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Psychology, Fourth EditionSaundra K. Ciccarelli • J. Noland White
Chapter 15psychological therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Learning Objective Menu
15.1 How have psychological disorders been treated throughout history, and are two modern ways they are treated today?
15.2 What were the basic elements of Freud’s psychoanalysis, and how do psychodynamic approaches differ today?
15.3 What are the basic elements of the humanistic therapies known as person-centered therapy and Gestalt therapy?
15.4 How do behavior therapists use classical and operant conditioning to treat disordered behavior, and how successful are these therapies?
15.5 What are the goals and basic elements of cognitive therapies such as cognitive–behavioral therapy and rational emotive behavior therapy?
15.6 What are the various types of group therapies and the advantages and disadvantages of group therapy?
15.7 How effective is psychotherapy, and what factors influence its effectiveness?
15.8 What are the various types of drugs used to treat psychological disorders?
15.9 How are electroconvulsive therapy and psychosurgery used to treat psychological disorders today?
15.10 How might computers be used in psychotherapy?
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Treatment in the Past
• Mentally ill people began to be confined to institutions called asylums in the mid-1500s
• Treatments were harsh and often damaging
• Philippe Pinel became famous for demanding that the mentally ill be treated with kindness, personally unlocking the chains of inmates in France
LO 15.1 Two Modern Ways to Treat Psychological Disorders
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Therapy
• Therapy: treatment methods aimed at making people feel better and function more effectively
• Two broad categories:– one based primarily in psychological theory
and techniques– the other uses medical intervention to bring
symptoms under control
LO 15.1 Two Modern Ways to Treat Psychological Disorders
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Therapy
• Psychotherapy: therapy for mental disorders in which a person with a problem talks with a psychological professional– insight therapies: psychotherapies in which
the main goal is helping people to gain insight with respect to their behavior, thoughts, and feelings
– action therapy: psychotherapy in which the main goal is to change disordered or inappropriate behavior directly
LO 15.1 Two Modern Ways to Treat Psychological Disorders
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Therapy
• Biomedical therapy: therapy for mental disorders in which a person with a problem is treated with biological or medical methods to relieve symptoms
LO 15.1 Two Modern Ways to Treat Psychological Disorders
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Freud’s Psychoanalysis
• Psychoanalysis: insight therapy based on the theory of Freud, emphasizing the revealing of unconscious conflicts– dream interpretation
manifest content: the actual content of one’s dream latent content: the symbolic or hidden meaning of
dreams
LO 15.2 Elements of Freud’s Psychoanalysis and Psychoanalysis Today
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Freud’s Psychoanalysis
• Psychoanalysis (cont’d)– free association: Freudian technique in which a
patient is encouraged to talk about anything that comes to mind without fear of negative evaluations
– resistance: occurs when a patient becomes reluctant to talk about a certain topic, either changing the subject or becoming silent
– transference: the tendency for a patient or client to project positive or negative feelings for important people from the past onto the therapist
LO 15.2 Elements of Freud’s Psychoanalysis and Psychoanalysis Today
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Psychoanalysis Today
• Directive: actively giving interpretations of a client’s statements in therapy, even suggesting certain behavior or actions– psychoanalysis today is generally directive
• Psychodynamic therapy: a newer and more general term for therapies based on psychoanalysis, with an emphasis on transference, shorter treatment times, and a more direct therapeutic approach
LO 15.2 Elements of Freud’s Psychoanalysis and Psychoanalysis Today
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Psychoanalysis Today
• Interpersonal therapy (IPT): form of therapy for depression which incorporates multiple approaches and focuses on interpersonal problems
LO 15.2 Elements of Freud’s Psychoanalysis and Psychoanalysis Today
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Rogers’s Person-Centered Therapy
• Person-centered therapy: a nondirective insight therapy in which the client does all the talking and the therapist listens– based on the work of Carl Rogers – nondirective: therapeutic style in which the
therapist remains relatively neutral and does not interpret or take direct actions with regard to the client, instead remaining a calm, nonjudgmental listener while the client talks
LO 15.3 Basic Elements of Humanistic Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Rogers’s Person-Centered Therapy
• Four elements:1. authenticity: the genuine, open, and honest
response of the therapist to the client
2. unconditional positive regard: the warmth, respect, and accepting atmosphere created by the therapist for the client in person-centered therapy
3. empathy: the ability of the therapist to understand the feelings of the client
4. reflection: the therapist restates what the client says rather than interpreting those statements
LO 15.3 Basic Elements of Humanistic Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Rogers’s Person-Centered Therapy
• Motivational interviewing (MI)– In contrast to client-centered therapy, MI has
specific goals: namely, to reduce ambivalence about change and to increase intrinsic motivation to bring that change about
LO 15.3 Basic Elements of Humanistic Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Gestalt Therapy
• Gestalt therapy: form of directive insight therapy in which the therapist helps clients accept all parts of their feelings and subjective experiences, using leading questions and planned experiences such as role-playing
LO 15.3 Basic Elements of Humanistic Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Today’s View of Humanistic Therapy
• Humanistic therapies are not based in experimental research and work best with intelligent, highly verbal persons
LO 15.3 Basic Elements of Humanistic Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Classical Conditioning
