Chapter 17

Therapy

Disorders

Psychologist view disorders as something that is biologically influenced, unconsciously motivated, and difficult to change

Freud believed that generalized anxiety disorder was a “free floating” disorder.

In other words, it’s not associated with a particular object, it can attack at any time

Depression

Most common disorder, sometimes considered the “common cold” of disorders

Most prevalent among womenAssociated with low levels of serotoninOften triggered by a stressful event

TherapyPsychotherapy• an emotionally charged, confiding

interaction between a trained therapist and someone who suffers from psychological difficulties

Eclectic Approach• an approach to psychotherapy that,

depending on the client’s problems, uses techniques from various forms of therapy

Have a little bit of everything

Therapy- PsychoanalysisResistance• blocking from consciousness of anxiety-

laden material

This can be a problem with some dissociative personality disorders, like dissociate fugue or dissociate identity disorder.

Therapy approaches to breaking through resistance

HypnosisInterpretation • the analyst’s noting supposed dream

meanings, resistances, and other significant behaviors in order to promote insight

Transference• the patient’s transfer to the analyst of

emotions linked with other relationships-e.g. love or hatred for a parent

Humanistic Therapy

Client-Centered Therapy (Client-Based therapy)• humanistic therapy developed by Carl

Rogers• therapist uses techniques such as active

listening within a genuine, accepting, empathic environment to facilitate clients’ growth

Behavior TherapyBehavior Therapy• therapy that applies learning principles

to the elimination of unwanted behaviors

Counterconditioning• procedure that conditions new

responses to stimuli that trigger behaviors

• based on classical conditioning• includes systematic desensitization and

aversive conditioning

Systematic Desensitization• type of counterconditioning • associates a pleasant, relaxed state with

gradually increasing anxiety-triggering stimuli

• commonly used to treat phobias

Exposure therapy (flooding)-Similar to systematic desensitization in

that the psychologist teaches the patient how to get into a calm and relaxed state.

OPPOSITE from systematic desensitization though in that the patient is not slowly introduced to their fear, but directly introduced to it in it’s fullest extent.

http://www.youtube.com/watch?v=rfI_lVlmmg0&feature=relmfu

Virtual reality exposure therapy-Exposure therapy that is conducted

from the safety of a computerized atmosphere.

Aversive Conditioning• type of counterconditioning that

associates an unpleasant state with an unwanted behavior

• nausea ---> alcoholUCS(drug)

UCR(nausea)

UCS(drug)

UCR(nausea)

CS(alcohol)

CS(alcohol)

CR(nausea)

Aversion therapy video

http://www.youtube.com/watch?v=Lc8rtjxG-eI

Behavior TherapyToken Economy• an operant conditioning procedure that rewards desired behavior• patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats

Cognitive TherapyCognitive Therapy • teaches people new, more adaptive ways of thinking and acting• based on the assumption that thoughts intervene between events and our emotional reactions

Cognitive Therapy

A cognitive perspective on psychological disorders

Lost job

Depression

Internal beliefs:I’m worthless. It’s hopeless.

Lost job

Internal beliefs:My boss is a jerk.I deserve something better.

Nodepression

Cognitive Therapy

The Cognitive Revolution

Cognitive Therapy

Cognitive therapy for depression

Waiting listpatients

Cognitivetraining patients

Cognitive trainingpatients muchless depressed

Pre-therapytest

Post-therapytest

30

25

20

15

10

5

0

Depressionscores

Cognitive Therapy

Cognitive-Behavioral Therapy• a popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

Group TherapiesFamily Therapy• treats the family as a system• views an individual’s unwanted behaviors as

influenced by or directed at other family members

• attempts to guide family members toward positive relationships and improved communication

Does Therapy Work?Meta-analysis• procedure for statistically combining the

results of many different research studies

Poor outcome Good outcome

Averageuntreated

person

Averagepsychotherapy

client

Number ofpersons

80% of untreated people have pooreroutcomes than average treated person

Who Does Therapy?

To whom do people turn for help for psychological difficulties?

Biomedical TherapiesPsychopharmacology• study of the effects of drugs on mind

and behavior

Benzodiazepine• Anti-anxiety medication used for

many disorders, including GAD and schizophrenia

Lithium• chemical that provides an effective drug

therapy for the mood swings of bipolar (manic-depressive) disorders

Simpsons clip

Can you see what kind of biomedical therapy Dr. Marvin Monroe is using?

Biomedical Therapies

Electroconvulsive Therapy (ECT)• therapy for severely depressed patients

in which a brief electric current is sent through the brain of an anesthetized patient

Psychosurgery• surgery that removes or destroys brain

tissue in an effort to change behavior• lobotomy

now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients

Biomedical TherapiesElectroconvulsive Therapy

Biomedical TherapiesThe emptying of U.S. mental hospitals

Introduction of antipsychotic drugs

Rapid declinein the mental

hospitalpopulation

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990Year

700

600

500

400

300

200

100

0

State and countymental hospital

residents, inthousands