PSYCH- Unit 13: Treating of Abnormal Behavior
electroconvulsive therapy
a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient
therapeutic alliance
a bond of trust and mutual understanding between a therapist and client, who work together constructively to overcome the client's problem
What should a person look for when selecting a therapist?
A person seeking therapy may want to ask about the therapist's treatment approach, values, credentials, and fees. An important consideration is whether the therapy seeker feels comfortable and able to establish a bond with the therapist.
animal magnetism
A term coined by F.A. Mesmer to refer to a putative force or fluid capable of being transmitted from one person to another, producing healing effects. See also Mesmerism. (hypnosis)
Clinical or psychiatric social workers
A two-year master of social work graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems. About half have earned the National Association of Social Workers' designation of clinical social worker.
Systematic desensitization
A type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias.
Which of the following best describes meta-analysis? -- Evidenced-based practice A treatment versus no treatment group A tendency for smaller scores to move toward the average Regressing from unusual to usual A way to combine the results of lots of studies
A way to combine the results of lots of studies
Which of the following is a feature of client-centered therapy? Free association Active listening Resistance Freudian interpretation Medical/biological treatment
Active listening
Some patients whose depression resists drugs have benefited from which experimental treatment? Transference Meta-analysis Antipsychotic drugs Deep-brain stimulation Resistance
Deep-brain stimulation
Which of the following is seen as an effective treatment for severe depression that does not respond to drug therapy? Lobotomy Token economy ECT Crisis debriefing EMDR therapy
ECT
A psychotherapist who uses a blend of therapies is practicing what kind of approach? Eclectic Psychodynamic Cognitive Cognitive-behavioral Humanistic
Eclectic
Biomedical therapy: therapeutic lifestyle change
PRESUMED PROBLEM: Stress and unhealthy lifestyle AIM: Restore healthy biological state. TECHNIQUE: Alter lifestyle through adequate exercise, sleep, and other changes.
Which of the following is the best phrase for a bond of trust and mutual understanding between a therapist and client who are working to overcome the client's problem? Therapeutic alliance EMDR Evidence-based practice Meta-analysis Outcome research
Therapeutic alliance
How do culture, gender, and values influence the therapist-client relationship?
Therapists differ in the values that influence their goals in therapy and their views of progress. These differences may create problems if therapists and clients differ in their cultural, gender, or religious perspectives.
psychoanalytic therapy
Uses various methods to help a patient become aware of his/her unconscious motives, in order to help the patient be more able to choose behaviors consciously. Therapy sessions usually focus on patients talking about their lives and reducing anxiety through self insight through analysis and interpretation.
12-week training program with the following goals
aerobic exercise adequate sleep light exposure social connection anti rumination nutritional supplements 77 percent of those who completed the program experienced relief from depressive symptoms, compared with 19 percent in those assigned to a treatment-as-usual control condition.
technique: take appropriate responsibility
aim: change beliefs therapists' directives: Challenge total self-blame and negative thinking, noting aspects for which you may be truly responsible, as well as aspects that aren't your responsibility.
technique: resist extremes
aim: change beliefs therapists' directives: Develop new ways of thinking and feeling to replace maladaptive habits. For example, change from thinking "I am a total failure" to "I got a failing grade on that paper, and I can make these changes to succeed next time."
Technique: question your interpretations
aim: reveal beliefs therapists' directives: Explore your beliefs, revealing faulty assumptions such as "I must be liked by everyone."
technique: Rank thoughts and emotions
aim: reveal beliefs therapists' directives: Gain perspective by ranking your thoughts and emotions from mildly to extremely upsetting.
technique: examine consequences
aim: test beliefs therapists' directives: Explore difficult situations, assessing possible consequences and challenging faulty reasoning.
technique: decatastrophize thinking
aim: test beliefs therapists' directives: Work through the actual worst-case consequences of the situation you face (it is often not as bad as imagined). Then determine how to cope with the real situation you face.
virtual reality exposure therapy
an anxiety treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders, or public speaking
electric approach
an approach to psychotherapy that, depending on the client's problems, uses techniques from various forms of therapy blend of psychotherapies
token economy
an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats
behavior therapy
applies learning principles to the elimination of unwanted behaviors - Doubt healing power of self awareness - Assume problem behaviors are the problems and applications learning principles can eliminate them - Used to treat phobias or sexual disorders, behavior therapists don't delve deeply below the surface for inner causes
evaluating psychotherapies
cognitive therapies are most widely used, followed by psychoanalytic and family/group therapies
group therapy
consists of 6-9 people attending 90 min. Session that can help more people and cost less Clients benefit from knowing others have similar problems Doesn't provide same decree of therapist involvement w/each client
CBT may be useful for
emotional disorders (regulation) OCD, anxiety, depression, anorexia
Mary Cover Jones helped a little boy named Peter overcome his fear of rabbits by gradually moving a rabbit closer to him each day while he was eating his snack. This was one of the first applications of group therapy. virtual reality exposure therapy. aversive therapy. exposure therapy. cognitive therapy.
exposure therapy.
