psych chapter 15

interpretation

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

posttraumatic grown

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

An approach that seeks to identify and alleviate conditions that put people at high risk for developing psychological disorders is called

preventative mental health

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

psychoanalysis

The most enthusiastic or optimistic view of the effectiveness of psychotherapy comes from

reports of clinicians and clients

What are the three components of evidence-based practice?

research evidence, clinical expertise, and knowledge of the patient

Compared with psychoanalysts, humanistic therapists are more likely to emphasize

self-fulfillment and growth

When drug therapies have not been effective, electroconvulsive therapy (ECT) may be used as treatment, largely for people with

severe depression

some antipsychotic drugs, used to calm people with schizophrenia, can have unpleasant side effects, most notably

sluggishness, tremors, twitches

psychosurgery

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

The technique of _______teaches people to relax in the presence of progressively more anxiety-provoking stimuli.

systematic desensitizeation

repetitive transcranial magnetic stimulation (rTMS)

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

resilience

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

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*

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 alternative therapies (nontraditional therapies that claim to cure certain ailments). *Eye movement desensitization and reprocessing (EMDR) has shown some effectiveness*—not from the eye movement but rather from the *exposure therapy nature of the treatments*. *Light exposure therapy does seem to relieve depression* symptoms for those with a *seasonal pattern* of major depressive disorder by *activating a brain region that influences arousal and hormones.*

psychoanalysis

Freud's therapeutic technique used in treating psychological disorders. 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.

How does the placebo effect bias patients' attitudes about the effectiveness of various 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.

therapeutic alliance

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

unconditioned positive regard

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

electroconclusive therapy

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

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.*)

*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 calm uncontrollably emotional or violent patients. The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain.

averse 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.

insight therapies

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

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

active listening

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.

electric 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.

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*

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

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

depression

antianxiety drugs

drugs used to control anxiety and agitation

antidepressant drugs

drugs used to treat depression, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. (Several widely used antidepressant drugs are selective serotonin reuptake inhibitors—SSRIs.)

antipsychotic drugs

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

in family therapy, the therapist assumes that

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

The goal of behavior therapy is to

eliminate the unwanted behavior.

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*

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.

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 and cost 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.

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.*

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.

biomedical therapy

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

What should a person look for when selecting a therapist?

A person seeking therapy may want to ask about the *therapist's treatment approach, values, credentials, and fees*. An important consideration is whether the *therapy seeker feels comfortable and able to establish a bond with the therapist.*

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.

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 behavior therapist might help Rico learn to replace his anxious response to freeway driving with a relaxation response.

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.

Does psychotherapy work? How can we know?

Clients' and therapists' positive testimonials cannot prove that *psychotherapy is actually 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 more quickly, and with less chance of relapse.*

How, by taking care of themselves with a healthy lifestyle, might people find some relief from depression? How does this reinforce the idea that we are biopsychosocial systems?

Depressed people who undergo a program of aerobic exercise, adequate sleep, light exposure, social engagement, negative-thought reduction, and better nutrition often gain some relief. In our integrated biopsychosocial system, stress affects our body chemistry and health; chemical imbalances can produce depression; and social support and other lifestyle changes can lead to relief of symptoms.

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 severely depressed people who have not responded to other therapy. Newer alternative treatments for depression include repetitive transcranial magnetic stimulation (rTMS) and, in preliminary clinical experiments, deep-brain stimulation that calms an overactive brain region linked with negative emotions. Psychosurgery removes or destroys brain tissue in hopes of modifying behavior. Radical psychosurgical procedures such as lobotomy were once popular, but neurosurgeons now rarely perform brain surgery to change behavior or moods. Brain surgery is a last-resort treatment because its effects are irreversible.

Are some psychotherapies more effective than others for specific disorders?

No one type of psychotherapy is generally superior to all others. Therapy is most effective for those with clear-cut, specific problems. Some therapies—such as *behavior conditioning for treating phobias and compulsions*—are more effective for specific disorders. *Psychodynamic therapy has been effective for depression and anxiety*, and *cognitive and cognitive-behavioral therapies have been effective in coping with anxiety, posttraumatic stress disorder, and depression*. *Evidence-based practice integrates the best available research with clinicians' expertise and patients' characteristics, preferences, and circumstances.*

What is the rationale for preventive mental health programs, and why is it important to develop resilience?

Preventive mental health programs are based on the idea that many psychological disorders could be prevented by changing oppressive, esteem-destroying environments into more benevolent, nurturing environments that foster growth, self-confidence, and resilience. Struggling with challenges can lead to posttraumatic growth. Community psychologists are often active in preventive mental health programs.

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

Psychopharmacology, the study of drug effects on mind and behavior, has helped make drug therapy the most widely used biomedical therapy. Antipsychotic drugs, used in treating schizophrenia, block dopamine activity. Side effects may include tardive dyskinesia (with involuntary movements of facial muscles, tongue, and limbs) or increased risk of obesity and diabetes. Antianxiety drugs, which depress central nervous system activity, are used to treat anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. These drugs can be physically and psychologically addictive. Antidepressant drugs, which increase the availability of serotonin and norepinephrine, are used for depression, with modest effectiveness beyond that of placebo drugs. The antidepressants known as selective serotonin reuptake inhibitors (often called SSRI drugs) are now used to treat other disorders, including strokes and anxiety disorders. 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's bias.

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 behaving in their everyday 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.

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

Therapists differ in the values that influence their goals in therapy and their views of progress. These differences may create problems if *therapists and clients differ in their cultural 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.

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

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.

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

insight

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

lithium

Studies show that ________ therapy is the most effective treatment for most psychological disorders.

no one type of

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*

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

psychotherapy

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