CHAPTER 15: TREATMENT O FP SYCHOLOGICAL D ISORDERS (PGS. 694-739)
The Elements of the Treatment Process
Treatments: How Many Types Are There?
Psychotherapists use many treatment methods that include discussion, advice, emotional
support, persuasion, condition procedures, relaxation training, role-playing, drug therapy,
biofeedback, and group therapy
(1) Insight Therapy – is a “talk therapy” in the tradition of Freud’s psychoanalysis
o Clients engage in complex verbal interactions with the therapist.
o Goal – pursue increased insight regarding the nature of client’s difficulties and
sort through possible solutions
o i.e. Family/Marital Therapy
(2) Behavior Therapy – based on principles of learning.
o Make direct efforts to alter problematic responses (i.e. phobias) and maladaptive
habits (i.e. drug use)
o Involves classical, operant and observational learning
(3) Biomedical Therapies – involve interventions into a person’s biological functioning,
through drug and electroconvulsive (shock) therapy
o These treatments have been provided only by physicians with a medical degree
Clients: Who Seeks Therapy
The two most common presenting problems are excessive anxiety and depression
A client does not necessarily have an identifiable psychological disorder
Reason’s people don’t pursue treatment – cost, lack of insurance, stigma (personal
Therapists: Who Provides Professional Treatment?
Psychology and psychiatry are the principal professions involved in the provision of
psychotherapy (refers to professional treatment with special training)
o 2 Types – clinical psychologists and counseling psychologists specialize in the
diagnosis and treatment of psychological disorders and everyday behavioral
o Clinical – treatment of full fledged disorders.
o Counseling – treatment of everyday adjustment problems in normal people.
o Must earn doctoral degree.
o Psychologists more likely to use behavioral techniques.
o Psychiatrist – physicians who specialize in the diagnosis and treatment of
o Treat everyday behavioural problem and devote more time to severe disorders
(schizophrenia, mood disorders)
o MD Degree
Other Mental Health Professionals
o Hospitals – clinical social workers, psychiatrist nurses as part of a team.
o Counselors – schools, colleges etc. – marital/drug counseling.
Involve verbal interactions intended to enhance the client’s self-knowledge and thus
promote healthful changes in personality and behavior
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Psychoanalysis – an insight therapy that emphasizes the recovery of unconscious,
conflicts, motives, and defenses through techniques such as free association and
Freud – neurotic problems are caused by unconscious conflicts left over from early
o He mostly treated anxiety-dominated disturbances ie. phobic, panic, obsessive-
compulsive and conversion disorders
o Inner conflicts involves battles among the Id, ego, and superego
o He noted that defensive maneuvers lead to self-defeating behavior
o He asserted that defenses tend to be only partially successful in alleviating
anxiety, guilt and other distressing emotions
Probing the Unconscious – two techniques
o Attempts to probe the murky depths of the unconscious to discover the
unresolved conflicts causing the client’s neurotic behavior
o Free Association – clients spontaneously express their thoughts and feelings
exactly as they occur, with as little censorship as possible
o Dream Analysis – therapist interprets symbolic meaning of the client’s dreams.
Interpretation – refers to the therapist’s attempts to explain the inner significance of the
Resistance – largely unconscious defensive maneuvers intended to hinder the progress of
Transference – clients unconsciously start relating to their therapist in ways that mimic
critical relationships in their live
o The client transfers conflicting feelings about important people onto the therapist
Modern Psychodynamic Therapies – based on Jung, Adler, etc.
o Other central features of modern psychodynamic therapies include:
(1) Focus on emotional experience
(2) Exploration of efforts to avoid distressing thoughts and feelings
(3) Identification of recurring patterns in patients’ life experiences
(4) Discussion of past experience, especially event in early childhood
(5) Analysis of interpersonal relationships
(6) A focus on the therapeutic relationship itself
(7) Exploration of dreams and other aspects of fantasy
Client-Centered Therapy – 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. (Rogers)
o Rogers – conflict due to incongruence between reality and self-concept.
o Help clients to realize that they do not have to worry constantly about pleasing
others and winning acceptance
Therapeutic Climate – therapist must provide:
o Genuineness – the therapist must be genuine with the client, communicating
honestly and spontaneously and not be phony or defensive
o Unconditioned positive regard – therapist must show a non-judgmental
acceptance the client as a person where therapists can disapprove of particular
o Empathy – the therapist must understand the world from client’s point of view
Therapeutic Process – therapist provides relatively little guidance, but primarily provides
o Key Task: Clarification
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o Therapists try to help clients better understand their interpersonal relationships
and become more comfortable with their genuine self
Therapies Inspired by Positive Psychology
Positive psychology uses theory and research to better understand the positive, adaptive,
creative and fulfilling aspects of human existence
Group therapy is the simultaneous treatment of several clients in a group.
Participant’s Roles – participants function as therapists for one another.
o Group members describe problems, viewpoints, and coping strategies.
o Therapist – selecting participants, setting goals for group, maintaining
therapeutic process, and protecting clients from harm.
Advantages of The Group Experience –
o Save time, money, clients learn misery not unique, work on social skills.
Couples and Family Therapy
Couples or Marital therapy involves the treatment of both partners in a committed,
intimate relationship, in which the main focus is on the relationship issues
Family Therapy involves the treatment of a family unit as a whole, in which the main
focus is on family dynamics an communication
How Effective Are Insight Therapies?
Clients usually invest considerable time, effort and money
Spontaneous Remission – recovery from a disorder that occurs without formal