Ch16: Therapy

2 examples of aversion conditioning

- To treat compulsive nail biting, the therapist may suggest painting the fingernails with a nasty-tasting nail polish - To treat alcohol use disorder, the therapist may offer the client appealing alcoholic drinks laced with a drug that produces severe nausea. If that therapy links alcohol with violent nausea, the person's reaction to alcohol may change from positive to negative

Antianxiety drugs - Depress _____ activity; Xanax, Ativan - Used in combination with ______________ therapy, can enhance exposure therapy's extinction of __________ fears and to help relieve the symptoms of ________________ _______ disorder and ___________________ disorder - May reduce symptoms without resolving ____________ _____________; withdrawal linked to increased anxiety and insomnia\

- CNS - psychological, learned, posttraumatic stress, obsessive-compulsive - underlying problems

what is active listening?

empathic listening in which the listener echoes, restates, and seeks clarification

Negative self talk with relentless, overgeneralized, self-blaming behavior is called :

catastrophizing

Counselors: could be __________ and ___________ counselors who specialize in problems arising from family relations. _________ provide counseling to countless people. ___________ counselors work with substance abusers and with spouse and child abusers and victims of abuse. Mental health and other counselors may be required to have a two-year master's degree.

family and couples Clergy Abuse

Since the 1950s, the introduction of effective drug therapies and community-based treatment programs has emptied most of those hospitals. This is referred to as ____________________, which has contributed to increased homelessness and incarceration

deinstitutionalization

Systematic desensitization: Associates a pleasant, relaxed state with a ____________ ____________ , anxiety-triggering stimuli

gradually increasing

To change such negative self-talk, cognitive therapists have offered stress ____________ _________: teaching people to restructure their thinking in stressful situations

inoculation training

- Both psychodynamic and humanistic therapies are ________ therapies, meaning they attempt to improve functioning by increasing clients' _____________ of motives and defenses. - _______________ therapies are not insight therapies. Their goal is to apply learning principles to modify problem ________________.

insight, awareness - Behavior, behaviors

A glimpse of psychotherapy's overall effectiveness can then be provided by means of a _______________, a statistical procedure that combines the conclusions of a large number of different studies - one showed that the average therapy client ends up better off than ___ percent of the untreated individuals on waiting lists

meta-analysis 80

Counterconditioning: Uses classical conditioning to evoke _____ responses to stimuli that are triggering _____________ behaviors

new, unwanted

Psychiatrists: _____________ who specialize in the treatment of ____________ _________. Not all psychiatrists have had extensive training in psychotherapy, but as M.D.s or D.O.s they can ___________ _____________. Thus, they tend to see those with the most serious problems. Many have their own private practice.

physicians, psychological disorders prescribe medications

Proponents of behavior therapies: - Treatment with _________ _________ is more __________ than punishing people or institutionalizing them for undesired behaviors.

positive rewards, humane

The first major psychological therapy was Sigmund Freud's _________________

psychoanalysis

How is psychodynamic therapy different from psychoanalysis? - Lack of belief in _____________________ - _________, less ___________, and more focused on helping clients find relief from their current ______________ - Helps clients understand how past relationships create _________ that may be acted out in present relationships

- id, ego, and superego - Briefer, expensive, symptoms - themes

Alternative neurostimulation therapies - ____________ _____________ stimulation (tDCS): Administers a weak (1- to 2-milliamp) current directly to the scalp (skeptics argue that such a current is too weak to penetrate to the brain; studies do not confirm cognitive benefits) - ____________ ______________ _____________ stimulation (rTMS): Sends magnetic energy to brain surface through coiled wire held close to brain; fewer side effects; modest effectiveness - ________ _______ stimulation: Manipulates the depressed brain via pacemaker; stimulates inhibition activity related to negative emotions and thoughts

- Transcranial electrical - Repetitive transcranial magnetic - Deep brain

A person seeking therapy is encouraged to ask about - ___________ ____________ - Values - ___________ - Fees - An important consideration is whether the potential client feels _____________ and able to establish a _______ with the __________.

