Chapter 13 - Psychological Therapies

Question 1

How were mental illnesses treated in the past?

Answer 1

• Mentally ill people began to be confined to institutions called asylums in the mid-fifteen hundreds.
• Treatments were harsh and often damaging.
• Philippe Pinel became famous for demanding that the mentally ill be treated with kindness, personally unlocking the chains of inmates in France.

Question 2

What is therapy? What are the categories?

Answer 2

Therapy: treatment methods aimed at making people feel better and function more effectively

• One is based primarily in psychological theory and techniques.
• The other uses medical intervention to bring symptoms under control.

Question 3

What is psychotherapy? What are the kinds?

Answer 3

Therapy for mental disorders in which a person with a problem talks with a psychological professional

• Insight therapies: psychotherapies in which the main goal is helping people to gain insight with respect to their behavior, thoughts, and feelings
• Action therapy: psychotherapy in which the main goal is to change disordered or inappropriate behavior directly

Question 4

What is biomedical therapy?

Answer 4

Therapy for mental disorders in which a person with a problem is treated with biological or medical methods to relieve symptoms

Question 5

What was Freud’s psychoanalysis? What are some key elements?

Answer 5

Insight therapy based on the theory of Freud, emphasizing the revealing of unconscious conflicts

• Dream Interpretation
  
  • Manifest content: the actual content of one’s dream
  • Latent content: the symbolic or hidden meaning of dreams
• Free association: Freudian technique in which a patient is encouraged to talk about anything that comes to mind without fear of negative evaluations
• Resistance: occurs when a patient becomes reluctant to talk about a certain topic, either changing the subject or becoming silent
• Transference: the tendency for a patient or client to project positive or negative feelings for important people from the past onto the therapist

Question 6

How is psychoanalysis handled today?

Answer 6

Directive: actively giving interpretations of a client’s statements in therapy, even suggesting certain behavior or actions Psychoanalysis today is generally directive.
Psychodynamic therapy: a newer and more general term for therapies based on psychoanalysis, with an emphasis on transference, shorter treatment times, and a more direct therapeutic approach

Question 7

What is Roger’s Person Centered Therapy? What are the elements of it?

Answer 7

A nondirective insight therapy in which the client does all the talking and the therapist listens

Nondirective: therapeutic style in which the therapist remains relatively neutral and does not interpret or take direct actions with regard to the client, instead remaining a calm, nonjudgmental listener while the client talks

Requires the therapist to have:
1. Authenticity: the genuine, open, and honest response of the therapist to the client
Unconditional positive regard: the warmth, respect, and accepting atmosphere created by the therapist for the client in person-centered therapy
Empathy: the ability of the therapist to understand the feelings of the client
Reflection: the therapist restates what the client says rather than interpreting those statements

Motivational Interviewing (MI)
In contrast to client-centered therapy, MI has specific goals: namely, to reduce ambivalence about change and to increase intrinsic motivation to create change

Question 8

What is Gestalt Therapy?

Answer 8

Form of directive insight therapy in which the therapist helps clients accept all parts of their feelings and subjective experiences, using leading questions and planned experiences such as role playing

Question 9

What are behavior therapies?

Answer 9

Action therapies based on the principles of classical and operant conditioning and aimed at changing disordered behavior without concern for the original causes of such behavior

Question 10

What are some behavior therapy methods?

Answer 10

Behavior modification or applied behavior analysis (A B A): the use of learning techniques to modify or change undesirable behavior and increase desirable behavior

Systematic desensitization: behavioral technique used to treat phobias; the client is asked to make a list of ordered fears and taught to relax while concentrating on those fears.
-Counterconditioning: replacing an old conditioned response with a new one by changing the unconditioned stimulus

Aversion therapy: a form of behavioral therapy in which an undesirable behavior is paired with an aversive stimulus to reduce the frequency of the behavior

Exposure therapy: behavioral techniques that introduce the client (under carefully controlled conditions) to situations related to their anxieties or fears
-Flooding: technique for treating phobias and other stress disorders in which the person is rapidly and intensely exposed to the fear-provoking situation or object and prevented from making the usual avoidance or escape response

Eye-movement desensitization reprocessing (EMDR): therapy for posttraumatic stress disorder and similar anxiety problems in which the client is given some form of bi-lateral stimulation (ex: eye movement) while thinking of a disturbing memory. Research suggests that traumatic memories are thereby redistributed and re-consolidated in the brain.

Modeling: learning through the observation and imitation of others
-Participant modeling: technique in which a model demonstrates the desired behavior in a step-by-step, gradual process while the client is encouraged to imitate the model

Reinforcement: the strengthening of a response by following it with a pleasurable consequence or the removal of an unpleasant stimulus

• Token economy: the use of objects called tokens to reinforce behavior in which the tokens can be accumulated and exchanged for desired items or privileges
• Contingency contract: a formal, written agreement between the therapist and client (or teacher and student) in which goals for behavioral change, reinforcements, and penalties are clearly stated

Extinction: the removal of a reinforcer to reduce the frequency of a behavior
-Time-out: an extinction process in which a person (usually a child) is removed from the situation that provides reinforcement for undesirable behavior, usually by being placed in a quiet corner or room away from possible attention and reinforcement opportunities

Question 11

In what way are behavioral therapies effective?

