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Chapter 17

Psychology 1000 Chapter Notes - Chapter 17: Sertraline, Diazepam, Deinstitutionalisation

Course Code
PSYCH 1000

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Chapter 17: Treating
Psychological Disorders
Helping Relationship
Overall goal: help people change maladaptive,
self-defeating thoughts, feelings and behaviour
patterns so they can live happier and more
productive lives
Healthy relationship between person & therapist
= key factor
Group A
o Counselling & clinical psychologists
o Psychologists
Hold Ph.D (Doctor of Philosophy) or Psy.D (Doctor of Psychology)
Received 5 or more years of intensive training & supervision in various
psychotherapeutic techniques
Group B
o Psychiatrists
Medical doctors who specialize in psychotherapy & biomedical treatments
Group C
o Psychiatric social workers
o Marriage & family counsellors
o Pastoral counsellors
o Abuse counsellors
Psychodynamic Therapies
Focuses on internal conflict & unconscious factors that underlie maladaptive behaviour
o Refers to Freud's theory of personality & specific approach to treatment
Goal: help clients achieve insight
o Conscious awareness of psychodynamics that underlie their problems
o Permits clients to adjust their behaviour to their current life situations
Client repeatedly encounters & deals with buried emotions, motives, and conflicts psychic energy
can be released and redirected to more adaptive ways of living
Free Association
Mental events are meaningfully associated with one another
Clues to contents of unconscious are to be found in the constant stream of thoughts, memories,
images, and feelings we experience
Asked his clients to recline on a couch and to report verbally without censorship any thoughts, feelings,
or images that entered awareness
Freud sat out of sight behind client so that client's thought processes would be determined primarily by
internal factors
Dream Interpretation
Dreams express impulses, fantasies, and wishes that defences keep in unconscious during waking

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Defensive processes usually disguise threatening material to protect dreamer from anxiety that material
might evoke
Tries to help client search for unconscious material contained in dreams
Ask client to free associate to each element of dream and to help client arrive at an understanding of
what symbols in dream really represent
Avoidance patterns emerged in course of therapy
Defensive manoeuvres that hinder process of therapy
Client may experience difficulty in free-associating
May come late or ―forget about‖ a therapy appointment
May avoid talking about certain topics
Sign that anxiety-arousing sensitive material is being approached
Explore reasons for resistance promote insight & guard against dropout
Occurs when client responds irrationally to te analyst as if he or she were an important figure from the
client's past
Most important process brings out into open repressed feelings and maladaptive behaviour patterns
Two Forms
o Positive Transference
Client transfers feelings of intense affection, dependency, or love
o Negative Transference
Irrational expressions of anger, hatred, or disappointment
Until transference reactions are analyzed and resolved no full resolution
Any statement by therapist intended to provide client with insight into their behaviour or dynamics
Confronts clients with something that they have not previously admitted into consciousness
o Ex. It's almost as if you're angry with me without realizing it
Interpret what is already near surface and just beyond client's current awareness
Deep interpretation - removed from awareness - cannot be informative or helpful
Brief Psychodynamic Therapies
Expensive & time-consuming process - goal is rebuilding client's personality
Not uncommon for client to be seen 5 times a week for 5 years or more
o Modern therapists consider level both impractical & unnecessary
Studies show regardless of how many sessions clients attended, rate of improvement was highest at
beginning & decreased over time
Modern Therapies
o Brief
o Emphasize understanding maladaptive influences of past & relating them to current patterns of
self-defeating behaviour
o Therapist and client are likely to sit facing each other
o Conversation typically replaces free association
o Clients are seen once or twice a week rather than daily
o Goal: typically limited to helping client deal with specific life problems rather than complete
rebuilding of the client's personality
o More likely to focus on the client's current life
Interpersonal Therapy
o Highly structured and no longer than 15 to 20 sessions
o Focuses on the client's current interpersonal problems
Dealing with role disputes such as marital conflict
Adjusting to the loss of a relationship or changed relationship
Identifying and correcting deficits in social skills
o Very effective for depression

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Humanistic Psychotherapies
Humans capable of consciously controlling & taking responsibility for choices & behaviour
Everyone possesses inner resources for self-healing & personal growth
Disordered behaviour reflects a blocking of natural growth process
o Blocking due to distorted perceptions, lack of awareness about feelings, or a negative self-
Goal: Create environment in which clients can engage in self-exploration and remove barriers that
block natural tendencies toward personal growth
o Barriers often result from childhood experiences that fostered unrealistic or maladaptive
standards for self-worth
People try to live lives according to expectations of others rather than in terms of own desires and
o Often feel unfulfilled & empty
o Unsure about who they really are as people
Focus primarily on present & future instead of past
Therapy directed at helping clients become aware of feelings as they occur rather than at achieving
insight into the childhood origins of the feelings
Client-Centered Therapy
Most widely used form of humanistic therapy - Carl Rogers
Relationship that develops between client and therapist key ingredient
Identified 3 important & interrelated therapist attributes:
o Unconditional Positive Regard
Therapists show clients that they genuinely care about & accept them, without judgment
or evaluation
Communicates sense of trust in clients
o Empathy
Willingness & ability to view world through client's eyes
Therapist reflects back to client what he or she is communicatingperhaps by
rephrasing something the client has just said in a way that captures the meaning and
emotion involved
o Genuineness
Consistency between way therapist feels & way they behave
Therapist must be open enough to honestly express feelings, whether positive or
Clients experience constructive therapeutic relationship exhibit increased self-acceptance, greater
self-awareness, enhanced self-reliance, increased comfort with other relationships, and improved life
Gestalt Therapy
Gestalt (organized whole)
o Perceptual principles through which people actively organize stimulus elements into meaningful
―whole‖ patterns
Percieve external stimuli, ideas, or emotions concentrate on only part o our whole experience
figurewhile largely ignoring background
Psychological difficulties background includes important feelings, wishes, & thoughts blocked from
ordinary awareness because they would evoke anxiety
Goal: bring them into immediate awareness so that client can be ―whole.
Often carried out in groups
Developed variety of imaginative techniques to help clients ―get in touch with their inner selves.‖
More active, dramatic & confrontational in nature
Often ask clients to role-play different aspects of themselves so that they directly experience inner
Empty-Chair technique
o Client may be asked to imagine his mother sitting in chair, & then carry on conversation in which
he alternatively role-plays his mother & himself
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