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Chapter 15

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University of Toronto Mississauga
Dax Urbszat

Feb/29/2004, Sunday CHANAPS Notes From Reading C HAPTER15: T REATMENT O FP SYCHOLOGICALD ISORDERS I. The Elements of the Treatment Process A. Treatments: How Many Types Are There? 1. Insight Therapy – i.e. “talking therapy”. Roots found in Freudian psychology. Clients engage in complex verbal interactions with therapists. a. Goal – pursue increased insight regarding the nature of client’s difficulties and sort through possible solutions. b. i.e. Family/Marital Therapy. 2. Behavior Therapy – based on principles of learning. Make direct efforts to alter problematic responses (i.e. phobias) and maladaptive habits (i.e. drug use). a. Involves classical, operant and observational learning. 3. Biomedical Therapies – involve interventions into a person’s biological functioning, through drug and electroconvulsive (shock) therapy i.e. Psychiatrist. B. Clients: Who Seeks Therapy 1. Most popular treatments for anxiety and depression. 2. 15% of population receives mental health service in a year. 3. Reason’s people don’t pursue treatment – cost, lack of insurance, stigma (personal weakness). C. Therapists: Who Provides Professional Treatment 1. Psychologists – a. 2 Types – clinical psychologists and counseling psychologists – both specialize in diagnosis and treatment of psychological disorders and everyday behavioral problems. b. Clinical – treatment of full fledged disorders. c. Counseling – treatment of everyday adjustment problems in normal people. d. Must earn doctoral degree. e. Psychologists more likely to use behavioral techniques. 2. Psychiatrist – physicians who specialize in the diagnosis and treatment of psychological disorders. a. MD Degree 3. Other Mental Health Professionals a. Hospitals – clinical social workers, psychiatrist nurses as part of a team. b. Counselors – schools, etc. – marital/drug counseling. II. Insight Therapies  Involve verbal interactions intended to enhance the client’s self knowledge and thus promote healthful changes in personality and behavior. A. Psychoanalysis 1. Psychoanalysis – an insight therapy that emphasizes the recovery of unconscious, conflicts, motives, and defenses through techniques such as free association and transference. 2. Freud – neurotic problems are caused by unconscious conflicts left over from early childhood. Inner conflicts of Id, ego, and superego. 3. Probing the Unconscious – two techniques a. Free Association – clients spontaneously express their thoughts and feelings exactly as they occur, with as little censorship as possible. 1/4 Feb/29/2004, Sunday CHANAPS Notes From Reading C HAPTER 15: TREATMENT O F PSYCHOLOGICAL DISORDERS b. Dream Analysis – therapist interprets symbolic meaning of the client’s dreams. 4. Interpretation – therapists attempts to explain the inner significance of the client’s thoughts, feelings, memories and behaviors. 5. Resistance – largely unconscious defensive maneuvers intended to hinder the progress of therapy. 6. Transference – clients unconsciously start relating to their therapist in ways that mimic critical relationships in their lives. 7. Modern Psychodynamic Therapies – based on Jung, Adler, etc. B. Client-Centered Therapy 1. 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) a. Rogers – conflict due to incongruence between reality and self concept. 2. Therapeutic Climate – therapist must provide: a. Genuineness – honesty and spontaneously b. Unconditioned positive regard – therapist must show a non judgmental acceptance of patient. c. Empathy – understand the world from client’s point of view. 3. Therapeutic Process – therapist provides relatively little guidance, but primarily provides feedback. Key Task: Clarification C. Cognitive Therapy 1. Cognitive Therapy – an insight therapy that emphasizes recognizing changing negative thoughts and maladaptive beliefs. (Beck) 2. Originally devised as a treatment for depression. 3. Depressed People tend to: a. Blame setbacks on personal inadequacies b. Focus on negative events c. Be pessimistic of the future d. Have a negative self worth. 4. Goals and Techniques – a. Goal – change the way clients think – taught to detect automatic negative thoughts and test them with reality. b. Therapists actively involved with pace of therapy. May argue with clients. 5. Kinship with Behavior Therapy – client may be given “homework assignments” and asked to perform overt behaviors. D. Group Therapy 1. Group therapy is the simultaneous treatment of several clients in a group. 2. Participant’s Roles – participants function as therapists for one another. a. Describe problems, viewpoints, coping strategies. b. Therapist – selecting participants, setting goals for group, maintaining therapeutic pr
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