Chapter 16.1 Intro to Therapy and Psychological Therapies

Resistance

in psychoanalysis, the blocking from consciousness of anxiety-laden material. - They hint that anxiety lurks and you are defending against sensitive material. The analyst will note your resistances and then provide insight into their meaning

Transference

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

aim of cognitive-behavioral therapy

promote healthier thinking and adaptive behaviors

aim of cognitive therapy

promote healthier thinking self-talk

Two main categories of Modern Western therapy

psychotherapy biomedical therapy

aim of psychodynamic therapy

reduce anxiety through self-insight

Presumed Problem in cognitive-behavioral therapy

self-harmful thoughts and behaviors

Presumed Problem in group and family therapy

stressful relationships

An influential cognitive therapy for depression was developed by ______________ ______________.

Aaron Beck

Psychoanalysis: the goal

Freud believed that in therapy, people could achieve healthier, less anxious living by releasing the energy they had previously devoted to id-ego-superego conflicts - aimed to bring patients' repressed or disowned feelings into conscious awareness. By helping them reclaim their unconscious thoughts and feelings, and by giving them insight into the origins of their disorders, he aimed to help them reduce growth-impeding inner conflicts

Aversive conditioning

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

Eclectic approach

an approach to psychotherapy that 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 their tokens for various privileges or treats - Token economies have been successfully applied in various settings and among members of various populations

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

Presumed Problem in behavior therapy

dysfunctional behaviors

humanistic perspective

emphasizes people's inherent potential for self-fulfillment. - Like psychodynamic therapies, humanistic therapies have attempted to reduce growth-impeding inner conflicts by providing clients with new insights.

aim of client-centered therapy

enable growth via unconditional positive regard, genuineness, acceptance, and empathy

Presumed Problem in psychodynamic therapy

unconscious conflicts from childhood expereinces

Psychodynamic Therapy: Goal

Although influenced by Freud's ideas, psychodynamic therapists don't talk much about id, ego, and superego. Instead they try to help people understand their current symptoms.

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. 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.

How do the humanistic and cognitive therapies differ?

By reflecting clients' feelings in a nondirective setting, the humanistic therapies attempt to foster personal growth by helping clients become more self-aware and self-accepting. 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.

Aaron Beck's Therapy for Depression

Cognitive therapist Aaron Beck believes that changing people's thinking can change their functioning. Beck and his colleagues (1979) 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 To change such negative self-talk, Meichenbaum offered stress inoculation training: teaching people to restructure their thinking in stressful situations. Sometimes it may be enough simply to say more positive things to oneself:

Classical Conditioning Techniques

Exposure Therapies Aversive Conditioning - One cluster of behavior therapies derives from principles developed in Ivan Pavlov's early twentieth-century conditioning experiments: we learn various behaviors and emotions through classical conditioning

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

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.

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

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

steps of active listening

Paraphrase. Invite clarification. Reflect feelings.

Psychoanalysis: the techniques

Psychoanalysis is historical reconstruction. Psychoanalytic theory emphasizes the power of childhood experiences to mold the adult. Thus, it aims to unearth one's past in the hope of unmasking the present. After discarding hypnosis as an unreliable excavator, Freud turned to free association.

How do psychotherapy and the biomedical therapies 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 therapy.

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. 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.

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 anxiety disorders, obsessive-compulsive disorder, depressive disorders, bipolar disorder, and eating disorders.

basic principle of operant conditioning

Voluntary behaviors are strongly influenced by their consequences. Knowing this, some behavior therapists practice behavior modification They reinforce desired behaviors, and they withhold reinforcement for undesired behaviors Therapists use positive reinforcers to shape behavior in a step-by-step manner, rewarding closer and closer approximations of the desired behavior. Rewards used to modify behavior vary

Presumed Problem in client centered therapy

barriers to self-understanding and self-acceptance

therapy technique of psychodynamic therapy

interpret patients'memories and feelings

aim of behavior therapy

learn adaptive behaviors; extinguish problem ones

therapy technique of client-centered therapy

listen actively and reflect clients' feelings

Self-Help Groups

most support groups focus on stigmatized or hard-to-discuss illnesses - In an individualistic age, with more and more people living alone or feeling isolated, the popularity of support groups, seems to reflect a longing for community and connectedness.

Group Therapy

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

Psychodynamic Therapy

therapy deriving from the psychoanalytic tradition; views individuals as responding to unconscious forces and childhood experiences, and seeks to enhance self-insight.

