Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

CHAPTER 17:Treatment

Psychology, 4/e by Saul Kassin

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Treatment

Psychological Therapies

Perspectives on Psychotherapy

Medical Interventions

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Professionals Involved in TherapyClinical Psychologists

Ph.D. in psychology, conducts testing, diagnosis, treatment, and research

Counseling Psychologists Ph.D. in counseling, help people with marital, family, and minor

adjustment problemsPsychiatrists

M.D., does a residency in psychiatry and can prescribe medications

Psychiatric Social Workers Master’s degree in social work with special training in counseling

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Psychoanalytic Therapies

Uncovering, resolving unconscious conflicts

Orthodox Psychoanalysis Free association Dream Analysis Resistance Transference

Brief Psychoanalytic Therapy

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Psychoanalytic TherapiesFree association

A basic technique of psychoanalysis in which the patient says whatever comes to mind-freely and without censorship

Resistance The tendency for patients to actively block, or

“resist,” psychologically painful insightsTransference

The tendency of patients to displace intense feelings for others onto the therapist

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Behavioral TherapiesBehavioral-therapy or Cognitive-behavioral

Therapy Techniques used to modify disordered thoughts,

feelings, and behaviors through the principles of learning

Classical Conditioning Techniques Flooding, Systematic Desensitization, Aversion Therapy

Operant-Conditioning Techniques Reward and Punishment, Token Economy, Biofeedback,

Social Skills Training

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Behavioral Therapies

Classical-Conditioning Techniques Flooding

• Technique in which the patient is saturated with a fear-provoking stimulus until the anxiety is extinguished

Systematic Desensitization • Technique used to treat anxiety disorders by pairing gradual

exposure to an anxiety-provoking situation with relaxation Aversion Therapy

• Technique for classically conditioned people to react with aversion to alcohol and other harmful substances

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Behavioral Therapies

These are Baseline-Instruction-Response Prevention (RP) cycles from a woman with a hand-washing compulsion.

After a few cycles, the woman was washing less often and getting fewer urges to wash.

Hand Washing

Urges

Therapeutic Effects of Exposure & Response Prevention

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Behavioral Therapies Aversion Therapy to Treat Alcoholism

Alcohol is paired with a chemical that causes nausea and vomiting.

Person should learn to associate alcohol with nausea.

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Behavioral TherapiesOperant-Conditioning Techniques

Reward and Punishment• Token Economy

Biofeedback• Procedure in which people learn to control physiological

responses with the help of “feedback” about their internal states

Social Skills Training• Used to teach interpersonal skills through modeling,

rehearsal, and reinforcement (e.g., assertiveness training)

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Behavioral Therapies Biofeedback and the Tension Headache

Sensors on the head detect muscle activity.

System converts signal to visual display.

Patient watches the display, learns to relax forehead muscles.

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Cognitive Therapies

Cognitive Therapy A form of psychotherapy in which people are

taught to think in more adaptive ways Rational-Emotive Behavior Therapy

• A form of cognitive therapy in which people are confronted with their irrational, maladaptive beliefs

Beck’s Cognitive Therapy• Uses a gentler, more collaborative approach to cognitive

therapy

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Cognitive Therapies Ellis’ A-B-C Theory of Emotional Distress

Emotional distress is caused by irrational thoughts and self-defeating beliefs.

Activating Event - Beliefs - Consequences

Emotional consequences then help sustain the irrational beliefs.

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Humanistic TherapiesRemoving impediments to personal growth Person-Centered Therapy

Involves a warm and accepting environment to foster self-insight and acceptance

Founded by Carl Rogers Therapists show empathy, unconditional positive regard, and

use reflection

Gestalt Therapy Therapy in which clients are aggressively prompted to

express their feelings Founded by Fritz Perls

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Psychological Therapies Humanistic TherapiesGroup-Therapy Approaches

Group Therapy The simultaneous treatment of several clients in a

group setting Each approach to psychotherapy has a form of group

therapy, e.g., transactional analysis is used by psychoanalysts.

Family Therapy Form of psychotherapy that treats the members of a

family as an interactive system

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Perspectives on PsychotherapyThe Bottom Line: Does Psychotherapy Work?

Based on the results of 475 studies (Smith et al., 1980), the average psychotherapy client shows more improvement than 80% of those in the no-treatment control group.

The Benefits of Psychotherapy

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Perspectives on PsychotherapyImprovement in Psychotherapy: The More The Better?

With additional therapy sessions, the percentage of people who improve increases up to 26 sessions.

Rate of improvement then levels off.

At one session per week, six months appears to be the ideal of amount of time.

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Perspectives on PsychotherapyAre Some Therapies Better Than Others?

All approaches are equally effective.However for some disorders, certain types

of therapy tend to be more successful. Examples: behavioral therapy for phobias,

person-centered therapy for raising self-esteem, and cognitive therapy for depression

There is no universal “best” type of therapy.

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Perspectives on PsychotherapyWhat are the Active Ingredients?

Three common, nonspecific factors are apparent in all types of psychotherapy. Supportive Relationship A Ray of Hope

• Placebo Effect (the curative effect of an inactive treatment that results simply from the patient’s belief in its therapeutic value) operates but it is not as effective as real psychotherapy.

Opportunity to Open Up

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Perspectives on PsychotherapyWhat is the Future of Psychotherapy? Orientations of Psychotherapists

Eclectic: Borrowing ideas and techniques from different approaches

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Medical InterventionsDrug Therapies

Psychopharmacology The study of the effects of drugs on psychological processes and disorders

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Medical InterventionsDrug TherapiesAntipsychotic Drugs & Hospitalization Trends

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Medical InterventionsTypes of Drug Treatments I

Antianxiety Drugs Tranquilizing medications used in the

treatment of anxiety Trade names: Librium, Valium, Xanax, BuSpar

Antidepressants Drugs that relieve depression by increasing the

supply of norepinephrine, serotonin, or dopamine

Trade names: Tofranil, Prozac

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Medical InterventionsTypes of Drug Treatments II Mood Stabilizer

Calms mania; may reduce bipolar mood swings Trade Name: Lithium Carbonate

• A drug used to control mania and mood swings in people with bipolar disorder

Antipsychotic Drugs Drugs used to control the positive symptoms of

schizophrenia and other psychotic disorders Trade names: Thorazine, Clozaril, Risperdal

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Medical InterventionsPerspectives on Drug Therapies

Drugs have helped numerous people who once lived in psychiatric institutions.

People may not respond well to psychotherapy.However, some drugs produce unpleasant or

dangerous side effects and may lead to a physical and/or psychological addiction.

Thus, patients become passive in the healing process.

Neither psychotherapy nor drug therapy has been found to be generally more effective.

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Medical Interventions

Electroconvulsive Therapy (ECT) Electric-shock treatments that often relieve

severe depression by triggering seizures in the brain

Psychosurgery The surgical removal of portions of the

brain for the purpose of treating psychological disorders

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

How To: Beating the Winter BluesSeasonal Differences in SAD

Seasonal Affective Disorder (SAD) is depression linked to certain times of year.

Symptoms are lethargy, withdrawal, increases in sleeping and eating

People with SAD feel even worse than most people do in the winter.

Light therapy can ease their suffering.

Psychology, 4/e by Saul Kassin ©2004 Prentice Hall

Where People Turn for Help