• Behavior therapies: action therapies based on the principles of classical and operant conditioning and aimed at changing disordered behavior without concern for the original causes of such behavior
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Classical Conditioning
• Behavior modification or applied behavior analysis: use of learning techniques to modify or change undesirable behavior and increase desirable behavior
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Classical Conditioning
• Systematic desensitization: behavioral technique used to treat phobias, in which a client is asked to make a list of ordered fears and taught to relax while concentrating on those fears– counterconditioning: replacing an old
conditioned response with a new one by changing the unconditioned stimulus
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Classical Conditioning
• Aversion therapy: form of behavioral therapy in which an undesirable behavior is paired with an aversive stimulus to reduce the frequency of the behavior
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Classical Conditioning
• Exposure therapy: behavioral techniques that introduce the client to situations (under carefully controlled conditions) that are related to their anxieties or fears– flooding: technique for treating phobias and
other stress disorders in which the person is rapidly and intensely exposed to the fear-provoking situation or object and prevented from making the usual avoidance or escape response
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Classical Conditioning
• Exposure therapy (cont’d)– eye-movement desensitization reprocessing
(EMDR): controversial therapy for posttraumatic stress disorder and similar anxiety problems in which the client is directed to move the eyes rapidly back and forth while thinking of a disturbing memory needs more controlled studies
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Operant Conditioning
• Modeling: learning through the observation and imitation of others– participant modeling: technique in which a
model demonstrates the desired behavior in a step-by-step, gradual process while the client is encouraged to imitate the model
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Operant Conditioning
• Reinforcement: the strengthening of a response by following it with a pleasurable consequence or the removal of an unpleasant stimulus– token economy: the use of objects called
tokens to reinforce behavior in which the tokens can be accumulated and exchanged for desired items or privileges
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Operant Conditioning
• Reinforcement (cont’d)– contingency contract: a formal, written
agreement between the therapist and client (or teacher and student) in which goals for behavioral change, reinforcements, and penalties are clearly stated
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Behavioral Therapy and Operant Conditioning
• Extinction: the removal of a reinforcer to reduce the frequency of a behavior– time-out: an extinction process in which a
person (usually a child) is removed from the situation that provides reinforcement for undesirable behavior, usually by being placed in a quiet corner or room away from possible attention and reinforcement opportunities
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Effectiveness of Behavioral Therapy
• Behavior therapies can be effective in treating specific problems, such as bedwetting, drug addictions, and phobias
• Behavior therapies can also help improve some of the more troubling behavioral symptoms associated with more severe disorders
LO 15.4 Behavior Therapists’ Use of Classical and Operant Conditioning
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Cognitive Therapy
• Cognitive therapy: therapy in which the focus is on helping clients recognize distortions in their thinking and replace distorted, unrealistic beliefs with more realistic, helpful thoughts
LO 15.55 Goals of Cognitive Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Cognitive Therapy
• Cognitive distortions:– arbitrary inference: drawing a conclusion
without any evidence– selective thinking: focusing on only one
aspect of a situation while ignoring all other relevant aspects
– overgeneralization: drawing sweeping conclusions based on only one incident or event and applying those conclusions to events that are unrelated to the original
LO 15.5 Goals of Cognitive Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Cognitive Therapy
• Cognitive distortions (cont’d):– magnification and minimization: blowing a
negative event out of proportion (magnification) while ignoring relevant positive events (minimization)
– personalization: taking responsibility or blame for events that are unconnected to the person
LO 15.5 Goals of Cognitive Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Cognitive-Behavioral Therapies
• Cognitive-behavioral therapy (CBT): action therapy in which the goal is to help clients overcome problems by learning to think more rationally and logically
LO 15.5 Goals of Cognitive Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Cognitive-Behavioral Therapies
• Three goals: 1. Relieve the symptoms and solve the
problems.
2. Help develop strategies for solving future problems.
3. Help change irrational, distorted thinking.
LO 15.5 Goals of Cognitive Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Rational Emotive Therapy
• Rational emotive behavior therapy (REBT): cognitive-behavioral therapy in which clients are directly challenged in their irrational beliefs and helped to restructure their thinking into more rational belief statements
LO 15.5 Goals of Cognitive Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Success of CBT
• CBT has seemed successful in treating depression, stress disorders, and anxiety.
• CBT has been criticized for focusing on the symptoms, not the causes, of disordered behavior.
LO 15.5 Goals of Cognitive Therapies
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Types of Group Therapy
• Family counseling (family therapy): family members meet together with a counselor or therapist to resolve problems that affect the entire family
LO 15.6 Types of Group Therapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Types of Group Therapy
• Self-help group (support group): a group composed of people who have similar problems and who meet together without a therapist or counselor for the purpose of discussion, problem solving, and social and emotional support
LO 15.6 Types of Group Therapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
When Is Group Therapy Useful?
