Chapter 16 Notes - Therapies PDF

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Notes over types of therapy methods ...

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PSYCHOLOGY: CHAPTER 16 – Therapies

1. Approaches to Treating Psychological Disorders - Clinical psychology – area of psychology that integrates science and theory to prevent and treat psychological disorders - Psychotherapy – nonmedical process that helps individuals with psychological disorders recognize and overcome their problems o Talking, interpreting, listening, rewarding and modeling - Biological therapies (biomedical) – treatments that reduce or eliminate the symptoms of psychological disorders by altering aspects of bodily functioning Both psychotherapy and biological therapies share the goal of relieving the suffering of individuals with psychological disorders. The Psychological Approach to Therapy Practiced by clinical psychologists, counselors and social workers. Licensing and certification are two ways in which society retains control over psychotherapy practitioners - State level law used to license or certify such professionals  specify training individuals must have some assessment of applicant’s skill through formal examination o Getting a PhD begins with graduate work and one year clinical internship The Biological Approach to Therapy - Psychiatrists – medical doctors who specialize in treating psychological disorders o Complete medical school and spend an additional 4 years in residency program and continue their training on diagnosing disorders

2. Psychotherapy Central Issues in Psychotherapy  Does Psychotherapy Work? - Resounding answer is yes  those who  Does One Therapy Work Better Than Others? - It is human nature for psychologists to have allegiances to the brand of psychotherapy they use and in which they were trained  BIAS! - No one therapy has been shown to be more effective than the others o Empirically supported treatment – for any given psychological disorder, treatment decisions should be based on the body of research that has been conducted showing which type of therapy works best o Evidence-based practice – decision about treatment are made using the best available research and considering the therapist’s clinical judgment and client characteristics, culture and preferences

 Factors in Effective Psychotherapy  The Therapeutic Alliance - The relationship between the therapist and client  when good relationship, characterized by trust, respect and cooperation alliance = strong  The Therapist - Whether therapy works or not depends on particular therapist than type of therapy used o Differ in level of expertise, deep knowledge about psychological problems and their treatment o Therapist’s style and client personality can influence if therapy is effective!  The Client - Quality of client’s participation is most important determinant if therapy is successful! - Their strengths, abilities, skills and motivation that account for therapeutic success  How Do Psychotherapies Differ? - Two ways to differentiate the types of therapy: 1) Extent to which they focus on insights vs. immediate symptoms and skills 2) Whether they are directive or not - Insight vs. symptoms and skill development – focus on gaining insight into deeper causes of a problem; others on person’s immediate symptoms and by helping person develop specific skills to manage symptoms - Directive vs. nondirective – therapist to be outspoken in giving advice; encourage therapist to play active role in client’s life – other prompt client to drive interaction with therapist taking less active role in treatment Psychodynamic Therapies - Stress importance of unconscious mind, extensive interpretation by the therapist, and role of early childhood experiences in development of an individual’s problems o GOAL: help individuals gain insight into unconscious conflicts underlying their problems  FREUD - Psychoanalysis – Freud’s therapeutic technique for analyzing an individual’s unconscious thoughts o To free from problems from childhood experience, psychoanalyst interprets aspects of individuals life o Free association – psychoanalyst ask individual to say aloud whatever comes to mind in response to symptoms that they’re having problems with - Transference – client’s relating to the analyst in ways that reproduce or relive important relationships in the individual’s life

Humanistic Therapies - Humanistic therapies – people encouraged toward self-understanding and personal growth  self-healing capacities o Emphasize conscious rather than unconscious thoughts, present rather than past, and self-fulfillment rather than illness - Client-centered therapy – form of humanistic therapy (Carl Rogers) therapist provides a warm, supportive atmosphere to improve the client’s self-concept and to encourage the person to gain insight into problems o GOAL: help clients identify/understand own feelings and become more congruent o Reflective speech – technique which the therapist mirrors client’s own feelings back to the client  describing sad situation and therapist saying “You sound angry” to identify feelings - Three elements in Rogers therapy approach: 1) Unconditional positive regard – therapist constantly recognizes value of client providing context for personal growth and self-acceptance 2) Empathy – therapist strives to put self in client’s shoes – to understand emotions client is feeling 3) Genuineness – therapist is real person in relationship with client, sharing feelings and not hiding behind “title” Behavior Therapies - Use principles of learning to reduce or eliminate maladaptive behavior o Based on behavioral/social cognitive theories of learning o Assume symptoms are central problem  Classical Conditioning Techniques - Been used in treating phobias - Systematic desensitization – method of behavior therapy that treats anxiety by teaching client to associate deep relaxation with increasingly intense anxiety-producing situations o Desensitization exposes someone to a feared situation in real or imagined way o Aversive conditioning – repeated parings of undesirable behavior with aversive stimuli to decrease behavior’s positive associations  avoid smoking, overeating, and drinking alcohol  Operant Conditioning Techniques - As maladaptive behavior patterns are learned, they can be unlearned o Unhealthy behaviors replaced with healthy ones - Conducting careful analysis of person’s environment to determine which factors need modification Cognitive Therapies - Emphasize that cognitions or thoughts are main source of psychological problems – attempt to change individual’s feelings and behaviors by changing cognitions

