Chapter 13

1. Chapter 13 Methods of Therapy

2. What is Therapy? • Psychotherapy: • a systematic interaction between a therapist and a client that: • Applies psychological principles to affect the client’s thoughts, feelings, or behavior in order to; • Help the client overcome psychological disorders, • Adjust to problems in living, • Or develop as an individual.

3. Psychodynamic Therapies: Modern Approaches • The modern approach is: • Briefer and less intense. • Focus on revealing unconscious material. • Client and therapist usually sit face to face rather than having the client lie on a couch. • The therapist is usually directive. • Usually more focus on the ego and less emphasis on the Id.

4. Humanistic-Existential Therapies • The focus is on quality of the client’s subjective, conscious experience. • Focus on the here and now. • Client-Centered Therapy: • Help people get in touch with their genuine feelings and pursue their own interests, regardless of other people’s wishes. • Therapy is non-directive and focuses on helping the person feel whole. To achieve this the therapist has the following qualities: • Unconditional positive regard. • Empathetic understanding. • Genuiness.

5. Behavior Therapy • Applies the principles of learning to directly promote desired behavioral change. • conditioning and observational learning. • Fear-Reduction Methods. • Systematic desensitization • The client learns to handle increasingly disturbing stimuli while anxiety is being counterconditioned.

6. Behavior Therapy • Aversive Conditioning. • Controversial procedure in which painful or aversive stimuli are paired with unwanted impulses. • Operant Conditioning Procedures. • We tend to repeat behavior that is reinforced. • Behavior that is not reinforced tends to become extinguished.

7. Examples of Operant Conditioning • The Token Economy. • Patients must use tokens to purchase things they like. • Tokens are reinforcements for productive activities. • Successive Approximations. • Successive approximations is often used to help clients build good habits. • Social Skills Training. • Employ self monitoring, coaching, modeling, role playing, behavioral rehearsal and feedback.

8. Cognitive Therapies • Cognitive therapy focuses on changing the beliefs, attitudes and automatic types of thinking that create and compound their client’s problems.

9. Cognitive Therapies • Cognitive Triad: • Expect the worst of themselves. • Expect the worst of the world at large. • Expect the worst of the future. • Therapists need to challenge beliefs that are not supported by evidence. • Cognitive errors contribute to client’s miseries by: • Clients selectively perceive. • Clients overgeneralize. • Clients magnify. • Clients engage in absolutist thinking.

10. Cognitive Therapies • Rational Emotive Behavior Therapy • focuses on beliefs about events as well as the events. • Many harbor irrational beliefs.

11. Group Therapies • Advantages to group therapies: • It is economical. • Provides more information and life experience for clients to draw on. • Appropriate behavior receives group support. • Affiliating with people with similar problems is reassuring. • Many clients practice social skills in a relatively non-threatening atmosphere.

12. Analysis of the Effectiveness of Therapy • Cognitive therapy or CBT has shown the most widespread applicability and success. • Psychodynamic and client-centered are most effective with well educated, verbal, strongly motivated clients. • Gestalt therapy wasn’t as effective. • Shadish found that: • Psychotherapy is generally effective. • The more therapy the better. • It is not enough to ask which type of therapy is most effective. • We must ask which type is most effective for a particular problem and a particular patient.

13. Biological Therapies • Biological therapies: • Drug Therapy: work by acting on neurotransmitters • Antianxiety drugs. • prescribed for patients with anxiety disorders. • Side effects. • Sedation is the most common side effect. • When use is stopped, clients may experience anxiety rebound. • Can induce physical dependence.

14. Biological Therapies: Drug therapies • Antipsychotic Drugs • reduce agitation, delusions, and hallucinations in patients with schizophrenia. • acts by blocking dopamine receptors in the brain.

15. Biological Therapies: Drug therapies • Antidepressants. • used to help clients with depression, eating disorders, panic attacks, obsessive-compulsive disorders and social phobia. • Antidepressants work by increasing levels of neurotransmitters. Mainly serotonin and noradrenaline. • Usually takes weeks to build up to therapeutic levels.

16. Biological Therapies: Drug Therapy • Lithium. • Lithium is used to flatten out cycles of manic behavior and depression. • Affects the functioning of neurotransmitters, including glutamate.

17. Biological Therapies • Electroconvulsive Therapy. • Used mainly for people with major depression who do not respond to antidepressants. • Side effects of ECT include: • Memory problems. • Effects may be temporary.

18. Psychosurgery • Prefrontal lobotomy: a picklike instrument severs the nerve pathways that link the prefrontal lobes of the brain to the thalamus. • This method has been largely discontinued in the U.S.

19. Does Biological Therapy Work? • Drug therapy has helped many people with severe psychological disorders. • The combination of cognitive therapy and antidepressants is superior to either treatment alone with chronically depressed people. • No chemical can show a person how to change an idea or solve an interpersonal problem.