Module 53-Types of Therapy & Therapists

Today, ____________ Americans receives some form of outpatient mental health therapy

1 in 5

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

A therapist committed to evidence-based practice selects whichever type of therapy enjoys the most empirical support for the disorder a given client is experiencing. The therapist is MOST likely to reflect a(n) _____ perspective.

eclectic

The more meetings AA members attend, the ____________________.

greater their alcohol abstinence.

According to one study, good therapies share much in common, including:

hope for demoralized people.

Nancy's therapist is an active listener who often paraphrases what she says. He does not judge her and is quite open to her exploration of her weaknesses. He gives her appropriate validation and encourages her to reflect on her feelings. He wants to deepen her self-understanding. Her therapy is MOST likely:

humanistic

Bonnie has just finished a 2-year master's program and now is in postgraduate supervision that is preparing her to offer psychotherapy to people with everyday personal and family problems. Bonnie is MOST likely preparing to be a:

psychiatric social worker.

Clarice seeks treatment for a history of childhood sexual abuse. She is interested in therapy which will help provide insight into her ongoing symptoms. Clarice is MOST likely to receive:

psychodynamic treatment.

Chelsea's therapist uses active listening within an empathic environment. Her therapist is MOST likely using:

client-centered therapy.

Drew's therapist believes in using only empirically supported therapies for treating his insomnia. She will probably use _____ therapy.

cognitive

Adam's therapist believes in using only empirically supported therapies for treating his depression. She will probably use:

cognitive therapy.

Psy.D. is to Ph.D. as _____ is to _____.

therapy emphasis; research training

Electroconvulsive therapy

A biomedical therapy used primarily in the treatment of depression; involves electrically inducing a brief brain seizure

cognitive therapy

a treatment method designed to identify and correct distorted thinking patterns that can lead to feelings and behaviors that may be troublesome, self-defeating, or self-destructive

eclectic approach

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

Stephanie meets with her therapist once a week in order to talk about her marriage as well as the relationship she has with her parents. Stephanie's therapist uses psychodynamic techniques to help her gain insight into her relationships as well as behavioral and cognitive techniques to improve Stephanie's communication skills. The therapist's work exemplifies:

an eclectic approach.

Systematic desensitization involves

anxiety hierarchy followed by progressive relaxation

Kavon is using a mental health smart phone app to treat his condition. Kavon is happy with the treatment, and it appears to be effective. Kavon's condition is MOST likely:

anxiety.

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

Roxanne suffers from severe anxiety. Her therapist believes in utilizing only empirically supported treatments to treat anxiety such as:

cognitive-behavioral therapy.

randomized clinical trials

conducted to evaluate treatments or interventions and their effectiveness over time

Advocates of token economies believe

control already exists: People's destructive behavior patterns are being maintained and perpetuated by natural reinforcers and punishers in their environments. the right to effective treatment and an improved life justifies temporary deprivation.

The American Psychiatric Association, the Canadian Psychological Association, and the British Psychological Society have warned against ___________________________________.

conversion therapies that purport to change people's gender identity or sexual orientation.

Christopher has a 2-year master's degree and specializes in helping those with a history of substance use disorder. Christopher is MOST likely a:

counselor.

The CEO of a large corporation is considering the benefits her firm will offer employees. If she offers employees psychotherapy for psychological problems, chances are good that:

medical costs will be reduced.

Studies show that when people seek psychological treatment, their search for other medical treatment drops substantially—by 16 percent in one digest of 91 studies

medical treatment drops by 16 %

Dr. Ramos is a client-centered therapist. Her type of therapy is empirically supported for the treatment of:

mild depression.

Before 1950, ___________________ were the primary providers of mental health care.

psychiatrists

meta-analysis

a "study of studies" that combines the findings of multiple studies to arrive at a conclusion a statistical procedure that combines the conclusions of a large number of different studies. Simply said, a meta-analysis summarizes the bottom-line result of lots of studies.

counterconditioning (exposure & aversive)

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

therapeutic alliance

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

OCD is sometimes treated with the drug ______________.

Prozac.

Hope for demoralized people

The belief that things can and will get better may improve morale, create feelings of self-efficacy, and diminish symptoms

Ashley has a master's degree. Based on this information alone, Ashley is NOT a:

clinical psychologist.

