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Chapter 13: Therapy

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anycia davila

on 17 October 2012

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Transcript of Chapter 13: Therapy

Chapter 13: Therapy Treating Psychological Disorders Therapies can be classified into two main categories: Psychotherapy:
treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth. Biomedical Therapy:
Prescribed medications or procedures that act directly on the persons physiology Some therapists tend to combine techniques and describe themselves as taking an eclectic approach:
an approach to psychotherapy that, depending on the clients problems, uses techniques from various forms of therapy The Psychological Therapies Each Psychotherapy is built on one or more psychology's major theories:
Cognitive Psychodynamic Therapy Psychodynamic therapists:
don't talk much about the id, ego, and superego. instead they try to help people understand their current symptoms by focusing on themes across important relationships. A Freud influenced perspective that sees behavior, thinking and emotions in terms of unconscious motives that does not believe in chemical imbalance in the brain. http://www.docstoc.com/docs/2203568/Psychodynamic-Therapy Treating Psychological Disorders Humanistic Therapies Attempt to reduce the conflicts that interfere with natural development and growth. Humanistic therapists differ from psychoanaltic therapists in many other ways:
humanistic therapists aim to boost people's self-fulfillment by helping them grow in self-awareness and self acceptance.
promoting this growth, not curing illness, is the focus of therapy. Thus, those in therapy are called "clients" or just "persons" rather than "patients"
The path to growth is taking immediate responsibility for ones feelings and actions, rather than uncovering possible hidden causes.
Conscious thoughts are more important than the unconscious.
The present and future are more important than the past. The goal is to explore feelings as they occur. Carl Rogers (1902-1987) Rogers developed the Client Centered Therapy:
a humanistic therapy, develop by Carl Rogers, in which, the therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to promote client's growth.
Hearing was "active listening"
Believed most people already possesses the resources for growth How can we develop our own communication strengths by listening more actively in our friendships?
check your understanding by repeating your friends statements in your own words
Invite Clarification
"what might be an example of that?" may encourage your friend to say more
Reflect feelings
"it sounds frustrating" might mirror what you are sensing from your friends body language and intensity. Behavior Therapies
Therapy that applies learning principles to the elimination of unwanted behaviors.
ex: you can become aware of why you are highly anxious during exams and still be anxious.
Behavior Therapist's
use conditioning principles to modify problem behaviors, rather than seeking insight into the source of those behaviors as psychoanalysis and humanistic therapy would do.
They assume that problem behaviors are the problems.
See phobias or sexual disorders as learned behaviors. Counterconditioning
a behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; includes exposure therapies and aversive conditioning.
The goal of both is replacing unwanted responses with new responses Exposure Therapies
Behavioral techniques, such as systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imagination or actual situations) to the things they fear and avoid.
Attempt to change peoples reactions by repeatedly exposing them to stimuli that trigger unwanted reactions.
ex: someone moving into a new apartment with loud traffic; with repeated exposure, the person adapts to the noise Systematic Desensitization
type of exposure therapy that associates a pleasant relaxed state with gradually increasing, anxiety-triggering stimuli
Therapists train their patients in progressive relaxation
Virtual Reality Exposure Therapy
an anxiety treatment that progressively exposes people to electronic simulations of their greatest fears, such as airplane flying, spiders, or public speaking.
ex: fear of flying; potentially peering out a virtual window of a simulated plane, feeling the vibrations and hearing the roar of the engine. Exposure Therapies Cont. Aversive Conditioning
type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol)
Helps you learn what you should NOT do.
ex: treating nail biting; painting the fingernails with a yucky tasting nail polish
Treating alcohol dependence, therapist offers the client with appealing drinks laced with a drug that produces severe nausea.
In one classic study 685 patients with alcohol dependence completed aversion therapy program. Operant Conditioning
a type of learning in which behavior is strengthened if followed by a reinforcer or diminished if followed by a punisher
Basic consequence in operant conditioning is that our behaviors are influenced by their consequences
Behavior therapists practice behavior modification
where they reinforce behaviors considered desirable and punish behaviors they consider undesirable.
they also reward behaviors that come closer and closer to the desired behaviors
ex: socially withdrawn children with autism have learned to interact;
therapists may create a token economy:
an operant conditioning procedure in which people earn a token for exhibiting a desired behavior and can later exchange the tokens for privileges or treats
ex: receiving a coin or token that can be later exchanged for TV time, candy, day trips, etc. Cognitive Therapies
Therapy that teaches people new, more, adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions; our thinking colors our feelings
aim to train people to think in healthier ways, such as Beck's therapy for depression Cognitive Behavioral Therapy
a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)
takes a double-barreled approach to depression and other disorders.