Aaron Beck
father of cognitive therapy, believed changing people's thinking could change functioning Sought to reverse client's beliefs about themselves
biomedical therapy
prescribed medications or procedures that act directly on the person's physiology
2 categories of therapy
psychotherapy & biomedical therapy
resillience
the personal strength that helps most people cope with stress and recover from adversity and even trauma
regression toward the mean
the tendency for extreme or unusual scores to fall back (regress) toward their average.
pseudotherapies
therapies with no scientific basis to suggest they are effective
EMDR
therapist waves a finger inferno of the eyes of the client to unlock and reprocess previously frozen traumatic memories Francine Shapiro (1989, 2007) developed EMDR while walking in a park and observing that anxious thoughts vanished as her eyes spontaneously darted about.
Behavior therapy
therapy that applies learning principles to the elimination of unwanted behaviors
light exposure therapy
therapy that involves a timed daily dose of intense light; used for SAD
evidence-based practice
clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences
EMDR Therapy
(eye movement desensitization and reprocessing): therapist attempts to unlock and reprocess previous frozen traumatic memories by waving a finger in front of the eyes of the client Has not held up under scientific testing
antidepressant drugs
(prozac, zoloft and paxil) selective serotonin reuptake inhibitors (SSRIs) that improve the mood by elevating levels of serotonin by inhibiting reuptake Used to treat: depression, anxiety disorders, OCD, and PTSD
antianxiety drugs
(xanax and ativan) depress the central nervous system and reduce anxiety and tension by elevating the levels of the Gamma-aminobutyric acid (GABA) neurotransmitter Usually used w/psychological therapy Can be addicting and lead to severe withdrawal symptoms
interpersonal therapy
A brief, psychodynamic psychotherapy that focuses on current relationships and is based on the assumption that symptoms are caused and maintained by interpersonal problems.
cognitive revolution
A shift in psychology, beginning in the 1950s, from the behaviorist approach to an approach in which the main thrust was to explain behavior in terms of the mind. One of the outcomes of the cognitive revolution was the introduction of the information-processing approach to studying the mind.
active listening
Empathic listening in which the listener echoes, restates, and clarifies. A feature of Rogers' client-centered therapy. Active listening is now an accepted part of therapeutic counseling practices in many high schools, colleges, and clinics.
talk therapies
Psychotherapies that focus on communicating and verbalizing emotions and motives to understand their problems.
transcranial magnetic stimulation (TMS)
Pulsating magnetic coil placed over prefrontal regions of the brain to treat depression w/minimal side effects Initial studies have found modest positive benefits
What do psychodynamic therapists call the blocking of anxiety-laden material from the conscious? Resistance Interpretation Transference Face-to-face therapy Interpersonal psychotherapy
Resistance
unconditional positive regard
a caring, accepting, nonjudgmental attitude, which Carl Rogers believed would help clients to develop self-awareness and self-acceptance.
tardive dyskinesia
long term use of antipsychotic drugs can produce tardive dyskinesia Involuntary movements of the facial muscles such as grimacing, tongue, and lips
counter conditioning
pairs the trigger stimulus (enclosed space of elevator) w/new response (relaxation) that is incompatible w/fear. Behavior therapist have successfully counter-conditioned people w/fears. A procedure that conditions new responses to stimuli that trigger unwanted behaviors Based on classical conditioning and includes exposure therapy
Double blind procedures
to test effectiveness of a drug, patients are tested w/the drug and a placebo 2 groups of patients and health professionals are unaware of who's taking the drug and who's taking the placebo
electroconvulsive therapy (ECT)
used for severely depressed patients who do not respond to drugs Patients is anesthetized and given a muscle relaxant Usually get a 100 volt shock that relieves them of depression Shock induced seizures calm neural centers where over activity produces depression Goal: produce a seizure
antipsychotic drugs
used to treat schizophrenia and other forms of psychosis Chlorpromazine (therazine): remove a number of positive symptoms associated w/schizophrenia such as agitation, delusions, and hallucinations Most antipsychotic drugs are antagonist: similar enough to molecules of dopamine to occupy receptor sites and block its activity
systematic desensitization
A type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias. flooding: patient is immersed in the feared object or situation
rational-emotive behavior therapy
Albert ellis: many problems arise from irrational thinking REBT: confrontational cognitive therapy that vigorously challenges people's illogical, self-defeating attitudes -stated therapy could challenge illogical thinking and enable healthier ind. Thought stopping (hear irrational thought, therapist yells, "stop!", reframing (look at situation at positive angle), etc. CBT v. REBT: c= common r = rough (yelling etc.)
How does the basic assumption of behavior therapy differ from those of psychodynamic and humanistic therapies? What techniques are used in exposure therapies and aversive conditioning?
Behavior therapies are not insight therapies. Their goal is to apply learning principles to modify problem behaviors. Classical conditioning techniques, including exposure therapies (such as systematic desensitization or virtual reality exposure therapy) and aversive conditioning, attempt to change behaviors through counterconditioning—evoking new responses to old stimuli that trigger unwanted behaviors.
What are the basic themes of humanistic therapy, and what are the specific goals and techniques of Rogers' client-centered approach?
Both psychoanalytic and humanistic therapies are insight therapies—they attempt to improve functioning by increasing clients' awareness of motives and defenses. Humanistic therapy's goals have included helping clients grow in self-awareness and self-acceptance; promoting personal growth rather than curing illness; helping clients take responsibility for their own growth; focusing on conscious thoughts rather than unconscious motivations; and seeing the present and future as more important than the past. Carl Rogers' client-centered therapy proposed that therapists' most important contributions are to function as a psychological mirror through active listening and to provide a growth-fostering environment of unconditional positive regard, characterized by genuineness, acceptance, and empathy.
atypical antipsychotic
Clozapine (clozaril): blocks receptors for dopamine and serotonin to remove the negative symptoms of schizophrenia
Which psychotherapy would be most effective for treating particular problem?
