Psychology - Ch 14

What is the basic idea of operant conditioning therapies?

1) A basic operant conditioning concept is that consequences drive our voluntary behaviors. 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. 2) Therapists may use a token economy, in which desired behavior earn his privileges.

What three elements are shared by all forms of psychotherapy?

1) All psychotherapies offer (1) new hope for demoralized people; (2) a fresh perspective; and (3) an empathic, trusting, and caring relationship. 2) The emotional bond of trust and understanding between therapist and client (the therapeutic alliance) is an important element in effective therapy.

Does psychotherapy work? How do we know?

1) Clients and therapists positive testimonials cannot prove that psychotherapy is actually effective. Clients justify their investment, tend to speak highly of the therapist, and often enter therapy in crisis. Sometimes they are healed by time alone. Therapists tend to track only their "success" stories. 2) Outcome research has found that people who remain untreated often improves, but those who receive psychotherapy are more likely to improve, to improve more quickly, and to improve with less chance of a relapse.

What are the goals and techniques of the cognitive therapies and of cognitive-behavioral therapy?

1) Cognitive therapies, such as Aaron Beck's 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 think in healthier ways. 2) 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 behaving in their every day life. A newer CBT variation, dialectical behavior therapy (DBT), combines cognitive tactics for tolerating distress and regulating emotions with social skills training and mindfulness meditation.

What should a person look for when selecting a psychotherapist?

1) College health centers are generally good starting point for counseling options, and they offer some free services. 2) A person seeking therapy may want to ask about the therapists 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.

What are the drug therapies? How do double-blind studies help researchers evaluate a drugs effectiveness?

1) Drug therapy is the most widely used in biomedical therapy by far. 2) Antipsychotic drugs are used in treating schizophrenia and other forms of severe thought disorders; some 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. 3) Anti-anxiety drugs, which depress central nervous system activity, are used to treat anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder, often in combination with psychotherapy. These drugs can reinforce a person's tendency to take drugs and can also cause physical problems. 4) Anti-depressant drugs, which often increase the availability of various neurotransmitters, are used to treat depression, but also anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder, with modest effectiveness. Given their widening use, some professionals prefer the term SSRI's (selective serotonin reuptake inhibitors) for drugs such as Prozac. 5) Mood stabilizing drugs, such as lithium and Depakote, are often prescribed for those with bipolar disorder. 6) Studies may use a double-blind procedure to avoid the placebo effect and researchers and patients potential bias.

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

1) Group therapy can help more people with less cost than individual therapy. Clients may benefit from learning that others have similar problems and from getting feedback on new ways of behaving. 2) Family therapy treats a family as an interactive system and attempts to help family members discover the roles they play and how to learn to communicate more openly and directly.

How are brain stimulation and psychosurgery used in treating specific disorders?

1) In electroconvulsive therapy (ECT), a brief electric current is sent through the brain of anesthetized patient. ECT is an effective treatment for severely depressed people who have not responded to other therapy. 2) New were alternative treatments for depression include repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation. 3) Psychosurgery (including very precise micropsychosurgery) removes or destroys brain tissue in hopes of modifying behavior. These irreversible psychosurgical procedures are used only as a last resort. Lobotomies are no longer performed.

What may help prevent psychological disorders, and why is it important to develop resilience?

1) Preventative mental health programs are based on the idea that many psychological disorders could be prevented by changing stressful social contexts and teaching people to cope better with stress. This may help them become more resilient, enabling recovery from adversity. 2) Community psychologists work to prevent psychological disorders by turning the struct of environments into more nurturing places that foster competence, health, and well-being.

How do psychotherapy and the biomedical therapies different?

1) Psychotherapy is treatment involving psychological techniques. It consists of interactions between a trained therapist and a person seeking to overcome difficulties or achieve personal growth. The major psychotherapies derive from psychology's psychodynamic, humanistic, behavioral, and cognitive perspectives. 2) biomedical therapy treats psychological disorders with medications and other biological treatments. 3) Therapists who take an electric approach combined different techniques tailored to the clients problems.

What are the goals and techniques of psychoanalysis, and how have they been adapted in psychodynamic therapy?

