Critical Thinking Exercise

 

�    Apart from financial constraints, what might stop someone from getting therapy if they needed it?

 

 

 

 

 

When to Get Help

 

�    If you are feeling distressed for a ____________________________.

�    If you have exhausted all of your resources and are still not improving.

�    If your symptoms or problems are compromising your _____________________.

�    If you are thinking about ____________ or ____________ yourself.

�    If others consistently suggest that you need professional help.

�    If you are legally mandated by court order.

�    If you want to learn more about yourself and make positive changes in your life.

�    �Not everyone ___________ therapy, but everyone can ___________ from therapy��Dr. Ano.

 

Psychotherapy

 

�    Psychotherapy - the use of psychological principles and techniques to treat _________________________ problems.

 

Types of Individual Psychotherapy

 

Psychoanalysis

 

�    Psychoanalysis - therapy formulated by Sigmund Freud that emphasizes resolving _____________________ conflicts.

� Focus is primarily on the past.

 

Psychoanalytic Theory of Pathology

 

�    Problems are a result of unconscious competing demands between the id, ego, and superego.

 

Psychoanalytic Theory of Healing

 

�    Healing occurs by promoting ______________ and true understanding of the root causes of maladaptive behaviors.

� �Make the unconscious conscious�.

� Insight can lead to ________________ (emotional release), which can lead to more adaptive, satisfying, and productive behaviors.

 

Psychoanalytic Therapeutic Techniques

 

�    Free Association - technique in which a person is encouraged to talk about __________________ that comes to mind without censorship (Breuer & Freud, 1895).

�  Usually involves lying on the couch.

�    Interpretation - technique in which the therapist identifies unconscious themes and issues that may be influencing the client�s behavior.

�  In psychoanalysis, everything usually has a _____________ meaning.

�    Dream Analysis � examining the hidden symbols in dreams to gain access to the unconscious.

�    Resistance - process whereby the person becomes reluctant to talk about a certain topic, either changing the topic or becoming silent.

�    Transference - process by which the patient unconsciously reacts to the therapist as though the therapist were some other __________________ _________________ in their life.

 

Client-Centered Therapy

 

�    Client-Centered Therapy - nondirective therapy developed by Carl Rogers that uses humanistic principles to help people reach their ____________________________.

� Focus is primarily on the _______________.

 

Client-Centered Theory of Pathology

 

�    Problems are a result of incongruence between one�s real self and ideal self.

� Conditions of Worth - standards of value externally enforced upon people by parents and society (causes incongruence).

 

Client-Centered Theory of Healing

 

�    Healing occurs by decreasing ____________________ and helping people discover their potential for growth.

� Help people actualize their potential by removing the blocks from conditions of worth.�

 

Client-Centered Therapeutic Techniques

 

�    Reflection - technique in which the therapist restates what the client says in slightly different words, rather than interpreting those statements.

� Reflection is not necessarily repeating.

� Allows the client to develop their own insights without the therapist potential misinterpretations or _________________.

�    Unconditional Positive Regard - accepting, respecting, and __________ the client for who he/she is, regardless of his/her faults or problems.

� Therapist can discourage various maladaptive behaviors, while affirming and validating the person�s identity.

�    Empathy - ability of the therapist to understand the client�s feelings.

� When used with reflection, empathy allows clients to ______________ themselves better.

�    Authenticity - the genuine, open, and honest response of the therapist to the client.

� Promotes trust and honest expression of thoughts and feelings.

 

Behavior Therapy

 

�    Behavior Therapy - therapy based on the principles of _______________ and _______________ conditioning aimed at changing disordered behavior without concern for the original causes of such behavior.

�  Focus is on symptoms and behaviors.

 

Behavioral Theory of Pathology

 

�    Problems are a result of learning maladaptive behavior patterns through classical and operant conditioning.�

 

Behavioral Theory of Healing

 

�    Healing occurs by unlearning maladaptive behaviors and learning new, adaptive behaviors.�

 

Therapeutic Techniques Based On Classical Conditioning

 

�         Systematic Desensitization - technique in which anxiety is decreased in a gradual, ________________________ process (Wolpe, 1958; 1991).

�      Client learns relaxation exercises.

�      Client develops a ___________________________.

�      Client �experiences� each item on the fear hierarchy while simultaneously practicing relaxation exercises.

�    Flooding - rapidly and intensely _____________ the client to the anxiety-provoking situation or object, and _______________ them from making the usual avoidance or escape response (Gelder, 1976).�

�    Aversion Therapy - pairing an undesirable behavior with an aversive stimulus to reduce the frequency of the behavior.

 

Therapeutic Techniques Based On Operant Conditioning

 

�    Token Economy - technique in which clients are rewarded with tokens for desired behavior, which can then be exchanged for whatever is reinforcing to them (Glynn, 1990).

�    Contingency Contract - a formal, written agreement between the therapist and client in which goals for behavioral change, reinforcements, and penalties are clearly stated (Salend, 1987).

�    Modeling - learning through the observation and imitation of others (Bandura, 1986).

 

Cognitive Therapy

 

�    Cognitive Therapy - therapy in which the focus is on helping clients recognize distortions in their _____________ and replace maladaptive, unrealistic beliefs with more realistic, helpful thoughts.

�  Focus is on thoughts and beliefs.

 

Cognitive Theory of Pathology

 

�    Problems are a result of maladaptive and __________________ thinking patterns.

 

Cognitive Theory of Healing

 

�    Healing occurs when clients can identify their negative thought processes and learn new, more adaptive ways of thinking and _______________.�

 

Therapeutic Techniques of Beck�s Cognitive Therapy (1979)

 

�         Cognitive Restructuring - process of helping clients shift their thinking away from the focus on automatic, dysfunctional thoughts to more realistic ones.

