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Chapter 16

PSY 202 Chapter 16: CH16Textbook Psychological and Biological Treatments

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Ryerson University
PSY 202
Kathleen Fortune

Tuesday April 11, 2017 | Katie Choi Chapter 16: Psychological and Biological Treatments – Helping People Change  Psychotherapy: a psychological intervention designed to help people resolve emotional, behavioural, and interpersonal problems and improve the quality of their lives Psychotherapy: Clients and Practitioners  Describe who seeks treatment, who benefits from psychotherapy, and who practises psychotherapy  Distinguish between professionals and paraprofessionals, and describe what it takes to be an effective therapist Who Seeks and Benefits From Treatment? Gender, Ethnic, and Cultural Differences in Entering Treatment  Women are more likely to seek treatment than men  Both sexes benefit equally from psychotherapy  Hispanics, are less likely to see mental health services than Caucasians  Individuals obtain psychotherapy are likely to benefit from it  No consistent evidence that client-therapist ethnic or gender matches enhance therapy outcome  People can be helped by therapists who differ from them in significance ways Reaping Benefits From Treatment  Clients who are better adjusted  Realize that they may be contributing to their own problems  Are motivated to work on those problems  Most likely to improve  Clients who experience some anxiety do better in psychotherapy  Distress fuels their motivation to make life changes The Ideal Clients? A 1964 study found that many therapists preferred to treat people who were relatively young, attractive, verbal, intelligent, and successful. Nevertheless, therapists have recently become more aware of the importance of assisting a broad clientele of all ages and cultural background. Who Practices Psychotherapy? Professionals Versus Paraprofessionals  Paraprofessionals: person with no professional training who provides mental health services Tuesday April 11, 2017 | Katie Choi  In most provinces, therapist isn’t legally protected  Obtain agency-specific training and attend workshops that enhance their educational backgrounds  Compensate for the sizeable gap between the high demand for and meagre supply of licensed practitioners  Don’t need to be professionally trained or have many years of experience to be effective  Professional helpers  Understand how to operate effectively within the mental health system  Appreciate complex ethical, professional, and personal issues  Can select treatments of demonstrated effectiveness  More confident, less defensive, and better able to appreciate clients’ world view What Does It Take To Be An Effective Psychotherapist?  Not to contradict clients  Select important topics to focus on in sessions  Match their treatments to the needs and characteristics of clients  “Good therapist” is an expert who is warm, respectful, caring, and engaged Insight Therapies: Acquiring Understanding  Describe the core beliefs and criticisms of psychodynamic therapies  Describe and evaluate the effectiveness of humanistic therapies  List the advantages of group methods, and describe the research evidence concerning the effectiveness of Alcoholics Anonymous  Identify different approaches to treating the dysfunctional family system  Psychodynamic therapy treatments inspired by classical psychoanalysis and influenced by Freud’s techniques  Psychoanalysis  Expensive and lengthy  Psychodynamic therapy  Less costly and briefer  Insight therapies: psychotherapies, including psychodynamic, humanistic, and group approaches, with the goal expanding awareness or insight Psychoanalytic and Psychodynamic Therapies: Freud’s Legacy Tuesday April 11, 2017 | Katie Choi  Three approaches and beliefs  Causes of abnormal behaviours stem from traumatic or other adverse childhood experiences  Strive to analyze  Distressing thoughts and feelings that clients avoid  Wishes and fantasies  Recurring themes and life patterns  When clients achieve insight into previously unconscious material, the causes and the significance of symptoms will become evident  symptoms disappear Psychanalysis: Key Ingredients  Goal is to decrease guilt and frustration and make the unconscious conscious by bringing to awareness previously repressed impulses, conflicts, and memories Free Association  Technique in which clients express themselves without censorship of any sort Interpretation  Explanations of the unconscious bases of a client’s dreams, emotions, and behaviours Dream Analysis  Interpret the relation of the dream to the client’s waking life and the dream’s symbolic significance  E.g. appearance of an ogre – manifest content  E.g. representing a hated and feared patent – latent content Resistance  Attempts to avoid confrontation and anxiety associated with uncovering previously repressed thoughts, emotions, and impulses  Make clients aware that they’re unconsciously blocking therapeutic efforts and make clear how and what they’re resisting Transference  Projecting intense, unrealistic feelings  Ambiguous figure of the analyst supposedly becomes the focus of emotions once directed at significant persons from the client’s childhood Tuesday April 11, 2017 | Katie Choi  Provides a vehicle for clients to understand their irrational expectations and demands of others Working Through  Help clients work through, or process, their problems Developments In Psychoanalysis: The Neo-Freudian Tradition  More concerned with conscious aspects of the client’s functioning  Carl Jung  Individuation – the integration of opposing aspects of the personality into a harmonious “whole” – the self  Considered their future goals as well as their past experiences  Acknowledge the impact of other needs  Love  Dependence  Power  Status  Harry Stack Sullivan  Interpersonal psychotherapy – emphasis on interpersonal relationships  Analyst’s role should be participant observer  Interpersonal therapy (IPT): treatment that strengthens social skills and targets interpersonal problems, conflicts, and life transitions Is Insight Necessary?  Insight – crucial ingredient in therapeutic change  Understanding our emotional history isn’t required to relieve psychological distress  To improve, clients need to engage in working through  Failure to rule out rival hypotheses lead to placebo effect Are Traumatic Memories Repressed?  