1) Sigmund Freud's psychoanalysis aimed to give people self-insight and relief from their disorders by bringing anxiety-laden feelings and thoughts into conscious awareness. 2) Techniques include free association, dream analysis, and interpretation of instances of resistance and transference. 3) Like psychoanalysis, psychodynamic therapy focuses on childhood experiences, therapist interactions, unconscious feelings, and unresolved conflicts. Yet it is briefer, less expensive, and focuses primarily on current symptom relief. Exploring past relationship troubles may help clients understand the origin of their current difficulties.

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 adversive conditioning?

1) The psychodynamic and humanistic therapies seek to provide insight to help clients address problems. The behavior therapies instead assume that problem behaviors are the problem. The goal of behavior therapists is to apply learning principles to modify problem behaviors. 2) Classical conditioning techniques, including exposure therapies (such as systematic desensitization or virtual reality exposure therapy) and adversive 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 goals and techniques of Rogers person-centered approach?

1) both psychoanalytic and humanistic therapies are insight therapies—They attempt to improve functioning by increasing clients awareness of motives and defenses. 2) 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. 3) Carl Rogers' person-centered therapy proposed that therapists' most important contribution is 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.

Are some psychotherapy is more effective than others for specific disorders?

1) no one psychotherapy is superior to all others. Therapy is most effective for those with clear-cut, specific problems. 2) Behavior therapies work best with specific behavior problems, such as bedwetting, phobias, compulsions, marital problems, and sexual dysfunctions. 3) Psychodynamic therapy has been effective for depression and anxiety, nondirective (person-centered) counseling often helps with mild to moderate depression, and cognitive-behavioral therapy's have been effective in helping people cope with anxiety, depression, and post traumatic stress disorder. 3) Evidence-based practice integrates the best available research with clinicians expertise and patience characteristics, preferences, and circumstances.

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

1) our lifestyle influences our brain and body, which affects our mental health. 2) Depressed people who undergo a program of aerobic exercise, adequate sleep, light exposure, social engagement, negative-thought reduction, and better nutrition have gained some relief. The biomedical therapies assume that mind and body a unit: affect one and you will affect the other.

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.

therapeutic alliance

A bond of trust and mutual understanding between a therapist and client, who work together constructively to overcome the clients problem.

unconditional positive regard

A caring, excepting, nonjudgmental attitude, which Rogers believed would help clients develop self-awareness and self-acceptance.

virtual reality exposure therapy

A counterconditioning technique that treats anxiety through creative electronics simulations in which people can safely face the greatest fears, such as flying, spiders, or public speaking.

person-centered therapy

A humanistic therapy, developed by Rogers, in which the therapist uses techniques such as active listening within a genuine, excepting, empathic environment to promote clients growth. (Also called client centered therapy.)

cognitive-behavioral therapy (CBT)

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

lobotomy

A psychosurgical procedure once used to cam uncontrollably emotional or violent patients. The procedure cuts the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain.

behavior therapy

A therapeutic approach that applies learning principles to the elimination of unwanted behaviors.

cognitive therapy

A therapeutic approach that teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions.

clinical or psychiatric social workers

A two-year master of social work a graduate program plus post graduate supervision prepares some social workers to offer psychotherapy, mostly to people with every day personal and family problems. About half have earned the National Association of Social Workers designation of clinical social worker.

aversive conditioning

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

systematic desensitization

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

eclectic approach

An approach to psychotherapy that, depending on the clients problems, uses techniques from various forms of therapy

token economy

An operant conditioning procedure in which people earn a token for exhibiting a desired behavior and can later exchange the tokens for privileges or treats.

After a near-fatal car accident, Rico developed such an intense fear of driving on the freeway that he takes lengthy alternative routes to work each day. Which psychological therapy might best help Rico overcome his phobia, and why?

Behavior therapies are often the best choice for treating phobias. Viewing Rico's fear of the freeway as a learned response, a behavioral therapist might help Rico learn to replace his anxious response to freeway driving with a relaxation response.

Counterconditioning

Behavior therapy procedures that use classical conditioning to evoke new responses to stimuli they are triggering unwanted behaviors; includes exposure therapy and aversive conditioning

exposure therapies

Behavioral techniques, such as systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imagination or actual situations) to the things they fear and avoid.

How do the humanistic and cognitive therapies differ?

By reflecting clients feelings in a non-directive setting, the humanistic therapies attempt to foster personal growth by helping clients become more self-aware and self excepting. By making clients aware of self-defeating patterns of thinking, cognitive therapies guide people toward more adaptive ways of thinking about themselves and their world.

