Chapter 15

Question 1

Early Treatment that is now therapy

Answer 1

1500s:
• Mentally ill confined to asylums
• Treatments harsh, often damaging

Philippe Pinel:
• Psychiatrist
• Demanded humane treatment of the mentally ill

Question 2

Two Kinds of Modern Therapy

Answer 2

Psychotherapy: Involves
a person talking to a psychological professional about the person’s problems
• Insight
• Action
• Goals

Biomedical therapy: Uses a medical procedure to bring about changes in behavior
• Drugs
• Surgical methods
• Electric shock treatments

Question 3

Rogers’s Person-Centered Therapy

Answer 3

Person-centered therapy
• Nondirective insight therapy
• Based on work of Carl Rogers • Client talks, therapist listens

Question 4

Four Elements of Rogers’s Therapy

Answer 4

Authenticity
Unconditional positive regard
Reflection
Empathy

Question 5

Motivational Interviewing

Answer 5

“Client-centered therapy with a twist” (Arkowitz and Miller).
• Four principles
• Express empathy
• Develop discrepancy between client’s present behaviors, values
• Roll with resistance
• Support the client’s self-efficacy

Question 6

Gestalt Therapy

Answer 6

Gestalt therapy: Client accepts all of self; directive, role playing, leading questions confrontation of clients’ statements
• Originated by Fritz Perls • “Empty-chair” technique

Question 7

Evaluation of Humanistic Therapies

Answer 7

• Broad application in career, workplace, marriage, etc.
• Works best with intelligent, highly verbal persons
• Not based in experimental research

Question 8

Learning One’s Way to Better Behavior

Behavior therapies:

Answer 8

Action therapies focused on behavior, not causes

• Classical and operant conditioning

Question 9

Behavior modification or applied behavior analysis

Answer 9

Change behaviors via learning techniques

Question 10

Therapies Based on Classical Conditioning

Answer 10

Systematic desensitization: For treating phobias
– Step 1: Relaxation training
– Step 2: Fear hierarchy
– Step 3: Progressive exposure

• Aversion therapy: Undesirable behavior paired with aversive stimulus

• Exposure therapy: Introduces clients to situations related to their anxieties under controlled conditions
– Graded exposure: Slow, gradual exposure
– Flooding:Rapid,intenseexposure
– EMDR

Question 11

Therapies Based on Operant Conditioning

Answer 11

Modeling:
Learning via observation and imitation
• Participant modeling: Model takes client through step-by-step process for desired behavior

Question 12

Therapies Based on Operant Conditioning

Answer 12

Reinforcement: Strengthening of response by following it with a pleasurable consequence (positive reinforcement) or the removal of an unpleasant stimulus (negative reinforcement)

• Token economy: Reinforcers earned and exchanged for desired things

Contingency contract: Formal agreement on behavior change, reinforcements, penalties

Question 13

Therapies Based on Operant Conditioning

Answer 13

Extinction: Remove reinforcer, reduce undesirable behavior

• Time Out: Removal from situation that reinforces undesirable behavior


Question 14

Evaluation of Behavior Therapies

Answer 14

Effective treatment of specific problems
• Control symptoms quickly and effectively
• Not effective with serious psychological disorders overall, but can improve specific symptoms

Question 15

Distortions of Thinking

Answer 15

Cognitive Distortions

Arbitrary Inference- jumping to conclusions without evidence

Personalization-Assuming too much personal responsibility

Magnification and minimization- Negative events blown out of proportion; positive events ignored

Overgeneralization- Making sweeping conclusions based on only one incident

Selective Thinking- Focusing on only one aspect of the situation


Question 16

Cognitive Therapies

Answer 16

Cognitive-behavioral therapy (CBT): Learning to think more rationally and logically
Three goals:
1. Relieve symptoms and solve problems
2. Develop strategies for solving future problems
3. Help change irrational, distorted thinking

Question 17

Cognitive Therapies

Rational- emotive behavior therapy (REBT):

Answer 17

Cognitive-behavioral therapy

Irrational beliefs challenged and restructured

Question 18

Evaluation of Cognitive and Cognitive-Behavioral Therapies

Answer 18

Relatively less expensive and short-term
• Effective for depression, stress, anxiety
• Criticized for focusing on symptoms and not causes of disordered behavior
• Potential bias in therapist’s opinions

Question 19

Characteristics of Effective Therapy

Answer 19

Matching therapy to client and problem
• Therapeutic alliance: Warm, caring, accepting, empathic, respectful relationship between therapist and client
• Protected setting
• Opportunity for catharsis
• Learning and practice of new behaviors
Positive Experiences

Question 20

Evidence-Based Treatment

Answer 20

Refers to techniques that produce desired changes in controlled studies (Barlow et al., 2013 Kazdin, 2008)

• Includes systematic reviews of
information ranging from
assessment to intervention (American Psychological Association, 2005; Hunsley & Mash, 2008; Kazdin, 2008; Nathan & Gorman, 2007)

Question 21

Evidence-Based Treatment

Answer 21

Examples
• Exposure therapies
• Cognitive–behavioral therapies
• Cognitive processing for PTSD
• Cognitive–behavioral treatment for panic disorder with agoraphobia
• Cognitive–behavioral group therapy for social anxiety disorder
• Cognitive therapy for depression
• Antipsychotic drugs for schizophrenia
• Interpersonal psychotherapy for depression

Question 22

Mental Health on Campus

Answer 22

Campus life is often very stressful.
• Many students arrive on campus already in therapy
for a diagnosed disorder.
• Students should make use
of the available resources on college campuses.
– Counseling centers

Question 23

Cultural, Ethnic, and Gender Concerns

Answer 23

Four barriers to effective psychotherapy:
• Culture-bound values
• Class-bound values
• Language
• Nonverbal communication

Question 24

Biomedical Therapies

Answer 24

• Biomedical therapies: Affect biological functioning of body and brain
• Psychopharmacology: Use of drugs to relieve symptoms of disorders

Question 25

Psychopharmacology

Answer 25

Antipsychotic drugs: Treat psychotic symptoms such as delusions and hallucinations
• Antianxiety drugs: Calm anxiety reactions
• Antimanic drugs: Treat symptoms of mania (e.g.,
manic phase of bipolar disorder)
• Antidepressant drugs: Treat depression and anxiety – Monamineoxidaseinhibitors(MAOIs)
– Tricyclics
– Selective serotonin reuptake inhibitors (SSRIs)

Question 26

Electroconvulsive Therapy

Answer 26

Electroconvulsive therapy (ECT): Delivery of an electric shock to either one side or both sides of a person’s head
• Quick, short-term treatment for severe depression

Question 27

Psychosurgery

Answer 27

Psychosurgery: Surgery on brain tissue to relieve symptoms of severe psychological disorders
• Prefrontal lobotomy: Connections between pre-frontal cortex
– Transorbitallobotomy
• Bilateral anterior cingulotomy: Deep lesioning of cingulate gyrus via electrode

Question 28

Psychosurgery

Answer 28

Emerging technologies:
• Transcranial magnetic stimulation (rTMS)
• Transcranial direct current stimulation (tDCS)
• Deep brain stimulation (DBS)