Mark suffers from a great deal of irrational thoughts that affect his social life. He would benefit MOST from _____ therapy.

cognitive-behavioral

Morton suffers from anxiety. His therapist is training him to replace his catastrophizing thinking with more realistic appraisals and then to gradually engage in activities that normally would be stressful for him. The therapist's approach BEST illustrates:

cognitive-behavioral therapy.

Nancy's therapist encourages her to think about her strengths rather than her weaknesses and to develop a habit of thanking others when they compliment her or provide emotional support. The therapist's approach BEST illustrates:

cognitive-behavioral therapy.

Which of the following treatment approaches has received little or no scientific support?

energy therapies

The most effective psychotherapists are those who _________________.

establish an empathic, caring relationship with their clients.

Psychodynamic therapists expect people's problems to diminish as they _______________________________.

gain insight into their unresolved and unconscious tensions.

In a residential treatment facility for troubled youth, adolescent children receive large colored buttons when they hang up their clothes, make their beds, and come to meals on time. The children return the buttons to staff members to receive bedtime snacks or television privileges. This BEST illustrates an application of:

operant conditioning.

biomedical therapy

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

Lindsey is a physician who specializes in the treatment of psychological disorders. She is an M.D. and can prescribe medication. Lindsey is MOST likely a:

psychiatrist.

EXCEPT for traditional _____, most therapies may also occur in small groups.

psychoanalysis

Freud

psychoanalysis id--ego--superego counselor is "analyst" repression free association resistance interpretation transference

Therapists using _____ provide the patient interpretations of their dreams, resistances, and other behaviors, whereas therapists using _____ focus more on helping the patient explore and gain perspective into their thoughts and feelings.

psychoanalysis; psychodynamic therapy

Which of the following factors is NOT a therapeutically effective component of eye movement desensitization and reprocessing?

rapidly moving one's eyes

Online and app-based therapy can help _________________________.

reduce depression, anxiety, and insomnia

For a recovering alcoholic, Alcoholics Anonymous (AA) may be beneficial because the group meetings:

reduce isolation.

In one experiment, Asian-American clients were more likely to perceive counselor empathy if their counselor:

shared the clients' cultural values.

One analysis of more than 14,000 self-help groups reported that most focus on ______________________________.

stigmatized, hard-to-discuss problems

The value of eye movement desensitization and reprocessing (EMDR) is in part due to ____________________.

the effectiveness of exposure therapy.

Winnie feels a close emotional bond with her therapist. She trusts her therapist, and she feels that her therapist truly understands her. Winnie's feelings BEST reflect:

the therapeutic alliance.

psychodynamic therapy (Freud)

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

British psychologist Hans Eysenck (1952) summarized 24 studies of psychotherapy outcomes.

2/3 of those receiving psychotherapy for disorders not involving hallucinations or delusions improved markedly. Eysenck also reported similar improvement among people who were untreated, such as those on treatment waiting lists. ***With or without psychotherapy, he said, roughly two-thirds improved noticeably. Time was a great healer.

AIDS patients were _________ than hypertension patients to be in support groups.

250 times more likely

Currently, 1 in _____ Americans receive some form of outpatient mental health treatment.

5

How durable are the behaviors gained by extrinsic reward?

Behavior modification advocates believe the behaviors will endure if therapists wean people from the tokens by shifting them toward other, real-life rewards, such as social approval.

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

Classical; Operant

Client-centered therapy

Client-centered therapy A type of humanistic therapy in which the therapist reflects the client's feelings and fosters personal growth and self-awareness in an environment that offers genuineness, acceptance, and empathy; developed by Carl Rogers

active listening

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

500 Massachusetts boys, aged 5 to 13 years, many of whom seemed bound for delinquency. By the toss of a coin, half the boys were assigned to a 5-year treatment program.

Experimental Group Receiving Treatment =66 percent had no official juvenile crime record. Control Group = 70 percent had no juvenile record

Clients believe that treatment will be effective.

The placebo effect is the healing power of positive expectations.

