Transcript Lecture 23 Fall 2013 12-3 Chapter 16

 Therapy
Chapter 16
 Therapy
The Psychological Therapies
Psychotherapy – interaction
between trained therapist and a
person seeking to overcome a
psychological disorder or achieve
personal growth
 Therapy
The Psychological Therapies
Psychoanalysis – Sigmund
Freud’s therapeutic approach
Freud’s “consulting room”
Aims and Methods:
Through free association
and dream analysis, to
uncover repressed
thoughts, memories, and
feelings, and bring them
into conscious awareness
to help patient to take
responsibility for their own
growth.
Criticisms: Interpretations
of therapist cannot be
proven or disproven; also,
psychoanalysis takes a
great deal of time (years)
and is expensive.
 Therapy
The Psychological Therapies
Humanistic Therapies –
emphasize people’s inherent
potential for self-fulfillment; goal
to boost self-fulfillment by helping
people grow in self-awareness
Credit: Michael Rougier/Life Magazine
Client-centered therapy: a humanistic therapy, developed
by Carl Rogers, in which the therapist uses techniques
such as active listening with a genuine, accepting,
empathic environment (a non-directive therapy).
Credit: Michael Rougier/Life Magazine
“Hearing has consequences. When I truly hear a person
and the meanings that are important to him at the present
moment, hearing not simply his words, but him, and when I
let him know that I have heard his own private personal
meanings, many things happen…” - Carl Rogers
 Therapy
The Psychological Therapies
Behavior Therapies – therapy
that applies learning principles to
the elimination of unwanted
behaviors
Classical Conditioning Techniques
Credit: Bob Mahoney/The Image Works
Exposure Therapies: behavior techniques that treats
anxiety by exposing people (in imagination or reality) to the
things they fear and avoid.
Classical Conditioning Techniques
Credit: Bob Mahoney/The Image Works
The idea: Just as people can habituate to the sound of a
passing train in a new apartment, they can become less
anxiously responsive to the things they once feared.
Aversive Conditioning: a
behavioral technique that
associates an unpleasant
state with an unwanted
behavior.
Aversive therapy for
alcohol dependency: After
drinking an alcoholic drink
mixed with a drug that
produces nausea
(antabuse), some people
develop conditioned
aversion to alcohol.
Operant Conditioning Techniques
Token economy: an operant conditioning procedure in
which people earn a token of some sort for exhibiting
desired behavior and can later exchange the tokens for
various privileges or treats.
 Therapy
The Psychological Therapies
Cognitive Therapies – therapy
that teaches people new, more
adaptive ways of thinking and
acting; based on the assumption
that thoughts intervene between
events and emotional reactions
A cognitive perspective on psychological disorders:
The person’s emotional reactions are produced not directly
by the event but by the person’s thoughts in response to
the event.
Cognitive-Behavior Therapy
Events
Thoughts
Behavior
Emotions
CBT – an integrative therapy that aims to alter the way
people think (cognitive therapy) and the way they act
(behavior therapy).
 Psychological Disorders and Therapy
The Psychological Therapies
Family Therapy – therapy that
treats the family as a system;
views an individual’s unwanted
behaviors as influenced by other
family members
Credit: Michael Newman/PhotoEdit
The therapist helps family
members understand how
their ways of relating to one
another creates problems;
the emphasis is not on
changing the individual but
on changing their
relationships.
 Therapy
Evaluating Psychotherapies
Is Psychotherapy Effective?
Clients’ Perceptions
© Mary Kate Denny/ PhotoEdit, Inc.
The problem with perceptions: People often enter
therapy in crisis, and when the crisis passes, people often
attribute improvement to therapy.
Clients’ Perceptions
© Mary Kate Denny/ PhotoEdit, Inc.
The problem with perceptions: Clients may need to
believe the therapy was worth the effort an expense.
Clients’ Perceptions
© Mary Kate Denny/ PhotoEdit, Inc.
The problem with perceptions: Clients generally speak
kindly of their therapists, even if the problems remain.
Clinicians’ Perceptions
© Mary Kate Denny/ PhotoEdit, Inc.
The problem with perceptions: Clinicians are human,
and as such, they remember their successes more than
their failures.
Outcome Research
Meta analysis – a procedure for statistically combining the
results of many different research studies. Above, data
from 475 studies showing improvement of untreated people
vs. psychotherapy clients.
Outcome Research
The bottom-line: Those not undergoing therapy often
improve, but those undergoing therapy are more likely to
improve.
 Therapy
Evaluating Psychotherapies
Relative Effectiveness of
Different Therapies
There is little connection
between outcomes and
clinicians’ experience,
licensing, etc., but certain
therapies are more effective
for certain disorders.
There is little connection
between outcomes and
clinicians’ experience,
licensing, etc., but certain
therapies are more effective
for certain disorders. For
example, there is good
evidence that light
exposure therapy is an
effective treatment of SAD.
Credit: Christine Brune
Disorder
Therapy
Depression
Behavior, Cognition, Interpersonal
Anxiety
Cognition, Exposure, Stress Inoculation
Bulimia
Cognitive-behavior
Phobia
Behavior
Bed Wetting
Behavior Modification
Evidence-based practice – clinical decision making that
integrates the best available evidence with clinical
expertise and patient characteristics and preferences
 Therapy
The Biomedical Therapies
Prescribed medications or
medical procedures that act
directly on the patient’s nervous
system
 Therapy
The Biomedical Therapies
Drug Procedures
Antipsychotic Drugs
Antipsychotic drugs – drugs used to treat schizophrenia
and other forms of severe thought disorders
Antianxiety Drugs
Credit: Nsaum75
Antianxiety drugs – drugs used to control anxiety and
agitation
Antidepressant Drugs
Credit: Tom Varco
Antidepressant drugs – drugs used to treat depression
(and increasingly prescribed for anxiety).
SSRI – Selective Serotonin Reuptake Inhibitor
Antidepressant Drugs
Credit: Tom Varco
There is some evidence for effectiveness of SSRIs.
Experts agree that people taking SSRIs for a month
improve. But some of this is spontaneous recovery.
 Therapy
The Biomedical Therapies
Brain Stimulation
Credit: Eric S. Lesser
Electroconvulsive Therapy
ECT – a treatment for
depression that does not
respond to drug therapy.
There is evidence that it is
effective, but no one is
quite sure how it works
(may calm neural centers
where overactivity
produces depression).
Alternative Neurostimulation Therapies
Repetitive TMS – the
application of repeated
pulses of magnetic energy
to the brain; used to
stimulate or suppress brain
activity.
 Therapy
The Biomedical Therapies
Psychosurgery – surgery that
removes or destroys brain tissue
Credit: Discover Magazine
 Therapy
The Biomedical Therapies
Therapeutic Life-Style Change
1. Aerobic exercise
2. Adequate sleep
3. Light exposure
4. Social connection
5. Nutritional supplements
 Chapter Review
What is psychotherapy? What are
major types of psychotherapy?
Is psychotherapy effective? What
certain approaches are better for
certain disorders?
What is biomedical therapy? How
effective are drugs? Other biomedical
treatments?