• Group therapy is most useful to persons who:– cannot afford individual therapy– may obtain a great deal of social and
emotional support from other group members
LO 15.6 Types of Group Therapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Group Therapy
• Advantages:– low cost– exposure to other people with similar
problems; social interaction with others– social and emotional support from people with
similar disorders or problems
LO 15.6 Types of Group Therapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Group Therapy
• Disadvantages:– need to share the therapist’s time with others
in the group– lack of a private setting in which to reveal
concerns– inability of people with severe disorders to
tolerate being in a group
LO 15.6 Types of Group Therapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Effectiveness of Psychotherapy
• Psychotherapy is more effective than no treatment at all
• Between 75 and 90 percent of people who receive therapy feel it has helped them– the longer a person stays in therapy, the
greater the improvement– psychotherapy works as well alone as with
drugs
LO 15.7 The Effectiveness of Psychotherapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Effectiveness of Psychotherapy
• Some types of psychotherapy are more effective for certain types of problems, and no one psychotherapy method is effective for all problems– effective therapy should be matched to the
particular client and the particular problem
LO 15.7 The Effectiveness of Psychotherapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Effectiveness of Psychotherapy
• Eclectic therapies: therapy style that results from combining elements of several different therapy techniques
• Common factors approach: modern approach to eclecticism focusing on factors seen as the source of success
LO 15.7 The Effectiveness of Psychotherapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Effectiveness of Psychotherapy
• Common factors approach– therapeutic alliance: the relationship between
therapist and client that develops as a warm, caring, accepting relationship characterized by empathy, mutual respect, and understanding
– protected setting– opportunity for catharsis– learning and practice of new behaviors– positive experiences for the client
LO 15.7 The Effectiveness of Psychotherapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Effectiveness of Psychotherapy
• Evidence-based treatment (EBT) refers to techniques or interventions that have produced desired outcomes, or therapeutic change in controlled studies
LO 15.7 The Effectiveness of Psychotherapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Culture and Psychotherapy
• When the cultures, ethnic groups, or genders of the therapist and the client differs, misunderstandings and misinterpretations can occur.
• Four barriers to effective psychotherapy exist when culture the backgrounds of client and therapist differ1. culture-bound values
2. class-bound values
3. language
4. nonverbal communication
LO 15.7 The Effectiveness of Psychotherapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Cybertherapy
• Cybertherapy: psychotherapy that is offered on the Internet– also called online, Internet, or Web therapy or
counseling– offers the advantages of anonymity and
therapy for people who cannot otherwise get to a therapist
LO 15.7 The Effectiveness of Psychotherapy
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Drug Treatments
• Biomedical therapies: therapies that directly affect the biological functioning of the body and brain
LO 15.8 Types of Drugs Used to Treat Psychological Disorders
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Drug Treatments
• Psychopharmacology: the use of drugs to control or relieve the symptoms of psychological disorders– antipsychotic drugs: used to treat psychotic
symptoms such as delusions, hallucinations, and other bizarre behavior
– antianxiety drugs: used to treat and calm anxiety reactions typically minor tranquilizers
LO 15.8 Types of Drugs Used to Treat Psychological Disorders
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Drug Treatments
• Psychopharmacology (cont’d)– mood-stabilizing drugs: used to treat bipolar
disorder include lithium and certain anticonvulsant drugs
– antidepressant drugs: used to treat depression and anxiety
LO 15.8 Types of Drugs Used to Treat Psychological Disorders
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Electroconvulsive Therapy
• Electroconvulsive therapy (ECT): biomedical treatment in which electrodes are placed on either one or both sides of a person’s head and an electric current strong enough to cause a seizure or convulsion is passed through the electrodes– still used to treat severe depression
LO 15.9 Electroconvulsive Therapy and Psychosurgery
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Psychosurgery
• Psychosurgery: surgery performed on brain tissue to relieve or control severe psychological disorders– prefrontal lobotomy: the connections of the
prefrontal lobes of the brain to the rear portions are severed
LO 15.9 Electroconvulsive Therapy and Psychosurgery
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Psychosurgery
• Psychosurgery (cont’d)– Bilateral anterior cingulotomy: an electrode
wire is inserted into the anterior cingulated gyrus area of the brain for the purpose of destroying that area of brain tissue with an electric current electrode is inserted with the guidance of a
magnetic resonance imaging (MRI) machine
LO 15.9 Electroconvulsive Therapy and Psychosurgery
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Psychosurgery
• Emerging techniques– repetitive transcranial magnetic stimulation
(rTMS): magnetic pulses are applied to the cortex
– transcranial direct current stimulation (tDCS): uses scalp electrodes to pass very low amplitude direct currents to the brain
LO 15.9 Electroconvulsive Therapy and Psychosurgery
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Psychology, Third EditionSaundra K. Ciccarelli • J. Noland White
Virtual Reality
• Virtual reality is a software-generated three-dimensional simulated environment with can be used in the treatment of PTSD– like playing a video game
LO 15.10 How Might Computers Be Used in Psychotherapy?
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