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10 Apr 2012
Chapter 15: Treatment of Psychological Disorders
Treaments: How Many Types Are There?
(1) Insight therapies – talk therapy, involving sort through problems and solutions.
(2) Behaviour therapies – making a direct effort to change problematic responses and
maladaptive habits. Most of their procedures involve classical/operant conditioning or
observational learning.
(3) Biomedical therapies – interventions into a person’s biological functioning. Ex. ECT
Clients: Who Seeks Therapy?
2 most common problems: anxiety and depression
Many who don’t have a mental disorder still go to therapy
There’s a stigma surrounding seeking mental professional help
Therapists: Who Provides Professional Treatment?
2 types: clinical and counselling psychologists specialize in the diagnosis and treatment of
psychological disorders and everyday behavioural problems.
Clinical psychologists’ training emphasizes the treatment of full-fledged disorders while
counselling psychologists’ training is slanted toward the treatment of everyday adjustment
Both must earn a doctoral degree, serve a one-year internship in a clinical setting, followed by
postdoc fellowship training.
Def: physicians who specialize in the diagnosis and treatment of psychological disorders
~ devote more time to relatively severe disorders
~ have an MD degree, including 4 years of coursework and 4 years of an apprenticeship in a
residency at a hospital.
More likely to use psychoanalysis, and medication
Other Mental Health Professionals
Clinical social workers and psychiatric nurses: work as part of a treatment team w/ a psychologist
or psychiatrist. Psychiatric nurses play a role in hospital inpatient treatment, while clinical social
workers typically work w/ patients and their families to ease the patient’s integration back into
the community
Counsellors provide therapeutic services, and specialize in particular types of problems
Insight Therapies
Def: involve verbal interactions intended to enhance clients’ self-knowledge and thus promote
healthful changes in personality and behaviour.
Def: an insight therapy that emphasizes the recovery of unconscious conflicts, motives, and defences
through techniques such as free association and transference.
Freud mostly treated anxiety-dominated disturbances; he believed that neurotic problems are
caused by unconscious conflicts left over from early childhood, and also, conflicts b/w the id, ego,
and superego over sex.
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Probing the Unconscious
Free association (def): in which clients spontaneously express their thoughts and feelings exactly as
they occur, with as little censorship as possible.
From details, no matter no trivial, clients gradually begin to let everything pour out w/o conscious
censorship. The analyst studies these free associations for clues to the client’s unconscious.
Dream analysis (def): in which the therapist interprets the symbolic meaning of the client’s dreams
Clients are trained to remember their dreams, which they describe in therapy,. The therapist then
analyzes the symbolism in these dreams.
Def: refers to the therapist’s attempts to explain the inner significance of the client’s thoughts,
feelings, memories and behaviours.
~ don’t dazzle w/ complex conclusions, but inch forward slowly based on the info available to
Def: largely unconscious defensive manoeuvres intended to hinder the progress of therapy.
Because patients don’t want to face the truth
Def: occurs when clients unconsciously start relating to their therapist in ways that mimic critical
relationships in their lives.
The client might start relating to the to a therapist as though the therapist were an
overprotective mother etc. psychoanalysts encourage ~ so that clients can re-enact
relationships w/ crucial ppl in the context of therapy, which can bring up repressed feelings and
conflicts to the surface, allowing the client to work through them.
Modern Psychodynamic Theories
Descendants of psychoanalysis are collectively known as psychodynamic approaches to therapy
People who exhibit more resistance to therapy are less likely to experience a positive outcome
~ can help in a variety of disorders, including panic disorder, borderline personality disorder and
substance abuse
Client-Centred Therapy
Client-centred therapy (developed by Rogers): an insight therapy that emphasizes providing a
supportive emotional climate for clients, who play a major role in determining the pace and direction
of their therapy
B/c Rogers’s theory about the main causes of neurotic anxieties is based on incongruence b/w a
person’s self-concept and reality, this makes ppl feel threatened by realistic feedback from
others. This then leads to defence mechanisms, to distortions of reality, and stifled personal
growth. analysts clarify, rather than interpret, the feelings expressed by their clients.
Therapeutic Climate
According to Rogers, the process of therapy is not as important as the emotional climate in which
the therapy takes place, in which clients can confront their shortcomings w/o feeling threatened.
To create this atmosphere of emotional support, therapists must:
o(1) Genuineness – the therapist should be genuine, not phony or defensive,
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o(2) Unconditional positive regard – the therapist must show complete, non-
judgemental acceptance of the client as a person, but still disapprove of certain bits of
the client’s behaviour,
o(3) Empathy – the therapist must understand the client’s world from the client’s point
of view.
Therapeutic Process
emotion-focused couples therapy (developed by Greenberg and Johnson) allows the partners to
identify and acknowledge their needs, and are encouraged to express these needs and arrive at a
solution. process-experiential therapy was just as effective as cognitive-behavioural therapy,
and it also results in a significant decrease in clients’ reports of interpersonal problems
Therapies Inspired by Positive Psychology
Well-being therapy (dev. by Fava and co.) – seeks to enhance clients’ self-acceptance, purpose in
life, autonomy, and personal growth. It has been used successfully in the treatment of mood and
anxiety disorders.
Positive psychotherapy (dev. by Seligman and co.) – attempts to get clients to recognize their
strengths, appreciate their blessings, savour positive experiences, forgive those who have wronged
them, and find meaning in their lives. ~ can be an effective treatment for depression.
Group Therapy
Def: the simultaneous treatment of several clients in a group.
Participants’ Roles
4 – 15 ppl, 8 is ideal
The participants function as therapists for one another, w/ the participants describing their
problems, trading viewpoints, sharing experiences and discussing coping strategies. They also
provide acceptance and emotional support for one another. Once they start caring about one
another’s opinions, they’ll work hard to display healthy changes to win the group’s approval.
The therapist selects participants, sets goals for the group, initiates and maintains the
therapeutic process, and protects clients from harm; also, the therapist mostly stays in the
background and focuses on maintaining group cohesiveness.
Advantages of the Group Experience
Less costly than individual therapy
Participants realize that they are not alone or unique in their problems
Participants can also work on their social skills in a safe environment
Evaluating Insight Therapies
Evaluating the effectiveness of any approach to treatment is complex b/c psychological disorders
sometimes run their course and clear up on their own.
Spontaneous remission (def): a revovery from a disorder that occurs w/o formal treatment one
can’t automatically assume that the recovery for a treatment was effective once a client recovers.
Generally, insight therapy is be than no therapy or placebo treatment, and about the same as
drug therapies. Studies find the greatest improve early in treatment w/ further gains gradually
diminishing in size over time.
Do Insight Therapies Work?
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