Chapter 16 Psych 1000

What might a psychodynamic therapist say about Mower's therapy for bed-wetting? How might a behavior therapists defend it?

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

How do alternate therapies fare under scientific scrutiny?

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

What three elements are shared by all forms of psychotherapy?

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

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

Behavior therapies are not insight therapies, and instead assume that problem behaviors are the problem. Their goal is to apply learning principles to modify these problem behaviors. Classical conditioning techniques, including exposure therapies (such as systemic 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.

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 responses 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 psychodynamic and humanistic therapists are insight therapies-- they attempt to improve functioning by increasing clients' awareness of motives and defenses. Humanistic therapy's goals include helping clients grow in self-awareness and self-acceptance; promoting personal growth rather than curing illness; helping clients take responsibility for their own growth; focusing on conscious thoughts rather than unconscious motivations; and seeing the present and future as more important than the past. Carl Rogers' client-centered therapy proposed that therapists' most important contributions are to function as a psychological mirror through active listening and to provide a growth-fostering environment of unconditional positive regard.

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-accepting. By making clients aware of self-defeating patterns of thinking, cognitive therapies guide people toward more adaptive ways thinking about themselves and their world.

What should a person look for when sleeting a psychotherapist?

Campus health centers are generally good starting points for counseling options, and they may offer some free services. A person seeking therapy may want to ask about the therapist's treatment approach, values, credentials, and fees. An important consideration is whether the therapy seeker feels comfortable and able to establish a bond with therapist. Recognizing the importance of strong therapeutic alliance, the American Psychological Association accredits programs that provide training in cultural sensitivity and that recruit underrepresented cultural groups.

Does psychotherapy work? How can we know?

Clients' and therapists' positive testimonials cannot prove that psychotherapy is effective, and the placebo effect makes it difficult to judge whether improvement occurred because of the treatment. Using meta-analysis to statistically combine the results of hundreds of randomized psychotherapy outcome studies, researchers have found that those not undergoing psychotherapy are more likely to improve-- and to improve more quickly and with less risk of relapse.

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

Electroconvulsive therapy (ECT), in which a brief electric current is sent though the brain of an anesthetized patient, is an effective, last-resort treatment for people with severe depression who have not responded to other therapy. Newer alternative treatments for depression include transcranial electrical stimulations (tDCS; also used for scientifically unproven cognitive benefits), repetitive transcranial magnetic stimulation (tTMS), and deep-brain stimulation (DBS; said no work by blaming an overactive brain region linked with negative emotions, and has shown benefit in some patients). Psychosurgery removes or destroys brain tissue in hope of modifying behavior. Radical psychosurgical procedures such as lobotomy are no longer performed. Today's microscope psychosurgery and MRI-guided precision brain surgery are rare, last-resort treatments because the effects are irreversible.

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.

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

Group therapies sessions can help more people with less cost than individual therapy. Clients may benefit from exploring feelings and developing social skills in a group situation, from learning that others have similar problems, and from getting feedback on new ways of behaving. Family therapy views a family as an interactive system. It attempts to help members discover the roles they play and learn to communicate more openly and directly.

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

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

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

Insight

Are some psychotherapies more effective than others for specific disorders?

No one type of psychotherapy is generally superior to all others. therapy is most effective for those with clear-cut, specific problems. Some therapies-- such as behavior conditioning for treating phobias and compulsions-- are more effective for specific disorders. Cognitive and cognitive-behavioral therapies have been effective in coping with anxiety, post traumatic stress disorder, insomnia, and depression; behavioral conditioning therapies with specific behavior problems; psychodynamic therapy for depression and anxiety; and non directive (client-centered) counseling for mild to moderate depression. Evidence based practice integrates the best available research with clinicians' expertise and patients' characteristics and preferences.

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

Operant conditioning operates under the premise that voluntary behaviors are strongly influenced by their consequences. Therapy based on operant conditioning principles therefore uses behavior modification techniques to change unwanted behaviors by positively reinforcing desired behaviors and ignoring or punishing undesirable behaviors. Critics maintain that techniques such as those used in token economies may produce behavior changes that disappear when rewards end, and deciding which behaviors should change is authoritarian and unethical. Proponents argue that treatment with positive rewards is more humane than punishing people or institutionalizing them for undesired behaviors.

What 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 the 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 prevent psychological disorders by turning destructive environments into more nurturing places that foster competence, health, and well-being.

What is the difference between preventive mental health and the psychological and biomedical therapies?

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

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

Psychopharmacology has helped make drug therapy the most widely used biomedical therapy. Antipsychotic drugs are used in treating schizophrenia; some block dopamine activity. Side effects may include tar dive dyskinesia (involuntary movements of facial muscles, tongue, and limbs) or increased risk of obesity and diabetes. Antianxiety drugs, which often increase the availability of serotonin and norepinephrine, are used to treat depression, anxiety disorders, obsessive-compulsive disorder, and post traumatic stress disorder with modest effectiveness. Given their widening use (from depression to anxiety to stokes), some professionals prefers the term SSRIs (selective serotonin reuptake inhibitors) rather than antidepressants. Lithium and Depakote are mood stabilizers prescribed for those with bipolar disorder. Studies may use a double-blind procedure to avoid the placebo effect and researcher bias.