Depression: behavior, cognition, interpersonal Anxiety: cognition, exposure, stress inoculation Bulimia: cognitive-behavior Phobia: behavior Bed-wetting: behavior modification
Which of the following is one of the ways humanistic therapies differ from psychoanalytic therapies? -- Humanist therapies believe the past is more important than the present and future. Humanist therapies boost self-fulfillment by decreasing self-acceptance. Humanist therapies believe the path to growth is found by uncovering hidden determinants. Humanist therapies believe that unconscious thoughts are more important than conscious thoughts. Humanist therapies focus on promoting growth, not curing illness.
Humanist therapies focus on promoting growth, not curing illness.
how does humanistic therapy differ from psychoanalytic therapy
Humanistic therapy aims to boost people's self-fulfillment by helping them grow in self-awareness and self-acceptance. Promoting this growth, not curing illness, is the focus of therapy. Thus, those in therapy became "clients" or just "persons" rather than "patients" (a change many other therapists have adopted). The path to growth is taking immediate responsibility for one's feelings and actions, rather than uncovering hidden determinants. Conscious thoughts are more important than the unconscious. The present and future are more important than the past. The goal is to explore feelings as they occur, rather than achieve insights into the childhood origins of the feelings.
Classical conditioning techniques
Learning theorist O.H. Mower though reconditioning could be a solution; developed a successful conditioning therapy for chronic bedwetters Child sleeps on liquid-sensitive pad connected to alarm. Moisture on pad triggers alarm, waking the child. w/sufficient repetition, this association of bladder relaxation w/waking up stops the bed wetting. In three out of 4 cases the treatment is effective. types: flooding, systematic desensitization, aversive conditioning
If you want to listen more actively in your own relationships, three Rogerian hints may help:
Paraphrase. Rather than saying "I know how you feel," check your understanding by summarizing the person's words in your own words. Invite clarification. "What might be an example of that?" may encourage the person to say more. Reflect feelings. "It sounds frustrating" might mirror what you're sensing from the person's body language and intensity.
Therapy: client-centered
Presumed Problem: Barriers to self-understanding and self-acceptance Therapy Aim: Enable growth via unconditional positive regard, genuineness, and empathy. Therapy Technique: Listen actively and reflect clients' feelings.
Therapy: Behavior
Presumed Problem: Dysfunctional behaviors Therapy Aim: Relearn adaptive behaviors; extinguish problem ones. Therapy Technique: Use classical conditioning (via exposure or aversion therapy) or operant conditioning (as in token economies).
Therapy: Cognitive
Presumed Problem: Negative, self-defeating thinking Therapy Aim: Promote healthier thinking and self-talk. Therapy Technique: Train people to dispute negative thoughts and attributions.
Therapy: Cognitive-behavioral
Presumed Problem: Self-harmful thoughts and behaviors Therapy Aim: Promote healthier thinking and adaptive behaviors. Therapy Technique: Train people to counter self-harmful thoughts and to act out their new ways of thinking.
Therapy: Group and family
Presumed Problem: Stressful relationships Therapy Aim: Heal relationships. Therapy Technique: Develop an understanding of family and other social systems, explore roles, and improve communication.
Therapy: Psychodynamic
Presumed Problem: Unconscious conflicts from childhood experiences Therapy Aim: Reduce anxiety through self-insight. Therapy Technique: Interpret patients' memories and feelings.
How do psychotherapy, biomedical therapy, and an eclectic approach to therapy differ?
Psychotherapy is treatment involving psychological techniques; it consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth. The major psychotherapies derive from psychology's psychodynamic, humanistic, behavioral, and cognitive perspectives. Biomedical therapy treats psychological disorders with medications or procedures that act directly on a patient's physiology. An eclectic approach combines techniques from various forms of psychotherapy.
psychoanalysis
Sigmund Freud's therapeutic technique. Freud believed the patient's free associations, resistances, dreams, and transferences - and the therapist's interpretations of them - released previously repressed feelings, allowing the patient to gain self-insight.
What are the goals and techniques of cognitive therapy and of cognitive-behavioral therapy?
The cognitive therapies, such as Aaron Beck's cognitive therapy for depression, assume that our thinking influences our feelings, and that the therapist's role is to change clients' self-defeating thinking by training them to view themselves in more positive ways. Rational-emotive behavior therapy (REBT) is a confrontational cognitive therapy that actively challenges irrational beliefs. The widely researched and practiced cognitive-behavioral therapy (CBT) combines cognitive therapy and behavior therapy by helping clients regularly act out their new ways of thinking and talking in their everyday life.
