Chapter 15 Notes.docx

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21 Mar 2012
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Chapter 15 Treatment of Psychological Disorders
The Elements of the Treatment Process
- Treatments used by psychotherapists can be classified into 3 major categories
o Insight therapies (talk therapy)
o Behaviour therapies (based on the principles of learning)
o Biomedical therapies
- Most common problems brought to therapy = anxiety and depression
- You don’t have to have a psychological disorder to seek therapy
- People may avoid therapy for fear of the stigma that comes with it
Therapists: Who Provides Professional Treatment
Psychologists
- Clinical psychologist emphasize the treatment of full-fledged disorders
- Counselling psychologist specialize in the treatment of everyday adjustment problems
- Use insight or behavioural approaches
o More likely to use behavioural techniques then psychoanalytic methods
- Treatment by psychologists is not covered by the government
- Have a Ph.D.
Psychiatrists
- Psychiatrists: physicians who specialize in the diagnosis and treatment of psychological
disorders
o Focus more on sever disorders than everyday problems
- Have a medical degree
- Emphasize drug therapies/psychoanalytic methods
Other Mental Health Professionals
- Clinical social workers, psychiatric nurses, councillors
Insight Therapies
- Insight therapies: verbal interactions intended to enhance clients’ self-knowledge and
thus promote healthful changes in personality and behaviour
- Psychoanalysis (Freud): an insight therapy that emphasizes the recovery of unconscious
conflicts, motives and defences through techniques such as free association and
transference
o Assumptions: neurotic symptoms (anxiety) are related to sources of conflict in the
past and these conflicts have been repressed
To alleviate the anxiety, the patient must become consciously aware of the
conflict and re-experience it
o Objective: to uncover the cause of the anxiety and help the patient gain insight to
the problem
o Techniques:
Free association when clients spontaneously express their thoughts and
feelings exactly as they occur with as little censorship as possible
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Used by analysts to determine what is going on in the client’s
unconscious
Dream analysis: the therapist interprets the symbolic meaning of a client’s
dreams
- Interpretation: the therapist’s attempts to explain the inner significance of a client’s
thoughts, feelings, memoirs and behaviours
- Resistance: a client’s largely unconscious defense manoeuvers intended to hinder the
progress of therapy
o Used to avoid facing what has been buried in the unconscious
- Transference: occurs when clients unconsciously start relating to their therapist in ways
that mimic critical relationships in their lives
o The client transfers conflicting feelings about important people onto the therapist
o This is encouraged by therapists
- Psychoanalysis usually requires 3-5 years of hard work
- Descendants of psychoanalysis = “psychodynamic” approaches to therapy
o Still emphasize the key roles played by interpretation, resistance and transference
Helpful in the treatment of a bunch of disorders including panic disorder,
borderline personality disorder and substance abuse
o Focuses on the unconscious
o Focuses on a specific issue (current social problems)
- Projective tests: Rorschach Inkblot and Thematic Apperception Test (TAT)
Client-Centred Therapy (Carl Rogers)
- Client/person centred therapy: 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
- Freud believed that neurotic anxieties were caused by supressed feelings in the
unconscious…. Rogers believed that they are caused by an incongruence between a
person’s self-concept and reality
o Client-centred therapists help clients to reconstruct their self-concept to
correspond better to reality, fostering self-acceptance and personal growth
This can best be achieved in a therapeutic climate
- Therapeutic climate was thought (by Rogers) to be more important than the process of
therapy itself… Three things are needed to get this climate right:
o Genuineness (from the therapist)
o Unconditional positive regard (non-judgemental acceptance)
o Empathy
- Therapeutic process involves the therapist providing feedback to helps clients sort out
their feelings
o Key task = clarification (helping clients become more aware of their true feelings
by highlighting themes that may be obscure in the client’s rambling discourse)
- Client-centred therapy resembles psychoanalysis in that both seek to achieve major
reconstruction of a client’s personality
Therapies Inspired by Positive Psychology
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