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Chapter 17

Psych 1000 Chapter 17 Review Notes.docx

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Department
Psychology
Course
Psychology 1000
Professor
Wolfe/ Quinlan
Semester
Winter

Description
Chapter 17 – Treatment of Psychological Disorders  Mental health professionals fall into several categories: o Counseling and clinical psychologists – typically hold a Ph.D. or Psy.D. o Psychiatrists – medical doctors who specialize in psychotherapy and biomedical treatments o Psychiatric social workers, marriage/family counselors, pastoral counselors and abuse counselors Psychodynamic Therapies  Psychoanalysis o Goal is to help clients achieve insight (conscious awareness of psychodynamics that underlie their problems) o Free association – procedure of verbalizing all thoughts that enter consciousness without censorship  Freud sat out of sight from patient so thought processes would be determined by internal factors o Dream interpretation through free association of dream elements o Resistance – defensive maneuvers that hinder the process of therapy o Transference - client responds irrationally to the analyst as if he were an important person from their past  Positive transference - client expresses intense affection, dependency, or love toward the analyst  Negative transference - client expresses anger, hatred, or disappointment toward the analyst o Interpretation – any statement by the therapist intended to provide the client with insight into their behaviour or dynamics  Brief Psychodynamic Therapies o Typically talk face-to-face, so conversation replaces free association o Clients seen a few times a week, rather than daily o Focus on current life situations, rather than on past childhood experiences o Interpersonal therapy – form of brief therapy that focuses on the client’s interpersonal problems and seeks to develop new interpersonal skills Humanistic Psychotherapies  Focus primarily on the present and future, rather than the past  Client-Centred Therapy o Most important part of therapy is relationship that develops between client and therapist o Three important and interrelated therapist attributes:  Unconditional positive regard – therapists show clients that they genuinely care about them and accept them, without judgment or evaluation  Empathy – willingness and ability to view the world through the client’s eyes  Therapist communicates understanding by reflecting back to client what they are communicating  Genuineness – therapist must honestly express his or her feelings, whether positive or negative  Gestalt Therapy o Term “gestalt” refers to perceptual principles through which people actively organize stimulus elements into meaningful “whole” patterns  Goals of therapy is to bring background figures into immediate awareness so that client can be “whole” again o Empty-chair technique involves the client role-playing, in which he/she may carry on a conversation with someone such as his mother, where he alternately plays his mother and himself Cognitive Therapies  Focus on the role of irrational and self-defeating thought patterns  Ellis’s Rational-Emotive Therapy o Therapy is embodied in ABCD model:  Activating event – triggers the emotion  Belief system – underlies way in which a person appraises the activating event  Consequences – emotional and behavioural consequences of the appraisal  Disputing – challenging an erroneous belief system o People are accustomed to viewing emotions (consequences) as being caused directly by activating events  Emotions are actually caused by belief system, which must be countered and altered  Beck’s Cognitive Therapy o Goal is to point out errors of thinking and logic that underlie emotional disturbances and to reprogram client’s automatic negative thought patterns o Self-instructional training – cognitive coping approach of giving adaptive self-instructions to oneself at crucial phases of the coping process Behaviour Therapies  Classical Conditioning Treatments o Most direct way to reduce a phobia is through process of classical extinction of anxiety response  Requires exposure to feared CS in absence of UCS while using response prevention (prevention of escape or avoidance responses during exposure so that extinction can occur)  Client may be exposed to real-life stimuli (flooding) or may be asked to imagine scenes involving the stimuli (implosion) o Systematic desensitization – attempt to eliminate anxiety using counterconditioning, in which a new response that is incompatible with anxiety is conditioned to the anxiety-arousing CS  Client must construct a stimulus hierarchy (a series of anxiety-arousing stimuli that are ranked in terms of amount of anxiety they evoke)  Client must relax, and then focus on first level of hierarchy, then next, until finished  Client can’t experience anxiety if relaxed strongly enough  Relaxation replaces anxiety as the CR  In vivo desensitization – carefully controlled exposure to a hierarchy of real life situations o Aversion therapy – therapist pairs a stimulus that is attractive to a person (and that stimulates deviant or self-defeating behaviour – the CS) with a noxious UCS in an attempt to condition an aversion to the CS  Operant Conditioning Treatments o Behaviour modification – treatment techniques that involve the application of operant conditioning procedures in an attempt to increase or decrease a specific behaviour o Token economy – system for strengthening desired behaviours through the systematic application of positive reinforcement  Tokens rewarded upon observing desired behaviours, and are then traded in for various privileges o Therapists only use punishment after asking two important questions:  Are there alternative, less painful approaches that might be effective?  Is the behaviour to be eliminated sufficiently injurious to the individual or society to justify the severity of the punishment?  Modelling and Social Skills Training o Social skills training – clients learn new skills by observing and then imitating a model who performs a socially skillful behaviour “Third Wave” Cognitive-Behavioural Therapies  Mindfulness – mental state of awareness, focus, openness and acceptance of immediate experience o Involves a nonjudgmental appraisal, so difficult thoughts and feelings have much less impact  Acceptance and commitment therapy (ACT) – focuses on process of mindfulness as a vehicle for change  Dialectical behaviour therapy (DBT) – package of techniques from all areas of psychological treatments, used primarily to treat borderline personality disorder Cultural and Gender Issues in Psychotherapy  Cultural Factors in Treatment Utilization o Utilization of mental health services is far less for minority groups than it is for the majority white population  Cultural norm against turning to professionals outside of one’s own culture for help  Inability to afford therapy  Too few skilled counselors who can provide culturally responsive forms of treatment o Culturally competent the
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