- Treatment approach, Credentials - comfortable, bond, therapist

Cognitive therapies - Teach people new, more ______________ ways of ___________ - Based on the assumption that thoughts _____________ between events and our emotional reactions - Between an ______ and our ____________ lies the ______

- adaptive, thinking - intervene - event, response, mind

- Drug therapies - 27 million Americans take prescribed __________________. - _________ and ______________ techniques are used to evaluate drug effectiveness.

- antidepressants - Placebo, double-blind

Psychosurgery - Removes or destroys ________ ________ in an effort to change behavior - Is ________________; least used biomedical therapy

- brain tissue - irreversible

Electroconvulsive therapy (ECT) - Manipulates the _______ by ____________ it - Involves administration of a general ____________ and muscle relaxation to prevent ______________ - Causes less ______________ disruption than earlier versions - The American Medical Association concluded that ECT methods have some of the most ___________ treatment effects and reduce __________ ___________. - Several theories about the reason for its effectiveness - Some research indicates that ECT stimulates _______________ (new neurons) and new ____________ _______________

- brain, shocking - anesthetic, convulsions - memory - positive, suicidal thoughts - neurogenesis, synaptic connections

Family therapy - Attempts to open up _________________ within the family and help family members discover and use _________ ___________ strategies - Treats the family as a system - Views an individual's ___________ _____________ as influenced by or directed at other family members

- communication - conflict resolution - unwanted behaviors

The Biomedical Therapies and Preventing Psychological Disorders - Psychopharmacology: Study of ______ effects on mind and behavior - Has helped make _____ __________ the most widely used biomedical therapy

- drug - drug therapy

Critics of behavior therapies: - How ____________ are the behaviors? Will people become so dependent on __________ __________ that the desired behaviors will stop when ____________ stop? - Is it right for one human to __________ another's behavior?

- durable, extrinsic rewards, reinforcers - control

Lobotomy - Psychosurgical procedure once used to calm uncontrollably ____________ or __________ patients. - Cuts the __________ connecting the _______ lobes to the ____________-controlling centers of the inner brain (Moniz) - Today, less invasive techniques are used; ______________ surgery may be performed in severe disorders.

- emotional or violent - nerves, frontal, emotion - MRI-guided

Group therapy - Conducted with groups rather than ______________ - Used when client problems involve ______________ with others Group therapy benefits: - Saves therapists ______ and clients ________ - Encourages exploration of social behaviors and _______ ______ development - Enables people to see that others ________ their problems - Provides _____________ as clients try out new ways of behaving

- individuals - interactions - time, money - social skill - share - feedback

Cognitive therapy techniques: Reveal beliefs: - Question your _______________ - Rank ____________ and _____________ Test beliefs: - Examine _____________ - ________________ thinking Change beliefs - Take appropriate _______________ - Resist ____________

- interpretations - thoughts and emotions - consequences - Decatastrophize - responsibility - extremes

Mood-stabilizing medications - Depakote: Controls ________ ___________ - Lithium: Levels out the __________ ______ and _____ of ________ disorder

- manic episodes - emotional highs and lows, bipolar

Biomedical therapy - Treatment with _________ _____________ - Trained therapist, most often a medical doctor, offers ______________ and other _____________ treatments.

- medical procedures - medications, biological

Antipsychotic drugs - Mimic certain __________________ (e.g., block or increase activity of __________); reduce overreaction to irrelevant ________ - May produce __________________, tremors, twitches, and tardive dyskinesia; Thorazine - Successfully used with life-skills programs and family support to treat schizophrenia - provided the most help to patients experiencing _____________ (actively inappropriate) symptoms of schizophrenia, such as auditory ______________ and _____________

- neurotransmitters, dopamine, stimuli - sluggishness - positive, hallucinations, paranoia