People with _______________________________ often join groups; those with migraines and ulcers usually do not.

anorexia and alcohol use disorder

Studies of 12-step programs such as AA have found that they help reduce alcohol use disorder at rates ________________________.

comparable to other treatment interventions

Leigh is a diligent clinician. In order to provide her clients with the best therapy she can provide, she keeps up to date on the latest psychotherapy research. She also takes into consideration her patients' values, characteristics, preferences, and circumstances. Finally, she is also mindful of her own expertise. Leigh is using which approach in clinical decision making?

evidence-based practice

A therapist helps Rebecca overcome her fear of water by getting her to swim in the family's backyard pool three times a day for 2 consecutive weeks. The therapist's approach to helping Rebecca BEST illustrates:

exposure therapy.

Silas' therapy with a 15-year-old patient has been going well, but the patient tends to bottle up her feelings when discussing her relationship with her mother. Silas believes that the patient can benefit from her mother's involvement, which will promote positive communication. Today's session brings together the patient and her parents. Silas is engaging in _____ therapy.

family

During a therapy session, Jenny focuses on several intrusive thoughts that have been bothering her. The therapist tells Jenny to report any ideas or memories stimulated by these thoughts. Jenny's therapist is using a technique known as:

free association.

A therapist takes notes during a free association session with a client so that she may help the client develop insight into unconscious conflicts and motivations. The therapist is BEST described as engaged in:

interpretation.

Those not undergoing therapy often improve, but those undergoing therapy are ________________________________.

more likely to improve—and to improve more quickly and with less risk of relapse

Delores has been in therapy for 2 years, but her last session is today. If you ask her next month how effective her psychotherapy was, she is likely to:

overestimate its effectiveness.

Counterconditioning (exposure therapy)

pairs the trigger stimulus (in this case, the enclosed space of the elevator) with a new response (relaxation) that is incompatible with fear.

Critics of token economies believe

process feels too authoritarian.

To help Adam reduce his fear of dogs, a therapist encourages him to physically relax and imagine that he is walking toward a friendly and harmless little dog. The therapist's technique BEST illustrates:

systematic desensitization.

A basic element of all effective psychotherapies is __________________.

the client's expectation that psychotherapy will make things better.

Todd is attracted to his therapist. His attraction reflects the feelings he had toward his mother when he was a young boy in the midst of the Oedipal conflict. Todd's experience illustrates:

transference

Therapy provides:

1. Hope for demoralized people 2. A new perspective 3. An empathic, trusting, caring relationship

Approximately _____ percent of all clinical psychologists work in private practice.

50 %

Drug therapy

A biomedical therapy focused on prescribing medications that alter mental functions to alleviate psychological symptoms

CBT online

By offering flexible, affordable, and effective treatment, online CBT can reach people who—because of rural location, low income, or embarrassment, for example—will seldom attend face-to-face therapy sessions

Another study of 2300 veterans who sought treatment for alcohol use disorder found that _______________________.

a high level of AA involvement was followed by diminished alcohol problems

cognitive therapies

assume that our thinking colors our feelings

Beck's Therapy for Depression (Cognitive Therapy)

assumes that changing people's thinking can change their functioning

Carlos is suffering from bipolar disorder, a disorder where his mood shifts between periods of depression, periods of mania, and normal functioning. To help control the symptoms of his disorder, Carlos takes prescribed drugs regularly. Carlos MOST likely sees a therapist who specializes in what type of therapy?

biomedical therapy

Humanistic therapists expect problems to diminish as people ____________________________.

get in touch with their feelings.

Taste aversion learning

has been a successful alternative to killing predators in some animal protection programs. After being sickened by eating a tainted sheep, wolves may later avoid sheep.

the Scared Straight program designed to tame teenage violence, the police-promoted D.A.R.E. anti-drug effort, and numerous weight-reduction and pedophile rehabilitation efforts—

have also been found ineffective or even harmful

Zander has been struggling with personal issues and has decided to seek help at a mental health clinic. Unfortunately, he was put on a waiting list and told he would likely have to wait several weeks before he could meet with a therapist. According to Hans Eysenck's findings, what do you predict will happen to Zander?

The chances are good that he will improve during this waiting period.

