Psychology Chapter 17: Therapy and Change

1. Psychology Chapter 17:Therapy and Change

2. What is Psychotherapy? A wide range of treatments to help troubled individuals overcome their problems • Involves 3 things • Verbal interaction between therapist and client • Development of a supportive and trusting relationship • Analysis by the therapist of the client’s problems • 2. Nature of Psychotherapy • “Healing of the Soul” • Usually thought of a moral or religious problem • Inhabited by demons • Treatments included exorcisms • Religious ceremonies or physical punishment • Mental illness not a good term because it leaves the person feeling passive and helpless

3. What is Psychotherapy cont. • b. Functions of Psychotherapy • Help people realize that they are responsible for their own problems • Only they can solve those problems • Major task of psychotherapist to help patient: • Examine their way of living • Understand how that way causes problems • Start living in a new beneficial way • c. Main Kinds of Therapy • Each based on a theory of how human personality works • Each is carried out in a different style • Many stick to one single approach, while others are eclectic • d. Goals of Therapy • Primary Goal - Strengthen a person’s control over their life • One of the biggest factors in treatment is a patient’s hope and belief that they will get better – placebo effect

4. What is Psychotherapy cont. • 3. Who are Therapists • Chart 17.3 • What Makes a Good Therapist • More skillful than friends in encouraging a person to examine uncomfortable feelings and problems • 3 Characteristics found in effective therapists • Be psychologically healthy • Have empathy – capacity for warmth and understanding • Experienced in dealing with people and understanding their complexities • 4. Group Therapies • Patient is in the company of others not alone • Chance to see others struggling with similar problems • Sees others recovering and gets hope from that • Family Therapy • Focus is on the interactions among family members • Untangles the twisted webs of relationships in the families • Psychologist is an objective viewpoint and can suggest ways of improving communications

5. What is Psychotherapy cont. • v. Self-Help Groups • Voluntary groups of people that share similar problems • Discuss difficulties and provide one another with support and possible solutions • Alcoholism, overeating, drug addiction, child abuse, cancer survivors, etc. • Most famous is AA • 5. Does Psychotherapy Work? • Studies clash yes and no • Therapy can improve the quality of life for patients and is better than no treatment at all Section 1 Review

6. Psychoanalysis and Humanistic Therapy • 1. What is Psychoanalysis • Based on the theories of Sigmund Freud • Psychoanalysis – therapy aimed at making patients aware of their unconscious motives so that they can gain control over their behavior • Psychological disturbances are caused by hidden conflicts • Make patient aware of unconscious impulses, desires and fears that cause anxiety • Insight – the apparent sudden solution to a problem, first step to gaining control of their behavior and problems • vi. Free Association • Psychoanalysis is a slow procedure • Years of 50 minute sessions, several times a week • Average of 600 sessions and years of meeting • Begins with the analyst having the patient relax and talk about everything that comes to mind – Free Association • Everything should be expressed, nothing inconsequential, nothing to unimportant or embarrassing • Describe dreams, private thoughts, long-forgotten experiences • Analyst says nothing, most of the work is done by the patient • Any behavior that impedes the course of therapy (painful feelings or not examining long-standing behavior patterns) is called resistance

7. Psychoanalysis and Humanistic Therapy cont. • vii. Dream Analysis • Freud also believed that dreams expressed unconscious thoughts and feelings • Dream Analysis – analyst interprets the dreams of the patient to find the unconscious thoughts and feelings • Freud believed that dreams contained two types of content • Manifest content • What you remember about your dream • Latent Content • Refers to the hidden meanings represented symbolically in the dream that the analyst interprets from the manifest content • viii. Transference – the process experienced by the patient of feeling towards the analyst the way they feel toward some other important figure in their life • Can be good or bad • Analyst can’t let this happen

8. Psychoanalysis and Humanistic Therapy cont. • 2. Humanistic Therapy • Focuses on the value, dignity and worth of each person. It holds that healthy living is the result of realizing one’s full potential • Can be reached through personal responsibility, freedom of choice and authentic relationships • Client-Centered Therapy • Based on theories of Carl Rogers • Uses “client” to imply an equal relationship (returns: positive regard, empathy and genuineness) • Assumes that people are good and that they are capable of handling their own lives • One goal: to help a person recognize their own strength and confidence, this way they will learn to be true to their standards and ideas about how to live effectively • Techniques of Client-Centered Therapy • Topics are entirely up to the patient – nondirective therapy • Therapist listens and encourages but avoids giving opinions • Therapist echoes back what they hear – active listening • Client and therapist work together to see how the client feels about themselves, their life and others. • Session held in an Unconditional positive regard – therapists consistent expression of acceptance of the client no matter what the client says or does • No opinions are made or spoken • All speech and actions are accepted • No emotion showed Section 2 Review