Antidepressant drugs - Increase availability of ________________ or ___________ which elevate __________ and mood; promote birth of new ________ cells - Two types: _______ and _______ work by prolonging the time ____________ molecules remain in the brain's _________ - Slow synaptic vacuuming up of serotonin (SSRIs: __________ _________ ______ _______) - Effectiveness sometimes questioned due to spontaneous recovery and placebo effect - treat depression but also anxiety, _____, and ______

- norepinephrine, serotonin, arousal, brain - Prozac and Zoloft, serotonin, synapse - selective serotonin reuptake inhibitors - OCD, PTSD

Humanistic therapies - Carl Rogers developed _______________________ therapy, which focuses on person's conscious __________________; is nondirective; and the therapist engages _________ listening and _______________ _________ regard - Most people possess ____________ for growth. - Therapists foster growth by exhibiting genuineness, ______________, and empathy.

- person-centered, self-perceptions, active, unconditional positive - resources - acceptance

Culture and values in psychotherapy - Psychotherapists' _________ ____________ and values influence their practice. - Differences in cultural and moral diversity and religious values can create a __________. - Therapist may be from _______________ culture, and client may have a _____________ perspective

- personal beliefs - mismatch - individualist, collectivist

Is Psychotherapy Effective? - Clients' and therapists' _________ ______________ cannot prove that psychotherapy is actually effective. - The _________ _______ makes it difficult to judge whether improvement occurred because of the treatment. - Research indicates that those persons who do not undergo treatment often __________, but those undergoing psychotherapy are more likely to improve more quickly and with less chance of __________.

- positive testimonials - placebo effect - improve, relapse

Aversive conditioning Goals: - Substitute a ____________ response for a ___________ response to a ___________ stimulus -Condition an ___________ to something the person should ________ Techniques: - Unwanted behavior is associated with _____________ feelings. - Ability to discriminate between aversive conditioning situation in therapy and other situations can limit treatment ________________.

- positive, negative, harmful - aversion, avoid - unpleasant - effectiveness

Which Psychotherapies Work Best? - Some forms of ________________ work best for particular problems. - Cognitive and cognitive-behavioral therapies treat: - Behavioral conditioning therapies: Bed-wetting, __________, _____________, marital problems, and _______ dysfunctions - Psychodynamic therapy: Depression and anxiety - Nondirective (client-centered) counseling: Mild to moderate ___________

- psychotherapy - Anxiety, depression, and posttraumatic stress disorder - phobias, compulsions, sexual - depression

Techniques of psychoanalysis: - Historical _________________ (since childhood experiences mold the adult) initially through __________ and later through _____ _____________ - Interpretation of ____________ and _______________

- reconstruction, hypnosis, free association - resistance, transference

Family Therapy - The therapist helps family members understand how their ways of ________ to one another create problems. - The treatment's emphasis is not on changing the _____________ but rather on changing their _____________ and _____________.

- relating - individuals, relationships, interactions

Self-Help Groups - More than 100 million Americans have participated in small ____________, __________, or _________ groups that meet regularly. - In an ________________ age, with more people living alone or feeling isolated, the popularity of support groups—for the addicted, the bereaved, the divorced, or simply for those seeking fellowship and growth—may reflect a longing for community and connectedness.

- religious, interest, support - individualist

Goals of psychoanalysis: - Bring patients' ____________ feelings into conscious awareness - Help patients release energy devoted to __________________ conflicts so they may achieve healthier, less __________ lives

- repressed - id-ego-superego, anxious

Preventive mental health programs work to build ____________. - Based on the idea that many psychological disorders could be prevented by changing ______________, esteem-destroying ________________ into more benevolent, nurturing environments that foster growth and self-confidence - Resilience - Personal ___________ that helps most people cope with stress and recover from adversity and trauma - Can be seen in New Yorkers after 9/11, patients who experience spinal cord injury, and Holocaust survivors, among others

- resilience, oppressive, environments - strength

Humanistic perspective - Theme: Emphasis on people's potential for __________________; to give people new __________ - Goals: Reduce ________ conflicts that interfere with ______________ development and growth; help clients grow in __________________ and _______________, promoting personal growth - Techniques: __________________ therapy; focus on taking __________________ for feelings and actions and on present and future rather than ______

- self-fulfillment, insights - inner, natural, self-awareness, self-acceptance - Person-centered, responsibility, past

Psychodynamic therapy - Goals: Help people understand current _____________; explore and gain _____________ on defended-against thoughts and feelings - Techniques: __________________ face-to-face meetings; exploration of past ____________ troubles to understand _________ of current difficulties

- symptoms, perspective - Client-centered, relationship, origins

Psychotherapy - Psychological techniques derived from psychological perspectives - Trained ____________ uses psychological techniques to assist someone overcome ______________ or achieve ____________ growth.

