation and produce positive outcomes
cognitive-behavior therapy – a therapy that combines cognitive therapy and behavior therapy with the goal of developing self-efficacy
self-defeating thoughts
incorporates behavior therapy
self-instructional methods

26. Therapy Integrations
Techniques from different therapies are combined for the benefit of the client (e.g., dialectical behavior therapy).

27. Comparing Psychotherapies
integrative therapy – a combination of techniques from different therapies based on the therapist’s judgment of which particular methods will provide the greatest benefit for the client
most therapists use an eclectic approach

28. How Does Therapy Affect the Brain?
Brain Imaging Studies
use of functional magnetic resonance imaging (fMRI)
shows that brain function can be normalized (e.g., cognitive remediation therapy increases prefrontal cortex activity in schizophrenics)

29. Sociocultural Approaches
Emphasis
influence of various social/cultural factors
Approaches to Therapy
group therapy – a sociocultural approach to the treatment of psychological disorders that brings together individuals who share a particular psychological disorders in sessions that are typically led by a mental health professional
family therapy – group therapy with a family
validation
reframing
structural change
detriangulation – shift attention away from scapegoat
couples therapy – group therapy with married or unmarried couples whose major problem lies within their relationship
self-help support groups
community mental health

30. Sociocultural Approaches and Issues
Group Therapy
group shares disorder
professional facilitates
Family and Couples Therapy
symptoms are a function of relationships
therapeutic techniques
validation
reframing
structural change
detriangulation

31. Sociocultural Approaches and Issues
Self-Help Support Groups
conducted by paraprofessionals – individuals who have been thought by a professional to provide some mental health services but who not have formal mental health training
Community Mental Health Act of 1963
deinstitutionalization (rise in homelessness) – large numbers of individuals with psychological disorders were transferred from mental institutions to community based facilities
prevention
empowerment

32. Sociocultural Approaches and Issues
Cultural Perspectives
individualistic v. collectivistic cultures
ethnicity
match between client and therapist
gender
balance between independence and relatedness
feminist therapies

33. Effectiveness of Psychotherapy
Research results show that all therapies are “winners”.
Common Themes in Successful Psychotherapy
expectations of help
increased sense of competence
emotional arousal is a motivator
therapeutic alliance - the relationship between the therapist and client—an important element of successful psychotherapy
client factors (active engagement)

34. Effectiveness of Psychotherapy

35. Effects of Therapy on Health and Wellness
stress reduction in cancer patients
reduces physical health risks in those who are depressed
not only reduces symptoms, but enhances psychological wellness
well-being therapy (WBT)
short-term, problem-focused, directive
notice and celebrate positive experiences

36. Chapter Summary Describe the biological approaches to therapy.
Define and characterize four types of psychotherapy.
Explain the sociocultural approaches and issues in treatment.
Discuss the effectiveness of psychotherapy.
Discuss the impact that therapy has on health and wellness.

37. Chapter Summary Biological Therapies Psychodynamic Therapies
drug therapy
electroconvulsive therapy
psychosurgery
Psychodynamic Therapies
Freud’s psychoanalysis
Humanistic Therapies
Rogers’s client-centered therapy

38. Chapter Summary Behavior Therapies Cognitive Therapies
systematic desensitization and flooding
aversive conditioning
Cognitive Therapies
Ellis’s rational-emotive behavior therapy
Beck’s cognitive therapy
cognitive-behavior therapies

39. Chapter Summary Sociocultural Approaches and Issues
group, family, and couples therapy
self-help groups and community mental health
cultural perspectives
Effectiveness of Psychotherapy
Therapies and Health and Wellness
physical health and preventing disorders