1. Geraldo, a high school senior, is so fearful of asking a girl out that he hasn't had a date in over three years. He has recently contacted a psychotherapist for help in overcoming his fear. Describe how a humanistic therapist and a psychoanalyst would treat Geraldo's problem. (Objectives 1 & 2)
Describe how a therapist might apply operant conditioning techniques to help Rosemary overcome a compulsive habit of eating too much junk food. Be clear about the exact procedures that would be used. (Objective 3)
One of your best friends feels that he fails at everything he does and that his life isn't worth living. When you suggest that he talk to a psychotherapist, your friend responds, “Talking won't help. The more I talk about myself, the more I think about my problems. The more I think about my problems, the more depressed I get.” What procedures would a cognitive therapist use to help your friend overcome his negative feelings? (Objective 4)

2. Geraldo, a high school senior, is so fearful of asking a girl out that he hasn't had a date in over three years. He has recently contacted a psychotherapist for help in overcoming his fear. Describe how a humanistic therapist and a psychoanalyst would treat Geraldo's problem. (Objectives 1 & 2)

3. Describe how a therapist might apply operant conditioning techniques to help Rosemary overcome a compulsive habit of eating too much junk food. Be clear about the exact procedures that would be used. (Objective 3)

4. Unit 13: Treatment of Psychological Disorders

5. Treatment
Psychoanalysis
Humanistic
Cognitive
Behavioral

6. Psychotherapy
Treatment

7. History of treatment Eclectic approach Psychotherapy Philippe Pinel
Dorothea Dix
Psychotherapy
treatment involving psychological techniques
consists of interactions between a trained therapist & someone seeking to overcome psychological difficulties or achieve personal growth.
Eclectic approach

8. The Psychological Therapies

9. Psychoanalysis
Psychotherapy
Treatment

10. Psychoanalysis Sigmund Freud
Freud believed the patient’s free associations, resistances, dreams, & transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight.
Childhood impulses &conflicts

11. Psychoanalysis Methods
Free association
Resistance
Blocking anxiety-laden
material
Interpretation
Dream analysis
Transference
in psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent).

12. Psychoanalysis Psychodynamic Therapy
therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight.
Similarities with psychoanalysis
Differences with psychoanalysis
Face-to-face/once a week for a few months

13. Psychoanalysis Humanistic Psychodynamic Psychotherapy patients
unconscious
past
hidden determinants
curing illness
Psychoanalysis
resistance
transference
interpret
Psychodynamic
Psychotherapy
Humanistic
promoting growth
“How does that make you feel?”
conscious
present & future
personal responsibility
insight
client-centered
clients
active listening
UPR

14. Humanistic Therapies Insight therapies focus more on:
increasing the client’s awareness of underlying motives and defenses
focus more on:
the present rather than the past
conscious rather than the unconscious
taking immediate responsibility
promoting growth instead of curing

15. Humanistic Therapies Client-centered therapy (person-centered)
Nondirective therapy
Genuineness, acceptance, and empathy
Active listening
Paraphrase
Invite clarification
Reflect feelings
Unconditional positive regard
I know how you feel….
What is an example of that?….
empathetic listening
echoing & restating
That sounds frustrating…
self-awareness
self-acceptance

16. Behavioral Psychoanalysis Humanistic Psychotherapy Psychodynamic
behavior mod
operant conditioning
Psychoanalysis
token economy
classical conditioning
Psychodynamic
counter-conditioning
Psychotherapy
exposure
aversion
Humanistic
desensitization
virtual reality
insight
client-centered
active listening
UPR

17. Behavior Therapies
uses learning principles to get rid of unwanted behaviors
Classical conditioning techniques
Operant conditioning techniques

18. Behavior Therapies Classical Conditioning Therapies
Counterconditioning
evoke new responses to stimuli that are
triggering unwanted behaviors
repeated exposure = less anxious
Exposure therapies
Systematic desensitization
progressive relaxation
anxiety hierarchy
Virtual reality exposure therapy
Aversive conditioning
can’t be simultaneously anxious & relaxed

19. Behavior Therapies Aversion Therapy
Sys. Des. =
substitute a
fearful/negative response with a relaxed/positive response to a HARMLESS stimulus
Aversion =
substitute a
positive response with a negative /aversive response to a HARMFUL stimulus (alcohol)