Behavior therapists, however, doubt the healing power of self-awareness. Rather than delving deeply below the surface looking for inner causes, behavior therapists assume that _____________________.

problem behaviors are the problems.

Dr. Wagner works in a large hospital. She specializes in treating adolescents with eating disorders. She prescribes antidepressants and, occasionally, antianxiety medication for some of her patients. Based on this information, Dr. Wagner is a:

psychiatrist.

Cognitive-behavioral therapy (CBT)

takes a combined approach to treating depressive and other disorders. widely practiced integrative therapy aims to alter not only the way people think but also the way they act. ***trains people both to replace their catastrophizing thinking with more realistic appraisals, and, as homework, to practice behaviors that are incompatible with their problem

Comorbidity

the co-occurrence of two or more disorders in a single individual *overlapping of 2 or more disorders

group therapy advantages

*increased feedback * modeling * less expensive * improve social skills

sudden gains = experienced by about 12 percent of people in therapy

1. After therapy, many people exhibit improved insight and emotional awareness, with a more patient, outgoing personality 2. Some people with depression or anxiety also experience sudden symptom reductions between their treatment sessions

systematic desensitization

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

One study worked with 19 withdrawn, uncommunicative 3-year-olds with ASD.

For two years, 40 hours each week, the children's parents attempted to shape their behavior. 1. positively reinforced desired behaviors 2. ignored or punished aggressive and self-abusive behaviors. 3. By first grade, 9 of the 19 were functioning successfully in school and exhibiting normal intelligence. 4. In a control group of 40 comparable children not undergoing this effortful treatment, only one showed similar improvement.

The three main features that humanistic therapists hope to exhibit are genuineness, _____, and empathy.

acceptance

Although Justin's therapist attends to what he has to say without judgment, she also seeks understanding by paraphrasing as well as asking for clarification and then reflecting Justin's feelings. Justin's therapist is using a therapeutic technique known as:

active listening.

Some analyses suggest that psychodynamic therapy and cognitive-behavioral therapy are _____________________________.

equally effective in reducing depression

resistance

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

Which of the following has been demonstrated to provide relief for those who suffer from a seasonal pattern of depression symptoms?

light exposure therapy

Active listening:

1. Paraphrase 2. Invite clarification 3. Reflect feelings

Boosting employees' psychological well-being can

1. lower medical costs 2. improve work efficiency 3. diminish absenteeism. ***U.S. health insurers and the National Health Service in Britain have increasingly funded therapy

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.

Patrick suffers from depression. Whenever something bad happens, he tends to blame himself or overgeneralizes the extent of the situation. To address Patrick's depression, his therapist is attempting to teach him more adaptive ways of thinking. The therapist's approach is MOST representative of:

cognitive therapy.

transference

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

operant conditioning therapy = behavior modification

positive reinforcers to shape behavior

behavior therapy

therapy that applies learning principles to the elimination of unwanted behaviors

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

Psychodynamic therapy is treatment for:

—depression and anxiety

CBT effectively treats people with ______________________.

CBT effectively treats people with obsessive-compulsive and related disorders, such as anxiety, depression, eating disorders, ADHD, and alcohol or other substance use disorders

Therapists welcomed the first meta-analysis of some 475 psychotherapy outcome studies, which showed that the average therapy client ends up better off than __________________________________.

80 percent of the untreated individuals on waiting lists

cognitive-behavioral therapy (CBT)

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

In an eating disorders clinic, the patients receive merits for good eating behaviors, such as finishing their meal and not exercising after their meal, and for appropriate behaviors in the unit. This BEST illustrates an application of:

a token economy

aversive conditioning

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

insight therapies (psychodynamic and humanistic)

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

Deinstitutionalization has contributed to ______________________________.

increased homelessness and incarceration.

Immigrants from Asia would most likely experience difficulty as clients of American psychotherapists who emphasize the value of:

individualism.

Mindi is using a mental health smart phone app to treat her condition. Mindi is happy with the treatment, and it appears to be effective. Mindi's condition is MOST likely:

insomnia.