Exposure therapies and aversive conditioning or applications of _______________ conditioning. Token economies are an application of ______________ conditioning.

Classical; operant

evidence-based practice

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

________-_________ therapy helps people to change their self-defeating ways of thinking and to act out those changes in their daily behavior.

Cognitive-behavioral

anti-anxiety drugs

Drugs used to control anxiety and agitation

anti-depressant drugs

Drugs used to treat depression, anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. (Several widely used anti-depressant drugs are selective serotonin re-uptake inhibitors - SSRIs.)

antipsychotic drugs

Drugs used to treat schizophrenia and other forms of severe thought disorders

active listening

Empathic listening in which a listener echoes, re-states, and clarifies. A feature of Rogers person-centered therapy.

What are some examples of lifestyle changes we can make to enhance our mental health?

Exercise regularly, get enough sleep, get more exposure to light (get outside and/or use a light box), nurture important relationships, redirect negative thinking, and eat a diet rich in omega-3 fatty acids.

Some unwanted behaviors are learned. What hope it does this fact provide?

If a behavior can be learned, it can be unlearned and replaced by other, more adaptive responses.

interpretation

In psychoanalysis, the analyst's noting supposedly dream meanings, resistance, and other significant behaviors and events in order to promote insight

Resistance

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

Transference

In psychoanalysis, the patients transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)

____________________ therapies are designed to help individuals discover the thoughts and feelings that guide their motivation and behavior.

Insight

Counselors

Marriage and family counselor's 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 masters degree.

Clinical psychologists

Most are psychologists with a PhD (includes research training) or PsyD (focuses on therapy), supplemented by a supervised internship and, often, post doctoral training. About half work in agencies and institutions, half in private practice.

posttraumatic growth

Positive psychological changes as a result of struggling with extremely challenging circumstances in life crises

biomedical therapy

Prescribed medications or procedures that act directly on the persons physiology

Psychiatrists

Psychiatrists are physicians who specialize in the treatment of psychological disorders. Not all psychiatrists have had extensive training and psychotherapy, but as MDs or DOs they can prescribe medications. Thus, they tend to see those with the most serious problems. Many have their own private practice.

What is the difference between preventative mental health and psychological or biomedical therapy?

Psychological and biomedical therapies attempt to relieve people's suffering from psychological disorders. Preventative mental health attempts to prevent suffering by identifying and eliminating the conditions that cause disorders.

How do you researchers evaluate the effectiveness of particular drug therapies?

Researchers assign people to treatment and no-treatment conditions to see if those who receive the drug therapy improve more than those who don't. Double blind controlled studies are most effective. If neither the therapist nor the client knows which participants have received the drug treatment, then any difference between the treated and untreated groups will reflect the drugs treatments actual effect.

Psychoanalysis

Sigmund Freud's therapeutic technique. Freud believed that the patient's free associations, resistance, dreams, and transferences - and the analysts interpretations of them - released previously repressed feelings, allowing the patient to gain self-insight

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.

What are insight therapies, and how do they differ from behavior therapies?

The insight therapies - psychodynamic and humanistic therapies - seek to relieve problems by providing an understanding of their origins. Behavior therapies assume the problem behavior is the problem and treated differently, paying less attention to it origins.

resilience

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

How does the placebo effect bias patients' attitudes about the effectiveness of drug therapies?

The placebo effect is the healing power of belief in a treatment. When patients expect a treatment to be effective, they may believe it was.

psychodynamic therapy

Therapeutic approach derived from the psychoanalytic tradition; views individuals as responding to unconscious forces in childhood experiences, and seeks to enhance self-insight

insight therapies

Therapies that aim to improve psychological functioning by increasing a persons awareness of underlying motives and defenses.

How do culture and values influence the client-therapist relationship?

Therapists differ from one another and from their clients. These differences may create problems if therapists and clients differ in their cultural or religious perspective.

group therapy

Therapy conducted with groups rather than individuals, providing benefits from group interaction.

family therapy

Therapy that treat the family as a system. Views an individuals unwanted behaviors as influenced by, or directed at, other family members.

What is cognitive-behavioral therapy, and what sorts of problems does this therapy best address?

