Psychology Week 11 (Chapter 16)

interpretation

in psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight

biomedical therapy

prescribed medications or medical procedures that act directly on the patient's nervous system

psychopharmacology

the study of the effects of drugs on mind and behavior

group therapy

therapy conducted with groups rather than individuals, permitting therapeutic benefits from group interaction

Psychoanalysis

Freud's theory of personality that attributes thoughts and actions to unconscious motives and conflicts; the techniques used in treating psychological disorders by seeking to expose and interpret unconscious tensions

electroconvulsive therapy (ECT)

a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient

cognitive behavioral therapy

a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

aversive conditioning

a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol)

unconditional positive regard

according to Rogers, an attitude of total acceptance toward another person

evidence-based practice

clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

insight therapies

a variety of therapies that aim to improve psychological functioning by increasing a person's awareness of underlying motives and defenses

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

eclectic approach

an approach to psychotherapy that, depending on the client's problems, uses techniques from various forms of therapy

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

antidepressent drugs

drugs used to treat depression; also increasingly prescribed for anxiety. Different types work by altering the availability of various neurotransmitters

antipsychotic drugs

drugs used to treat schizophrenia and other forms of severe thought disorder

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

systemic desensitization

A type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias.

Psychotherapy

treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth

Resistance

in psychoanalysis, the blocking from consciousness of anxiety-laden material

Transference

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

posttraumatic growth

positive psychological changes as a result of struggling with extremely challenging circumstances and life crises

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

antianxiety drugs

A category of drugs that includes the barbiturates and benzodiazepines, drugs that diminish feelings of anxiety.

lobotomy

A now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain.

How do alternative therapies fare under scientific scrutiny?

Abnormal states tend to return to normal on their own, and the placebo effect can create the impression that a treatment has been effective. These two tendencies complicate assessments of nontraditional therapies that claim to cure certain ailments. Eye movement desensitization and reprocessing (EMDR) has shown some effectiveness—but not from the eye movement (rather from the exposure therapy nature of the treatments). Light exposure therapy does seem to help those with a seasonal pattern in depression symptoms by activating a brain region that influences arousal and hormones.

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.

How does the basic assumption of behavior therapy differ from the assumptions of psychodynamic and humanistic therapies? What techniques are used in exposure therapies and aversive conditioning?

Behavior therapies are not insight therapies, and instead assume that problem behaviors are the problem. Their goal is to apply learning principles to modify these 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? What are the specific goals and techniques of Rogers' client-centered approach?

Both psychodynamic and humanistic therapists are insight therapies they attempt to improve functioning by increasing clients' awareness of motives and defenses. Humanistic therapy's goals include 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.

What should a person look for when selecting a psychotherapist?

Campus health centers are generally good starting points for counseling options, and they may offer some free services. 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. Recognizing the importance of a strong therapeutic alliance, the American Psychological Association accredits programs that provide training in cultural sensitivity and that recruit underrepresented cultural groups.

Does psychotherapy work? How can we know?

Clients' and therapists' positive testimonials cannot prove that psychotherapy is effective, and the placebo effect makes 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—and to improve more quickly and with less risk of relapse.

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, last-resort treatment for people with severe depression who have not responded to other therapy. Newer alternative treatments for depression include transcranial electrical stimulation (tDCS; also used for scientifically unproven cognitive benefits), repetitive transcranial magnetic stimulation (rTMS), and deep-brain stimulation (DBS; said to work by calming an overactive brain region linked with negative emotions, and has shown benefit in some patients). Psychosurgery removes or destroys brain tissue in hopes of modifying behavior. Radical psychosurgical procedures such as lobotomy are no longer performed. Today's microscale psychosurgery and MRI-guided precision brain surgery are rare, last-resort treatments because the effects are irreversible.

active listening

Empathic listening in which the listener echoes, restates, and clarifies. A feature of Rogers' client-centered therapy.

What are the aims and benefits of group and family therapies?

Group therapy sessions can help more people with less cost than individual therapy. 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. It attempts to help members discover the roles they play and learn to communicate more openly and directly.

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. Cognitive and cognitive-behavioral therapies have been effective in coping with anxiety, posttraumatic stress disorder, insomnia, and depression; behavioral conditioning therapies with specific behavior problems; psychodynamic therapy for depression and anxiety; and nondirective (client-centered) counseling for mild to moderate depression. Evidence-based practice integrates the best available research with clinicians' expertise and patients' characteristics and preferences.

What is the main premise of therapy based on operant conditioning principles, and what are the views of its proponents and critics?

Operant conditioning operates under the premise that voluntary behaviors are strongly influenced by their consequences. Therapy based on operant conditioning principles therefore uses behavior modification techniques to change unwanted behaviors by 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 drug therapies? How do double-blind studies help researchers evaluate a drug's effectiveness?

Psychopharmacology has helped make drug therapy the most widely used biomedical therapy. Antipsychotic drugs are used in treating schizophrenia; some block dopamine activity. Side effects may include tardive dyskinesia (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, and can be addictive. Antidepressant drugs, which often increase the availability of serotonin and norepinephrine, are used to treat depression, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder with modest effectiveness. Given their widening use (from depression to anxiety to strokes), some professionals prefer the term SSRIs (selective serotonin reuptake inhibitors) rather than antidepressants. 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 researcher bias.

How do psychotherapy and the biomedical therapies differ?

Psychotherapy is treatment involving psychological techniques that 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 therapy.

repetitive transcranial magnetic stimulation (rTMS)

the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity

What are the goals and techniques of the cognitive therapies 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 perceive and interpret events in more constructive ways. The widely researched and practiced cognitive-behavioral therapy (CBT) combines cognitive therapy and behavior therapy by helping clients regularly try out their new ways of thinking and behaving in their everyday life. A newer CBT variation, dialectical behavior therapy (DBT), teaches clients cognitive tactics for tolerating distress and regulating emotions, and trains them in social skills and mindfulness meditation.

Why is therapeutic lifestyle change considered an effective biomedical therapy, and how does it work?

Therapeutic lifestyle change is considered a biomedical therapy because it influences the way the brain responds. Mind and body are a unit; affect one and you will affect the other. Our exercise, nutrition, relationships, recreation, relaxation, and religious or spiritual engagement affect our mental health. People who undergo a program of aerobic exercise, adequate sleep, light exposure, social engagement, rumination reduction, and better nutrition have gained relief from depressive symptoms.

How do culture and values influence the client-therapist 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 or religious perspectives.

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. Psychoanalytic techniques included using free association and interpretation of instances of resistance and transference. Psychodynamic therapy has been influenced by traditional psychoanalysis but differs from it in many ways, including the lack of belief in id, ego, and superego. This contemporary therapy is briefer, less expensive, and more focused on helping the client find relief from current symptoms. Psychodynamic therapists help clients understand how past relationships create themes that may be acted out in present relationships.

meta-analysis

a "study of studies" that combines the findings of multiple studies to arrive at a conclusion

counterconditioning

a behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; includes exposure therapies and aversive conditioning

therapuetic alliance

a bond of trust and mutual understanding between a therapist and client, who work together constructively to overcome the client's problem

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.)

psychosurgery

surgery that removes or destroys brain tissue in an effort to change behavior

resilience

the personal strength that helps most people cope with stress and recover from adversity and even trauma

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

behavior therapy

therapy that applies learning principles to the elimination of unwanted behaviors

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