Critics of behavior modification express two concerns
The first is practical: How durable are the behaviors? Will people become so dependent on extrinsic rewards that the appropriate behaviors will stop when the reinforcers stop? Proponents of behavior modification believe the behaviors will endure if therapists wean patients from the tokens by shifting them toward other, real-life rewards, such as social approval. They also point out that the appropriate behaviors themselves can be intrinsically rewarding The second concern is ethical: Is it right for one human to control another's behavior? Those who set up token economies deprive people of something they desire and decide which behaviors to reinforce. To critics, this whole process has an authoritarian taint. Advocates reply that some patients request the therapy. Moreover, control already exists; rewards and punishers are already maintaining destructive behavior patterns. So why not reinforce adaptive behavior instead? Treatment with positive rewards is more humane than being institutionalized or punished, advocates argue, and the right to effective treatment and an improved life justifies temporary deprivation.
What is the main premise of therapy based on operant conditioning principles, and what are the views of its proponents and critics?
Therapy based on operant conditioning principles uses behavior modification techniques to change unwanted behaviors through positively reinforcing desired behaviors and ignoring or punishing undesirable behaviors. Critics maintain that (1) techniques such as those used in token economies may produce behavior changes that disappear when rewards end, and (2) deciding which behaviors should change is authoritarian and unethical. Proponents argue that treatment with positive rewards is more humane than punishing people or institutionalizing them for undesired behaviors.
What are the goals and techniques of psychoanalysis, and how have they been adapted in psychodynamic therapy?
Through psychoanalysis, Sigmund Freud tried to give people self-insight and relief from their disorders by bringing anxiety-laden feelings and thoughts into conscious awareness. - Techniques included using free association and interpretation of instances of resistance and transference. -- Contemporary psychodynamic therapy has been influenced by traditional psychoanalysis but is briefer, less expensive, and more focused on helping the client find relief from current symptoms. Therapists help clients understand themes that run through past and current relationships. Interpersonal therapy is a brief 12- to 16-session form of psychodynamic therapy that has been effective in treating depression.
Goals of Psychoanalytic Therapy
To make the unconscious conscious. To reconstruct the basic personality. To assist clients in reliving earlier experience and working through repressed conflicts. To achieve intellectual awareness.
humanistic therapies
Treatments, unique in their emphasis on people's self-healing capacities, that encourage clients to understand themselves and to grow personally.
rational-emotive behavior therapy (REBT)
a confrontational cognitive therapy, developed by Albert Ellis, that vigorously challenges people's illogical, self-defeating attitudes and assumptions Change people's thinking by revealing the "absurdity" of their self-defeating ideas, the sharp-tongued Ellis believed, and you will change their self-defeating feelings and enable healthier behaviors.
cognitive-behavioral therapy (CBT)
a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior) seeks to make people aware of their irrational negative thinking, to replace it with new ways of thinking, and to practice the more positive approach in everyday settings.
aversive conditioning
a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol) Reverse of systematic desensitization
insight therapies
a variety of therapies that aim to improve psychological functioning by increasing a person's awareness of underlying motives and defenses
insight therapy
a variety of therapies that aim to improve psychological functioning by increasing the client's awareness of underlying motives and defenses - psychoanalytic - interpersonal
cognitive behavior therapy
aims to alter way people act and alter the way they think Successful for treating anxiety, mood disorders, OCD, depression, and eating disorders
Psychoanalytic theory
attempts to explain personality, motivation, and mental disorders by focusing on unconscious determinants of behavior resumes that healthier, less anxious living becomes possible when people release the energy they had previously devoted to id-ego-superego conflicts Freud's therapy aimed to bring patients' repressed or disowned feelings into conscious awareness. - By helping them reclaim their unconscious thoughts and feelings and giving them insight into the origins of their disorders, he aimed to help them reduce growth-impeding inner conflicts.
exposure therapies
behavioral techniques, such as systematic desensitization, that treat anxieties by exposing people (in imagination or actuality) to the things they fear and avoid
clinician's perceptions
believe in therapy's success. believe client is better off after therapy than if client had not taken part in therapy 1. clinicians are aware of failures, but they believe failures are the problems of other therapists 2. if a client seeks another clinician, the former therapist is more likely to argue that the client has developed another psychological problem 3. clinicians are likely to testify to the efficacy of their therapy regardless of the outcome of treatment
Many clinical psychologists incorporate a variety of approaches into their therapy. They are said to take a(n) ___________ approach. transference biomedical psychoanalytic eclectic psychodynamic
eclectic
operant conditioning
enable therapists to use behavior modification in which desired behaviors are rewarded and undesired behaviors are un-rewarded/punished
Psychoanalytic techniques
free association, analysis of transference, interpretation
Rogers encouraged therapists to exhibit
genuineness, acceptance, empathy When therapists enable their clients to feel unconditionally accepted, when they drop their façades and genuinely express their true feelings, and when they empathically sense and reflect their clients' feelings, the clients may deepen their self-understanding and self-acceptance
free association
in psychoanalysis, a method of exploring the unconscious in which the person relaxes and says whatever comes to mind, no matter how trivial or embarrassing
interpretation
in psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight
transference
in psychoanalysis, the patient's transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent) By exposing such feelings, you may gain insight into your current relationships.
benefits of group therapy
it saves the therapist's time and client's money. It offers a social laboratory for exploring social behaviors and developing social skills. It enables people to see that others share their problems. It provides feedback as clients try out new ways of behaving.