20. Behavior Therapies Aversion Therapy

21. Behavior Therapies Aversion Therapy
DOES IT WORK?

22. Behavior Therapies Operant Conditioning
Behavior modification
Token economy
Criticisms?

23. Cognitive-Behavioral (CBT) Humanistic
operant conditioning
Psychoanalysis
Buckbeak
1st 3 minutes
classical conditioning
Psychodynamic
Boggart’s Wardrobe 4min
Psychotherapy
Cognitive
Cognitive-Behavioral
(CBT)
Humanistic
insight
client-centered
active listening
UPR

24. Cognitive Therapies Cognitive therapy Beck’s therapy for depression
Catastrophizing beliefs
CBT
stress inoculation training
re-label obsessive thoughts
assertive

25. Assertiveness Test B A C A C B C B A C A B B C A Nonassertive
Aggressive
Assertive
B A C
A C B
C B A
C A B
B C A

26. Cognitive Therapies

27. Cognitive Therapies

28. Cognitive Therapies

29. Cognitive Therapies

30. Cognitive Therapies

31. Cognitive Therapies

32. Cognitive-Behavioral
Psychoanalysis
Group Therapy
Psychodynamic
Psychotherapy
BioMedical
Humanistic
Cognitive-Behavioral
(CBT)

33. Objective 5: Group & Family Therapy
What are the aims & benefits of group and family therapy?

34. Evaluating Psychotherapies

35. (#6)Is Psychotherapy Effective?
Regression toward the mean
Client’s perceptions
crisis
time & $
speak well of therapist
Mass. Study
Clinician’s perceptions
Feedback usually positive
Outcome research –
time heals
Meta-analysis
Those not in therapy often improve; those in therapy more likely to improve
Placebo treatments

36. (#7)The Relative Effectiveness of Different Therapies
Behavioral
Bed wetting, phobias, compulsions
Cognitive
Depression
Negative Symptoms of Schizophrenia / change entire personality will see less benefit from psychotherapy alone
More specific the problem the greater the hope

37. The Relative Effectiveness of Different Therapies
Evidence-based practice
Insurance

38. (#8)Evaluating Alternative Therapies
Eye movement desensitization & reprocessing (EMDR)
anxious thoughts vanished as eyes darted about
Unlock & reprocess previously frozen memories
What is actually therapeutic is the combination of exposure therapy - repeatedly associating w/ trauma memories a safe context & a robust placebo effect.
Light exposure therapy
Seasonal affective Disorder (SAD)
Morning bright light does dim symptoms as effectively (for some) as antidepressant drugs or CBT
Not a lot of evidence for or against
When comparing any treatment against nothing at all, it to would seem effective = placebo

39. (#9)Commonalities Among Psychotherapies
placebo effect
Hope for demoralized people
A new perspective on oneself & the world
An empathic, trusting, caring relationship
plausible explanation
communicate their concern, show respect, reassure
therapeutic alliance

40. Culture & Values in Psychotherapy (#10)
Similarities between cultures
Differences between cultures
minorities reluctance to seek therapy
religion
Albert Ellis & Allen Bergin
thought stopping
values differ & those values effect how a therapist views a healthy person.
rational-emotive therapy

41. The Biomedical Therapies

42. Introduction Biomedical therapy Drugs Electroconvulsive therapy
Magnetic impulses
Psychosurgery
Psychiatrist

43. Drug Therapies (#11) Psychopharmacology
Factors to consider with drug therapy
Normal recovery rate of untreated patients
Placebo effect
Double blind procedure

44. Drug Therapies

45. Drug Therapies

46. Drug Therapies

47. Drug Therapies

48. Drug Therapies Antipsychotic Drugs
Psychoses
Chlorpromazine (Thorazine)
Dopamine block
Tardive dyskinesia
Atypical antipsychotics (clozapine)
negative symptoms (& positive)
xxx
dampens responsiveness
side effects like Parkinson’s b/c too little dopamine
stimulate glutamate = atypical antipsychotic

49. Drug Therapies Antianxiety Drugs
Xanax, Ativan, D-cycloserine
acts upon a receptor that helps the extinction of learned fears
Physiological dependence?
rid of symptoms w/o getting rid of problem

50. Antidepressant drugs aerobic exercise CT
Use with mood and anxiety disorders
4 weeks
increase the availability of norepinephrine & serotnin
Neurogenesis – birth of new brain cells
Fluoxetine (Prozac), Paxil
Selective-serotonin-reuptake inhibitors
Side effects of antidepressants
aerobic exercise CT
top-down/bottom-up

