1. Copyright © 2014 McGraw-Hill Education. All rights reserved
Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.

2. Therapy Types
Insight Therapies (Psychodynamics, Person-centered Therapy)
Behavioral Therapies
Cognitive Therapies
Biological Therapies

3. Effectiveness of Psychotherapy
All therapies are “winners”.
Factors in Successful Psychotherapy
therapeutic alliance (monitored)
therapist expertise & personality
client active engagement
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4. Psychodynamic Perspective
Causes: fixation (early childhood), unresolved unconscious conflicts, breakdown of ego defense mechanisms
Treatment methods: psychoanalysis (free association, dream analysis)
Primary disorders treated: General feelings of unhappiness, unresolved problems from childhood.

5. Psychodynamic Perspective
Presumed Problem: unconscious conflict from childhood experiences
Therapy aim: Reduce anxiety through self-insight.
Therapy Technique: interpret patient’s memories and feelings.

6. Psychodynamics therapy techniques
Free association: helps patients discover unconscious thoughts and feelings that had been repressed or ignored.
Analysis of resistance: client is unwilling to discuss to discuss a particular topic—therapist have to interpret why it is occurring.
Dream analysis: dreams represent wish fulfillment, unconscious desires, and conflicts.
Analysis of transference: transfer of feelings from the past to someone in the present. (usually the therapist)
(dream analysis)

7. Humanistic Therapy
Presumed Problems Barriers to self-understanding and self-acceptance.
Treatment Techniques: person-centered therapy (the therapist listen actively and reflect client’s feelings.
Goals of therapy: Enable growth via unconditional positive regard, geniuses, acceptance and empathy.
Primary disorders treated: general feelings of unhappiness, interpersonal problems
Acceptance

8. Client-Centered Therapy
Founded by carl rogers
Warm, supportive, encouraging environment
Therapist must genuinely like the client
Uses mirroring and reflective speech to promote self-actualization
Therapist must have empathy for client
Suggestion: Ask students, “If you had a mental illness and were seeking therapy, which would you prefer, psychoanalysis or client-centered therapy, and why?”
Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.
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9. Only the client can judge if he or she is better
Humanistic therapy
Only the client can judge if he or she is better
No way to independently verify success

10. Limitations of insight therapies
A client must be motivated, intelligent, articulate, and rich
Not as effective as cognitive-behavioral therapy

11. Behavioral perspective
Much more active and are related to the symptoms
Causes: abnormal behavior is learned by reinforcement, or classical conditioning, or observation and modeling
Treatment methods: behavior therapy (behavior modification, token economy, desensitization, therapy modeling, etc.)
Primary disorders treated: fears, phobias, panic disorder, ocd, unhealthy habits.
Goals of Therapy: reduce or eliminate maladaptive behaviors
CBT- cognitive behavior therapy

12. Therapy based on classical conditioning
Classical Conditioning Techniques Treating Phobias
(systematic desensitization)
Teach relaxation
Exposure: Create a hierarchy ranging from least to most feared stimulus
Work through a hierarchy while maintaining calm
Flooding
intense exposure without allowing avoidance
It has helped a lot of people with anxiety or phobias. A lot of phobias because of classical conditioning. It was build by association by anxiety. Systematic. Help them to relax, you can’t be calm and anxious in the same time
First step:
Guided relaxation---lay down and relax, begin at feet (muscle relaxtion) clentch your toes and let go and as you let go think of beach
Tight you calf muscles, work your way up the body and relaxing. Process takes minutes. Conditioning relaxtion with a trigger work.
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13. Hierarchy of fears (public speech)
Watching someone else speak
Have others sing “happy birthday” to you
Be asked to give a toast to a small gathering of friends
Be asked to give a toast at a wedding
Flooding
intense exposure without allowing avoidance
It has helped a lot of people with anxiety or phobias. A lot of phobias because of classical conditioning. It was build by association by anxiety. Systematic. Help them to relax, you can’t be calm and anxious in the same time
First step:
Guided relaxation---lay down and relax, begin at feet (muscle relaxtion) clentch your toes and let go and as you let go think of beach
Tight you calf muscles, work your way up the body and relaxing. Process takes minutes. Conditioning relaxation with a trigger work. Begin imaginary and then
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14. Aversive Conditioning
Nauseating Drug
(Stimulus)
UCS
No Response
Unlearned
Reflex
Repeatedly
Paired NS
UCR
Alcohol
(Stimulus 2)
Nausea
(Response)
Learned Association CS CR
Note: This example is illustrative only. Contrary to the implication of this diagram, Antabuse does not cause nausea when taken by itself: It only causes nausea if alcohol is also consumed. Moreover, in practice, Antabuse is not used so much to create a lasting distaste for alcohol as to prevent sneaking beers when in detox.
Conditioned Stimulus
Neutral Stimulus
Unconditioned Stimulus
Acquisition/Learning
Innate S-R Association
Unconditioned Response
Conditioned Response
(stimulus satiation)

