exam 4: approaches to therapy

Question 1

what therapy cannot be likened to (2)

Answer 1

fixing a machine (there are no rules or prescriptions that universally apply to the treatment of all psychological disorders), treating physical ailments (might not be an easy diagnosis; an art and not just a science)

Question 2

different goals for psychotherapy (2)

Answer 2

alleviation of suffering, facilitation of growth

Question 3

psychoanalysis

Answer 3

repressed childhood impulses and conflicts are at the heart of adult psychopathology

Question 4

free association

Answer 4

Freud’s main technique for psychoanalysis; the client lies on the couch, relaxes, and says whatever comes to mind without censorship; the therapist’s job is to listen, interpret, and attempt to put the pieces together of the emerging psychological puzzle

Question 5

resistance

Answer 5

an unconscious defense mechanism that is used to keep unwanted thoughts and memories out of awareness; unwillingness to face unpleasant thoughts and memories

Question 6

transference

Answer 6

unconscious tendency to transfer feelings onto therapist (i.e. Freud noticed that many of his patients developed amorous feelings toward him)

Question 7

way to accelerate the healing process

Answer 7

therapist sitting face-to-face with the client (more active role; not orthodox) involves less time plunging into the past and more time addressing current life difficulties and problems

Question 8

behavioral approach

Answer 8

maladaptive behaviors can be unlearned through deconditioning

Question 9

flooding

Answer 9

particularly useful for patients with specific phobias; the patient is exposed to the feared stimulus all at once; the anxiety disappears after stimulus presentation is met without negative consequences

Question 10

counter-conditioning (founder and definition)

Answer 10

• founder: Mary Cover Jones
• definition: a procedure used to counteract anxiety among patients with phobias; anxiety can be erased by repeatedly pairing the feared stimulus with a pleasurable experience; the feared stimulus becomes associated with the pleasurable experience, and the anxiety dissipates

Question 11

the story of Peter

Answer 11

Peter was a 3-year-old boy who was intensely afraid of rabbits. Jones took peter into a room with a caged white rabbit. He was given a glass of milk and some cookies. This routine was repeated several times. Through repetition, the caged rabbit was gradually moved closer and closer to Peter. Eventually, the rabbit is out of the cage on Peter’s lap. He is stroking the rabbit with one hand and eating cookies with the other.

Question 12

systematic desensitization (founder and steps (3))

Answer 12

• founder: Joseph Wolpe
• definition: a very successful form of deconditioning; relaxation, hierarchy of fear, exposure

Question 13

aversive conditioning

Answer 13

a technique designed to elicit an aversive rather than a pleasurable response to a harmful stimulus

Question 14

behavior modification

Answer 14

shaping behavior by reinforcing desired behaviors and withholding reinforcement for undesired behaviors

Question 15

token economies

Answer 15

patients can earn tokens (i.e. gold stars) for engaging in desired behavior that can be cashed in for reinforcements

Question 16

cognitive approach

Answer 16

humans are innately and inherently irrational, but we can be reeducated and retrained

Question 17

rational emotive behavior therapy (REBT) and the chain of events leading to ill-being (ABC model) (founder and definitions)

Answer 17

• founder: Albert Ellis
• rational emotive behavior therapy: we have the power over our emotional destinies because our thoughts/cognitions are the most proximal determinates of our behavior and our emotions
• chain of events leading to ill-being (ABC model): activating event, beliefs, consequences of beliefs

Question 18

cognitive therapy (CT) (founder and idea)

Answer 18

• founder: Judith Beck
• definition: we have automatic thoughts (maladaptive schema) that exist, are automatic, and create and maintain depression within us

Question 19

humanistic approach

Answer 19

the task for the therapist is to provide a warm and accepting environment in which healing forces can operate

Question 20

actualization tendency (founder and definition)

Answer 20

• founder: Carl Rogers
• definition: inner drive toward fulfillment of one’s potential

Question 21

person-centered therapy (founder and definition (4))

Answer 21

• founder: Carl Rogers
• definition: trust the client, focus on feelings, be present-focused, make the client responsible for change

Question 22

necessary and sufficient conditions for person-centered therapy (3)

Answer 22

• empathy: therapist should sense and reflect the inner life of the client
• genuineness: therapist should be genuinely present with the client
• unconditional positive regard: prize and cherish all aspects of the client

Question 23

Gestalt therapy (founder and definition)

Answer 23

• founder: Fritz Perls
• definition: focuses on feelings that are unconscious; interests shown to dreams; techniques that are dramatic and oftentimes confrontational; mostly occurred in groups; whoever you have problems with goes in the “hot seat”

Question 24

various systems of therapy differ in their approach to facilitating change (psychoanalysis, humanistic perspective, behavioral approach, cognitive models)

Answer 24

• psychoanalysis: by raising awareness to unconscious contents, change and growth and movement toward thriving and flourishing can be facilitated
• humanistic perspective: focus on providing necessary and sufficient conditions (unconditional positive regard, genuineness)
• behavioral approach: pays no attention to repressed psychological contents; focuses on maladaptive behavior
• cognitive models: maladaptive behaviors are underlain by maladaptive cognitions

Question 25

important questions about therapy (2)

