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.
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
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
d. Must earn doctoral degree.
e. Psychologists more likely to use behavioral techniques.
2. Psychiatrist – physicians who specialize in the diagnosis and treatment of
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.
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
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