Dexter's therapist takes careful notes of Dexter's dreams as well as his resistance to talk about certain sensitive issues in an effort to provide his _____ of Dexter's disorder.

interpretation

In one analysis of a dozen studies, a strong therapeutic alliance predicted _______________________________.

less frequent suicidal thoughts, self-harming behaviors, and suicide attempts

A research team combines the results of nearly two dozen studies examining the effectiveness of dialectical behavior therapy in treating self-injurious behavior among clients with borderline personality disorder. The research team is conducting a:

meta-analysis.

U.S. military personnel who have perceived greater barriers to treatment have been _______________________.

most likely to die by suicide

deinstitutionalization

moving people with psychological or developmental disabilities from highly structured institutions to home- or community-based settings

Since Eysenck's study, numerous studies have been conducted to look at the effectiveness of psychotherapy. Generally, these studies have shown that those who:

sought therapy were more likely to improve than those who did not.

Shania sees a cognitive therapist for depression. Shania's therapist has explained to her that cognitive therapy is very effective for depression because it addresses:

the relationship between thoughts and feelings.

CBT

In one classic study, people learned to prevent their compulsive behaviors by: 1. relabeling their obsessive thoughts "I'm having a compulsive urge." 2. spend 15 minutes in an enjoyable, alternative behavior—practicing an instrument, taking a walk, gardening 3. helped "unstick" the brain by shifting attention and engaging other brain areas.

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.

_____________________ often provide support to people who struggle to find it elsewhere.

Self-help groups

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.

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

Mikkia needs therapy for help with procrastination. She says, "There's no way I'm going to that therapist! He sees patients three times a week for years on end. I need to get better soon!" The therapist MOST likely uses the _____ approach.

traditional psychoanalytic

psychotherapy

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

cost of opioid epidemic in U.S. between 2001 to 2017

more than $1 trillion

Jonathan Shedler (2009)

"We can have loving feelings and hateful feelings toward the same person." "We can desire something and also fear it."

Those whose personal stories include a ________________________ more often sustain sobriety

"redemptive narrative"—who see something good as having come from their struggles

With more than 2 million members in 180 countries, AA is said to be ______________________.

"the largest organization on Earth that nobody wanted to join"

For the last three months, Selma has been seeing her therapist weekly. She is feeling much better because:

- she has been given a new perspective. - her therapist is empathic & she feels he cares - she has more hope.

According to the American Psychological Association, your therapist should follow these principles:

1. Seek to benefit you and do you no harm 2. Establish a feeling of trust and a defined role as your therapist, as well as be of service to the therapeutic community 3. Be honest, truthful, and accurate 4. Be fair and promote justice for you and others, helping everyone to have access to the benefits of therapy 5. Respect the dignity and worth of you and others, recognizing the right to privacy, confidentiality, and self-determination

unconditional positive regard

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

Deena's therapist believes in using only empirically supported therapies for treating her dog phobia. She will probably use _____ therapy.

behavior

As a parent, Wendy is skeptical of treatments that sound too good to be true. When she arrives at the psychologist's office, she asks about effective treatment for bed-wetting because her 6-year-old son has been having difficulties. She learns that _____ is the empirically supported treatment.

behavior conditioning

interpretation

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

psychodynamic therapists

try to help people understand their current symptoms by focusing on important relationships and events, including childhood experiences and the therapist-client relationship. "We can have loving feelings and hateful feelings toward the same person," observed psychodynamic therapist Jonathan Shedler (2009), and "we can desire something and also fear it." ***without embracing all of Freud's theory, psychodynamic therapists aim to help people gain insight into unconscious dynamics that arise from their life experience.

Anxiety, depressive, and bipolar disorders share a common problem: _______________________________.

unhealthy emotion regulation

There is a civil war currently under way regarding the effectiveness of psychotherapy. There are those who support the use of scientific methods to determine which therapies are the most effective for various people and disorders. Then there are those who:

view psychotherapy as something that cannot be described in a manual or tested in an experiment.

_____ therapy progressively exposes people to simulations of their greatest fears, such as flying in airplanes, spiders, or public speaking.

virtual reality exposure

Behavioral psychologist Mary Cover Jones (1924)

working with 3-year-old Peter, who is petrified of rabbits and other furry objects.

