Chapter 15 Flashcards
Early Treatment that is now therapy
1500s:
• Mentally ill confined to asylums
• Treatments harsh, often damaging
Philippe Pinel:
• Psychiatrist
• Demanded humane treatment of the mentally ill
Two Kinds of Modern Therapy
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
Rogers’s Person-Centered Therapy
Person-centered therapy
• Nondirective insight therapy
• Based on work of Carl Rogers • Client talks, therapist listens
Four Elements of Rogers’s Therapy
Authenticity
Unconditional positive regard
Reflection
Empathy
Motivational Interviewing
“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
Gestalt Therapy
Gestalt therapy: Client accepts all of self; directive, role playing, leading questions confrontation of clients’ statements
• Originated by Fritz Perls • “Empty-chair” technique
Evaluation of Humanistic Therapies
- Broad application in career, workplace, marriage, etc.
- Works best with intelligent, highly verbal persons
- Not based in experimental research
Learning One’s Way to Better Behavior
Behavior therapies:
Action therapies focused on behavior, not causes
• Classical and operant conditioning
Behavior modification or applied behavior analysis
Change behaviors via learning techniques
Therapies Based on Classical Conditioning
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
Therapies Based on Operant Conditioning
Modeling:
Learning via observation and imitation
• Participant modeling: Model takes client through step-by-step process for desired behavior
Therapies Based on Operant Conditioning
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
Therapies Based on Operant Conditioning
Extinction: Remove reinforcer, reduce undesirable behavior
• Time Out: Removal from situation that reinforces undesirable behavior

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

Cognitive Therapies
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
Cognitive Therapies
Rational- emotive behavior therapy (REBT):
Cognitive-behavioral therapy
Irrational beliefs challenged and restructured
Evaluation of Cognitive and Cognitive-Behavioral Therapies
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
Characteristics of Effective Therapy
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
Evidence-Based Treatment
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)
Evidence-Based Treatment
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
Mental Health on Campus
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
Cultural, Ethnic, and Gender Concerns
Four barriers to effective psychotherapy: • Culture-bound values • Class-bound values • Language • Nonverbal communication
Biomedical Therapies
- Biomedical therapies: Affect biological functioning of body and brain
- Psychopharmacology: Use of drugs to relieve symptoms of disorders
Psychopharmacology
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)
Electroconvulsive Therapy
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
Psychosurgery
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
Psychosurgery
Emerging technologies:
• Transcranial magnetic stimulation (rTMS)
• Transcranial direct current stimulation (tDCS)
• Deep brain stimulation (DBS)