aims not only to alter the way people think, but also to alter they they act
seeks to make people aware of their irrational negative thinking and to replace it with new ways of thinking
trains people to practice the more positive approach in everyday settings.
ex: people with obsessive compulsive behaviors learned to relabel their compulsive thoughts. They would explain to themselves that the "act" was a result of their brain's abnormal activity. They replaced the "act" with an alternative behavior and helped "unstick" the brain by shifting attention and engaging other brain areas. Lost Job Lost Job Internal Beliefs:
I'm worthless. It's hopeless. Internal Beliefs:
My boss is a jerk. I deserve something better Depression No depression The person's emotional reactions are produced not directly by the event but by the persons thoughts in response to the event. Interprets a suggestion as criticism, disagreement as dislike, praise as flattery, friendliness as pity Group and Family Therapies
Group Therapies
can be a relief to find that others, despite their calm appearance, share your problems and your troubling feelings.
can also be helpful to receive feedback Family Therapy
therapy that treats the family as a system. Views an individuals unwanted behaviors as influenced by or directed at other family members
therapists often attempt to guide family members toward positive relationships and improved communication Evaluating Psychotherapies
Clients Perceptions
Client testimonials don't persuade everyone
clients generally speak kindly of their therapists
people often enter therapy in crisis
Clinicians Perceptions
therapist's tend to track only their "success" stories
Outcome Research
has found that people who remain untreated often improve, but those who receive psychotherapy are more likely to improve Which Psychotherapies Work Best
No one psychotherapy is superior to all others
Behavior therapies work best with specific behavior problems, such as phobias, bed-wetting, compulsions, martial problems, and sexual disorders.
Cognitive therapy is effective in reducing depression and suicide risk How Do Psychotherapies Help People?
All psychotherapies offer three basic benefits:
Hope for Demoralized People
A new perspective on one's self and the world
An empathetic, trusting, caring relationship Culture and Values in Psychotherapy
Cultural and value differences can create stress about therapy's goals and prevent the formation of a strong emotional bond between the client and therapist. People can avoid these conflicts by asking potential therapists about their treatment approach and values. Changes the brains functioning by altering its chemistry with drugs, or affecting its circuitry with electrical stimulation, magnetic impulses, or psychosurgery. But with a few exceptions, only psychiatrists offer biomedical therapies Drug Therapies
Most widely used biomedical treatment
Several types of drugs have proven useful in treating psychological disorders:
Antipsychotic Drugs
used in treating schizophrenia and other disorders, alter the availability of some neurotransmitters. Side effects can include tardive dyskinesia or increased risk of obesity and diabetes. Short term side effects include sluggishness, tremors, and twitches.
Antianxiety Drugs
which depresses central nervous system activity, are used to treat anxiety disorders, often in combination with psychotherapy. These drugs can be physically and psychologically addictive.
Antidepressant Drugs
which increase the availability of serotonin or norepinephrine, are used for depression and anxiety disorders. Side effects may include decreased sexual desire, and their effectiveness is relatively low.
Mood-Stabilizing Drugs
such as lithium, are more prescribed for those with bi-polar disorder Brain Stimulation
Electrconvulsive Therapy
a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient
manipulates the brain by shocking it
although ECT is often an effective treatment for depression that does not respond to drug therapy, is no longer accurate because patients are now given a drug that prevents convulsions
Alternative Neurostimulation Therapies
Newer alternative treatments for depression include vagus nerve stimulation, an electrical device implanted in the chest, deep-brain stimulation, implant that sends electrical impulses to specific parts of the brain, and repetitive transcranial magnetic stimulation, a coiled wire held close to the skull sends a magnetic field through the skull to the brain. Psychosurgery
Surgery that removes or destroys brain tissue in an effort to change behavior.
Most drastic and least used biomedical intervention for changing thoughts and behaviors.
Used only as a last resort
Lobotomies are no longer performed
a Psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cuts the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain Therapeutic Life-Style Change
Our bodies and minds affect each other. Research suggests that aerobics exercise, adequate sleep and sunlight, social connections, anti-rumination strategies, and good nutrition may relieve symptoms of depression. Body Mind The biomedical therapies assume that the mind and body are a unit. Affect one, and you will affect the other. Psychodynamic Client-centered Behavior Cognitive Biomedical Presumed Problem Therapy Aim Therapy Technique Unconscious conflicts and urges Blocking off self -acceptance Dysfunctional behaviors Self-harmful thoughts Brain or neurotransmitter malfunctions Promote insight into repressed material Enable growth via unconditional positive regard, genuineness, and empathy. Preventing Psychological Disorders
Changing stressful social contexts and teaching people to cope better with stress may help them become more resilient, enabling recovery from adversity
Community psychologists work to prevent psychological disorders by turning destructive environments into more nurturing places that foster competence, health, and well-being.
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