51. Drug Therapies Antidepressant Drugs

52. Drug Therapies Antidepressant Drugs

53. Drug Therapies Antidepressant Drugs

54. Drug Therapies Mood-Stabilizing Medications
Lithium
bipolar

55. Brain Stimulation (#12) Electroconvulsive Therapy
Procedure
general anesthetic
muscle relaxant
30-60 seconds
no memory of treatment
3 sessions/wk 2-4 weeks
Severe depression
Problems/side effects
4 in 10 relapse
calm neural centers where overactivity causes depression

56. Brain Stimulation Electroconvulsive Therapy

57. Brain Stimulation Alternative Neurostimulation Therapies
Magnetic Stimulation
Repetitive transcranial magnetic stimulations (rTMS)
left frontal lobe
Deep-Brain Stimulation
excites neurons that inhibit negative emotion-feeding activity (frontal lobe & limbic system)
sTMS – awake, weeks, no side effects

58. Brain Stimulation Alternative Neurostimulation Therapies

59. Psychosurgery (#13)
surgery that removes or destroys brain tissue in an effort to change behavior
Lobotomy
History – 1930s
Procedure – cut nerves connecting frontal lobe w/ emotion controlling centers
coma; eye socket; wiggle to severe connection
Side effects
Use today

60. Therapeutic Life-Style Change (#14)
Integrated biopsychosocial system
Therapeutic life-style change
Aerobic exercise
Adequate sleep
Light exposure
Social connection
Anti-rumination
Nutritional supplements

61. Preventing Psychological Disorders

62. Preventing Psychological Disorders (#15)
Resilience
Preventing psychological disorders
water rescue
medicine - vaccinate

63. C. systematic desensitization. D. transference.
While focusing on several intrusive thoughts that had been bothering her recently, Jenny was instructed by her therapist to report any ideas or memories stimulated by these thoughts. Jenny’s therapist was making use of a technique known as:
A. active listening.
B. free association.
C. systematic desensitization.
D. transference.
Answer: B

64. Humanistic therapies differ from psychoanalytic therapies in all of the following ways, EXCEPT:
A. psychoanalytic therapists are more likely to encourage the client to take immediate responsibility for feelings.
B. humanistic therapists are more oriented to the present and future, rather than the past.
C. psychoanalytic therapists are more likely to emphasize unconscious processes.
D. humanistic therapists are more growth-oriented.
Answer: A

65. McKenzie’s therapist believes that active listening is an extremely important component of therapy. He is probably a:
A. psychoanalyst.
B. cognitive therapist.
C. behavior therapist.
D. client-centered therapist.
Answer: D

66. Client-centered therapists emphasize the importance of:
A. exploring clients’ childhood relationships with other family members.
B. interpreting the meaning of clients’ nonverbal behaviors.
C. enabling clients to feel unconditionally accepted.
D. helping clients identify a hierarchy of anxiety-arousing experiences.
Answer: C

67. A therapist helps Rebecca overcome her fear of water by getting her to swim in the family’s backyard pool three times a day for two consecutive weeks. The therapist’s approach to helping Rebecca best illustrates:
A. stress inoculation training.
B. aversive conditioning.
C. exposure therapy.
D. humanistic therapy.
Answer: C

68. A cognitive therapist would be most likely to say:
A. “That sounds quite frustrating. It isn’t easy to be in a situation like that.”
B. “Can you think of a more positive interpretation of what happened?”
C. “Just say whatever comes to mind, no matter how trivial or irrelevant it might seem.”
D. “Next time you start to feel anxious, you can use the relaxation techniques we’ve been working on.”
Answer: B

69. For which of the following disorders is psychotherapy most likely to be effective in the long run?
A. generalized anxiety disorder
B. major depressive disorder
C. chronic schizophrenia
D. phobias
Answer: D

70. Researchers have sought to answer the question, “Does psychotherapy work?” Generally speaking, the answer seems to be:
A. yes, people in therapy improve more than people in control groups.
B. yes, but people in therapy improve at the same rate as people who are receiving placebo treatments.
C. no, therapy does not provide any benefits; people who just let time pass improve at the same rate as people in therapy.
D. no one really knows, because so far the only method used to answer this question has been interviewing former therapy clients.
Answer: A

71. The effectiveness of psychotherapy shows little if any connection to:
A. the level of training and experience of the therapist.
B. the length of time a client has experienced symptoms of disorder prior to therapy.
C. the particular disorder experienced by a client.
D. the extent to which the process depends on changing clients’ personalities.
Answer: A

72. The placebo effect best illustrates the importance of _______ in therapeutic success.
A. active listening
B. psychopharmacology
C. behavior modification
D. cognitive processes
Answer: D