mood-stabilizing medications
lithium carbonate, a common salt, has been used to stabilize manic episodes in bipolar disorders Moderates the levels of norepinephrine and glutamate neurotransmitters
progressive relaxation
lying down comfortably and tensing and releasing the tension in each major muscle group in turn
aaron beck
pioneer in Cognitive Therapy. Suggested negative beliefs cause depression. sought to reverse clients' catastrophizing beliefs about themselves, their situations, and their futures Gentle questioning seeks to reveal irrational thinking, and then to persuade people to remove the dark glasses through which they view life
lobotomies
psychosurgical procedure once used to calm uncontrollable emotional or violent patients Cut the nerves connecting frontal lobes to inner brain Modern methods use stereotactic neurosurgery and radiosurgery that refine older methods of psychosurgery
self-help groups
studies show that self-help groups focus on stigmatized or hard to discuss illness ex) AIDS patients are more likely to be in a group than hypertension patients Alcoholics anonymous (AA) has more than 2 mil. Members worldwide
goal of aversive conditioning
substituting a negative (aversive) response for a positive response to a harmful stimulus (such as alcohol). Thus, aversive conditioning is the reverse of systematic desensitization—it seeks to condition an aversion to something the person should avoid.
stress inoculation training
teaching people to restructure their thinking in stressful situations "Relax. The test may be hard, but it will be hard for everyone else, too. I studied harder than most people. Besides, I don't need a perfect score to get a good grade in this class." After being trained to dispute their negative thoughts, depression--prone children, teens, and college students exhibit a greatly reduced rate of future depression
behavior modification
the use of operant conditioning techniques to bring about desired changes in behavior reinforcing desired behaviors, and withholding reinforcement for undesired behaviors
group therapy
therapy conducted with groups rather than individuals, permitting therapeutic benefits from group interaction
psychodynamic therapy
therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight
cognitive therapy
therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions Behavioral therapy treat specific and problem behaviors - Cognitive therapy helps deal w/things like depression and anxiety that are clearly defined problems Focus on teaching patients new ways of thinking
Family therapy
therapy that treats the family as a system. Views an individual's unwanted behaviors as influenced by, or directed at, other family members We live and grow in relation to others, especially our families. We struggle to differentiate ourselves from our families, but we also need to connect with them emotionally. Some of our problem behaviors arise from the tension between these two tendencies, which can create family stress. therapists work with multiple family members to heal relationships and to mobilize family resources. They tend to view the family as a system in which each person's actions trigger reactions from others, and they help family members discover their role within their family's social system
psychotherapy
treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth
family therapy
treats family as a system Guides members toward positive relationships and improve communication
psychosurgery
used as a last resort in alleviating psychological disturbances Irreversible Removal of brain tissue changes the mind Although used sparingly today, 200 such operations to take place in US alone
therapy study w/Massachusetts boys
500 Massachusetts boys, aged 5 to 13 years half the boys were assigned to a 5-year treatment program. The treated boys were visited by counselors twice a month. They participated in community programs, and they received academic tutoring, medical attention, and family assistance as needed. ---- Client testimonials yielded encouraging results, even glowing reports. Some men noted that, had it not been for their counselors, "I would probably be in jail." - Even among the "difficult" boys in the treatment group, 66 percent had no official juvenile crime record. --- For every boy in the treatment group, there was a similar boy in a control group, receiving no counseling. Of these untreated men, 70 percent had no juvenile record. On several other measures, such as a record of having committed a second crime, alcohol use disorder, death rate, and job satisfaction, the untreated men exhibited slightly fewer problems. --- *The glowing testimonials of those treated had been unintentionally deceiving.
What three elements are shared by all forms of psychotherapy?
All psychotherapies offer new hope for demoralized people; a fresh perspective; and (if the therapist is effective) an empathic, trusting, and caring relationship. The emotional bond of trust and understanding between therapist and client—the therapeutic alliance—is an important element in effective therapy.
Which kind of drug is most closely associated with increasing the availability of norepinephrine or serotonin? Antidepressant Antipsychotic Antianxiety Mood-stabilizing Muscle relaxant
Antidepressant
In an effort to help a child overcome a fear of dogs, a therapist pairs a trigger stimulus (something associated with dogs) with a new stimulus that causes a response that is incompatible with fear (for example, an appealing snack or toy). Which clinical orientation is this therapist using? Psychodynamic Behavioral Biomedical Client-centered Humanistic
Behavioral
Which of the following is a similarity between humanistic and psychoanalytic therapies? -- Both approaches focus on the present more than the past. Both approaches are more concerned with conscious than unconscious feelings. Both approaches focus on taking immediate responsibility for one's feelings. Both approaches focus on growth instead of curing illness. Both approaches are generally considered insight therapies.
Both approaches are generally considered insight therapies.
clinical decision making
Careful reasoning so that the best options are chosen for the best outcomes
Does psychotherapy work? Who decides?
Clients' and therapists' positive testimonials cannot prove that therapy is actually effective, and the placebo effect and regression toward the mean (the tendency for extreme or unusual scores to fall back toward their average) make it difficult to judge whether improvement occurred because of the treatment. Using meta-analyses to statistically combine the results of hundreds of randomized psychotherapy outcome studies, researchers have found that those not undergoing treatment often improve, but those undergoing psychotherapy are more likely to improve more quickly, and with less chance of relapse.