Behavioral conditioning therapies is treatment for:

—behavior problems such as bed-wetting, specific phobias, compulsions, marital difficulties, and sexual dysfunctions

Cognitive and cognitive-behavioral therapies is treatment for:

—primarily anxiety, posttraumatic stress disorder, insomnia, and depression

Malika sees her therapist every other week. When she is at her therapist's office, she feels accepted and can share everything with her therapist. Although her therapist listens to what Malika has to say without judgment, he also seeks understanding by paraphrasing as well as asking for clarification. Malika's therapist is using which therapeutic approach?

client-centered therapy

Nancy's therapist is an active listener who often paraphrases what she says. He does not judge her and is quite open to her exploration of her weaknesses. He gives her appropriate validation and encourages her to reflect on her feelings. He wants to deepen her self-understanding. Her therapy is MOST likely:

client-centered therapy.

Yvonne works for a government agency where she treats those who have psychological disorders. In order to do this, she has a Psy.D. When she was younger, she also had a supervised internship and postdoctoral training. Yvonne is MOST likely a:

clinical psychologist.

Aaron Beck's _____ therapy teaches people new and more adaptive ways of thinking. It is based on the assumption that thoughts intervene between events and our emotional reactions.

cognitive

The placebo effect best illustrates the importance of _____________ in therapeutic outcomes.

cognitive processes

Marlow is suffering from schizophrenia. Marlow sees a therapist once a week to help him improve his social skills and modify his maladaptive behaviors. His therapist uses a combination of behavioral conditioning techniques and more cognitive approaches. Marlow's therapist is MOST likely using which approach?

eclectic

Angelina is suffering from depression. Once a week, she sees a therapist, and with the therapist's help, she has begun to explore her past experiences and how they might have contributed to her depression. In addition, Angelina's therapist has Angelina begin to adopt new ways of thinking about the current events in her life. Angelina's therapist is MOST likely using which type of therapy?

psychotherapy

An eight-year, $27 million investigation found that AA participants __________________________________.

reduced their drinking sharply, as did those assigned to CBT or an alternative therapy

Joseph Wolpe

refined Jones' counterconditioning technique into the exposure therapies used today. These therapies, in a variety of ways, try to change people's reactions by repeatedly exposing them to stimuli that trigger unwanted reactions.

Clients can benefit from psychotherapy _______________.

regardless of their clinicians' experience, training, supervision, and licensing

A psychoanalyst would use this term to describe the tendency for some people to crack jokes when a conversation gets heavy.

resistance

During her weekly therapy sessions, Sabrina will often abruptly shift the focus of her attention and lose her train of thought. A psychoanalyst would suggest that this illustrates:

resistance.

The exposure therapy program for OCD reports that ___________ percent of those with OCD show some improvement with cognitive-behavioral therapy.

75 percent

People often enter therapy in crisis.

When, with the normal ebb and flow of events, the crisis passes, people may attribute their improvement to the therapy.

person-centered therapy

a nondirective insight therapy based on the work of Carl Rogers in which the client does all the talking and the therapist listens

More than __________ Americans have belonged to religious, special-interest, or support groups that meet regularly—with _________ reporting that group members "support each other emotionally"

100 million 9 in 10

In one classic study, 685 hospital patients with alcohol use disorder completed an aversion therapy programs. Over the next year, they returned for several booster treatments that paired alcohol with sickness. At the end of that year, _____________ percent were not drinking alcohol. But after three years, only ____________- percent were alcohol free.

63 percent not drinking alcohol 33 percent not drinking alcohol

Therapists are susceptible to:

1. Confirmation bias- can lead them to unconsciously seek evidence that confirms their beliefs and to ignore contradictory evidence 2. illusory correlation-can lead them to perceive associations that don't really exist

The American Psychological Association offers these common trouble signals:

1. Feelings of hopelessness 2. Deep and lasting depression 3. Self-destructive behavior, such as substance abuse 4. Disruptive fears 5. Sudden mood shifts 6. Thoughts of suicide 7. Compulsive rituals, such as lock checking 8. Sexual difficulties 9. Hearing voices or seeing things that others don't experience

critics note reasons for skepticism:

1. People often enter therapy in crisis. 2. Depressed people often get better no matter what they do. 3. Clients believe that treatment will be effective. 4. Clients generally speak kindly of their therapists. 5. Clients want to believe the therapy was worth the effort.

evidence-based practice

1. endorsed by APA 2. clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

group therapy

A form of psychotherapy that involves one or more therapists working simultaneously with a small group of clients.

