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Chapter 15

Chapter 15.docx

Course Code
Kris Gerhardt

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Week 12: Chapter 15/Treatment of
Psychological Disorders
The Elements of the Treatment Process
Treatments: How Many Are There?
1. As varied as therapists’ procedures are, approaches to treatment can be classified into 3 major
1. Insight Therapies: aka the “talk therapy.” Clients engage in complex verbal interactions
with their therapists. The goal in these discussions is to pursue increased insight
regarding the nature of the client’s difficulties and to sort through possible solutions. It
can be done individually or in a group manner. (EXAMPLES: Family therapy and
marital therapy fall into this category…think of Kourtney and Scott)
2. Behaviour Therapies: Instead of emphasizing personal insights, behaviour therapists
make direct efforts to alter problematic responses (e.g. phobias) and maladaptive habits
(such as drug use). They use different procedure for different kinds of problems. Most of
their procedures involve classical conditioning, operant conditioning, and observational
3. Biomedical Therapies: involves interventions into a person’s biological functioning. The
most widely used procedures are drug therapy and electroconvulsive (shock) therapy.
Clients: Who Seeks Therapy?
1. In the therapeutic triad (therapists, treatments, clients), the greatest diversity of all is seen
among the clients. People bring to therapy the full range of human problems: anxiety, depression,
unsatisfactory interpersonal relationships, troublesome habits, poor self-control, low self-esteem,
marital conflicts, self-doubt, a sense of emptiness, and feelings of personal stagnation. The two
most common presenting problems are excessive anxiety and depression.
Therapists: Who Provides Professional Treatment?
1. Psychologists: there are two types of psychologists: Clinical psychologists and counselling
psychologists. They both specialize in the diagnosis and treatment of psychological disorders and
everyday behavioural problems. Clinical Psychologists’ training emphasizes the treatment of
full-fledged disorders. Counselling Psychologists’ training is slanted toward the treatment of
everyday adjustable problems. However, there is a bit of overlap between clinical and counselling
psychologists in training, skills, and the clientele that they serve.
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2. Psychiatrists: are physicians who specialize in the diagnosis and treatment of psychological
disorders. They also treat every day behavioural problems. However, in comparison to
psychologists, they devote more time to relatively severe disorders (schizophrenia, mood
disorders) and less time to everyday marital, family, job, and school problems. Psychiatrists
increasingly emphasize drug therapies which the other, nonmedical professions cannot provide.
3. Other Mental Health Professionals: In hospitals and other institutions, clinical social workers
and psychiatric nurses often work as a part of the treatment team with a psychologist or
Insight Therapies
1. Insight Therapies: involve verbal interactions intended to enhance clients’ self-knowledge and
thus promote healthful changes in personality and behaviour.
2. Freuds View of the Roots of Disorders:
1. Psychoanalysis: is an insight therapy that emphasizes the recovery of unconscious conflicts,
motives, and defences through techniques such as free association and transference.
2. Free Association: clients spontaneously express their thoughts and feelings exactly as they
occur, with as little censorship as possible
3. Dream Analysis: the therapist interprets the symbolic meaning of the client’s dreams
4. Interpretation: refers to the therapist’s attempts to explain the inner significance of the client’s
thoughts, feelings, memories, and behaviours
5. Resistance: refers to largely unconscious defensive manoeuvers intended to hinder the progress
of therapy
6. Transference: occurs when clients unconsciously start relating to their therapist in ways that
mimic critical relationships in their lives
Other Insight Therapies
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1. Client-Centred Therapy: is an insight therapy that emphasizes providing a supportive emotional
climate for clients, who play a major role in determining the pace and direction of their therapy
1. To create an atmosphere of emotional support, client-centred therapists must provide three
1. Genuineness: the therapist must be genuine with the client, communicating
honestly and spontaneously. The therapist should not be phony or defensive.
2. Unconditional Positive Regard: the therapist must also show complete,
nonjudgmental acceptance of the client as a person. The therapist should
provide warmth and caring for the client, with no strings attached.
3. Empathy: the therapist must provide accurate empathy for the client. This
means that the therapist must understand the client’s world from the client’s point
of view.
1. Group Therapy: is the simultaneous treatment of several clients in a group
2. Couples/Marital Therapy: involves the treatment of both partners in a committed, intimate
relationship, in which the main focus is on relationship issues
3. Family Therapy: involves the treatment of a family unit as a whole, in which the main focus is on
family dynamics and communication
4. Spontaneous Remission: is a recovery from a disorder that occurs without formal treatment
Behaviour Therapies
1. Behaviour Therapies: involve the application of learning principles to change clients’ maladaptive
1. Systemic Desensitization: is a behaviour therapy used to reduce phobic clients’ anxiety
responses through counterconditioning
1. Systemic desensitization involves three steps:
1. The therapist helps the client build an anxiety hierarchy. The hierarchy is
a list of anxiety-arousing stimuli related to the specific source of anxiety,
such as flying, academic tests, or snakes. The client ranks the stimuli
from the least anxiety-arousing to the most anxiety-arousing. This
ordered list of stimuli is the anxiety hierarchy.
2. Training the client in deep muscle relaxation. This second phase may
begin during early sessions while the therapist and client are still
constructing the anxiety hierarchy. Various therapists use different
relaxation training procedures. Whatever procedures are used, the client
must learn to engage in deep, thorough relaxation on command from the
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