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-be as it may, I’m gonna impose a schedule,
anyway.
APRIL important schedules
4/21 Monday Ch 15 & 16 test (no comprehensive)
4/23-4/24 block day 2 free response
4/28-4/29 Mon-Tues Review activities
4/30-5/1 block day Final exam (multiple choice)
MAY important schedules 5/5 Monday
AP exam 5/6 Tuesday
class potluck 5/7-5/8 block day
Careers in psychology project due 5/13-5/16 Tues-Fri
Work on final project 5/19-5/30 Mon-Fri
Present final projects
HW of the week 4/14-4/18 Monday
Ch 16 p.673-679 ½ Tuesday
Ch 16 p. 679-683 Block day
Ch 16 p.684-685 Study for vocab quiz
Friday Lunch review for Monday test
Agenda Monday 4/14
Return free response Therapy
Approaches (handout)
Objectives 1. Describe psychoanalytic therapeutic techniques (e.g., free
association, interpretation)2. Discuss Roger’s client-centered therapy3. Identify counterconditioning techniques4. Describe the goals of cognitive therapies5. Discuss the benefits of group therapy and family therapy6. Differentiate between antianxiety, antidepressant and
antipsychotic medication7. Describe electroconvulsive therapy and lobotomies8. Discuss the effectiveness of the psychotherapies
Things we will learn Treatment approaches Modes of therapy (individual, group,
community, preventive) Effectiveness
THERAPY
Therapy
Psycho(logical) therapy : an emotionally charged, confiding interaction between a therapist and patient (treats learned behaviors; phobia)
Biomedical therapy: use drugs or other procedures that act directly on the patient’s nervous system.
Eclectic approach: combination of various techniques.
Psychological TherapiesWe will look at four major forms of psychotherapies
based on different theories of human nature:
1. Psychoanalytical theory
2. Humanistic theory
3. Behavioral theory
4. Cognitive theory
PsychoanalysisThe first formal psychotherapy to emerge was
psychoanalysis, developed by Sigmund Freud.
Sigmund Freud's famous couch
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Therapy- Psychoanalysis
Psychoanalysis Aims to gain awareness/insight
of repressed feelings Therapist interprets patient’s
free associations, resistances, dreams, and transferences
use has rapidly decreased in recent years
Causes of Psychological Problems Undesirable urges and conflicts are
“repressed” or pushed to the unconscious Unconscious conflicts exert influence on
behaviors, emotions, and interpersonal dynamics
Psychoanalysis: Aims
Now the patient can deal with the issue (recognition, resolution); when energy devoted to id-ego-superego conflicts is released, anxiety lessens.
Psychoanalysis: MethodsFree association: saying aloud anything that comes to mind.
Analyst watches for “resistance”
Analyst interprets resistance, dreams, other behaviors (e.g., transference) and provides insight
Resistance: the defensive blocking of anxiety-laden material from the conscious
Transference: transferring to the therapist the strong feelings harbored against a family member or other significant person
Criticism relied on after-the fact interpretations and
repressed memories it is time-consuming and very costly.
Other Dynamic Therapies
Psychodynamic/interpersonal therapies
Focus: current symptoms (e.g., depression), recurring patterns in interpersonal relations
Goal: insight. client’s self awareness and understanding of past on present behavior
Shorter-term, less expensive
Humanistic Therapies People have the power to control their fate, ideas, and
movements as they move towards self-actualization.
Instead of curing a disorder, seeks to promote growth, fulfillment and self-acceptance
Humanistic Therapy Client-Centered Therapy
Carl Rogers active listening and unconditional positive
regard within a genuine, non-judgmental, empathic environment
Therapist and client are equal partners Client directs the topic and direction of the
discussion
http://www.youtube.com/watch?v=Ew8CAr1v48M
Humanistic Therapy Active Listening-empathic listening in which the listener
echoes, restates, and clarifies http://www.youtube.com/watch?v=TA-RaDNVKpw http://www.youtube.com/watch?v=4VOubVB4CTU
QW #1 Compare psychoanalytic and humanistic
theories in terms of their:1) understanding of the source of the
problem, 2) treatment techniques, and 3) therapy goals.
Joe has been seeing a psychoanalyst for four years for treatment of the fear that he had monsters under his bed. His progress was very poor, and he knew it. So, one day he stops seeing the psychoanalyst and decides to try something different.
A few weeks later, Joe's former psychoanalyst meets his old client in the supermarket, and is surprised to find him looking well-rested, energetic, and cheerful. "Doc!" Joe says, "It's amazing! I'm cured!""That's great news!" the psychoanalyst says. "you seem to be doing much better. How?""I went to see another doctor," Joe says enthusiastically, "and he cured me in just ONE session!""One?!" the psychoanalyst asks incredulously."Yeah," continues Joe, "my new doctor is a behaviorist.""A behaviorist?" the psychoanalyst asks. "How did he cure you in one session?""Oh, easy," says Joe. "He told me to cut the legs off of my bed."
Behavior TherapyApplies learning principles to eliminate/change behaviors.
