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Terry Biggs (155)

Chapter 17.docx

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Psychology 1000
Terry Biggs

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Chapter 17: Treatment of Psychological Disorders THE HELPING RELATIONSHIP: - basic goal: change maladaptive, self-defeating thoughts, feelings and behaviour patterns so they can live happier and be more productive in life - Counselling and clinical psychologists – doctor of philosophy or doctor of psychology. 5+ years of training and supervision in psychotherapeutic techniques and research - Psychiatrists – medical doctors specializing in psychotherapy and biomedical treatments PSYCHOANALYSIS: - goal: help patients achieve insight – the conscious awareness of the psychodynamics that underlie their problem - allows them to adjust their behaviour FREE ASSOCIATION: - verbalizing all thoughts that enter consciousness without censorship - thought to provide clues of important themes or issues in patients mind DREAM INTERPRETATION: - dreams express impulses, fantasies, and wishes that a person’s defence’s will keep in the unconscious - threatening material in dreams is generally still protected to prevent anxiety RESISTANCE: - defensive maneuvers to hinder the process of therapy - sign of anxiety-arousing sensitive material is being approached TRANSFERENCE: - client responds irrationally to the analyst as if they are an important figure from client’s past - brings repressed feelings and maladaptive patterns into the open – therapist is able to bring them to the attention of the client - 2 basic forms: o positive transference: client transfers feelings of intense affection, dependency, or love to the analyst o negative transference: irrational expressions of anger, hatred, or disappointment INTERPRETATION: - any statement by the therapist intended to provide the client with insight into his or her behaviour or dynamics - confronts clients with something they have not yet admitted into consciousness - interpret something that is near the surface – just beyond client’s current awareness HUMANISTIC PSYCHOTHERAPIES: - view humans as capable for consciously controlling their actions and taking responsibility for their choices and behaviour - everyone possesses inner resources for self-healing and personal growth - disordered behaviour reflects blocking of natural growth process – brought on by distorted perceptions, lack of awareness about feelings or negative self image - therapists goal: create an environment the clients can engage in self exploration and remove the barriers that block growth - barriers: often from childhood experiences that involved unrealistic or maladaptive standards for self worth - focuses primarily on the present CLIENT-CENTERED THERAPY: - Carl Rogers - Focused on the therapeutic environment that seemed most effective in fostering self-exploration and personal growth - 3 important attributes: o Unconditional positive regard – therapists show genuine care and acceptance for clients, no judgment or evaluation  Communicate a sense of trust in client’s ability to work through their problems o Empathy – willingness and ability to see the world through client’s eyes o Genuineness – consistency between the way the therapist feels and behaves  Honestly express feelings – positive or negative - As client’s experience a constructive therapeutic relationship, they show increased self-acceptance, self-awareness, self-reliance, comfort with other relationship and life functioning GESTALT THERAPY: - bring client’s into immediate awareness so they can be “whole” once again - often carried out in groups - imaginative techniques to “get in touch with their inner selves” - confrontational in nature - active and dramatic - role play – empty chair technique ELLIS’S RATIONAL-EMOTIVE THERAPY: - irrational thoughts are the most immediate cause of self-defeating emotions - ABCD Model o A – Activating event – triggers the emotion o B – Belief system – way the person appraises the event o C – consequences – emotional and behavioural o D – Disputing – key to changing maladaptive emotions and behaviours BECK’S COGNITIVE THERAPY: - point out errors of thinking and logic that underlie emotional disturbance and help clients identify and reprogram their overlearned “automatic” thought patterns BEHAVIOUR THERAPIES: Exposure: An Extinction Approach: - exposure to the feared conditioned stimulus while unconditioned stimulus is absent - exposure to real life stimuli (flooding), imagine scenes with stimuli (implosion therapy) - anxiety will extinguish if person stay with CS and UCS does not occur - treatment of choice for PTSD Systematic Desensitization: A Counterconditioning Approach: - Joseph Wolpe - Anxiety as a classically conditioned emotional response - Eliminate anxiety with “counterconditioning” – new response that is incompatible with anxiety is conditioned to be the anxiety-arousing CS - First step: voluntary muscles relaxation - Create a “stimulus hierarchy” – low anxiety to high anxiety situations with feared stimulus - Desensitization – deeply relaxed – therapist asks client to remember first scene off hierarchy, stay relaxed, move to next on.. etc. - Relaxation becomes the CR to the stimulus Aversion Therapy: - therapist pairs a stimulus attractive to the person with a noxious one - e.g. nausea producing drug + alcohol OPERANT CONDITIOING TREATMENTS: - Behaviour Modification – application of operant conditioning procedures in an attempt to increase or decrease a specific behaviour Positive Reinforcement: - many hospitalized psychiatric patients lose social, personal care, and occupational skills - Ayllon and Azrin – token economy – system to strengthened desired behaviours (grooming, housekeeping, social responses, working on assigned jobs and participation in vocational training programs) - Earned plastic tokens – save up to be redeemed for tangible reinforcers Therapeutic Use of Punishment: - least preferred way - aversive qualities and potential negative side effects - therapists must ask: o is there an alternative way? o Is the behaviour to be eliminated sufficiently injurio
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