9. Cognitive and Behavior Therapies Behavior Modification – a systematic method of changing the way a person acts and feels • 1. Cognitive Therapy • Focuses on changing the way people think • To improve our lives, we must work to change our pattern of thinking • Disconfirmation – clients may be confronted with evidence that directly contradicts their existing beliefs • Reconceptualization – clients work toward an alternative belief system to explain their experiences or current observations • Insight – clients work toward understanding and deriving new or revised beliefs • Rational-Emotive Therapy – form of help aimed at changing unrealistic assumptions about oneself and other people • Goal is to correct false and self-defeating beliefs • Use of role-playing, modeling, humor, persuasion or a homework type approach • See Figure 17.8 • g. Beck’s Cognitive Therapy – Focuses on illogical thought processes • Maladaptive Thought Patterns – Overgeneralization, Polarized Thinking and Selective Attention • See Figure 17.9

10. Cognitive and Behavior Therapies cont. • 2. Behavior Therapies – changing undesirable behavior through conditioning techniques • Counterconditioning – pairs the stimulus that triggers an unwanted behavior (or fear) with a new, more desirable behavior • Systematic Desensitization – technique used to overcome irrational fears and anxieties that patient has learned • Encourages people to imagine a feared situation while relaxing thus extinguishing the fear response. • Flooding – therapist exposes the client to a feared object or situation • Modeling – therapist models/demonstrates behavior • Aversive Conditioning – links an unpleasant state with an unwanted behavior in an attempt to eliminate that behavior • Operant Conditioning • Based on the assumption that behavior that is reinforced tends to be repeated, whereas behavior that isn’t reinforced tends to be extinguished • Contingency Management – therapist and patient decide what old, undesirable behavior needs to be eliminated and which new, desirable behavior needs to appear. • Old behavior is unrewarded and desired behavior is positively reinforced • If you do X, I will give you Y • Token Economies – desirable behavior is reinforced with valueless objects or points, which can be accumulated and exchanged for various rewards

11. Cognitive and Behavior Therapies cont. 3. Cognitive-Behavior Therapy – based upon a combination of substituting healthy thoughts for negative thoughts and beliefs and changing disruptive behaviors in favor of healthy behaviors Section 3 Review Watch “One Flew Over the Cuckoo’s Nest” and complete Worksheet

12. Biological Approaches to Treatment • 1. Biological Therapy • Assumes that there is an underlying physiological reason for disturbed behavior, faulty thinking and inappropriate emotions • Medication, shock therapy and surgery are examples • Psychologists may decide that a biological approach is necessary but a physician or psychiatrist administer them • Drug Therapy – biological therapy that uses medications • Usually only treats the symptoms but doesn’t cure the cause • ii. Anti-Psychotic Drugs – medication to reduce agitation, delusions and hallucinations by blocking the activity of dopamine in the brain, tranquilizers • Long time use for dangerous and overactive schizophrenics was straightjacket, wet-sheet wrapping or isolation • Calmed by ECT or lobotomy • Now (with meds) become less withdrawn, confused and agitated, fewer auditory hallucinations, less irritable and hostile • Theory • When a person’s dopamine neurotransmitter becomes overactive, the person develops schizophrenia • Side effects • Muscular rigidity, impaired coordination and tremors • Best Known • `Thorazine, Haldol, Closaril

13. Biological Approaches to Treatment cont. • iii. Anti-Depressant Drugs – medication used to treat major depression by increasing the amount of one or both of the neurotransmitters noradrenaline and serotonin • Side effects • Dizziness, fatigue, forgetfulness, weight gain • Best Known • Nadril, Prozac • iv. Lithium Carbonate – Chemical used to counteract mood swings of bipolar disorder (natural compound) • v. Anti-Anxiety Drugs – Medication that relieves anxiety and panic disorders by depressing the activity of the central nervous system • Best used for acute not chronic anxiety • Side effects • Short term – drowsiness • Long term – dependence and with alcohol death results • Best Known • Xanax, Librium, Valium

14. Biological Approaches to Treatment cont. • 2. Electroconvulsive Therapy – electrical shocks sent through the brain to try to reduce symptoms of mental disturbance • No one understands how it works, it induces a convulsion like an epileptic seizure that may last up to a minute • Used lots in the past • Very little pain today due to sedatives and muscle relaxants • Drastic treatment, used with great caution today • Current was run through both hemispheres of the brain, now only through the right hemisphere • Side effects • Extensive amnesia • Language and verbal abilities • Highly effective for depression 3. Insulin Shock Therapy– a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks.

15. Biological Approaches to Treatment cont. • 4. Psychosurgery – medical operation that destroys part of the brain to make the patient calmer and freer of symptoms • Prefrontal Lobotomy – section of the frontal lobe of the brain is destroyed • Contains the nerve connections that control emotions Watch PBS Video on Dr. Walter Freeman “Freeman developed the ice pick lobotomy in 1947. In the procedure, he put the sharp point of the pick in the tear duct. Then, with a light tap of a hammer, plunged it two inches inside, pulled it 30 degrees backward, and then moved it up and down in a 20 degree arc, in order to cut the nerves at the base of the frontal lobes. The procedure took only a few minutes. Within several years, the procedure had been preformed on over 20,000 individuals.” Complete Section 4 Review Complete Chapter 17 Study Guide Chapter 17 Test