1. Involves 3 things

a. Verbal interaction between therapist and clientb. Development of a supportive and trusting relationship c. Analysis by the therapist of the client’s problems

2. Nature of Psychotherapy

a. “Healing of the Soul”i. Usually thought of a moral or religious problem ii. Inhabited by demonsiii. Treatments included exorcisms

a. Religious ceremonies or physical punishmentiv. Mental illness not a good term because it leaves the person feeling

passive and helpless

A wide range of treatments to help troubled individuals overcome their problems

b. Functions of Psychotherapyi. Help people realize that they are responsible for their own problemsii. Only they can solve those problemsiii. Major task of psychotherapist to help patient:

a. Examine their way of livingb. Understand how that way causes problemsc. Start living in a new beneficial way

c. Main Kinds of Therapyi. Each based on a theory of how human personality worksii. Each is carried out in a different styleiii. Many stick to one single approach, while others are eclectic

d. Goals of Therapyi. Primary Goal - Strengthen a person’s control over their lifeii. One of the biggest factors in treatment is a patient’s hope and belief that

they will get better – placebo effect

3. Who are Therapistsi. Chart 17.3ii. What Makes a Good Therapist

a. More skillful than friends in encouraging a person to examine uncomfortable feelings and problems

b. 3 Characteristics found in effective therapistsa) Be psychologically healthyb) Have empathy – capacity for warmth and understandingc) Experienced in dealing with people and understanding their

complexities

4. Group Therapiesi. Patient is in the company of others not aloneii. Chance to see others struggling with similar problemsiii. Sees others recovering and gets hope from thativ. Family Therapy

a. Focus is on the interactions among family membersb. Untangles the twisted webs of relationships in the familiesc. Psychologist is an objective viewpoint and can suggest ways of improving

communications

v. Self-Help Groupsa. Voluntary groups of people that share similar problemsb. Discuss difficulties and provide one another with support and possible

solutionsc. Alcoholism, overeating, drug addiction, child abuse, cancer survivors, etc.d. Most famous is AA

5. Does Psychotherapy Work?i. Studies clash yes and noii. Therapy can improve the quality of life for patients and is better than no

treatment at all

Section 1 Review

1. What is Psychoanalysisi. Based on the theories of Sigmund Freudii. Psychoanalysis – therapy aimed at making patients aware of their unconscious

motives so that they can gain control over their behavioriii. Psychological disturbances are caused by hidden conflictsiv. Make patient aware of unconscious impulses, desires and fears that cause

anxietyv. Insight – the apparent sudden solution to a problem, first step to gaining control

of their behavior and problems

vi. Free Associationi. Psychoanalysis is a slow procedureii. Years of 50 minute sessions, several times a week

a. Average of 600 sessions and years of meetingiii. Begins with the analyst having the patient relax and talk about everything

that comes to mind – Free Associationa. Everything should be expressed, nothing inconsequential, nothing to

unimportant or embarrassingb. Describe dreams, private thoughts, long-forgotten experiences

a. Analyst says nothing, most of the work is done by the patientc. Any behavior that impedes the course of therapy (painful feelings or not

examining long-standing behavior patterns) is called resistance

vii. Dream Analysisa. Freud also believed that dreams expressed unconscious thoughts and

feelingsb. Dream Analysis – analyst interprets the dreams of the patient to find the

unconscious thoughts and feelingsc. Freud believed that dreams contained two types of content

a) Manifest contenti. What you remember about your dream

b) Latent Contenti. Refers to the hidden meanings represented symbolically in the

dream that the analyst interprets from the manifest content

viii. Transference – the process experienced by the patient of feeling towards the analyst the way they feel toward some other important figure in their life

a. Can be good or badb. Analyst can’t let this happen

2. Humanistic Therapyi. Focuses on the value, dignity and worth of each person. It holds that healthy living is the

result of realizing one’s full potentialii. Can be reached through personal responsibility, freedom of choice and authentic

relationshipsa. Client-Centered Therapy

i. Based on theories of Carl Rogersii. Uses “client” to imply an equal relationship (returns: positive regard, empathy and

genuineness)iii. Assumes that people are good and that they are capable of handling their own livesiv. One goal: to help a person recognize their own strength and confidence, this way they will

learn to be true to their standards and ideas about how to live effectivelyv. Techniques of Client-Centered Therapy

a) Topics are entirely up to the patient – nondirective therapyb) Therapist listens and encourages but avoids giving opinionsc) Therapist echoes back what they hear – active listeningd) Client and therapist work together to see how the client feels about themselves, their

life and others.e) Session held in an Unconditional positive regard – therapists consistent

expression of acceptance of the client no matter what the client says or doesi. No opinions are made or spokenii. All speech and actions are accepted iii. No emotion showed