- therapist, difficulties, personal

Three basic benefits for all psychotherapies 1. Hope for _____________ people 2. New ______________ for oneself and the world 3. Empathic, trusting, caring _____________(___________ __________)

1. demoralized 2. perspective 3. relationship (therapeutic alliance)

Most common drug treatments for psychological disorders?

Antipsychotic drugs Antianxiety drugs Antidepressant drugs Mood-stabilizing medications

________ therapy for depression - Gentle questioning seeks to reveal ___________ thinking and then to persuade people to change their _____________ of their own and others' actions as dark, negative, and pessimistic. - People are trained to ____________ and modify negative _________.

Beck's - irrational, perceptions - recognize, self-talk

Therapist testimonials can be biased: ________________ bias can lead them to unconsciously seek evidence that confirms their beliefs and to ignore contradictory evidence

Confirmation

Operant conditioning therapy: __________________ drive behavior; ____________ behaviors are strongly influenced by their consequences.

Consequences, voluntary

List 3 classical conditioning techniques used in behavior therapy

Counterconditioning, exposure therapies, systematic desensitization

What is the technique called that uses techniques from various forms of therapy?

Eclectic approach▪ U

Psychodynamic therapy is influences by ________ but don't talk much about ____________________ conflicts. Instead it helps people understand their current ____________ by focusing on important _______________ and events, including childhood experiences and the _______________ relationship

Freud id-ego-superego symptoms relationships therapist-client

Clinical psychologists: have a _____ (includes research training) or Psy.D. (focuses on therapy) supplemented by a supervised internship and, often, ______________ training. About half work in agencies and institutions, half in ________ _________.

Ph.D. postdoctoral private practice

Virtual Reality Exposure Therapy

Treats anxiety by creative electronic simulations in which people can safely face their greatest fears, such as flying in airplanes, spiders, or speaking in public

unconditional positive regard

a caring, accepting, nonjudgmental attitude, which Carl Rogers believed would help people develop self-awareness and self-acceptance.

Token economy: People earn ____________ for exhibiting a desired behavior and can later ___________ the tokens for ___________ or ________

a token, exchange, privileges or treats.

Exposure therapies: Treat _______________ by exposing people (in imaginary or actual situations) to the things they ______ and _________.

anxieties fear and avoid

Modern Western therapies can be classified into two main categories:

psychotherapy and biomedical therapy

Clinical or psychiatric social workers: A two-year master of social work graduate program plus postgraduate supervision prepares some social workers to offer _______________, mostly to people with everyday ___________ and __________ problems. About half in the United States have earned the National Association of Social Workers' designation of clinical social worker.

psychotherapy, personal, family

Behavior modification: Desired behavior is _______________; undesired behavior is not reinforced and sometimes is ______________.

reinforced, punished

evidence-based practice: clinical decision making that integrates the best available _____________ with ____________ expertise and _________ characteristics and preferences

research, clinical, patient

Cognitive-behavioral therapy (CBT) - Integrative therapy that combines cognitive therapy (changing ______________ thinking) with behavior therapy (changing ___________) - Aims to alter the way people act and the way they think - Helps people learn to make more ___________ appraisals - This widely practiced integrative therapy aims to alter not only the way people think but also the way they act - CBT effectively treats people with _____________________ and related disorders

self-defeating behavior realistic obsessive-compulsive

resistance

the blocking from consciousness of anxiety-laden material

transference

the patient's transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)