1. Approaches to Treatment and Therapy
Prepared by Michael J. Renner, Ph.D.
These slides ©2002 Prentice Hall Psychology Publishing.

2. Approaches to Treatment and Therapy
Biological Treatments
Kinds of Psychotherapy
Evaluating Psychotherapy

3. Biological Treatments
The Question of Drugs
Surgery and Electroshock

4. The Question of Drugs Figure from p372 of
Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall.

5. Cautions About Drug Treatment
Placebo Effect
High Relapse and Dropout Rates
Dosage Problems
Long-Term Risks

6. Surgery and Electroshock
Psychosurgery:
Any surgical procedure that destroys selected areas of the brain believed to be involved in emotional disorders or violent, impulsive behavior.
Electroconvulsive Therapy (ECT):
A procedure used in cases of prolonged and severe major depression, in which a brief brain seizure is induced.

7. Kinds of Psychotherapy
Psychodynamic Therapy
Behavioral and Cognitive Therapy
Humanist and Existential Therapy
Family Therapy
Psychotherapy in Practice

8. Psychodynamic Therapy
Free Association:
In psychoanalysis, a method of uncovering unconscious conflicts by saying freely whatever comes to mind.
Transference:
In psychodynamic therapies, a critical step in which the client transfers unconscious emotions or reactions, such as conflicts about his or her parents, onto the therapist.

9. Behavioral and Cognitive Therapy
Systematic Desensitization
Aversive Conditioning
Exposure Treatments
Behavioral Records and Contracts
Skills Training

10. Cognitive Techniques Examine the evidence for beliefs.
Consider other explanations for the behavior of others.
Identify assumptions and biases.

11. Humanist and Existential Therapy
Client-Centered Therapy :
Developed by Carl Rogers; therapist tries to create climate of Unconditional Positive Regard to allow clients to seek self-actualization and self-fulfillment.
a.k.a., “Nondirective Therapy”
Existential Therapy:
Helps clients explore the meaning of existence and face with courage the great issues of life.

12. One Family’s Genogram Figure 11.02 of
Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall.

13. Systemic Therapy Salvador Minuchin (structural family therapy)
All individuals belong to a system.
Systems have structure.
Structure is defined by rules and boundaries.
Rules and boundaries define interaction patterns.
A family system consists of three smaller subsystems
Spousal
Parental
Sibling
Treatment focus is on fixing the systems structural problem and not on the individual or identified patient.

14. Primary Goals of Therapies
Psychodynamic:
Insight into unconscious motives and feelings.
Cognitive-Behavioral:
Modification of behavior and irrational beliefs.

15. Primary Goals of Therapies
Humanist:
Insight; self-acceptance and self-fulfillment.
Family:
Modification of individual habits and family patterns.

16. Primary Methods of Therapies
Psychodynamic:
Probing the unconscious through dream analysis, free association, transference.
Cognitive-Behavioral:
Behavioral techniques such as systematic desensitization, flooding; cognitive exercises to identify and change faulty beliefs.

17. Primary Methods of Therapies
Humanist:
Providing a safe, non-judgmental setting in which to discuss life issues.
Family:
Working with couples, families, and sometimes individuals to identify and change patterns that perpetuate problems.

18. Evaluating Psychotherapy
The Scientist-Practitioner Gap
When Therapy Helps
Which Therapy for Which Problem?
When Therapy Harms

19. The Scientist-Practitioner Gap
Some psychotherapists believe that evaluating therapy using research methods is futile.
Scientists find that therapists who do not keep up with empirical findings are less effective and can do harm to clients.
Economic pressures require empirical assessment of therapies.

20. Is More Psychotherapy Better?
With additional therapy sessions, the percentage of people improved increased up to 26 sessions.
Rate of improvement then levels off.
Based on a summary of 15 studies, 2400 clients (Howard, et al., 1996)
Patients’ sense of improvement slower but more steady.
Figure of
Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall.
Source:
Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41,

21. Psychotherapy Research: Three Questions
What are the common ingredients in successful therapies?
What kinds of therapy are best suited for which problems?
Under what conditions can therapy be harmful?

22. When Therapy Helps Therapeutic Alliance:
The bond of confidence and mutual understanding established between therapist and client, which allows them to work together to solve the client’s problems.

23. Which Therapy for Which Problem?
Depression:
Cognitive therapy’s greatest success has come in treatment of mood disorders.
Anxiety Disorders:
Exposure techniques are more effective than others.
Anger and Impulsive Violence:
Cognitive therapy is extremely successful.

24. Which Therapy for Which Problem?
Health Problems:
Cognitive and behavior therapies are effective for a wide range of health problems.
Childhood and Adolescent Behavior Problems:
Behavior therapy is the most effective treatment.

25. Cognitive Inoculation Against Depression
Children at risk for depression split into two groups
Cognitive intervention with one group lowered depression risk
Effects of intervention seem to grow over time
Figure of
Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall.

26. Successful Therapy
Psychotherapy outcome depends not only on method of therapy.
Qualities of client and therapist, and their alliance, also determine success.
Figure of
Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall.

27. When Therapy Harms
Animosity or biased treatment on the part of the therapist.
Coercion to adopt the therapist’s advice, sexual intimacies, or other unethical behavior.

28. When Therapy Harms
Therapist-induced disorders resulting from inadvertent suggestions or influence.
Although suggestive techniques may result in false memories, one third of licensed psychotherapists use these methods.