Disturbing events are actually more memorable and less subject to forgetting than everyday occurrences  Richard McNally  Scientific support for repressed memories is weak Tuesday April 11, 2017 | Katie Choi  Memories are often subject to distortion Psychodynamic Therapies Evaluated Scientifically  Less effective than cognitive-behavioural therapies, which don’t emphasize insight  Isn’t especially effective for psychotic disorders Humanistic Therapies: Achieving Our Potential  Humanistic therapies: therapies that emphasize the development of human potential and the belief that human nature is basically positive  Reject the interpretive techniques of psychoanalysis  Understand clients’ inner worlds through empathy and focus on clients’ thoughts and feelings in the present  Help people overcome the sense of alienation  Develop their sensory and emotional awareness  Express their creativity and help them become more positive  Do not attribute our problems to the past, and living fully and finding meaning in the present Person-Centred Therapy: Attaining Acceptance  Carl Rogers  Non-directive – because therapists don’t define or diagnose clients’ problems or try to get at the root cause of their difficulties  Person-centred therapy: therapy centering on the client’s goals and ways of solving problems  Three conditions of a positive outcome: 1. Must be an authentic person who reveals his or her own reactions to what the client is communicating 2. Must express unconditional positive regard – non-judgemental acceptance of all feelings the client expresses 3. Must relate to clients with empathic understanding  Communicate empathy by reflection – mirroring back the client’s feelings  With increased awareness and heighted self-acceptance  People come to think more realistically  Become more tolerant of others Tuesday April 11, 2017 | Katie Choi  Engage in more adaptive behaviours  Motivational interviewing recognizes many clients are about changing long-standing behaviours and is geared toward clarifying and bringing forth their reasons for changing – and not changing – their lives  Treating alcohol-related problems Gestalt Therapy: Becoming Whole  Fritz Perls  Gestalt therapy: therapy that aims to integrate different and sometimes opposing aspects of personality into a unified sense of self  Getalt – organized whole  People with psychological difficulties are “incomplete gestalts”  Excluded from their awareness experiences and aspects of their personalities that trigger anxiety  Key: accepting responsibility for one’s feelings and maintaining contact with the here and now  First to recognize the importance of awareness, acceptance, and expression of feelings  Two-chair technique  Move from chair to chair creating a dialogue with two conflicting aspects of their personalities  Allows a synthesis of the opposing sides to emerge Humanistic Therapies Evaluated Scientifically  Core concepts (self-actualization) are difficult to measure and falsify  Establishing a strong alliance is helpful to the ultimate success of therapy  Therapeutic relationship is a strong predictor of success in therapy  Therapeutic relationship isn’t necessary for improvement  Clients may first improve and then develop a stronger emotional bond with the therapist as a result  Effectiveness of person-centred therapy are inconsistent Group Therapies: The More, The Merrier  Jacob Moreno  Group therapy: therapy that treats more than one person at a time  Efficient, time saving, and less costly Tuesday April 11, 2017 | Katie Choi  Provide and receive support  Exchanging information and feedback  Practise new skills  Recognizing that they’re not alone  The most recent trend is for self-help groups to form over the internet Alcoholics Anonymous  Self-help groups are composed of peers who share a similar problem; don’t include a professional mental illness specialist  Alcoholics Anonymous (AA): 12 step, self-help program that provides social support for achieving  Treating people with alcoholism  Based on the assumptions that alcohol is a physical disease and “once an alcoholic, always an alcoholic”  Require members never drink another drop after entering treatment  AA and cognitive-behavioural therapy results similar outcome Controlled Drinking and Relapse Prevention  Controlled drinking – drinking in moderation  Relapse preventions (RP) treatment teaches people to not feel ashamed or discouraged when they lapse, in an effort to avoid the abstinence violation effect  Teaches people to rebound after a lapse and to avoid situations in which they’re tempted to drink  Lapse doesn’t mean a relapse Family Therapies: Treating the Dysfunctional Family System  Psychological problems as rooted  Focus on interactions among family members Strategic Family Therapy  Strategic family interventions: family therapy approach designed to remove barriers to effective communication  Families often scapegoat one family member as the identified patient with the problem  Difficulties lies in which family members communicate, solve problems, and relate to one another 1. Identify the family’s unhealthy communication patterns Tuesday April 11, 2017 | Katie Choi 2. Invite family members to carry out planned tasks knowns as directives: shift how family members solve problems and interact – involves paradoxical requests a. Reverse psychology b. Comment their “resistant” to intentionally produce the thought, feeling, or behavioural that troubled them Structural Family Therapy  Structural family therapy: treatment in which therapists deeply involve themselves in family activities to change how family members arrange and organize interactions Behavioural Approaches: Changing Maladaptive Actions  Describe the characteristics of behavioural therapy, and identify different behavioural approaches  Describe the features of cognitive-behavioural therapies (CBT)  Behavioural therapists: therapists who focus on specific problem behaviours and on current variables that maintain problematic thought, feelings, and behaviours  Behavioural change results from the operation of basic principles of learning  Use behavioural assessment techniques to pin-point environmental causes of the person’s problem, establish specific and measurable treatment goals, and devise therapeutic p
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