A psychotherapist states, "Getting people to change what they say to themselves is an effective way to change their thinking." This statement best exemplifies which kind of therapeutic approach? Behavioral Psychodynamic Biomedical Cognitive Active listening
Cognitive
Which of the following therapeutic approaches is scientifically supported? Recovered-memory therapies Rebirthing therapies Cognitive therapy Energy therapies Crisis debriefing
Cognitive therapy
Which kind of therapy below is most closely associated with the goal of altering thoughts and actions? Aversive conditioning Psychodynamic Client-centered Family Cognitive-behavioral
Cognitive-behavioral
Which of the following does the text's author call psychology's most powerful tool for sorting reality from wishful thinking? ESP or "psychic powers" Regression toward the mean Client perception Control group Placebo effect
Control group
How do alternative therapies fare under scientific scrutiny?
Controlled research has found some benefits of eye movement desensitization and reprocessing (EMDR) therapy for PTSD, though possibly for reasons unrelated to eye movements. Light exposure therapy does seem to relieve depression symptoms for those with a seasonal pattern of major depressive disorder by activating a brain region that influences arousal and hormones.
How, by taking care of themselves with a healthy lifestyle, might people find some relief from depression, and how does this reflect our being biopsychosocial systems?
Depressed people who undergo a program of aerobic exercise, adequate sleep, light exposure, social engagement, negative-thought reduction, and better nutrition often gain some relief. In our integrated biopsychosocial system, stress affects our body chemistry and health; chemical imbalances can produce depression; and social support and other lifestyle changes can lead to relief of symptoms.
Which of the following is most effectively treated with electroconvulsive therapy (ECT)? Psychosis Schizophrenia Obsessive-compulsive disorder Depression Generalized anxiety disorder
Depression
Most antipsychotic drugs mimic a certain neurotransmitter by blocking its activity at the receptor sites. These drugs affect which one of the following neurotransmitters? Adrenaline Epinephrine Serotonin Dopamine Acetylcholine
Dopamine
Which neurotransmitter is affected by antipsychotic medications? Epinephrine Dopamine Norepinephrine Acetylcholine Serotonin
Dopamine
How are brain stimulation and psychosurgery used in treating specific disorders?
Electroconvulsive therapy (ECT), in which a brief electric current is sent through the brain of an anesthetized patient, is an effective treatment for severely depressed people who have not responded to other therapy. Newer alternative treatments for depression include repetitive transcranial magnetic stimulation (rTMS) and, in preliminary clinical experiments, deep-brain stimulation that calms an overactive brain region linked with negative emotions. Psychosurgery removes or destroys brain tissue in hopes of modifying behavior. Radical psychosurgical procedures such as the lobotomy were once popular, but neurosurgeons now rarely perform brain surgery to change behavior or moods. Brain surgery is a last-resort treatment because its effects are irreversible.
Allowing people to discover, in a social context, that others have problems similar to their own is a unique benefit of what kind of therapy? Psychodynamic Psychopharmacological Group Cognitive Humanistic
Group
What are the aims and benefits of group and family therapy?
Group therapy sessions can help more people and costs less per person than individual therapy would. Clients may benefit from exploring feelings and developing social skills in a group situation, from learning that others have similar problems, and from getting feedback on new ways of behaving. Family therapy views a family as an interactive system and attempts to help members discover the roles they play and to learn to communicate more openly and directly.
all therapies offer at least three benefits:
HOPE FOR DEMORALIZED PEOPLE (people seeking therapy typically feel anxious, depressed, devoid of self-esteem, and incapable of turning things around; "things can and will get better") A NEW PERSPECTIVE (offers people a plausible explanation of their symptoms and an alternative way of looking at themselves or responding to their world. Armed with a believable fresh perspective, they may approach life with a new attitude, open to making changes in their behaviors and their views of themselves.) AN EMPATHIC, TRUSTING, CARING RELATIONSHIP (effective therapists are empathic people who seek to understand another's experience; who communicate their care and concern to the client; and who earn the client's trust through respectful listening, reassurance, and advice.)
Which of the following is considered a benefit of group therapy? It is the most effective therapy for children. It is particularly effective in the treatment of antisocial personality disorder. It is particularly effective in the treatment of schizophrenia. It is the only setting proven effective for virtual reality exposure therapy. It saves time and money when compared with other forms of therapy.
It saves time and money when compared with other forms of therapy.
Hans Eysenck
Launching a spirited debate, he summarized studies showing that two-thirds of those receiving psychotherapy for nonpsychotic disorders improved markedly. To this day, no one disputes that optimistic estimate. Eysenck also reported similar improvement among untreated persons, such as those who were on waiting lists. With or without psychotherapy, he said, roughly two-thirds improved noticeably. Time was a great healer.
Counselors
Marriage and family counselors specialize in problems arising from family relations. Clergy provide counseling to countless people. Abuse counselors work with substance abusers and with spouse and child abusers and their victims. Mental health and other counselors may be required to have a two-year master's degree.
Clinical psychologists
Most are psychologists with a Ph.D. (includes research training) or Psy.D. (focuses on therapy) supplemented by a supervised internship and, often, postdoctoral training. About half work in agencies and institutions, half in private practice.
Are some psychotherapies more effective than others for specific disorders?
No one type of psychotherapy is generally superior to all others. Therapy is most effective for those with clear-cut, specific problems. Some therapies—such as behavior conditioning for treating phobias and compulsions—are more effective for specific disorders. Psychodynamic therapy helped treat depression and anxiety, and cognitive and cognitive-behavioral therapies have been effective in coping with anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and depression. Evidence-based practice integrates the best available research with clinicians' expertise and patients' characteristics, preferences, and circumstances.