Answer 11

Behavior therapies can be effective in treating specific problems, such as bedwetting, drug addictions, and phobias.
Behavior therapies can also help improve some of the more troubling behavioral symptoms associated with severe disorders.

Question 12

What is cognitive therapy?

Answer 12

Therapy in which the focus is on helping clients recognize distortions in their thinking and replace distorted, unrealistic beliefs with more realistic, helpful thoughts

Question 13

What are some types of cognitive distortions?

Answer 13

Arbitrary inference: drawing a conclusion without any evidence

Selective thinking: focusing on only one aspect of a situation while ignoring all other relevant aspects

Overgeneralization: drawing sweeping conclusions based on only one incident or event and applying those conclusions to events that are unrelated to the original

Magnification and minimization: blowing a negative event out of proportion (magnification) while ignoring relevant positive events (minimization)

Personalization: taking responsibility or blame for events that are unconnected to the person

Question 14

What is CBT? What are the goals?

Answer 14

Cognitive-behavioral therapy: action therapy in which the goal is to help clients overcome problems by learning to think more rationally and logically

1. Relieve the symptoms and solve the problems.
2. Help develop strategies for solving future problems.
3. Help change irrational, distorted thinking.

Question 15

What is REBT?

Answer 15

Rational emotive behavior therapy: cognitive-behavioral therapy in which clients are directly challenged in their irrational beliefs and helped to restructure their thinking into more rational belief statements

Question 16

What are the types of group therapy?

Answer 16

Family therapy: family members meet together with a therapist to resolve problems that affect the entire family. Family therapy follows from a systemic perspective of human interaction in which fault is minimized and circular interactions and patterns of behavior are given a more prominent place.

Self-help group (support group): a group composed of people who have similar problems and who meet together without a therapist or counselor for the purposes of discussion, problem solving, and social and emotional support

Question 17

What are the advantages and disadvantages of group therapy?

Answer 17

Advantages:

• Low cost
• Exposure to other people with similar problems; social interaction with others
• Social and emotional support from people with similar disorders or problems

Disadvantages:

• Need to share the therapist’s time with others in the group
• Lack of a private setting in which to reveal concerns
• Inability of people with severe disorders to tolerate being in a group

Question 18

How effective is psychotherapy?

Answer 18

Between 75 and 90 percent of people who receive therapy feel that it has helped them.

• The longer a person stays in therapy, the greater the improvement.
• Psychotherapy works as well alone as with drugs.

Some types of psychotherapy are more effective for certain types of problems, and no one psychotherapy method is effective for all problems.

• Effective therapy should be matched to the particular client and the particular problem.
• Eclectic approach: combining elements of several different therapy techniques

Question 19

What is cybertherapy? What are some advantages and disadvantages?

Answer 19

Cybertherapy: therapy offered via the Internet

Advantages
Low or no cost
Availability of therapy opportunities
Access to support groups
Relative anonymity

Disadvantages
Lack of body language
Lack of vocal tones

Question 20

What are common factors in psychotherapy?

Answer 20

Common Factors Approach

• Therapeutic alliance: the relationship between therapist and client that develops as a warm, caring, accepting relationship characterized by empathy, mutual respect, and understanding
• Protected setting
• Opportunity for catharsis
• Learning and practice of new behaviors
• Positive experiences for the client

Question 21

What is EBT?

Answer 21

Evidence-based treatment: refers to techniques or interventions that have produced desired outcomes or therapeutic change in controlled studies

Question 22

How can culture affect psychotherapy?

Answer 22

When the cultures, ethnic groups, or genders of the therapist and the client differ, misunderstandings and misinterpretations can occur.

Four barriers to effective psychotherapy exist when the cultural backgrounds of client and therapist differ.
Culture-bound values
Class-bound values
Language
Nonverbal communication

Question 23

What are some drug treatments?

Answer 23

Biomedical therapies: therapies that directly affect the biological functioning of the body and brain

Psychopharmacology: the use of drugs to control or relieve the symptoms of psychological disorders
Antipsychotic drugs: used to treat psychotic symptoms such as delusions, hallucinations, and other bizarre behavior
Antianxiety drugs: used to treat and calm anxiety reactions. Typically minor tranquilizers
Mood-stabilizing drugs: used to treat bipolar disorder
include lithium and certain anticonvulsant drugs
Antidepressant drugs: used to treat depression and anxiety

Question 24

What is electroconvulsive therapy?

Answer 24

Biomedical treatment in which electrodes are placed on either one or both sides of a person’s head and an electric current strong enough to cause a seizure or convulsion is passed through the electrodes

Question 25

What is psychosurgery? What kinds are there?

Answer 25

Surgery performed on brain tissue to relieve or control severe psychological disorders

Prefrontal lobotomy: the connections of the prefrontal lobes of the brain to the rear portions are severed

Bilateral anterior cingulotomy: an electrode wire is inserted into the anterior cingulated gyrus area of the brain for the purpose of destroying that area of brain tissue with an electric current
-An electrode is inserted with the guidance of a magnetic resonance imaging (MRI) machine.

Emerging Techniques:

• Repetitive transcranial magnetic stimulation (rTMS): magnetic pulses are applied to the cortex
• Transcranial direct current stimulation (tDCS): uses scalp electrodes to pass very-low-amplitude direct currents to the brain

Question 26

What is Virtual Reality used for?

Answer 26

Virtual reality is a software-generated, three-dimensional, simulated environment with can be used in the treatment of PTSD. Like playing a video game