o Focuses on symptoms and skill development - Guide individuals in identifying their irrational and self-defeating thoughts  Foundations of Cognitive Therapies - Two basic assumptions: 1. Human beings have control over their feelings 2. Individuals feel about something depends on how they think about it - Cognitive restructuring – general concept for changing a pattern of thought that’s presumed to be causing maladaptive behavior or emotion is central to cognitive therapies o 1st goal of therapy to bring automatic thoughts into awareness so they can be changed  Cognitive-Behavior Therapy - Combination of cognitive therapy, with emphasis on reducing self-defeating thoughts and behavior therapy with emphasis on changing behavior o Self-instructional methods – cognitive-behavior therapy aimed at teaching individuals to modify their own behavior  Prompt clients to change what they say to themselves o Self-efficacy – belief that one can master a situation and produce positive outcomes Therapy Integrations - Combination of techniques from different therapies based on therapist’s judgment of which particular methods will provide greatest benefit for the client o Therapist might use behavioral approach to treat panic disorder and a cognitive approach to treat client with depressive disorder

3. Biological Therapies Administered by psychiatrists or other medical doctors by altering aspects of bodily functioning to treat psychological disorders.  Drug therapy most common form of biomedical therapy Drug Therapy - Psychotherapeutic drugs used to treat disorders o Why particular drug works for particular problem  Antianxiety Drugs - Commonly known as tranquilizers – make individuals calmer and less excitable - Benzodiazepines – offer greatest relief for anxiety  bind receptor sites of neurotransmitters that become overactive during anxiety o Fast-acting  makes drowsiness, loss of coordination, fatigue and mental slowing o Possibly linked to abnormalities in babies born to mothers who took the drug  Antidepressant Drugs - Regulate mood - Four mains classes: o Tricyclics – work by increasing level of norepinephrine and serotonin

o Tetracyclics – increase levels of both norepinephrine and serotonin in the brain o MAO inhibitors – work because they block monoamine oxidase (breaks down serotonin and norepinephrine in the brain  Allows these neurotransmitters to remain in brain’s synapses and regulate mood o Selective serotonin reuptake inhibitors – target serotonin and work by interfering only with reabsorption of serotonin in brain  Medication For Bipolar Disorder - Lithium – widely used to treat bipolar disorder o Lightest of solid elements in periodic table  stabilizes moods  Antipsychotic Drugs - Powerful drugs that diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior and produce better sleep patterns o Used for schizophrenia! o If one with schizophrenia stops taking, symptoms return - Two types to treat schizophrenia: 1) Neuroleptics – block dopamine’s action in the brain a. Haldol, Loxitane, Throazine b. Carry high risk of tardive dyskinesia 2) Atypical antipsychotic medications – influence dopamine and serotonin a. Clozaril, Risperdal b. Carry high risk of metabolic syndrome - Two serious side affects: I. Tardive dyskinesia – neurological disorder characterized by involuntary random movements of facial muscles, tongue and mouth – neck twitches, arms and legs II. Metabolic syndrome – condition associated with obesity and risk for diabetes and heart disease Electroconvulsive Therapy - Also known as shock therapy to set off a seizure in the brain - This idea has been around since Hippocrates and ancient Greece o Early 20th century, schizophrenia was thought to be treated by inducing seizures - Today, doctors use ECT to treat severe depression and show some usefulness in treating severe PTSD  given to those who haven’t responded to drug therapy or psychotherapy - Deep brain stimulation – doctors surgically implant electrodes in the brain that emit signals to alter brain’s electrical circuitry o Used to treat severe depression Psychosurgery

- Biological intervention that involves the removal or destruction of brain tissue to improve the individual’s adjustment  effects cannot be reversed!

4. Sociocultural Approaches and Issues in Treatment In treating psychological disorders: a. Behavior therapies modify person’s behavior b. Cognitive therapies alter person’s thinking c. Biological therapies change person’s body Sociocultural therapy focuses on individual as part of system of relationships influenced by social/cultural factors. Group Therapy - Brings together individuals who share a psychological disorder in sessions that are typically led by a mental health professional - Six features characterize group therapy: A. Information – individuals receive information about their problems from group leader or other group members B. Universality – individuals see that they’re not alone (all share experiences) C. Altruism – members support one another with advice and sympathy and learn they can offer something to others D. Experience of a positive family group – therapy group often resembles a family (leaders=parents, members=siblings) new family may offer healing and positive family ties E. Development of social skills – corrective feedback from peers may correct flaw in individual’s interpersonal skills Family and Couples Therapy - Family therapy – group therapy among family members - Couples therapy – group therapy with married or unmarried couples whose major problem lies within their relationship o Stress that although one person has abnormal symptoms, those symptoms are function of family or couple relationships - Four widely used family therapy techniques: 1) Validation – therapist expresses understanding/acceptance of each member’s feelings and validates the person 2) Reframing – therapist helps families reframe problems as family problems, NOT individual’s problems 3) Structural change – therapist tries to restructure coalitions in a family 4) Detriangulation – tries to disentangle scapegoat situations by shifting attention from child to parents problems...