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Chapter 1 - Introduction. Identify a thorough definition of psychotherapy Distinguish different views of how to live life espoused by different schools of psychotherapy Recognize the structure of the text. Orlinsky and Howard’s (1987) definition: Psychotherapy is:

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slide2

Identify a thorough definition of psychotherapy

Distinguish different views of how to live life espoused by different schools of psychotherapy

Recognize the structure of the text

slide3

Orlinsky and Howard’s (1987) definition:

    • Psychotherapy is:
      • A relation among persons, engaged in by
      • one or more individuals defined as needing special assistance to
      • improve their functioning as persons, together with
      • one or more individuals defined as able to render such help.
slide4

Optimistic / Comic:

    • View hard work and personal improvements as leading to good outcomes if the client participates as prescribed
      • E.g., Cognitive-Behavioral Therapy, Experiential therapy
  • Tragic:
    • Coming to terms with the limitations imposed by the troubled world
      • E.g., Psychoanalysis, Existential therapy
slide5

Emphasis on most widely practiced schools of psychotherapy

Concern with theory

To be used as a launching pad to further exploration

slide6

This book is NOT:

    • Focused on specific personal factors that make a good therapist
    • A training manual
    • A how-to guide to the specifics of each treatment
    • Focused on differences in treatments between adults and children/adolescents
slide8

Classical Conditioning: learning that occurs when two stimuli are presented in close temporal proximity and with some degree of contingency or correlation between them

Instrumental Conditioning: learning that occurs when a response is consistently followed by either a positive or negative consequence

slide9

Generalization: when one stimulus comes to elicit an emotional response, other stimuli that resemble the original stimulus will also elicit a similar emotional response

Extinction: a weakening of the strength of the learned response that occurs when the unconditioned stimulus or reinforcer is no longer contingent on the conditioned stimulus, instrumental response, or discriminative stimulus

slide10

Pavlov – classical conditioning

    • Unconditioned stimulus
    • Unconditioned response
    • Conditioned stimulus
    • Conditioned response
    • Extinction: of particular importance for behavior therapy
  • Watson – classical conditioning
    • Behavior can be understood without reference to mental constructs
    • Watson and Rayner: Little Albert
    • Mary Cover Jones: Peter, tx of phobia by in vivo exposure
slide11

Skinner – neobehaviorism

    • Operationalism: concepts should be defined via objective measurement
    • Psychology should focus on describing the relationships between responses and their outcomes
    • Functional Analysis – identification of reinforcers
    • Operant conditioning
      • Reinforcement
        • Positive
        • Negative
      • Punishment
        • Positive
        • negative
    • Problem behaviors can be modified by changing environmental contingencies
slide12

Mowrer – two-factor theory

    • Studied avoidance behavior, which can help in understanding many psychological disorders
    • Tried to explain avoidance behavior without relying on expectancies
    • Combined classical and operant conditioning
      • Relationship between a stimulus and a fear response is learned (classical)
      • Relationship is learned between avoidance and reduction in fear (operant)
slide13

Systematic Desensitization: Wolpe

    • Reciprocal inhibition: opposite emotional states cannot be experienced simultaneously
    • Fear hierarchy
  • Prolonged Exposure Therapy: Foa
    • Fear network – many stimuli associated with trauma, exposure to as many as possible - habituation
    • Flooding
    • Response prevention – prevent maladaptive response, e.g. avoidance
  • Behavioral Rehearsal
    • Patient and therapist act out various situations that are problematic
    • Social/observational learning – modeling: Bandura
slide14

prepare the client: give rationale, test alternative behaviors, discuss appropriate expectations

Identify targets for change: hierarchy of situations to rehearse

Role-play or behavioral rehearsal: should be as realistic as possible

Carry out the behaviors in the real world

slide15

Behavioral Activation

    • Targeted toward depression, based on the notion that people with depression lack positive reinforcers for healthy behaviors in their lives, while depression may be reinforced
    • Positive reinforcement of healthy or pleasurable activities
  • Interoceptive Exposure in Panic Control Treatment
    • Exposure to bodily sensations associated with panic, e.g. hyperventilation, chair-spinning
slide16

Specific behavioral goals

  • Assessment
    • Functional assessment
    • Single case design
  • Process of Psychotherapy
    • Active and directive therapist
    • Short-term
    • Therapeutic alliance
slide17

Extinction

Stimulus Control

Contingency management

Skill acquisition

Shaping

Homework- behavioral assignments are necessary and sufficient for improvement in therapy

slide18

Specific Strategies

    • Role of worry as avoidance strategies
    • Exposure to negatively valenced imagery
  • Empirical support for treatment of generalized anxiety disorder (GAD)
    • High end state functioning achieved in approximately 50% of cases
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