Chapter 15 - Treatment of Psychological Disorders
The Elements of the Treatment Process
Treatments: How Many Types Are There?
1. Insight therapies - "talk therapy"
2. Behaviour therapies - based on principles of learning
3. Biomedical therapies - involve interventions into a person's biological functioning
Client: Who goes to therapy?
People with problems: anxiety, depression (2 most common), unsatisfactory interpersonal
relations, troublesome habits, poor self-control, low self-esteem, marital conflicts, self-doubt, a
sense of emptiness, and feelings of personal stagnation
Therapists: Who practices therapy?
Clinical psychologists & counselling psychologists: provide therapy, diagnose and treat
psychological disorders & everyday behavioural problems
o Require doctoral degree
Psychiatrists - physicians who specialize in the diagnosis and treatment of psychological disorders
o More time on severe disorders (schizophrenia, mood disorders)
Mental health counsellors, clinical social workers, psychiatric nurses - all other professions will be
called clinician, therapist, provider
Who benefits most from therapy?
Patients with some anxiety often do better
Patients who are better adjusted to begin with
Insight therapies - involve verbal interactions intended to enhance clients’ self-knowledge and thus
promote healthful changes in personality and behavior
Psychoanalysis is an insight therapy that emphasizes the recovery of unconscious conflicts, motives, and
defenses through techniques such as free association and transference
Probing the Unconscious
o Free association - clients spontaneously express their thoughts and feelings exactly as they
occur, with as little censorship as possible
o Dream analysis the therapist interprets the symbolic meaning of the client’s dreams
Interpretation
o Interpretation refers to the therapist’s attempts to explain the inner significance of the
client’s thoughts, feelings, memories, and behaviors
Resistance
o Resistance refers to largely unconscious defensive maneuvers intended to hinder the
progress of therapy
Transference o Transference occurs when clients unconsciously start relating to their therapist in ways that
mimic critical relationships in their lives
Modern Psychodynamic Therapies
o Interpretation, resistance, and transference continue to play key roles in therapeutic effects
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
Therapeutic Climate
Therapists must provide three conditions:
a. Genuineness
b. Unconditional positive regard
c. Empathy
Therapeutic Process
o
The therapist’s key task is clarification
o Emotion-focused therapy
o Client-centered therapy resembles psychoanalysis in that both seek to achieve a major
reconstruction of a client’s personality
Therapies Inspired by Positive Psychology
Well being therapy (Gava) - seeks to enhance clients’ self-acceptance, purpose in life, autonomy,
and personal growth
o Treat mood disorders and anxiety disorders
Positive psychotherapy (Seligman) - get clients to recognize their strengths, appreciate their
blessings, savor positive experiences, forgive those who have wronged them, and find meaning in
their lives
o Treat depression
Group Therapy
WWII in 1950s
Group therapy is the simultaneous psychological treatment of several clients in a group
Participants’ Roles
o Consists of 4-15 people with ideal of 8 participants
o Participants essentially function as therapists for one another
o
Therapist’s responsibilities include selecting participants, setting goals for the group,
initiating and maintaining the therapeutic process, and protecting clients from harm
Advantages of the Group Experience
o Save time and money
o Same effective as individual treatment
o Certain types of problems and clients respond especially well to the social support that
group therapy can provide
How Effective Are Insight Therapies?
Spontaneous remission - a recovery from a disorder that occurs without formal treatment
They are as effective as other therapies How Do Insight Therapies Work?
Approaches to therapy share common factors:
1. Development of a therapeutic alliance with a professional helper
2. Provision of emotional support and empathic understanding by the therapist
3. Cultivation of hope and positive expectations in the client
4. Provision of a rationale for the client's problems and a plausible method for reducing them
5. Opportunity to express feelings, confront problems, gain new insights, and learn new patterns of
behaviour
Behavior Therapies - involve the application of learning principles to direct efforts to change clients’
maladaptive behaviors
Assumptions:
Behaviour is a product of learning
What has been learned can be unlearned
Systematic Desensitization
A behavior therapy used to reduce phobic clients’ anxiety responses through counterconditioning
(reversal of classical conditioning)
Assumption: most anxiety responses are acquired through classical conditioning
1. Therapist helps the client build an anxiety hierarchy (list of anxiety-arousing stimuli)
2. Training client in deep muscle relaxation
3. Client tries to work through hierarchy, learning how to remain relaxed while imagining each
stimulus
4. As clients conquer imagined phobic stimuli, they may be encouraged to confront the real stimuli.
Aversion therapy
A behavior therapy in which an aversive stimulus is paired with a stimulus that elicits an
undesirable response
Social skills training
Behavior therapy designed to improve interpersonal skills that emphasizes modeling
(observation), behavioral rehearsal(practice social techniques in structured role-playing exercises),
and shaping (clients handle more complicated & delicate social situations)
Cognitive-Behavioral Treatments
Use varied combinations of verbal interventions and behavior modification techniques to help
clients change maladaptive patterns of thinking
Ex: rational emotive behaviour therapy, mindfulness-based cognitive therapy
Aaron Beck's cognitive therapy uses specific strategies to correct habit
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