To treat phobias or sexual disorders, behavior therapists do not seek to explain the origin of a behavior (psychoanalytic), or to promote self-acceptance and awareness (humanistic)
Classical Conditioning Techniques
Behaviorists assume that abnormal behaviors are the result of faulty (inappropriate) learning.
Counterconditioning: pairs new response with old stimuli (that used to trigger maladaptive behaviors)
Example: exposure therapy,
aversive conditioning
Exposure TherapyExpose patients to things they fear and avoid. Through repeated exposures, anxiety lessens because they habituate to the things feared.
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Exposure TherapyExposure therapy involves exposing people to fear-driving
objects in real or virtual environments.
*arachnophobia
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Behavior Therapy: classical conditioning Systematic Desensitization
type of counterconditioning associates a pleasant, relaxed state with gradually
increasing anxiety-triggering stimuli commonly used to treat phobias
Uses three steps:1. Progressive relaxation
2. Development of anxiety hierarchy and control the scene
3. Combination of progressive relaxation with anxiety hierarchy
http://www.youtube.com/watch?v=lMZ5o2uruXY
http://www.youtube.com/watch?v=omYECykyQWE
Behavior Therapy Aversive Conditioning
type of counterconditioning that associates an unpleasant state with an unwanted behavior
nausea ---> alcohol
Agenda Tuesday 4/15
• Behavior and cognitive therapies
• Effectiveness of psychotherapies
Behavior Therapy
Aversion therapy for alcoholics
Operant ConditioningOperant conditioning (rewarded or punished) procedures enable therapists to use behavior modification.
* Success in training 3 year old autistic children
Behavior Therapy Token Economy
an operant conditioning procedure that rewards desired behavior
client exchanges a token for various privileges or treats
Cognitive Therapy
Cognitive Therapy
Cognitive Therapy Source: emotional disturbance comes
from cognitive bias and distorted perceptions (e.g., self-blame)
Goal: new, more adaptive ways of thinking
Cognitive Therapy for Depression
Aaron Beck believes that cognitions such as “I can never be happy” need to change in order for depressed patients to recover. This change is brought about by gently questioning patients.
Cognitive Therapy for Depression
Rabin et al., (1986) trained depressed patients to record positive events each day, and relate how they contributed to
these events.
Stress Inoculation Training
Meichenbaum (1977, 1985) trained people to restructure their thinking in stressful situations.
“Relax, the exam may be hard, but it will be hard for everyone else too. I studied harder than most people. Besides, I don’t need a perfect score to get a good grade.”
• https://www.youtube.com/watch?v=95SNt21Jyyk
CBT therapists believe that emotional upsets occur when people hold irrational/negative ideas.
Cognitive Behavioral Therapy
The pioneering form is Rational-Emotive therapy, developed by Albert Ellis.
The treatment is directive and structured; involves a therapist who challenges/changes clients’ thinking
Cognitive Therapy
The Cognitive Revolution
QW #2 Compare and contrast behavior therapy,
cognitive therapy, and cognitive behavioral (rational-emotive) therapy in terms of their:
1) origin/source of the problem 2) treatment techniques 3) goals
Group TherapyGroup therapy normally consists of 6-9 people attending
a 90-minute session that can help more people and costs less. Clients benefit from knowing others have
similar problems.
© M
ary Kate D
enny/ PhotoE
dit, Inc.
Group treatment is especially helpful when members share similar (stigmatized) problems. https://www.youtube.com/watch?v=uxeR95aYer0 (~ 1:00)
p. 604
Group and Family Therapies
Family Therapy
Focus: family as a system
Origin of problem: behavior is influenced by or directed at other family members
Goal: positive relationships and improved communication
Group and Family Therapy
Couple therapy— relationship therapy that helps with difficulty in marriage or other committed relationships
Is Psychotherapy Effective?
Who can sense improvement?
Patient/clientTherapistFamily and friends
Client’s Perceptions
Clients often overestimate effectiveness of therapies.
1. We enter therapy in crisis, but crisis subsides over time (regression toward the mean).
2. Clients may need to believe the therapy was worth the effort.
3. Clients generally speak kindly of their therapists.
Evaluating Psychotherapies
Regression toward the mean tendency for extremes of unusual scores to
fall back (regress) toward their average
Outcome Research
Randomized clinical trials
Meta-analysis procedure for statistically combining the
results of many different research studies
Meta-analysis results Untreated people improve Treated people more likely to improve People who received psychotherapy spent less time and money later on medical treatment
Which psychotherapy?
Do not write on the paper!
Solve the sheet with a partner
Factors in Successful Therapy Therapeutic relationship—caring and respectful Therapist characteristics—caring, active listener,
sensitive, shared values (**no connection to training, experience, supervision, licensing)
Client characteristics—motivated, actively involved, mature
Common Benefits of Psychotherapies
1. New hope.
2. A fresh perspective.
3. An empathic, trusting and caring relationship.
© M
ary Kate D
enny/ PhotoE
dit, Inc.