Cognitive-behavioral therapy (CBT)

today's most widely practiced psychotherapy: a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior).

therapy technique of cognitive-behavioral therapy

train people to counter self-harmful thoughts and act out their new ways of thinking

*humanistic therapy* v. insight therapy

- Humanistic therapists aim to boost people's self-fulfillment by helping them grow in self-awareness and self-acceptance. - Promoting this growth, not curing illness, is the therapy focus -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.

benefits of group therapy

- It saves therapists' time and clients' 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.

Criticism of Behavior Modification

1. How durable are the behaviors? Will people become so dependent on extrinsic rewards that the appropriate behaviors will stop when the reinforcers stop? 2. 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.

What might a psychodynamic therapist say about Mowrer's therapy for bed-wetting? How might a behavior therapist reply?

A psychodynamic therapist might be more interested in helping the child develop insight about the underlying problems that have caused the bed-wetting response. A behavior therapist would be more likely to agree with Mowrer that the bed-wetting symptom is the problem, and that counterconditioning the unwanted behavior would indeed bring emotional relief.

What are the basic themes of humanistic therapy? What are the specific goals and techniques of Rogers' client-centered approach?

Both psychoanalytic and humanistic therapists 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.

Interpretation

In psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight. - The analyst may also offer an explanation of how this resistance fits with other pieces of your psychological puzzle, including those based on analysis of your dream content.

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 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.

Psychodynamic Therapy: Techniques

Rather than lying on a couch, out of the therapist's line of vision, patients meet with their therapist face-to-face. These sessions take place once or twice a week (rather than several times per week), and often for only a few weeks or months.

criticism of psychoanalysis

Relatively few North American therapists now offer traditional psychoanalysis. Much of its underlying theory is not supported by scientific research Analysts' interpretations cannot be proven or disproven. And psychoanalysis takes considerable time and money, often years of several sessions per week.

Psychoanalysis

Sigmund Freud's theory of personality that attributes thoughts and actions to unconscious motives and conflicts. (2) Freud's therapeutic technique used in treating psychological disorders. Freud believed that 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 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 treat it directly, paying less attention to its origins.

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. Interpersonal therapy is a brief 12- to 16-session form of psychodynamic therapy that has been effective in treating depression.

Interpersonal psychotherapy

a brief (12- to 16-session) variation of psychodynamic therapy, has effectively treated depression - Although interpersonal psychotherapy 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.

Unconditional positive regard

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

Client-centered therapy

a humanistic therapy, developed by Carl Rogers (1902-1987), 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.)

Systematic desensitization

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

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 electronic simulations of their greatest fears, such as airplane flying, spiders, or public speaking.

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.

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

classical; operant

biomedical therapy

prescribed medications or procedures that act directly on the person's physiology. - Some psychologists consider psychotherapy to be a biological treatment, because changing the way we think and behave can prompt physical changes in the brain

therapy technique of group and family therapy

develop an understanding of family and other social systems, explore roles, and improve communication

Active listening

empathic listening in which the listener echoes, restates, and clarifies. A feature of Rogers' client-centered therapy. - is now an accepted part of therapeutic counseling practices in many schools, colleges, and clinics.

aim of group and family therapy

heal relationships

Presumed Problem in cognitive therapy

negative, self-defeating thinking

nondirective therapy

the therapist listens, without judging or interpreting, and seeks to refrain from directing the client toward certain insights.

Behavior therapy

therapy that applies learning principles to the elimination of unwanted behaviors. - doubt the healing power of self-awareness - assume that problem behaviors are the problems, and the application of learning principles can eliminate them - behavior therapists view maladaptive symptoms as learned behaviors that can be replaced by constructive behaviors

Cognitive therapy

therapy that teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions. - Self-blaming and overgeneralized explanations of bad events are often an integral part of the vicious cycle of depression. * If such thinking patterns can be learned, then surely they can be replaced*

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.

therapy technique of cognitive therapy

train people to dispute negative thoughts and attributions

In psychoanalysis, when patients experience strong feelings for their therapist, this is called ______________. Patients are said to demonstrate anxiety when they put up mental blocks around sensitive memories, indicating ______________. The therapist 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.

therapy technique of behavior therapy

use classical conditioning (via exposure or aversion therapy) or operant conditioning (as in token economies)