1. ©2002 Prentice Hall Approaches to Treatment and Therapy

2. ©2002 Prentice Hall Approaches to Treatment and Therapy  Biological Treatments  Kinds of Psychotherapy  Evaluating Psychotherapy

3. ©2002 Prentice Hall Biological Treatments The Question of Drugs Surgery and Electroshock

4. ©2002 Prentice Hall The Question of Drugs

5. ©2002 Prentice Hall Cautions About Drug Treatment  Placebo Effect  High Relapse and Dropout Rates  Dosage Problems  Long-Term Risks

6. ©2002 Prentice Hall 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. ©2002 Prentice Hall Kinds of Psychotherapy Psychodynamic Therapy Behavioral and Cognitive Therapy Humanist and Existential Therapy Family Therapy Psychotherapy in Practice

8. ©2002 Prentice Hall 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. ©2002 Prentice Hall Behavioral and Cognitive Therapy  Systematic Desensitization  Aversive Conditioning  Exposure Treatments  Behavioral Records and Contracts  Skills Training

10. ©2002 Prentice Hall Cognitive Techniques  Examine the evidence for beliefs.  Consider other explanations for the behavior of others.  Identify assumptions and biases.

11. ©2002 Prentice Hall 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. ©2002 Prentice Hall One Family’s Genogram

13. ©2002 Prentice Hall Primary Goals of Therapies  Psychodynamic: Insight into unconscious motives and feelings.  Cognitive-Behavioral: Modification of behavior and irrational beliefs.  Humanist: Insight; self-acceptance and self- fulfillment.  Family: Modification of individual habits and family patterns.

14. ©2002 Prentice Hall 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.  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.

15. ©2002 Prentice Hall Evaluating Psychotherapy The Scientist-Practitioner Gap When Therapy Helps Which Therapy for Which Problem? When Therapy Harms

16. ©2002 Prentice Hall 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.

17. ©2002 Prentice Hall 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

18. ©2002 Prentice Hall 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?

19. ©2002 Prentice Hall 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.

20. ©2002 Prentice Hall 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.  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.

21. ©2002 Prentice Hall 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

22. ©2002 Prentice Hall Successful Therapy  Psychotherapy outcome depends not only on method of therapy.  Qualities of client and therapist, and their alliance, also determine success.

23. ©2002 Prentice Hall 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.  Therapist-induced disorders resulting from inadvertent suggestions or influence.