Therapists and their Training
Clinical psychologists Most are psychologists with a Ph.D. and
expertise in research, assessment, and therapy, supplemented by a supervised internship
About half work in agencies and institutions, half in private practice
Therapists and their Training
Clinical or Psychiatric Social Worker 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 have earned the National Association of Social Workers’ designation of clinical social worker
Therapists and their Training
Counselors Marriage and family counselors specialize in
problems arising from family relations Pastoral counselors provide counseling to
countless people Abuse counselors work with substance
abusers and with spouse and child abusers and their victims
Therapists and their Training
Psychiatrists Physicians who specialize in the treatment of
psychological disorders Not all psychiatrists have had extensive
training in psychotherapy, but as M.D.s they can prescribe medications. Thus, they tend to see those with the most serious problems
Many have a private practice
Agenda block day 4/16-4/17 Biomedical therapies Cinderella’s therapist
The Relative Effectiveness of Different Therapies
Which psychotherapy would be most effective for treating a particular problem?
Disorder Therapy
Depression Behavior, Cognition, Interpersonal
Anxiety Cognition, Exposure, Stress Inoculation (CBT)
Bulimia CBT
Phobia Behavior (counterconditioning)
Bed Wetting Behavior Modification
Eye Movement Desensitization and Reprocessing (EMDR)
Therapist attempts to unlock and reprocess clients’ traumatic memories by triggering eye movements (waving a finger in front of the eyes).
https://www.youtube.com/watch?v=GTLLfdcJE0Q
*EMDR has not held up under scientific testing.
Placebo effect?
Light Exposure Therapy
For Seasonal Affective Disorder (SAD), light exposure therapy has
valid effect.
Courtesy of C
hristine Brune
Biomedical Therapies
Psychopharmacology study of the effects of drugs on mind and
behavior
Antipsychotics => schizophrenia
Occupies dopamine receptor sites and dampens responsiveness to irrelevant stimuli
* side effects: Tardive dyskinesia
On the news: http://health.usnews.com/health-news/articles/2014/04/10/too-many-foster-kids-with-adhd-treated-with-antipsychotic-drugs-study
Antianxiety Drugs Antianxiety Drugs
Depress nervous system activity.
Valium, Xanax, Lithium
*side effect: drowsiness, depression, dependence
Antidepressants=> depression, anxiety Increases the availability of the scarce
neurotransmitters (serotonin), which elevate arousal and mood
Anti-Depressant Medication
• First generation—tricyclics and MAO inhibitors Effective for about 75% of patients Produce troubling side effects
MAO inhibitors can have serious physiological side effects when taken with some common foods
Tricyclics caused weight gain, dry mouth, dizziness, sedation
https://www.youtube.com/watch?v=m4PXHeHqnmE
Anti-Depressant Medication Second generation—chemically different but no
more effective than earlier drugs (Wellbutrin, Desyrel)
Selective serotonin reuptake inhibitors (SSRI)— have fewer undesirable side effects than earlier drugs
(Prozac, Paxil, Zoloft)
Fig. 15-12, p. 612
Biomedical Therapies
Antidepressant Drugs Lithium— a chemical that provides an effective drug
therapy for the mood swings of bipolar (manic-depressive) disorders.
Prozac—blocks the reabsorption and removal of serotonin from synapses.
Zoloft— cousin to Prozac; blocks reabsorption of serotonin. https://www.youtube.com/watch?v=6vfSFXKlnO0
Paxil— cousin to Prozac; serotonin-uptake-inhibitor.https://www.youtube.com/watch?v=Wt7Xq4TwOjg
Biomedical Therapies The emptying of U.S. mental hospitals
Biomedical Therapies
Biomedical Therapies Electroconvulsive Therapy (ECT)
therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient
Side effects: memory loss https://www.youtube.com/watch?v=TvXlxW-JP6Y
Psychosurgery surgery that removes or destroys brain tissue in an
effort to change behavior lobotomy
now-rare psychosurgical procedure once used to calm uncontrollably
emotional or violent patients
Preventing Psychological Disorders
Problem source: disorders result from stressful social situations
Aim: change oppressive, esteem-destroying environments into more nurturing ones.
Strategies: reduce abuse and illiteracy. Alleviate poverty, increase parenting and teaching skills
Cinderella therapists activity Form groups of 5 people Decide who will take which role
Moderator, therapist (team of 2; divvy up script), Cinderella, fairy
Each group will be reading their script. As you hear other groups, write down: (1) the correct therapy approach (2) the specific treatment technique
Activity continued- your turn http://www.buzzfeed.com/leonoraepstein/
disney-characters-who-really-need-to-see-a-psychiatrist
Select a character Write a short script with a moderator,
therapist, characters (2~3) based on one of the therapy approaches and treatment
If time Anti-depressant:Makes shrimps too calmhttps://www.youtube.com/watch?v=D1WFfTVmmOMDuring pregnancyhttp://www.cbsnews.com/videos/antidepressants-during-
pregnancy-linked-to-new-risks/
Friday agenda Vocab quiz Practice disorder and treatment Placebo effect
Lunch review today