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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

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


Chapter 1 introduction

  • 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.


Chapter 1 introduction

  • 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


Chapter 1 introduction

Emphasis on most widely practiced schools of psychotherapy

Concern with theory

To be used as a launching pad to further exploration


Chapter 1 introduction

  • 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



Chapter 1 introduction

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


Chapter 1 introduction

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


Chapter 1 introduction

  • Pavlov – classical conditioning emotional response, other stimuli that resemble the original stimulus will also elicit a similar emotional response

    • 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


Chapter 1 introduction

  • Skinner – neobehaviorism emotional response, other stimuli that resemble the original stimulus will also elicit a similar emotional response

    • 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


Chapter 1 introduction

  • Mowrer – two-factor theory emotional response, other stimuli that resemble the original stimulus will also elicit a similar emotional response

    • 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)


Chapter 1 introduction

  • Systematic Desensitization: Wolpe emotional response, other stimuli that resemble the original stimulus will also elicit a similar emotional response

    • 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


Chapter 1 introduction

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


Chapter 1 introduction

  • Behavioral Activation behaviors, discuss appropriate expectations

    • 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


Chapter 1 introduction

  • Specific behavioral goals behaviors, discuss appropriate expectations

  • Assessment

    • Functional assessment

    • Single case design

  • Process of Psychotherapy

    • Active and directive therapist

    • Short-term

    • Therapeutic alliance


Chapter 1 introduction

Extinction behaviors, discuss appropriate expectations

Stimulus Control

Contingency management

Skill acquisition

Shaping

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


Chapter 1 introduction

  • Specific Strategies behaviors, discuss appropriate expectations

    • 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