�      Identify cognitive distortions.

�      Critically evaluate cognitive distortions.

�      Generate alternative, more adaptive thoughts.

 

Therapeutic Techniques Based Upon Ellis�s

Rational Emotive Behavior Therapy (1997; 1998)

 

�    Active Disputing - technique in which the therapist directly challenges the client�s irrational, self-defeating beliefs.

 

Cognitive-Behavioral Therapy

 

�    Cognitive-Behavioral Therapy - therapy that attempts to help clients think more rationally and logically by also incorporating behavioral techniques.

 

Evaluating Individual Psychotherapy

 

Does Psychotherapy Work?

 

�    YES! An estimated 75% - 90% of people feel that psychotherapy has helped them (Consumer Reports, 1995; Kotkin et al., 1996).

�    The ______________ a person stays in therapy, the greater the improvement (Lambert & Ogles, 2003; Seligman, 1995; Thase, 1999).

�    Psychotherapy may even improve __________ functioning (Brody et al., 1998; Beauregard, 2007; Felmingham et al., 2007; Kennedy et al., 2007).

 

Which Psychotherapy is Best?

 

�    Different approaches produce relatively equivalent results in terms of client improvement (Chambless & Ollendick, 2001; Wampold et al., 1997; Westen & Bradley, 2005).

�    Some therapies are more effective for __________________ of disorders (Hollon et al., 2002).�

 

What Makes Therapy Effective?

 

�    Therapeutic Alliance - the interactive and collaborative ______________ between the therapist and client (Barber et al., 2000; Kozart, 2002; Martin, Garske, & Davis, 2000).

 

What Else Makes Therapy Effective?
(Adapted from: Garfield & Bergin, 1994)

 

�    Instillation of ______________.

�    Chance for _______________ expression.

�    Support and advice.

�    An explanation and understanding of one�s difficulties.

�    Opportunity to __________________ with new behaviors and thoughts.

 

Culture and Psychotherapy

 

�         When the culture, ethnic group, or gender of the therapist and the client differs, misunderstandings and misinterpretations can occur.

�         Four potential barriers (Sue & Sue, 2003):

�      Language.

�      Cultural Values.

�      Social Class.

�      Nonverbal Communication.

 

Group Therapy

 

�    Group Therapy - therapy that is administered to more than one person at a time in a group setting.

 

Types of Group Therapy

 

�    Family Therapy � therapy in which family members meet together to resolve problems and improve functioning of the entire family system.

�    Process Groups - group therapy that may contain people with different problems in which the focus is on the process and interpersonal dynamics between members.

�    Support Groups - group therapy for people with similar problems who meet for the purpose of discussion, problem-solving, and social and emotional support.

� Examples include Social Skills Groups, Bereavement Groups, etc.

�    Self-Help Groups - similar to support groups, but usually are not facilitated by a professional therapist.

� Examples include Alcoholics Anonymous, Narcotics Anonymous, etc.

 

Advantages of Group Therapy

 

�    Less expensive than individual therapy.

�    Safe environment to explore new social behaviors.

�    Normalization of problems by identifying with others.

�    Social and emotional support from other people with a variety of perspectives.

�    Opportunity to provide support and assistance to others.

 

Disadvantages of Group Therapy

 

�    Client must share the therapist�s time during therapy.

�    Presence of others may make it difficult to speak freely and candidly.�

�    Group therapy may not be for everyone (e.g., extremely shy people or clients with severe psychiatric disorders).

 

Biomedical Therapy

 

�    Biomedical Therapy - therapy that directly affects the biological functioning of the body and brain.

 

Types of Biomedical Therapy

 

Psychopharmacology

 

�    Psychopharmacology � the use of psychotropic medications to control or relieve the symptoms of psychological disorders.

 

Four Categories of Psychotropic Medications

 

�    Antianxiety Drugs - medications used to treat and calm anxiety reactions (minor tranquilizers).

� Benzodiazepines: Xanax, Ativan, and Valium.

�    Antidepressant Drugs - medications used to treat depression and anxiety.

� Monamine Oxidase Inhibitors (MAOIs): Marplan, Nardil, and Parnate.

� Trycyclics: Tofranil, Norpramin, Pertofrane, Elavil, Sinequan, and Adapin.

� Selective Serotonin Reuptake Inhibitors (SSRIs): Prozac, Zoloft, and Paxil.

�    Antimanic Drugs - medications used to treat manic symptoms.

� Lithium

� Anticonvulsants: Depakote

�    Antipsychotic Drugs - medications used to treat psychotic symptoms, such as hallucinations, delusions, and other bizarre behaviors.

� Typical Neuroleptics: Thorazine, Prolixin, Haldol, and Mellaril.

� Atypical Neuroleptics: Clozaril, Zyprexa, Risperdal, Seroquel, and Geodon.

 

Electroconvulsive Therapy

 

�    Electroconvulsive Therapy - therapy in which an electric shock is delivered to either one or both sides of a person�s head, resulting in a seizure or convulsion of the body and the release of a flood of neurotransmitters in the brain (APA, 2001).�

� Improves mood almost immediately.

� Used to treat disorders that have not responded to medication (e.g., severe depression, mania, or schizophrenia).

 

Psychosurgery

 

�    Psychosurgery - surgery performed on brain tissue to relieve or control severe psychological disorders.

� VERY RARE due to the ethical, social, and legal implications (Cosgrove & Rauch, 1995).