15. Therapies based on operant conditioning
Ignore the maladaptive behaviors
Rewarding positive behaviors
Token economies: using tokens that can be exchanged for other items or privileges as a reinforcers (juvenile)
Punishment (police) following some undesired behavior by an aversive stimulus.
Give them the opportunities to gain tokens. Immediate reinforcement

16. Cognitive therapy
Causes: abnormal behavior is caused by faulty, irrational, negative thinking.
Treatment methods: cognitive therapy is aimed at developing more positive and rational thinking patterns-structured analysis and specific guidance.
Primary disorders treated: depression, anxiety, panic disorder, general feelings of unhappiness.
Goals of therapy: Cognitive reconstructing, to train people to dispute negative thoughts and attributions.

17. Elli’s Rational- emotive therapy
By pointing out alternative ways of viewing a situation, the person’s view of life, and ultimately their mood will improve.
**Research has shown that cognitive therapy can be as effective as medication in the long-term treatment of depression.

18. Common irrational thoughts
I must be prefect
Everyone must love me
The past determines the future
It is catastrophic wen things don’t go as planned
I have no control over my happiness

19. Common Cognitive Error/distortion
Selective abstraction: (Mental Filter) you pay undue attention to one negative detail instead of seeing the whole picture.
Example:  “Because I got one low rating on my evaluation (which also contained several high ratings), it means I’m doing a lousy job.”

20. Biological Therapies
Causes: hereditary factors, malfunctioning of the NS or body’s biochemistry.
Treatment methods: Drug therapies, electroconvulsive therapy (ECT) and Psychosurgery
Primary disorders treated: Schizophrenia, depression, Bipolar disorder, anxiety disorders.
Goals of therapy: reduce/eliminate symptoms by altering body functioning
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21. Drug Therapy Antianxiety Drugs ---Family of Tranquilizers
e.g. Valium, Xanax
short term effectiveness
prone to tolerance
Bipolar Disorder
Lithium-evens out mood swings.
majority improve substantially
toxicity reactions
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22. Antidepressant Drugs Antidepressant Drugs
selective serotonin reuptake inhibitors (SSRIs)
majority improve moderately
risk of multiple significant side effects
Risks of Antidepressants for Children
FDA hearings on risk of suicide (2004)
“Black Box” warning
Are Drugs Necessary in Treatment? This question presents an opportunity for students to reflect on the necessity/value of the various therapies described in this chapter.
Suggestion: Instructor might bring up the fact that there is a controversy about whether drugs that alter neurotransmitter levels are in fact effective. For example, research shows that while antidepressant drugs effectively increase targeted neurotransmitter levels within an hour or so of administration, reduction of depressive symptoms does not typically occur till more than a week has passed. Note that this particular evidence does concede the effectiveness of the drug, but undermines the explanation of why the drug works.
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23. Drug Therapy Antipsychotic Drugs
-Neuroleptics
e.g. Compazine (treats hallucinations and delusions)
--inhibits the NT (Dopamine)
atypical antipsychotic medications
Newer drugs- target both dopamine and serotonin
Improves positive and negative symptoms of schizophrenia
Clozapine
Note: (As with antidepressants, see previous two slides) similar criticism of the dopamine connection to schizophrenia has been made in regard to antipsychotic drugs.
Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.
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24. Biological Therapies
Electroconvulsive Therapy-used with informed consent (requires sedation and anesthesia)
small electric current produces a brief seizure
used to treat major depressive disorder which has not responded to other treatments
Unilateral ETC (admin to the RH)
Memory loss
Psychosurgery (discontinued)
prefrontal lobotomies
Results are unpredictable
Irreversible
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25. Biological Therapies Modern treatment—Neurofeed back)
Non invasive therapy
No sedation required
No side effects (seizures or memory loss)
Highly effective in treating schizophrenia negative symptoms
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26. Chapter Review
Describe approaches to treating psychological disorders.
Define psychotherapy and characterize four types of psychotherapy.
Describe the biological therapies.
Explain the sociocultural approaches and issues in treatment.
Discuss therapy's larger implications for health and wellness and characterize the client's role in therapeutic success.
Note: Instructors may use the learning objectives presented on this slide to review the chapter material.
Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.
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