Continuing and Distance EducationIntroductory Psychology 1023

Lecture 7: Therapy

Reading: Chapter 15

Psychotropic drug therapies

• Antipsychotic drugs: Neuroleptics– Cloropromazine: Block’s dopamine reuptake– Reduce positive symptoms of schizophrenia

• Antidepressant drugs: MAO Inhibitors and SSRI tricylics (e.g., Prozac)– increase serotonin & norepinephrine in synapse

• Barbituates and Benzodiazepines– valium, librium: relax muscles and tranquilize– barbituates: CNS depressant, addictive, lethal

• Concerns: Placebo effect, relapse & dropout, dosage & side effects, latency & long term effects

Electroconvulsive therapy (ECT) in 1940s:

• 150 volts run through the head for 1-2 seconds– Can lead to memory loss, broken bones, still

used as “last resort” for depression– Today the patient is usually placed under

general anesthesia, paralysed with drugs, monitored and assisted with breathing.

Psychodynamic therapy approaches

• Patients improve once they become conscious of ego-threatening material

• Free association: Client says whatever comes to mind; Dream analysis

• Resistance is an impediment to progress

• Transference of feelings from significant others to therapist; Countertransference

Cognitive-Behavioral Approaches

• Clients change their behavior by changing their cognitions

• Goal: change how people think about things• Rational-emotive behavior therapy

– Cognition precedes emotion and irrational thoughts therefore cause emotional distress

– “I need to be a perfect student”

– Therapist needs to challenge irrational cognitions

Group therapy

• What group therapies are you aware of?

• Example: Parenting group

• Anger, Agoraphobia groups

• Advantages: Less expensive, group support, social pressure to change

• Disadvantages: Less intensive, conflicts within group, side-tracking

• Focus on teaching skills or support

Behavior therapy

• Treatment of symptoms, objective behaviors, scientific methods – single subject designs

• Counterconditioning: stimulus response is replaced by alternative response– Aversion therapy: e.g., anta-abuse – Systematic desensitization: Relaxation paired with

gradually more threatening images and experiences, e.g., dog phobia, sex therapy

Behavior therapy (continued)

• Extinction procedures, Exposure treatment– Flooding: Exposure to threatening stimuli, e.g., fear of

flying– Implosion therapy: Imagine you are confronted with very

threatening stimuli

• Operant conditioning– token economy: earned tokens based on a system of

rewards and punishers– behavioral contract: e.g., gain weight to earn privilege

• Specific Skills Training– Social skill, parenting programs, anger management

Treatment Effectiveness• Short-term treatment for common problems is usually sufficient• Psychotherapy better than doing nothing• Motivation, therapeutic alliance, and (lack of) severity are

related to effectiveness• Therapy can be harmful if

– therapist is out of realm of competence– has biases against person– is behaving unethically (e.g., sexual intimacies with clients used to be

common, now seen as a most serious breech of professional responsibility)

– Problems are induced such as false memories for trauma

Self-help

• Bibliotherapy: Self-help books from the bookstore

• Surf the net: You can join “chat lines” of people with similar problems

• Videotapes: How to parent, how to communicate, how to be assertive are at “Blockbuster”

• Lifestyle: General health and fitness improves mental health