THEORY - Ciccarelli, Chapter 15: Psychological Therapy

therapy
= treatment methods aimed at making people feel better and function more effectively

 eclectic approach
combining elements of several different approaches of techniques

 psychotherapy
therapy for mental disorders; a person (or group) with a problem talks with a psychological
professional in order to reach a better understanding of the problem

o insight therapies
therapies in which the main goal is helping people to gain insight with respect to
their behaviour, thoughts and feelings

o action therapy
therapy in which the main goal is to change disordered or inappropriate behaviour
directly

 biomedical therapies
therapies that directly affect the biological functions of the body and brain
therapies for mental disorders in which a person with a problem
(include the use of medical interventions such as drugs or surgical methods)

PSYCHODYNAMIC APPROACH

Freud: techniques to reveal repressed information stored in the unconscious mind

 dream interpretation
 manifest content (actual events)
 latent content
the symbolic or hidden meaning of dreams

 free association
encouraging the patient to talk about anything that came to mind without fear of negative
values

 resistance
occurring when a patient becomes reluctant to talk about a certain topic, by either changing
the subject or becoming silent

 transference
the tendency for a patient to project positive or negative feelings for important people in the
past onto the therapist
  directive
the therapist actively gives interpretations of a client’s statements and may suggest certain
behaviour or actions

psychodynamic therapy
= a newer and more general term for therapies based on psychoanalysis with an emphasis on
transference, shorter treatment times and a more direct therapeutic approach

 interpersonal therapy (IPT)

form of therapy for depression which incorporates multiple approaches and focuses on
interpersonal problems and functioning

HUMANISTIC THERAPY

person-centred therapy (Carl Rogers, 1961)

a nondirective insight therapy in which the client does all the talking and the therapist listens,
purpose of the therapist is to provide unconditional positive regard that may have been absent from
that person’s life

 non-directive
therapy style in which the therapist remains relatively neutral and does not interpret or
take directions with regard to the client, instead remaining a calm, non-judgemental
listener while the client talks

 authenticity
the genuine, open and honest response of the therapist to the client

 unconditional positive regard

referring to the warmth, respect and accepting atmosphere created by the therapist for
the client in person-centred therapy; positive regard that is given without conditions

 empathy
ability of the therapist to understand the feelings of the client, very important

 reflection
the therapist restates what the client says rather than interpreting those statements

 motivational interviewing
‘person-centred with a twist’; specific goals to reduce ambivalence (mixed feelings) about
change and increase intrinsic motivation

Gestalt therapy
form of directive insight therapy in which the therapist helps clients to accept all parts of their
feelings and subjective experiences, using leading questions and planned experiences such as
role-playing
BEHAVIOUR THERAPIES AND COGNITIVE THERAPIES

behaviour therapies
= action therapies based on the principle of classical and operant conditioning and aimed at changing

disordered behaviour using learning theories; without concern for the original causes of such
behaviour

“learning created the problem and new learning can correct it”
(behaviour modification)

THERAPIES BASED ON CLASSICAL CONDITIONING

 systematic desensitization
behaviour technique used to treat phobias, in which a client is asked to make a list of
ordered fears and taught to relax while concentrating on those fears

 aversion therapy
an undesirable is paired with an aversive stimulus o reduce the frequency of the
behaviour

 exposure therapies
exposing individuals to anxiety or fear-related stimuli, under carefully controlled
conditions, to promote new learning

o flooding
if the exposure to the stimuli is rapid and intense
o gradual / graded
development of a fear hierarchy as in systematic desensitization

THERAPIES BASED ON OPERANT CONDITIONING

techniques include reinforcement, shaping and modelling to change frequency of voluntary

behaviour

 contingency contract
formal, written agreement between the therapist and client in which goals for
behavioural change, reinforcements and penalties are clearly stated

 time-out
extinction process in which a person is removed from the situation that provides
reinforcement for undesired behaviour, usually being placed in a quiet corner or room
away from possible attention and reinforcement opportunities

 modelling
learning through observation and imitation of others

 participant modelling
 a model demonstrates the desired behaviour in a step-by-step, gradual process wile the
client is encouraged to imitate the model

cognitive therapy

= focusses on helping clients recognize distortions in their thinking and replacing distorted,
unrealistic beliefs with more realistic, helpful thoughts

 arbitrary interference (‘jumping to conclusions’)

 selective thinking (when a person only focuses on one aspect of a situation, leaving out
others resulting in a false assumption)

 overgeneralization (drawing a sweeping conclusion from one incident and assuming that this
applies to actually completely different areas of life)

 magnification and minimization (‘blowing something out of proportion’ while not

emphasizing good things)

 personalization (taking responsibility for events that in reality are not connected to the
individual)

cognitive-behavioural therapy (CBT)

action therapy in which the goal is to overcome problems by learning to think more rationally and
logically, which in turn will impact their behaviour

rational emotive behaviour therapy (Ellis, 1997/8)

in this therapy clients are directly challenged in their irrational beliefs and helped to restructure their
thinking into more rational belief statements

GROUP THERAPIES

group therapy
form of therapy or treatment during which a small group of clients with similar concerns meet
together with a therapist to address their issues

 family counselling / therapy

a form of group therapy in which family members meet together with
a counsellor / therapist to resolve problems that affect the entire family

 self-help groups (support groups)

a group composed of people who have similar problems and who meet together without
a therapist or counsellor for the purpose of discussion, problem solving and social and
emotional support
  advantages: lower cost, social and emotional support
disadvantages: less one-on-one contact with therapist

PSYCHOTHERAPY

therapeutic alliance
the relationship between therapist and client that develops as warm, caring, accepting relationship
characterized by empathy, mutual respect and understanding

evidence based treatment

(also: empirically supported treatment) refers to interventions, strategies or techniques that have
been found to produce therapeutic and desired changes during controlled research studies

Barriers to Effective Psychotherapy

 culture-bound values
 class-bound values
 language
 “American” cultural assumptions
 communication style

BIOMEDICAL THERAPIES

psychopharmacology
the use of drugs to control or relieve the symptoms of psychological disorders

 antipsychotic drugs
drugs used to treat psychotic symptoms such as delusions, hallucinations and other bizarre
behaviour

 antianxiety drugs
used to treat and calm anxiety reactions, typically minor tranquilizers (ex. Xanax, Valium)

 antidepressant
drugs used to treat depression and anxiety (block the activity of an enzyme called
monoamine oxidase which breaks down neurotransmitters in control of mood)

electroconvulsive therapy (ECT)

treats severe depression using electrodes that are placed on either one or both sides of a person’s
head and an electric is passed through the electrodes that is strong enough to cause a convulsion or
a seizure

psychosurgery
surgery performed on brain tissue to relieve or control severe psychological disorders
 prefrontal lobotomy
in this psychosurgery the connections of the prefrontal cortex to other areas of the brain
are severed
 bilateral anterior cingulotomy
an electrode wire is inserted into the anterior cingulate gyrus, with the guidance of MRI
to destroy a very small portion of that brain area with electric current