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Chapter 14

Chapter 14 - Treatment of Psychological Disorders


Department
Psychology
Course Code
PSYCH 1000
Professor
Laura Fazakas- De Hoog
Chapter
14

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Chapter 14
"Treatment of Psychological Disorders"
The Helping Relationship
- basic goal of all treatment approaches: help people change maladaptive, self-defeating thoughts,
feelings, behaviours
- majority of people with mental health problems seek help from family members, physicians, members of
clergy, acquaintances, or self-help groups (not mental health professionals)
- various groups for mental health professionals
- counselling and clinical psychologists
- psychiatrists
- medical doctors who specialize in psychotherapy and in biomedical treatments (ex:
drug therapy)
- psychiatric social workers
- often work in community agencies
- marriage and family counsellors
- specialize in problems arising from family relations
- pastoral counsellors
- tend to focus on spiritual issues
- abuse counsellors
- work with substance and sexual abusers and their victims
Therapies for psychological disorders
- psychodynamic
- psychoanalysis (Freud)
- brief psychodynamic therapies
- humanistic
- client-centred therapy (Rogers)
- Gestalt therapy (Peris)
- cognitive
- rational-emotive therapy (Ellis)
- cognitive therapy (Beck)
- behavioural
- classical conditioning
- exposure
- systematic-desensitzation
- aversion therapy
- operant conditioning
- positive reinforcement
- punishment
- modelling
- social skills training
- biological
- drug therapy
- electro-convulsive therapy
- psychosurgery
Psychodynamic Therapies
(1) PSYCHOANALYSIS
- focuses on internal conflict and unconscious factors that underlie maladaptive behaviour

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- goal is to help clients achieve insight (conscious awareness of psychodynamics that underlie their
problems)
- such awareness permits clients to adjust behaviour to current life situations, rather than
continuing to repeat old maladaptive routines learned in childhood
- free association - belief that mental events are meaningfully associated with one another
- analyst does not expect free association to necessarily lead directly to unconscious
material...will provide clues concerning important themes or issues
- dream interpretation - belief that dreams express impulses, fantasies, wishes that client's defences
keep in the unconscious
- analyst tries to help client search for unconscious material contained in dreams
- resistance - defensive manoeuvres that hinder the process of therapy
- sign that anxiety-arousing sensitive material is being approached
- important to explore reason for resistance - both to promote insight and guard against ultimate
resistance: client's decision to drop out of therapy prematurely
- transference - occurs when client responds irrationally to analyst as if he or she were an important
figure from client's past
- considered important process in psychoanalysis
- it brings out into the open repressed feelings and maladaptive behaviour patterns
that therapist can point out to client
- takes two forms...
- positive transference - occurs when client transfers feelings of intense affection,
dependency, or love to analyst
- negative transference - involves irrational expressions of anger, hatred,
disappointment
- analyst believes that until transference reactions are analyzed and resolved - can be not full
resolution of client's problem
- interpretation - any statement by therapist intended to provide the client with insight into his or her
behaviour or dynamics
- interpretative statement confronts clients with something that they have not previously
admitted into consciousness
- general rule in psychoanalytic treatment is to interpret what is already near the surface and just
beyond client's current awareness
- offering "deep" interpretations of strongly defended unconscious dynamics is
considered poor techniques
- even if correct, so far removed from client's current awareness that it is not
informative or helpful
(2) BRIEF PSYCHODYNAMIC THERAPIES
- no evidence that long-term classical analysis yields better therapeutic outcomes than briefer forms of
psychodynamic therapy
- emphasize understanding the maladaptive influences of the past and relating them to current patterns of
self-defeating behaviour (like psychoanalysis)
- conversation typically replaces free association
- clients are often seen less and limited to helping client deal with specific life problems
- most likely focusing on client's current life situations than past childhood experience
- interpersonal therapy - highly structured and seldom takes longer than 15-20 seconds - focuses on
client's current interpersonal problems
- deals with role disputes (ex: marital conflict, adjusting to loss of relationship or to changed
relationship, identifying and correcting deficits in social skills that make it difficult for client to initiate or
maintain satisfying relationships
- in controlled outcome studies, interpersonal therapy was proven to be one of more
effective current therapies for depression
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