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Therapy Chapter 14

Therapy Chapter 14. History of Insane Treatment. Maltreatment of the insane throughout the ages was the result of irrational views. Many patients were subjected to strange, debilitating, and downright dangerous treatments. The Granger Collection. The Granger Collection.

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Therapy Chapter 14

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    1. 1 Therapy Chapter 14

    2. 2

    3. 3 History of Insane Treatment

    4. 4 Therapies

    5. 5 Psychological Therapies We will look at four major forms of psychotherapies based on different theories of human nature:

    6. 6 Psychoanalysis The first formal psychotherapy to emerge was psychoanalysis, developed by Sigmund Freud. Preview Question 1: What are the aims and methods of psychoanalysis, and how have they been adapted in psychodynamic therapy?Preview Question 1: What are the aims and methods of psychoanalysis, and how have they been adapted in psychodynamic therapy?

    7. 7 Psychoanalysis: Aims Since psychological problems originate from childhood repressed impulses and conflicts, the aim of psychoanalysis is to bring repressed feelings into conscious awareness where the patient can deal with them.

    8. 8 Psychoanalysis: Methods Dissatisfied with hypnosis, Freud developed the method of free association to unravel the unconscious mind and its conflicts.

    9. 9 Psychoanalysis: Methods During free association, the patient edits his thoughts, resisting his or her feelings to express emotions. Such resistance becomes important in the analysis of conflict-driven anxiety.

    10. 10 Psychoanalysis: Criticisms Psychoanalysis is hard to refute because it cannot be proven or disproven. Psychoanalysis takes a long time and is very expensive.

    11. 11 Psychodynamic Therapy Influenced by Freud, in a face-to-face setting, psychodynamic therapists understand symptoms and themes across important relationships in a patient’s life.

    12. 12 Psychodynamic Therapies Interpersonal psychotherapy, a variation of psychodynamic therapy, is effective in treating depression. It focuses on symptom relief here and now, not an overall personality change.

    13. 13 Humanistic Therapies Humanistic therapists aim to boost self-fulfillment by helping people grow in self-awareness and self-acceptance. Preview Question 2: What are the basic themes of humanistic therapy, such as Rogers’ client-centered approach?Preview Question 2: What are the basic themes of humanistic therapy, such as Rogers’ client-centered approach?

    14. 14 Client-Centered Therapy Developed by Carl Rogers, client-centered therapy is a form of humanistic therapy.

    15. 15 Humanistic Therapy The therapist engages in active listening and echoes, restates, and clarifies the patient’s thinking, acknowledging expressed feelings.

    16. 16 Behavior Therapy Therapy that applies learning principles to the elimination of unwanted behaviors. Preview Question 3: What are the assumptions and techniques of the behavior therapies?Preview Question 3: What are the assumptions and techniques of the behavior therapies?

    17. 17 Classical Conditioning Techniques Counterconditioning is a procedure that conditions new responses to stimuli that trigger unwanted behaviors.

    18. 18 Exposure Therapy Expose patients to things they fear and avoid. Through repeated exposures, anxiety lessens because they habituate to the things feared.

    19. 19 Exposure Therapy Exposure therapy involves exposing people to fear-driving objects in real or virtual environments.

    20. 20 Systematic Desensitization A type of exposure therapy that associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli commonly used to treat phobias.

    21. 21 Aversive Conditioning A type of counterconditioning that associates an unpleasant state with an unwanted behavior. With this technique, temporary conditioned aversion to alcohol has been reported.

    22. 22 Operant Conditioning Operant conditioning procedures enable therapists to use behavior modification, in which desired behaviors are rewarded and undesired behaviors are either unrewarded or punished.

    23. 23 Token Economy In institutional settings, therapists may create a token economy in which patients exchange a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats.

    24. 24 Cognitive Therapy Teaches people adaptive ways of thinking and acting based on the assumption that thoughts intervene between events and our emotional reactions. Preview Question 4: What are the goals and techniques of the cognitive therapies?Preview Question 4: What are the goals and techniques of the cognitive therapies?

    25. 25 Beck’s Therapy for Depression Aaron Beck (1979) suggests that depressed patients believe that they can never be happy (thinking) and thus associate minor failings (e.g. failing a test [event]) in life as major causes for their depression.

    26. 26 Stress Inoculation Training

    27. 27 Cognitive-Behavior Therapy Cognitive therapists often combine the reversal of self-defeated thinking with efforts to modify behavior.

    28. 28 Group & Family Therapies Preview Question 5: What are the benefits of group therapy?Preview Question 5: What are the benefits of group therapy?

    29. 29 Family Therapy

    30. 30 Who do people turn to for help with psychological difficulties? Evaluating Therapies

    31. 31 Is Psychotherapy Effective? It is difficult to gauge the effectiveness of psychotherapy because there are different levels upon which its effectiveness can be measured. Preview Question 6: Does psychotherapy work? Who decides?Preview Question 6: Does psychotherapy work? Who decides?

    32. 32 Client’s Perceptions If you ask clients about their experiences of getting into therapy, they often overestimate its effectiveness. Critics however remain skeptical.

    33. 33 Clinician’s Perceptions Like clients, clinicians believe in therapy’s success. They believe the client is better off after therapy than if the client had not taken part in therapy.

    34. 34 Outcome Research How can we objectively measure the effectiveness of psychotherapy?

    35. 35 Outcome Research Research shows that treated patients were 80% better than untreated ones.

    36. 36 The Relative Effectiveness of Different Therapies Which psychotherapy would be most effective for treating a particular problem? Preview Question 7: Are some therapies more effective than others?Preview Question 7: Are some therapies more effective than others?

