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Chapter 18

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John Bassili

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Chapter 18 The Treatment of Psychological Disorders
Psychological Disorders and Psychotherapy
Early Treatment of Psychological Disorders
Trephining drilling holes in a persons skull; earliest known attempts to treat
psychological disorders
Philippe Pinel French physician, believed that mental patients would respond favourably
to kind treatment
The Development of Psychotherapy
Mesmerism an older name for hypnosis
Eclectic approach involves the therapists using whatever methods he or she feels work
best for a particular client at particular time; most therapist adopt this approach
Insight Therapies
Insight therapy practitioners of this type of therapy assume that people are essentially
normal but learn maladaptive thought patterns and emotions, which are revealed in
maladaptive behaviours; view behaviour as a symptom of deeper underlying psychological
Psychoanalysis and Modern Psychodynamic Approaches
Psychoanalysis (Freud) form of therapy aimed at providing the client with insight into
their unconscious motivations and impulses; recall psychodynamic approach
Id representing biological urges
Superego representing the moral dictates of society
Ego representing reality
Main goal of the psychoanalyst is to interpret the clues about the origins of intrapsychic
conflict given by the client
Purpose of therapy is to create a setting in which clues about the origins of
intrapsychic conflicts are most likely to be revealed by the client
Freud felt that the veil of amnesia lifts the moment that insight is achieved; when the
client begins to understand the nature of their problem

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Psychoanalytic Techniques: free association, dream interpretation
Free association client is encouraged to speak freely, without censoring possibly
embarrassing or socially unacceptable thoughts
Dream interpretation evaluation of underlying meaning of dream content
Dreams are subjected to some censoring; analyst must be able to distinguish between the
dreams manifest and latent contents
Manifest content of a dream actual images and events that occur within the dream
Latent content of a dream hidden meaning of the dream
Resistance development during therapy in which client becomes defensive at some point,
unconsciously attempting to halt further insight by censoring their true feelings; when
the client begins to change topic, skip appointments, or forgets what they were about to say
Transference the client begins to project powerful attitudes and emotions onto the
Countertransference the process by which the therapist projects their emotions onto the
client; unhealthy and undesirable, therapist should remain emotionally detached
Modern Psychodynamic Therapy
Psychodynamic therapy variation of the Freudian approach to therapy in which
therapists search for unconscious conflicts and motivations but do not adhere strictly to
Freuds conception of psychoanalysis; modern form of Freudian therapy
Brief psychodynamic therapy takes about 10 to 25 sessions to complete; goal is to
understand and improve the clients interpersonal skills through interpretation of
transference processes
Humanistic Therapy
Humanistic therapy provide the client with a greater understanding of their unique
potential for personal growth and self-actualization
2 major forms of humanistic therapy: client-centred therapy and Gestalt therapy
Client-centred therapy client decides what to talk about without direction or judgement
from the therapist; client takes ultimate responsibility for resolving their problem

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Incongruence discrepancy between a clients real and ideal selves; is said to be the root
of many psychological problems
By reflecting the concerns of the client, the therapist demonstrates empathy, the ability
to perceive the world from anothers viewpoint; used by the therapist to deal with
incongruence between the real and ideal selves
Unconditional positive regard (According to Rogers) therapist tries to convey to the client
that their worth as a human being is not dependent on anything they do, say, feel, or
Gestalt therapy emphasizes the unity of mind and body by teaching the client to get in
touch with bodily sensations and emotional feelings long hidden from awareness;
emphasis on present experiences not the past; and often confrontational, unlike
client centred therapy
Empty chair technique client imagines that they are talking to someone sitting in the
chair beside them; allows client to experience in the here and now the feelings and
perceptions they might have suppressed to that imagined person
Overall, insight therapies are based on the assumption that understanding leads to
behavioural change
Behaviour and Cognitive-Behaviour Therapies
Fundamental assumption made by behaviour therapists is that people learn maladaptive
behaviour in the same way that they learn adaptive behaviour; undesirable behaviour
is the problem, not just a reflection of the problem
Therapies Based on Classical Conditioning: systematic desensitization, aversion
Systematic desensitization designed to remove unpleasant emotional response
produced by feared objects or situations and replace it with an incompatible one
Hierarchy of anxiety-related stimuli a list of events that provoke the fear of certain object
or situation; in the order of least to most feared; and used by therapist to help client
overcoming each stimuli
In vivo exposure clients are exposed to intense levels of feared stimuli in an attempt to
diminish the fear through extinction
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