Section 2 Review

Behavior Modification – a systematic method of changing the way a person acts and feels

1. Cognitive Therapya. Focuses on changing the way people thinkb. To improve our lives, we must work to change our pattern of thinkingc. Disconfirmation – clients may be confronted with evidence that directly contradicts their

existing beliefsd. Reconceptualization – clients work toward an alternative belief system to explain their

experiences or current observationse. Insight – clients work toward understanding and deriving new or revised beliefsf. Rational-Emotive Therapy – form of help aimed at changing unrealistic assumptions about

oneself and other peoplei. Goal is to correct false and self-defeating beliefs

a) Use of role-playing, modeling, humor, persuasion or a homework type approachb) See Figure 17.8

g. Beck’s Cognitive Therapy – Focuses on illogical thought processesi. Maladaptive Thought Patterns – Overgeneralization, Polarized Thinking and

Selective Attentionii. See Figure 17.9

2. Behavior Therapies – changing undesirable behavior through conditioning techniquesi. Counterconditioning – pairs the stimulus that triggers an unwanted behavior (or fear)

with a new, more desirable behaviora. Systematic Desensitization – technique used to overcome irrational fears and

anxieties that patient has learneda) Encourages people to imagine a feared situation while relaxing thus

extinguishing the fear response.b. Flooding – therapist exposes the client to a feared object or situation c. Modeling – therapist models/demonstrates behaviord. Aversive Conditioning – links an unpleasant state with an unwanted behavior in an

attempt to eliminate that behaviorii. Operant Conditioning

a. Based on the assumption that behavior that is reinforced tends to be repeated, whereas behavior that isn’t reinforced tends to be extinguished

b. Contingency Management – therapist and patient decide what old, undesirable behavior needs to be eliminated and which new, desirable behavior needs to appear.a) Old behavior is unrewarded and desired behavior is positively reinforcedb) If you do X, I will give you Y

c. Token Economies – desirable behavior is reinforced with valueless objects or points, which can be accumulated and exchanged for various rewards

3. Cognitive-Behavior Therapy – based upon a combination of substituting healthy thoughts for negative thoughts and beliefs and changing disruptive behaviors in favor of healthy behaviors

Section 3 Review

Watch “One Flew Over the Cuckoo’s Nest” and complete Worksheet

1. Biological Therapyi. Assumes that there is an underlying physiological reason for disturbed behavior,

faulty thinking and inappropriate emotionsii. Medication, shock therapy and surgery are examplesiii. Psychologists may decide that a biological approach is necessary but a

physician or psychiatrist administer them

a. Drug Therapy – biological therapy that uses medicationsi. Usually only treats the symptoms but doesn’t cure the cause

iii. Anti-Depressant Drugs – medication used to treat major depression by increasing the amount of one or both of the neurotransmitters noradrenaline and serotonin

a) Side effectsi. Dizziness, fatigue, forgetfulness, weight gain

b) Best Knowni. Nadril, Prozac

iv. Lithium Carbonate – Chemical used to counteract mood swings of bipolar disorder (natural compound)

v. Anti-Anxiety Drugs – Medication that relieves anxiety and panic disorders by depressing the activity of the central nervous system

a) Best used for acute not chronic anxietyb) Side effects

i. Short term – drowsinessii. Long term – dependence and with alcohol death results

c) Best Knowni. Xanax, Librium, Valium

2. Electroconvulsive Therapy – electrical shocks sent through the brain to try to reduce symptoms of mental disturbancei. No one understands how it works, it induces a convulsion like an epileptic

seizure that may last up to a minuteii. Used lots in the past iii. Very little pain today due to sedatives and muscle relaxantsiv. Drastic treatment, used with great caution todayv. Current was run through both hemispheres of the brain, now only through

the right hemispherevi. Side effects

a. Extensive amnesiab. Language and verbal abilities

vii. Highly effective for depression

3. Insulin Shock Therapy– a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks.

4. Psychosurgery – medical operation that destroys part of the brain to make the patient calmer and freer of symptomsi. Prefrontal Lobotomy – section of the frontal lobe of the brain is destroyed

Contains the nerve connections that control emotions

Watch PBS Video on Dr. Walter Freeman

“Freeman developed the ice pick lobotomy in 1947. In the procedure, he put the sharp point of the pick in the tear duct. Then, with a light tap of a hammer, plunged it two inches inside, pulled it 30 degrees backward, and then moved it up and down in a 20 degree arc, in order to cut the nerves at the base of the frontal lobes. The procedure took only a few minutes. Within several years, the procedure had been preformed on over 20,000 individuals.”

Complete Section 4 Review

Complete Chapter 17 Study Guide

Chapter 17 Test