On which of the following are token economies based? Classical conditioning Operant conditioning Group therapy Cognitive therapy Cognitive-behavioral therapy
Operant conditioning
Biomedical therapy: psychosurgery
PRESUMED PROBLEM: Brain malfunction AIM: Relieve severe disorders. TECHNIQUE: Remove or destroy brain tissue.
Biomedical therapy: drug therapies
PRESUMED PROBLEM: Neurotransmitter malfunction AIM: Control symptoms of psychological disorders. TECHNIQUE: Alter brain chemistry through drugs.
Biomedical therapy: Brain stimulation
PRESUMED PROBLEM: Severe, "treatment-resistant" depression AIM: Alleviate depression that is unresponsive to drug therapy. TECHNIQUE: Stimulate brain through electroconvulsive shock, magnetic impulses, or deep-brain stimulation.
What is the rationale for preventive mental health programs?
Preventive mental health programs are based on the idea that many psychological disorders could be prevented by changing oppressive, esteem-destroying environments into more benevolent, nurturing environments that foster growth, self-confidence, and resilience.
psychiatrists
Psychiatrists are physicians who specialize in the treatment of psychological disorders. Not all psychiatrists have had extensive training in psychotherapy, but as M.D.s or D.O.s they can prescribe medications. Thus, they tend to see those with the most serious problems. Many have their own private practice.
In which kind of therapy would the therapist be most likely to note the following during a session: "Blocks in the flow of free associations indicate resistance"? Cognitive therapy Psychoanalysis Client-centered therapy Behavioral therapy Person-centered therapy
Psychoanalysis
What are the drug therapies? How do double-blind studies help researchers evaluate a drug's effectiveness?
Psychopharmacology, the study of drug effects on mind and behavior, has helped make drug therapy the most widely used biomedical therapy. Antipsychotic drugs, used in treating schizophrenia, block dopamine activity. Side effects may include tardive dyskinesia (with involuntary movements of facial muscles, tongue, and limbs) or increased risk of obesity and diabetes. Antianxiety drugs, which depress central nervous system activity, are used to treat anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. These drugs can be physically and psychologically addictive. Antidepressant drugs, which increase the availability of serotonin and norepinephrine, are used for depression, with modest effectiveness beyond that of placebo drugs. The antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are now used to treat other disorders, including strokes, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. Lithium and Depakote are mood stabilizers prescribed for those with bipolar disorder. Studies may use a double-blind procedure to avoid the placebo effect and researchers' bias.
Which of the following is not recommended by therapists as a way to help prevent or get over depression? Recovered-memory therapies Aerobic exercise Light exposure Increased social connections Antirumination strategies
Recovered-memory therapies
Which of the following was the purpose of lobotomies? -- To alleviate depression To minimize delusions and hallucinations To "erase" troubling memories To recover repressed memories To separate the reasoning centers of the brain from the emotional centers
To separate the reasoning centers of the brain from the emotional centers
In the context of psychoanalytic theory, experiencing strong positive or negative feelings for your analyst is a sign of what? Counterconditioning Meta-analysis Transference Tardive dyskinesia Aversive conditioning
Transference
interpersonal psychotherapy
a form of psychotherapy that focuses on helping clients improve current relationships aims to help people gain insight into the roots of their difficulties, its goal is symptom relief in the here and now. Rather than focusing mostly on undoing past hurts and offering interpretations, the therapist concentrates primarily on current relationships and on helping people improve their relationship skills.
self-help groups
a group composed of people who have similar problems and who meet together without a therapist or counselor for the purpose of discussion, problem solving, and social and emotional support
client-centered therapy
a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients' growth. (Also called person-centered therapy.)
therapeutic lifestyle change
a lifestyle modification that includes diet, physical activity, and weight loss
meta-analysis
a procedure for statistically combining results of many different research studies
meta-analysis
a procedure for statistically combining the results of many different research studies
lobotomy
a psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain It usually decreased the person's misery or tension, but also produced a permanently lethargic, immature, uncreative person.
Echoing, restating, and seeking clarification of what a person expresses (verbally or nonverbally) in a therapy session is called active listening. virtual reality exposure therapy. systematic desensitization. family therapy. classical conditioning.
active listening.
Dr. Welle tries to help her clients by teaching them to modify the things they do when under stress or experiencing symptoms. This means that Dr. Welle engages in _________ therapy. behavior cognitive group rational-emotive behavior client-centered
behavior
counterconditioning
behavior therapy procedures that use classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; include exposure therapies and aversive conditioning pairs the trigger stimulus (in this case, the enclosed space of the elevator) with a new response (relaxation) that is incompatible with fear. Indeed, behavior therapists have successfully counterconditioned people with such fears. Two specific counterconditioning techniques—exposure therapy and aversive conditioning—replace unwanted responses.