73. If a therapist tells a client, “Rank order the things that frighten you from least to most,” the therapist is most likely practicing:
A. Freudian therapy.
B. systematic desensitization.
C. Gestalt therapy.
D. token economy.
Answer: B

74. Jon’s therapist laces his alcoholic drink with a drug that makes Jon sick. After getting sick a few times, just the sight of the drink makes Jon nauseous. In this example, the conditioned stimulus is the:
A. drug.
B. alcohol.
C. nauseous response to the drug.
D. nauseous response to the sight of the drink.
Answer: B

75. Your therapist asks you to try to remember your dreams
Your therapist asks you to try to remember your dreams. He also encourages you to review incidents in early childhood. Your therapist is most likely practicing:
A. Freudian therapy.
B. cognitive therapy.
C. behavior therapy.
D. humanistic therapy.
Answer: A

76. In your therapy session you often review your current behaviors as compared to what you think you should be doing. Your therapist is kind and listens to your ideas, even if you think they are silly. Your therapist is most likely practicing:
A. Freudian therapy.
B. Jungian therapy.
C. cognitive therapy.
D. humanistic therapy.
Answer: D

77. Samuel receives some very bad news, and feels quite low
Samuel receives some very bad news, and feels quite low. As time passes, you would expect:
A. his emotions to return to their usual state.
B. his emotions to stay low until something unusually good happens to him.
C. him to become much happier than usual, since people typically bounce back and forth between emotional extremes.
D. him to stay emotionally low unless he goes in for psychotherapy.
Answer: A

78. QUIZ Thursday 4/4

79. Definition Slides

80. Eclectic Approach
= an approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy.

81. Psychotherapy
= treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth.

82. Psychoanalysis
= Sigmund Freud’s therapeutic technique. Freud believed the patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight.

83. Resistance
= in psychoanalysis, the blocking from consciousness of anxiety-laden material.

84. Interpretation
= in psychoanalysis, the analyst’s noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight.

85. Transference
= in psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent).

86. Psychodynamic Therapy
= therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight.

87. Insight Therapies
= a variety of therapies that aim to improve psychological functioning by increasing the client’s awareness of underlying motives and defenses.

88. Client-centered Therapy
= a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate client’s growth. (Also called person-centered therapy.)

89. Active Listening
= empathic listening in which the listener echoes, restates, and clarifies. A feature of Roger’s client-centered therapy.

90. Unconditional Positive Regard
= a caring, accepting, nonjudgmental attitude, which Carl Rogers believed would help clients to develop self-awareness and self-acceptance.

91. Behavior Therapy
= therapy that applies learning principles to the elimination of unwanted behaviors.

92. Counterconditioning
= a behavior therapy procedure that used classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; includes exposure therapies and aversive conditioning.

93. Exposure Therapies
= behavioral techniques, such as systematic desensitization, that treat anxieties by exposing people (in imagination or actuality) to the things they fear and avoid.

94. Systematic Desensitization
= a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias.

95. Virtual Reality Exposure Therapy
= an anxiety treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders, or public speaking.

96. Aversive Conditioning
= a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol).

97. Token Economy
= an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats.

98. Cognitive Therapy
= therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions.

99. Cognitive-behavioral Therapy
= a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior).

100. Family Therapy
= therapy that treats the family as a system. Views an individual’s unwanted behaviors as influenced by, or directed at, other family members.

101. Regression Toward the Mean
= the tendency for extreme or unusual scores to fall back (regress) toward their average.

102. Meta-analysis
= a procedure for statistically combining the results of many different research studies.

103. Evidence-based Practice
= clinical decision-making that integrates the best available research with clinical expertise and patient characteristics and preferences.

104. Biomedical Therapy
= prescribed medications or medical procedures that act directly on the patient’s nervous system.

105. Psychopharmacology
= the study of the effects of drugs on mind and behavior.

106. Antipsychotic Drugs
= drugs used to treat schizophrenia and other forms of severe thought disorder.

107. Tardive Dyskinesia
= involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors.

108. Antianxiety Drugs
= drugs used to control anxiety and agitation.

109. Antidepressant Drugs
= drugs used to treat depression; also increasingly prescribed for anxiety. Different types work by altering the availability of various neurotransmitters.

110. Electroconvulsive Therapy (ECT)
= a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient.

111. Repetitive Transcranial Magnetic Stimulation (rTMS)
= the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity.

112. Psychosurgery
= surgery that removes or destroys brain tissue in an effort to change behavior.

113. Lobotomy
= a now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain.

114. Resilience
= the personal strength that helps most people cope with stress and recover from adversity and even trauma.