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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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Chapter 1 - Introduction

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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:
      • 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.

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

Emphasis on most widely practiced schools of psychotherapy

Concern with theory

To be used as a launching pad to further exploration


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

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


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


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

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

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)

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

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


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

Specific behavioral goals

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


Stimulus Control

Contingency management

Skill acquisition


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


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