How do psychotherapy and the biomedical therapies differ?

Psychotherapy is treatment involving psychological techniques that consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth. The major psychotherapies derive from psychology's psychodynamic, humanistic, behavioral, and cognitive perspectives. Biomedical therapy treats psychological disorders with medications or procedures that act directly on a patient's physiology. Al electric approach combines techniques from various forms of therapy.

How do researchers determine if particular drug therapies are effective?

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 drug treatment's actual effect.

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

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

The cognitive therapies, such as Aaron Beck's cognitive therapy for depression, assume that our thinking influences our feelings, and that the therapist's role is to change clients' self-defeating thinking by training them to perceive and interpret events in more constructive ways. The widely researched and practiced cognitive-behavioral therapy (CBT) combines cognitive therapy and behavior therapy any helping clients regularly try out their new ways of thinking and behaving in their everyday life. A newer CBT variation, dialectical behavior therapy (DBT), teaches clients cognitive tactics for tolerating distress and regulating emotions, and trains them in social skills and mindfulness meditation.

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.

How might the placebo effect bias clients' and clinicians' appraisals of the effectiveness of psychotherapies?

The placebo effect is the healing power of belief in a treatment. Patients and therapists who expect a treatment to be effective may beehive it was.

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.

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

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

How do culture and values influence the 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 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.

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

Through psychoanalysis, Sigmund Freud trend 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 pass relationships create themes that may be acted out in present relationships.

What is evidence based clinical decision making?

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

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. psychoanalysis b. humanistic therapies c. client-centered therapy d. behavior therapy

a

Electroconvulsive Therapy

a biomedical therapy for severely depressed patients in which a brief electric current id dent 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 client's problem

Unconditional Positive Regard

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

Virtual Reality Exposure Therapy

a counterconditioning technique that treats anxiety though creative electronic simulations in which people can safely face their greatest fears, such as airplane flying, spiders, or public speaking

Client-Centered Therapy

a humanistic therapy, developed by Carl Rogers, in as active e listening within an accepting, genuine, empathic environment to facilitates clients' growth (also called person-centered therapy)

Cognitive Behavioral Therapy (CBT)

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

Meta-Analysis

a procedure for statistically combing the results of many different research studies

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

Systemic Desensitization

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

A therapist who restates and clarifies the client's statements is practicing the technique of ___________________________ _________________________.

active listening

Eclectic Approach

an approach to psychotherapy that uses techniques from various forms or 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

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 this with problems that ____________________ (are/are not) well-defined.

are

Aversive Conditioning

associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol)

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

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

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

Exposure Therapies

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

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

c

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

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

c

Exposure therapies and aversive conditioning are applications of ______________________ conditions. 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 characteristic 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

A critical attributes of the _____________________ ____________________ developed by Aaron Beck focuses on the belief that changing people's thinking can change their functioning.

cognitive therapy

Behavior therapies often use _____________________ techniques such as systemic desensitization and aversive conditions to encourage clients to produce new responses to old stimuli.

counterconditioning

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-stablizing perspective c. spontaneous recovery d. preventive mental health

d

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

d

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

d

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

Antianxiety Drugs

drugs used to control anxiety and agitation

Antidepressant Drugs

drugs used to treat depression, anxiety disorders, obsessive-compulsive disorder, and post traumatic 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

Serve depression that has not responded to other therapy may be treated with ________________ _________________, which can cause brain seizures and memory loss. More moderate neural stimulation techniques designed to help alleviate depression include _________________ direct current stimulation, ___________________ _____________________ magnetic stimulation, and ___________________-__________________ stimulation.

electroconvulsive therapy; transcranial; repetitive transcranial; deep-brain

Active Listening

empathic listening in which the listeners echoes, restates, and clarifies. A feature of Roger's client-centered therapy

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)

Which alternative psychotherapy has shown more promises as an authentic treatment-- EMDR or light therapy?

light therapy

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 than those who do not undergo psychotherapy.

more

Posttraumatic Growth

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

Biomedical Therapy

prescribed medications or procedures that act directly on the person's physiology

What are the three components fo evidence-based practices?

research evidence, clinical expertise, and knowledge of the patient

Psychosurgery

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

The techniques of _______________________ ______________________ teaches people to relax in the presence of progressively more anxiety-provoking stimuli.

systemic desensitization

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 o the effect of drugs on mind and behavior

Insight Therapies

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

Group Therapy

therapy conducted with groups rather than individuals, providing 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

Behavior Therapy

therapy that applies learning principles to the emanation of unwanted 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

Family Therapy

therapy that treats people in the context of their family system. Views an individual's unwanted behaviors as influenced by, or directed at, other family members

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

In psychoanalysis, when patients experience strong feelings for their therapists, this is called _____________________. Patients are said to demonstrate anxiety when they put up mental blocks around sensitive memories, indicating ________________. The therapists 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; consist of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth.