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Chapter 15: Therapy
Paul J. Wellman
Texas A&M University
Psychology in Action, Fifth Edition
by
Karen Huffman, Mark Vernoy, and
Judith Vernoy
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Lecture Overview
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Elements of Psychotherapy
Psychoanalysis
Cognitive Therapies
Humanistic Therapies
Behavior Therapies
Group and Family Therapies
Biomedical Therapies
Issues of Therapy
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Psychotherapy Goals
• Psychotherapy can provide relief to a client
for issues relating to
– Disturbed thoughts
– Disturbed emotions
– Disturbed behaviors
– Interpersonal and life situation difficulties
– Biomedical disturbances (chemical
imbalances)
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Myths of Psychotherapy
There is one best therapy
 Therapists can “read minds”
 People who go to therapists are crazy
or just weak
 Only the rich can afford therapy
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© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Psychoanalysis
• Psychoanalysis involves techniques that
are designed to expose unconscious
issues for resolution
– Psychoanalysis was devised by Freud
– Unconscious issues often relate to
childhood experiences
• The ego serves to keep these issues below the
level of consciousness
• Catharsis is an emotional energy that is
released when early conflicts are relived
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Psychoanalytic Techniques
• Making the unconscious conscious can
be achieved through:
– Free association: patient says whatever
comes to mind
– Dream analysis: Dreams express
unconscious issues
• Manifest content: the actual content of a dream
• Latent content: Freud argued that dreams
contain symbols that are disguised unconscious
issues or motives
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
– Resistance: Therapist looks for evidence
that the patient is avoiding an issue
– Transference: Does the patient treat the
therapist in ways that are similar to their
parents?
– Interpretation: Therapist provides analysis
of the meaning of the thoughts, behaviors,
and dreams of the patient
• Interpretation leads to understanding and
resolution of unconscious issues
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Cognitive Therapies
• Cognitive Therapy
– Assumes that problem behaviors and
emotions result from faulty thought
processes and beliefs
– Analyzes a person’s thought processes
– Attempts to restructure thought processes
• Changing thought patterns will in turn alter
problem behaviors and emotions
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Cognitive Therapy: Depression
• Beck argues that depression reflects
maladaptive thought processes
– Selective perception: Depressed person
focuses on negative events while ignoring
positive life events
– Overgeneralization: Depressed persons draw
negative conclusions about their self-worth,
based on minimal data
– Magnification: Person magnifies the
significance of a negative event
– All-or-none thinking: Everything is good or bad
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Humanistic Therapy
• Rogers’s Client-Centered Approach
– Treats people as clients rather than patients
– Creates an atmosphere that emphasizes the
clients’ tendency toward health
– Therapeutic techniques include:
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Empathy
Unconditional positive regard
Genuineness
Active listening
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Behavior Therapies
• The focus of behavior therapies is the
use of learning techniques to change
behaviors
– Therapist determines frequency of
maladaptive and adaptive behaviors
– Learning techniques are used to alter
behaviors; these techniques include:
• Classical conditioning
• Operant conditioning
• Modeling
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Systematic Desensitization
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Behavior Therapy Techniques
• Classical conditioning:
– Aversion therapy pairs an aversive stimulus
with the unwanted behavior
• Operant Conditioning:
– Shaping new behaviors
– Punishment: making an aversive stimulus
contingent on the unwanted behavior
– Extinction: removing all rewards
• Modeling: client observes and imitates
appropriate behaviors
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Group Therapy
• Some approaches offer treatment to a
group of persons rather than to one client
• Advantages of group therapy:
– Economy: group therapy is less expensive
– Group support: comfort knowing that others
have similar problems
– Feedback: group members learn from each
other
– Behavioral rehearsal: Group members can
role play key persons in a member’s life
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Drug Therapy
• Biomedical therapy may administer drugs to
improve abnormal behavior
• Drug classes include:
– Antianxiety drugs relieve muscle tension
– Antipsychotic drugs improve thought processes
• Act by blocking dopamine receptors
• Can have major adverse side effects
– Antidepressant drugs can reverse depression
• Tricyclics
• MAO inhibitors
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Electroconvulsive Therapy
• Electroconvulsive therapy (ECT) can
alleviate profound depression
– Electrodes are used to pass electrical
current through one of the hemispheres,
thereby provoking a brain seizure
• Anesthesia is given to minimize trauma
– ECT can lift depression (but the mechanism
of action of ECT on depression is unknown)
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Psychosurgery
• Physicians have long recognized that the
brain is key to the control of behavior
– Trephining: the opening of the skull to release
evil spirits
– Roman times: sword wound of the head
could relieve insanity
– Moniz argued that the frontal lobes could be
changed to alleviate mental illness
• Lobotomy procedure cut fibers in the frontal lobes
• Problem: patients were calm after the procedure
but also had changed personality and drive
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Length of Therapy Matters
From Seligman, M.E.P. (1995)
Effectiveness of psychotherapy.
American Psychologist, 50, 965-974.
Reprinted by permission. Copyright
American Psychological Association.
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Therapy Cultural Universals
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Naming the problem
Qualities of the therapist
Establishing credibility
Placing the problem in a familiar
framework
• Applying techniques to bring relief
• A special time and place
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e
Copyright
Copyright 2000 by John Wiley and Sons, New York, NY.
All rights reserved. No part of the material protected by
this copyright may be reproduced or utilized in any form
or by any means, electronic or mechanical, including
photocopying, recording, or by any information storage
and retrieval system, without written permission of the
copyright owner.
© 2000 John Wiley & Sons, Inc.
Huffman/Vernoy/Vernoy: Psychology in Action 5e