exposure therapy
behavioral techniques such as systematic desensitization and virtual reality, that treat anxieties by exposing patients to things they fear and avoid Through repeated exposures anxiety lessons because they habituate to the things feared Suggested by joseph wolpe
SSRI
class of drugs used to relieve anxiety by limiting reuptake of a neurotransmitter
Client's Perceptions
client self-reports indicate that psychotherapy is effective -- for several reasons, client testimonials don't persuade psychotherapy's skeptics: -people often enter therapy in crisis -clients may need to believe the therapy was worth the effort -clients generally speak kindly of their therapists
Joseph Wolpe
described use of systematic desensitization to treat phobias
Anti-anxiety drugs
drugs used to control anxiety and agitation depress central nervous system activity. often used in combination with psychological therapy. One antianxiety drug, the antibiotic D-cycloserine, acts upon a receptor that, in combination with behavioral treatments, facilitates the extinction of learned fears. Experiments indicate that the drug enhances the benefits of exposure therapy and helps relieve the symptoms of PTSD and OCD. criticism: reduce symptoms without resolving underlying problems - "Popping a Xanax" at the first sign of tension can create a learned response; the immediate relief reinforces a person's tendency to take drugs when anxious. - Anti-anxiety drugs can also be addicting. After heavy use, people who stop taking them may experience increased anxiety, insomnia, and other withdrawal symptoms. Over the dozen years at the end of the twentieth century, the rate of outpatient treatment for anxiety disorders, OCD, and PTSD nearly doubled.
Antidepressants
drugs used to treat depression, anxiety disorders, OCD, and PTSD (several are selective serotonin reuptake inhibitors- SSRIs) The label is a bit of a misnomer now that these drugs are increasingly being used to successfully treat anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. These drugs are agonists; they work by increasing the availability of certain neurotransmitters, such as norepinephrine or serotonin, which elevate arousal and mood and appear scarce when a person experiences feelings of depression or anxiety. Prozac and its cousins Zoloft and Paxil, work by blocking the reabsorption and removal of serotonin from synapses (FIGURE 73.1). Given their use in treating disorders other than depression—from anxiety to strokes—this group of drugs is most often called SSRIs (selective serotonin reuptake inhibitors) rather than antidepressants Some of the older antidepressant drugs work by blocking the reabsorption or breakdown of both norepinephrine and serotonin. Though effective, these dual-action drugs have more potential side effects, such as dry mouth, weight gain, hypertension, or dizzy spells
antipsychotic drugs
drugs used to treat schizophrenia and other forms of severe thought disorder - calm patients w/psychoses ex) chlorpromazine dampened responsiveness to irrelevant stimuli - provided most help to patients w/positive symptoms of schizophrenia (hallucinations & paranoia) most are antagonists: similar enough to molecules of neurotransmitter dopamine to occupy its receptor sites and block its activity have powerful side effects: - Some produce sluggishness, tremors, and twitches similar to those of Parkinson's disease - Long-term use of antipsychotics can produce tardive dyskinesia, with involuntary movements of the facial muscles (such as grimacing), tongue, and limbs. Antipsychotics, combined with life-skills programs and family support, have given new hope to many people with schizophrenia. - - Hundreds of thousands of patients have left the wards of mental hospitals and returned to work and to near-normal lives
biopsychosocial system
each individual is this kind of system: their cells make organs, their organs make up an individual and its processes, and the individual is part of a family, culture, community Stress affects body chemistry and health. And chemical imbalances, whatever their cause, can produce schizophrenia, depression, and other mental disorders.
resistance
in psychoanalysis, the blocking from consciousness of anxiety-laden material
randomized clinical trials
researchers randomly assign people on a waiting list to therapy or no therapy and later evaluate everyone, using tests and the reports of people who don't know whether therapy was given
Enthusiasm for treatment often diminishes after
researchers subtract the rates of: (1) normal recovery among untreated persons and (2) recovery due to the placebo effect, which arises from the positive expectations of patients and mental health workers alike.
1st meta-analysis of psychotherapy outcome studies
showed that the average therapy client ends up better off than 80 percent of the untreated individuals on waiting lists Those not undergoing therapy often improve, but those undergoing therapy are more likely to improve more quickly, and with less risk of relapse.
psychopharmacology
study of drug effects on mind and behavior
Psychosurgery
surgery that removes or destroys brain tissue in an effort to change behavior
repetitive transcranial magnetic stimulation (rTMS)
the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity.
Neurogenesis
the development of new neurons promoted by increased serotonin
mood-stabilizing drugs
used to treat mood instability and bipolar disorders; an example is lithium after suffering mood swings for years, about 7 in 10 people with bipolar disorder benefit from a long-term daily dose of this cheap salt, which helps prevent or ease manic episodes and, to a lesser extent, lifts depression (Solomon et al., 1995). It also protects neural health, thus reducing bipolar patients' vulnerability to significant cognitive decline. Lithium also reduces bipolar patients' risk of suicide
Clients' and therapists' perceptions of therapy's effectiveness
vulnerable to inflation from two phenomena. One is the placebo effect—the power of belief in a treatment. If you think a treatment is going to be effective, it just may be (thanks to the healing power of your positive expectations). The second phenomenon is regression toward the mean—the tendency for unusual events (or emotions) to "regress" (return) to their average state.
Is psychotherapy cost effective?
yes. Studies show that when people seek psychological treatment, their search for other medical treatment drops—by 16 percent in one digest of 91 studies. Given the staggering annual cost of psychological disorders and substance abuse—including crime, accidents, lost work, and treatment—psychotherapy is a good investment the claim—that psychotherapy, on average, is somewhat effective—refers to no one therapy in particular. It is like reassuring lung-cancer patients that "on average," medical treatment of health problems is effective
