approaches to treatment and therapy. biological treatments kinds of psychotherapy evaluating...
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Approaches to Treatment and Therapy
• Biological Treatments• Kinds of Psychotherapy• Evaluating Psychotherapy
Cautions About Drug Treatment
• Placebo Effect• High Relapse and Dropout Rates• Dosage Problems• Long-Term Risks
Surgery and Electroshock
• Psychosurgery: – Any surgical procedure that destroys
selected areas of the brain believed to be involved in emotional disorders or violent, impulsive behavior.
• Electroconvulsive Therapy (ECT): – A procedure used in cases of prolonged and
severe major depression, in which a brief brain seizure is induced.
Kinds of Psychotherapy
• Psychodynamic Therapy• Behavioral and Cognitive Therapy• Humanist and Existential Therapy• Family Therapy• Psychotherapy in Practice
Psychodynamic Therapy
• Free Association: – In psychoanalysis, a method of uncovering
unconscious conflicts by saying freely whatever comes to mind.
• Transference: – In psychodynamic therapies, a critical step in
which the client transfers unconscious emotions or reactions, such as conflicts about his or her parents, onto the therapist.
Behavioral and Cognitive Therapy
• Systematic Desensitization• Aversive Conditioning• Exposure Treatments• Behavioral Records and Contracts• Skills Training
Cognitive Techniques
• Examine the evidence for beliefs.• Consider other explanations for the
behavior of others.• Identify assumptions and biases.
Humanist and Existential Therapy
• Client-Centered Therapy : – Developed by Carl Rogers; therapist tries to
create climate of Unconditional Positive Regard to allow clients to seek self-actualization and self-fulfillment.
– a.k.a., “Nondirective Therapy”
• Existential Therapy: – Helps clients explore the meaning of
existence and face with courage the great issues of life.
Systemic Therapy
• Salvador Minuchin (structural family therapy)– All individuals belong to a system.– Systems have structure.– Structure is defined by rules and boundaries.– Rules and boundaries define interaction patterns.– A family system consists of three smaller
subsystems• Spousal• Parental• Sibling
– Treatment focus is on fixing the systems structural problem and not on the individual or identified patient.
Primary Goals of Therapies
• Psychodynamic: – Insight into unconscious motives and
feelings.
• Cognitive-Behavioral: – Modification of behavior and irrational
beliefs.
Primary Goals of Therapies
• Humanist: – Insight; self-acceptance and self-fulfillment.
• Family: – Modification of individual habits and family
patterns.
Primary Methods of Therapies
• Psychodynamic: – Probing the unconscious through dream
analysis, free association, transference.
• Cognitive-Behavioral: – Behavioral techniques such as systematic
desensitization, flooding; cognitive exercises to identify and change faulty beliefs.
Primary Methods of Therapies
• Humanist: – Providing a safe, non-judgmental setting in
which to discuss life issues.
• Family: – Working with couples, families, and
sometimes individuals to identify and change patterns that perpetuate problems.
Evaluating Psychotherapy
• The Scientist-Practitioner Gap• When Therapy Helps• Which Therapy for Which Problem?• When Therapy Harms
The Scientist-Practitioner Gap
• Some psychotherapists believe that evaluating therapy using research methods is futile.
• Scientists find that therapists who do not keep up with empirical findings are less effective and can do harm to clients.
• Economic pressures require empirical assessment of therapies.
Is More Psychotherapy Better?
• With additional therapy sessions, the percentage of people improved increased up to 26 sessions.
• Rate of improvement then levels off.– Based on a summary
of 15 studies, 2400 clients (Howard, et al., 1996)
• Patients’ sense of improvement slower but more steady.
Psychotherapy Research: Three Questions
• What are the common ingredients in successful therapies?
• What kinds of therapy are best suited for which problems?
• Under what conditions can therapy be harmful?
When Therapy Helps
• Therapeutic Alliance: – The bond of confidence and mutual
understanding established between therapist and client, which allows them to work together to solve the client’s problems.
Which Therapy for Which Problem?
• Depression: – Cognitive therapy’s greatest success has
come in treatment of mood disorders.• Anxiety Disorders:
– Exposure techniques are more effective than others.
• Anger and Impulsive Violence: – Cognitive therapy is extremely successful.
Which Therapy for Which Problem?
• Health Problems: – Cognitive and behavior therapies are
effective for a wide range of health problems.• Childhood and Adolescent Behavior Problems:
– Behavior therapy is the most effective treatment.
Cognitive Inoculation Against Depression
• Children at risk for depression split into two groups
• Cognitive intervention with one group lowered depression risk
• Effects of intervention seem to grow over time
Successful Therapy
• Psychotherapy outcome depends not only on method of therapy.
• Qualities of client and therapist, and their alliance, also determine success.
When Therapy Harms
• Animosity or biased treatment on the part of the therapist.
• Coercion to adopt the therapist’s advice, sexual intimacies, or other unethical behavior.