Family therapy

A form of psychotherapy that treat the family as a unit, focusing on relationships and problems among the various members of the family

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 in the United States have earned the National Association of Social Workers' designation of clinical social worker.

Aversive conditioning

A type of behavioral therapy that attempts to reduce the frequency of a problem behavior by associating it with an unpleasant experience

Cognitive therapy for depression

A type of cognitive therapy that helps people discover and change their habitually negative patterns of thinking; developed by Aaron Beck

Glenn suffers from depression. He frequently thinks of situations as overwhelmingly bad with no hope of future improvement. Glenn would most benefit from _____ therapy.

Aaron Beck's cognitive

O. H. Mowrer (chronic bed-wetting)

Developed a successful conditioning therapy for chronic bed-wetting, using a liquid-sensitive pad connected to an alarm. If the sleeping child wets the bed pad, moisture triggers the alarm, waking the child. After a number of trials, the child associates bladder relaxation with waking. In three out of four cases, the treatment has been effective and the success has boosted the child's self-image

Clients generally speak kindly of their therapists.

Even if the problems remain, clients "work hard to find something positive to say. The therapist had been very understanding, the client had gained a new perspective, he learned to communicate better, his mind was eased, anything at all so as not to have to say treatment was a failure"

Counselors

Family and couples 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 victims of abuse. Mental health and other counselors may be required to have a two-year master's degree.

humanistic therapies differ from psychodynamic therapies in many ways:

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. Thus, those in therapy are called "persons" or "clients" 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 unconscious thoughts. The present and future are more important than the past. Therapy thus focuses on exploring feelings as they occur, rather than on achieving insights into the childhood origins of those feelings.

Clients want to believe the therapy was worth the effort.

If you invested time and money in something, wouldn't you be motivated to find something positive about it? Psychologists call this effort justification.

The goal of this therapeutic approach explores feelings as they occur rather than trying to achieve insight in the childhood origins of feelings.

humanistic

Patty is a recovering addict. After several years of clean time, Patty completed a 16-week course in addiction counseling. She now helps fellow addicts at a residential treatment center. Patty is BEST described as a:

P paraprofessional.

Reformers:

Reformers Philippe Pinel (1745-1826) Dorothea Dix (1802-1887) *pushed for gentler, more humane treatments and for constructing psychiatric hospitals. *Since the 1950s, the introduction of effective drug therapies and community-based treatment programs has emptied most of those hospitals.

Barry's good friend has been dealing with severe anxiety for the last few months. However, he is reluctant to see a therapist because he is hoping that his anxious feelings will eventually go away. What can Barry say that might convince his friend that seeing a therapist would be beneficial?

Those undergoing therapy are more likely to improve more quickly and with less risk of relapse.

The more specific the problem, the greater the hope that psychotherapy might solve it

Those who experience panic or specific phobias, who are unassertive, or who are frustrated by sexual performance problems can hope for improvement. Those with less-focused problems, such as depression and anxiety, usually benefit in the short term but often relapse later. There often is also an overlapping of disorders (known as comorbidity).

stress inoculation training:

To change such negative self-talk cognitive therapists teach people to restructure their thinking in stressful situations

Several years after his wife's death, Mr. Sanchez remains incapacitated by feelings of guilt and sadness. To reduce Mr. Sanchez's depression, a therapist is actively encouraging him to stop blaming himself for his inability to prevent his wife's death. The therapist's approach is MOST representative of:

cognitive therapy.

dialectical behavior therapy (DBT) = "opposing"

helps change harmful and even suicidal behavior patterns Dialectical means "opposing" this therapy attempts to make peace between two opposing forces—acceptance and change. Therapists create an accepting and encouraging environment, helping clients feel they have an ally who will offer them constructive feedback and guidance. In individual sessions, clients learn new ways of thinking that help them tolerate distress and regulate their emotions. They also receive training in social skills and in mindfulness meditation, which helps alleviate depression