    37. 37 Evaluating Alternative Therapies Preview Question 8: How do alternative therapies fare under scientific scrutiny? Preview Question 8: How do alternative therapies fare under scientific scrutiny?

    38. 38 Eye Movement Desensitization and Reprocessing (EMDR) In EMDR therapy, the therapist attempts to unlock and reprocess previous frozen traumatic memories by waving a finger in front of the eyes of the client. EMDR has not held up under scientific testing.

    39. 39 Light Exposure Therapy Seasonal Affective Disorder (SAD), a form of depression, has been effectively treated by light exposure therapy. This form of therapy has been scientifically validated.

    40. 40 Commonalities Among Psychotherapies Three commonalities shared by all forms of psychotherapies are the following: Preview Question 9: What three elements are shared by all forms of psychotherapy?Preview Question 9: What three elements are shared by all forms of psychotherapy?

    41. 41 Culture and Values in Psychotherapy Psychotherapists may differ from each other and from clients in their personal beliefs, values, and cultural backgrounds. Preview Question 10: How do differences in culture and values influence the relationship between a therapist and a client? Preview Question 10: How do differences in culture and values influence the relationship between a therapist and a client?

    42. 42 Therapists & Their Training Clinical psychologists: They have PhDs mostly. They are experts in research, assessment, and therapy, all of which is verified through a supervised internship.

    43. 43 Therapists & Their Training Counselors: Pastoral counselors or abuse counselors work with problems arising from family relations, spouse and child abusers and their victims, and substance abusers.

    44. 44 The Biomedical Therapies These include physical, medicinal, and other forms of biological therapies.

    45. 45 Drug Therapies Psychopharmacology is the study of drug effects on mind and behavior. Preview Question 11: What are the most common forms of biomedical therapies? What criticisms have been leveled against drug therapies? Preview Question 11: What are the most common forms of biomedical therapies? What criticisms have been leveled against drug therapies?

    46. 46 Drug Therapies However, many patients are left homeless on the streets due to their ill-preparedness to cope independently outside in society.

    47. 47 Double-Blind Procedures

    48. 48 Antipsychotic Drugs Classical antipsychotics [chlorpromazine (Thorazine)]: Remove a number of positive symptoms associated with schizophrenia such as agitation, delusions, and hallucinations.

    49. 49 Atypical Antipsychotic Clozapine (Clozaril) blocks receptors for dopamine and serotonin to remove the negative symptoms of schizophrenia.

    50. 50 Antianxiety Drugs Antianxiety drugs (Xanax and Ativan) depress the central nervous system and reduce anxiety and tension by elevating the levels of the Gamma-aminobutyric acid (GABA) neurotransmitter.

    51. 51 Antidepressant Drugs Antidepressant drugs like Prozac, Zoloft, and Paxil are Selective Serotonin Reuptake Inhibitors (SSRIs) that improve the mood by elevating levels of serotonin by inhibiting reuptake.

    52. 52 Mood-Stabilizing Medications Lithium Carbonate, a common salt, has been used to stabilize manic episodes in bipolar disorders. It moderates the levels of norepinephrine and glutamate neurotransmitters.

    53. 53 Brain Stimulation Electroconvulsive Therapy (ECT) ECT is used for severely depressed patients who do not respond to drugs. The patient is anesthetized and given a muscle relaxant. Patients usually get a 100 volt shock that relieves them of depression. Preview Question 12: What is electroconvulsive therapy? When is it used? Preview Question 12: What is electroconvulsive therapy? When is it used?

    54. 54 Alternatives to ECT Repetitive Transcranial Magnetic Stimulation (rTMS) In rTMS, a pulsating magnetic coil is placed over prefrontal regions of the brain to treat depression with minimal side effects.

    55. 55 Psychosurgery Preview Question 13: Under what conditions might psychosurgery be considered for changing behavior or moods?Preview Question 13: Under what conditions might psychosurgery be considered for changing behavior or moods?

    56. 56 Psychosurgery Psychosurgery is used as a last resort in alleviating psychological disturbances. Psychosurgery is irreversible. Removal of brain tissue changes the mind.

    57. 57 Preventing Psychological Disorders Preview Question 14: What is the rationale for preventive mental health programs?Preview Question 14: What is the rationale for preventive mental health programs?

    58. 58 Psychological Disorders are Biopsychosocial in Nature

    59. Trivia! 59

    60. 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. free association. Answer: B. free association.

    61. 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. psychoanalytic therapists are more likely to encourage the client to take immediate responsibility for feelings.Answer: A. psychoanalytic therapists are more likely to encourage the client to take immediate responsibility for feelings.

    62. 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. client-centered therapist.Answer: D. client-centered therapist.

    63. 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. enabling clients to feel unconditionally accepted.Answer: C. enabling clients to feel unconditionally accepted.

    64. 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. exposure therapy.Answer: C. exposure therapy.

    65. 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. “Can you think of a more positive interpretation of what happened?” Answer: B. “Can you think of a more positive interpretation of what happened?”

    66. 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. phobiasAnswer: D. phobias

    67. 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: yes, people in therapy improve more than people in control groups.Answer: yes, people in therapy improve more than people in control groups.

    68. 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. the level of training and experience of the therapist.Answer: A. the level of training and experience of the therapist.

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

    70. 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. systematic desensitization.Answer: B. systematic desensitization.

    71. 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. alcohol.Answer: B. alcohol.

    72. 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. Freudian therapy.Answer: A. Freudian therapy.

    73. 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. humanistic therapy.Answer: D. humanistic therapy.

    74. 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. his emotions to return to their usual state. Answer: A. his emotions to return to their usual state.

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