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Chapter 14

Chapter 14 Notes

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Psychology 1000

CHAPTER 14: TREATMENT OF PSYCHOLOGICAL DISORDERS > THE HELPING RELATIONSHIP Basic Goal of all treatment is to help people change maladaptive, self-defeating thought, feelings and behaviour patterns so that they can live happier and more productive lives Counseling and clinical psychologists: typically hold a PhD usually 5+ years of training in psychological assessment techniques Psychiatrists: medical doctors who specialize in psychotherapy and in biomedical treatments such as drug therapy > PSYCHODYNAMIC THERAPIES: The psychodynamic approach to psychotherapy focuses on internal conflict and unconscious factors that underlie maladaptive behaviour Psychoanalysis Psychoanalysis: Freuds theory of personality as well as the specific approach to treatment that he developed Goal is to help achieve insight: the conscious awareness of the psychodynamics that underlie their problems o Permits clients to adjust their behaviour to current life situations rather than continuing maladaptive routines o As client deals with buried emotions and conflicts, the psychic energy that was previously devoted to keeping the unconscious under control can be released and redirected to more adaptive ways of living Free association: client reclines on a couch and gives verbal reports without censorship of any thoughts, feelings, or images that entered awareness (analyst sits behind client) Dream interpretation: Dreams express impulses, fantasies, and wishes that clients defenses keep in the unconscious o Free associate to each element of the dream and to help the client arrive at an understanding of what the symbols in the dream really represent Resistance: defensive maneuvers that hinder the process of therapy o May experience difficulty in free-associating, coming late to appointment or avoid certain topics o A sign that anxiety-arousing sensitive material is being approached Transference: when the client responds irrationally to the analyst as if he or she was an important figure from the clients past o Brings out the repressed feelings that the therapist can point out to the client o Positive transference: when the client transfers feelings of intense affection, dependency or love to the analyst o Negative transference: involves irrational expressions of anger, hatred or disappointment o Until transference reactions are analyzed/resolved there can be no full recovery Interpretation: any statement by the therapist intended to provide the client with insight into his or her behaviour or dynamics o General rule in psychoanalytic treatment is to interpret what is already near the surface and just beyond the clients current awareness deep analysis will not be understood or helpful to the patient o It is the patient who must ultimately arrive at the insight Brief Psychodynamic Therapies About half of clients approve within 8 sessions, and most of the therapeutic effects occur within 26 sessions It becomes very expensive and time consuming Brief psychodynamic psychotherapies: Employ insight and interpretation at a more focused and active fashion Sit face-to-face conversation replaces free-association Aimed at helping to deal w/ specific life problems only a few sessions a week Interpersonal therapy: (15-20 sessions) focus on clients current interpersonal problems (marriage, etc.) > HUMANISTIC PSYCHOTHERAPIES View humans as capable of consciously controlling their actions and taking responsibility for choices and behaviour Believe everyone has inner resources for self-healing and personal growth, and that disorders reflect a blocking of these resources o Brought on by distorted perceptions, lack of awareness about feelings, negative self-image Focus on present and future rather than past Seen as a human encounter between equals Goal is to create an environment where the client can engage in self-exploration and remove the barriers that block their natural tendencies toward personal growth o Barriers often result from standards being set too high in childhood Client-centered Therapy Developed by Carl Rogers stressed the relationship between client and therapist 3 important therapist attributes: 1. unconditional positive regard: a communicated attitude of total and unconditional acceptance towards the client that convey their intrinsic worth 2. empathy: the ability of a therapist to view the world through the clients eyes and to understand the clients emotions 3. genuineness: ability of a therapist to honestly express their feelings to a client when all 3 attributes are present they create a situation which the client feels accepted, understood and free to explore without judgment or rejection Gestalt Therapy Frederick S. Perls concentrate on whole experiences Goal: bring background feelings, wishes and thoughts, into immediate awareness so the client can be whole again. Empty chair technique: client asked to imagine someone sitting in the chair and carry a conversation role-playing for both themselves and the absent person o makes ppl aware of unresolved issues that affect relationships and their lives Unlike Rogers, who was committed to research that would help identify the factors that contribute to therapeutic success, such as tape recorded sessions, Perls used anantiscientific method could not do systematic research on the effectiveness of Gestalt therapy, and it began to wane in the 70s > COGNITIVE THERAPIES - focus on the of irrational and self-defeating thought patterns - tries to help clients discover and change the cognitions that underlie their problems - do not emphasize the importance of unconscious psychodynamic processes - clients need help in identifying the beliefs, ideas, and self-statements that trigger maladaptive emotions and behaviours Albert Elliss Rational-Emotive Therapy: ABCD model: - A activating event that triggers the emotion - B belief system that underlies the way a person appraises the event - C emotional and behavioural consequences of the appraisal - D disputing or challenging belief system to change maladaptive emotions Example: a young man is turned down for a date. - the womans refusal is not the cause of the feeling of rejection and depression - instead it is his believe that he needs to be loved and accepted that caused it - Rational-emotive therapists introduce clients to common irrational ideas and train them to reject the
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