This integrative therapy helps people change self-defeating thinking and behavior. It has been shown to be effective for those with obsessive-compulsive disorder, anxiety disorders, depressive disorders, bipolar disorder, and eating disorders.

In psychoanalysis, when patients experience strong feelings for their analyst, this is called _________. Patients are said to demonstrate anxiety when they put up mental blocks around sensitive memories, showing ___________. The analyst will attempt to provide insight into the underlying anxiety by offering a(n) ___________ of the mental blocks.

Transference; resistance; interpretation

Psychotherapy

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

What is evidence-based practice?

Using this approach, therapists make decisions about treatment based on research evidence, clinical expertise, and knowledge of the patient.

A therapist who helps patients search for the unconscious roots of their problem and offers interpretations of their behaviors, feelings, and dreams, is drawing from a) psycho analysis. b) Humanistic therapies. c) Person centered therapy. d) Behavior therapy.

a) psycho analysis.

A therapist who restates and clarifies the client's statements is practicing _____________ ______________.

active listening

Drugs such as Xanax and Ativan, which depress central nervous system activity, can become addictive when used as ongoing treatment. These drugs are referred to as _______________ drugs.

antianxiety

The drugs given most often to treat depression are called _______________. Schizophrenia is often treated with ________________ drugs.

antidepressants; antipsychotic

Therapy is most likely to be helpful for those with problems that __________ (are/are not) well defined.

are

In family therapy, the therapist assumes that a) only one family member needs to change. b) each person's actions trigger reactions from other family members. c) dysfunctional family behaviors are based largely on genetic factors. d) therapy is most effective when clients are treated apart from the family unit.

b) each person's actions trigger reactions from other family members.

When drug therapies have not been effective, electroconvulsive therapy (ECT) may be used as treatment, largely for people with a) severe obsessive-compulsive disorder. b) severe depression. c) schizophrenia. d) anxiety disorders.

b) severe depression.

The goal of behavior therapy is to a) identify and treat the underlying causes of the problem. b) improve learning and insight. c) eliminate the unwanted behavior. d) improve communication and social sensitivity.

c) eliminate the unwanted behavior.

The most enthusiastic or optimistic view of the effectiveness of psychotherapy comes from a) outcome research. b) randomized clinical trials. c) reports of clinicians and clients. d) a government study of treatment for depression.

c) reports of clinicians and clients.

Some antipsychotic drugs, used to calm people with schizophrenia, can have unpleasant side effects, including a) hyperactivity. b) convulsions and momentary memory loss. c) sluggishness, tremors, and twitches. d) paranoia.

c) sluggishness, tremors, and twitches.

Behavior therapies often use _________ techniques such as systematic desensitization and aversive conditioning to encourage clients to produce new responses to old stimuli.

counterconditioning

Cognitive therapy has been especially effective in treating a) nail biting. b) phobias. c) alcohol use disorder. d) depression.

d) depression

Studies show that _______ therapy is the most effective treatment for most psychological disorders. a) behavior b) humanistic c) psychodynamic d) no one type of

d) no one type of

An approach that seeks to identify and alleviate conditions that put people at high risk for developing psychological disorders is called a) deep brain stimulation. b) the mood-stabilizing perspective. c) natural recovery. d) preventive mental health.

d) preventive mental health.

Compared with psychoanalysis, humanistic therapies are more likely to emphasize a) hidden or repressed feelings. b) childhood experiences. c) psychological disorders. d) self-fulfillment and growth.

d) self-fulfillment and growth.

Severe depression that has not responded to other therapy may be treated with __________ ___________, which can cause memory loss for the immediate past. More moderate neural stimulation techniques designed to help alleviate depression include _____________ _____________ stimulation and _____________ magnetic stimulation.

electroconvulsive therapy (ECT); repetitive transcranial; deep brain

A simple salt that often brings relief to patients suffering the highs and lows of bipolar disorder is __________.

lithium

Those who undergo psychotherapy are _________ (more/less) likely to show improvement then those who do not undergo psychotherapy.

more

What are the three components of evidence-based practice?

research evidence, clinical expertise, and knowledge of the patient.

The technique of __________ _____________ teaches peoples to relax in the presence of progressively more anxiety-provoking stimuli.

systematic desensitization

At a treatment center, people who display a desired behavior receive coins that they can later exchange for other rewards. This is an example of a(n) _________ ____________.

token economy