Answer 25

• can humans help other humans change? (people can stay up and listen to other people’s problems; can we study it systematically and find evidence?)
• are some forms of helping better than others? (i.e. therapy vs free counseling at school)

Question 26

client’s success rate (%)

Answer 26

90%

Question 27

reasons for skepticism (3)

Answer 27

• time may be the best healer: placebo effect; hedonic treadmill (highs and lows, biological setpoints); clients may mistakenly attribute natural healing to what is going on with the encounter
• need to believe that therapy is worthwhile: clients invest a lot of time, money, and hope into therapy
• generally speak kindly of their therapists: even when their problems remain, clients oftentimes work hard to find something positive to say about their therapist

Question 28

a field study of “counseling effectiveness”

Answer 28

Over 500 Massachusetts boys between 5 and 13 years old who seemed bound for delinquency were randomly assigned to two conditions. One group received a 5-year treatment program, and the other half received no treatment. Those who were in the 5-year treatment condition were visited by counselors two times per month. At the end of the trial, those who were in the treatment condition provided glowing testimonials. Of those who were in the no treatment control group, 70% of those individuals had no criminal record, and, on some measures, the untreated men had fewer problems (i.e. less likely to have committed a second crime, higher levels of job satisfaction, lower levels of alcohol dependence and death rates).

Question 29

Hans Eysenck’s (1952) evaluation of therapy and its criticisms (2)

Answer 29

• evaluation: He reviewed results of 24 therapy studies and found that roughly 2/3 of patients showed improvement during therapy. He found similar improvement in people who were on waiting lists but were never actually treated. Based on this, he concluded that therapy is worthless because people are just as likely to show improvement over time if they are treated or untreated. There are two important criticisms..
• criticisms: Those who were on waiting lists were more psychologically healthy than those who made it into therapy. Some of those who were on waiting lists were prescribed medication (psychopharmacology).

Question 30

Smith et al.’s (1980) meta-analysis

Answer 30

Looked at 475 therapy outcome studies. Smith showed that the average patient in therapy improved more than 80% of those who were no treatment control groups. This suggests that therapy is effective for a range of psychological problems.

Question 31

meta-analysis

Answer 31

a statistical technique in which you take a whole bunch of published studies on a particular phenomenon

Question 32

what problems behavioral (2), cognitive (1), and humanistic (1) therapies can treat

Answer 32

• behavioral: phobias and compulsions
• cognitive: depression
• humanistic: low self-esteem

Question 33

active therapeutic ingredients (3)

Answer 33

a supportive relationship (warmth, trust, concern, encouragement, reassurance, unconditional acceptance, empathy), a ray of hope (for those that are unhappy, demoralized, and down on themselves), an opportunity to open up (benefits like catharsis and insight)

Question 34

catharsis

Answer 34

we release the psychological tension represented by the pent-up urges/experiences/wishes that we don’t tell others

Question 35

psychopharmacology

Answer 35

the study of drug effects on mind and behavior

Question 36

classes of drugs (4)

Answer 36

anti-psychotic, anti-anxiety, anti-depressant, mood-stabilizing

Question 37

anti-psychotic drugs

Answer 37

Researchers who developed drugs for other unrelated physical ailments noticed that some drugs seem to calm the symptoms of psychosis. Some drugs seem to dampen people’s responses to irrelevant stimuli by blocking the neuroreceptors of dopamine. These can be used to reduce various losses of contact with reality (i.e. confused speech, exaggerations of emotion, paranoia, bizarre behavior). People are able to stay connected with reality and function in it.

Question 38

anti-anxiety drugs

Answer 38

For people with anxiety disorders, there tends to be an overactivation of the central nervous system. These drugs work to depress the activity of the central nervous system. These can be used to treat PTSD and OCD.

Question 39

anti-depressant drugs

Answer 39

The biology of depression has a neurochemical basis to it (i.e. a lack of serotonin and norepinephrine). These drugs work to increase the supply of serotonin and norepinephrine in the brain. By doing this, they help not only to relieve depression but also to elevate mood.

Question 40

mood-stabilizing drugs

Answer 40

Lithium (most common) and other mood stabilizers work to manage the mood swings that mark bipolar disorder. They have been shown to significantly decrease the risk of suicide with people with bipolar disorder.

Question 41

electroconvulsive therapy (ECT)

Answer 41

was and is a very controversial form of brain manipulation; used to be very inhumane but now involves an anesthetic and muscle relaxant (no pain or convulsions) before the electric currents are administered; used to relieve severe depression; marked improvement shown within 2 to 4 weeks; limited in use

Question 42

psychosurgery

Answer 42

involves the removal and/or destruction of brain tissue to change behavior; the most drastic and least-used because its effects are irreversible

Question 43

frontal lobotomy (founder and definition) and its effects (3)

Answer 43

• founder: Egas Moniz (1930s)
• definition: patients who suffer from uncontrollable violent emotions can be calmed by cutting the nerves that connect the frontal lobes to the emotion controlling centers of the inner brain; a crude but easy and inexpensive procedure (shock the patient into a coma, insert an icepick-like chisel underneath the eyelid right above each eye, wiggle the chisels then remove); was successful in disconnecting emotion from thought and in tempering people with violent emotional outbursts
• effects: people experienced things like permanent lethargy, non-creativity, and emotional immaturity