Humanistic-Existential Therapies

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Cognitive Therapies

Behavior TherapyBehavior Therapy

Group, Couples, and Family Group, Couples, and Family TherapyTherapyEffectiveness of Psychotherapy

Psychodynamic TherapiesPsychodynamic Therapies

Psychotherapy and Human Psychotherapy and Human DiversityDiversityBiomedical Therapies

AdjustmentAdjustment

What is Psychotherapy?What is Psychotherapy?

A systematic interaction between a therapist and a client that brings

psychological principles to bear on influencing the client’s thoughts, feelings, or behavior to help that

client overcome abnormal behavior or adjust to problems in living.

Essentials of PsychotherapyEssentials of Psychotherapy

• Systematic Interaction: Psychotherapy is a systematic interaction between a client and a therapist. The therapist structures the therapy process based upon a theoretical viewpoint and an understanding of the client’s cultural and social background.

• Psychological Principles: Psychotherapy is based on psychological theory and research in various areas such as personality, learning and abnormal behavior.

• Thoughts, feelings and behaviors: Psychotherapy influences clients’ thoughts, feelings and behavior.

• Psychological Disorders, adjustment problems, and personal growth: While psychotherapy is often used with people who have psychological disorders, it can also be used to help people with adjustment (loss of spouse, shyness) and personal growth.

Psychodynamic TherapiesPsychodynamic Therapies

Psychodynamic TherapyPsychodynamic Therapy

• Psychodynamic theories are based on the thinking of Sigmund Freud, the founder of psychodynamic theory.

• Focus upon the conflict amongst the there psychic structures (id, ego and superego).

• Freud’s method of therapy, psychoanalysis, was the first psychodynamic therapy.

PsychoanalysisPsychoanalysis• Psychoanalysis seeks to help people

develop insight into the dynamic struggles occurring within the psyche between the three psychic structures.

• The goal is to bring conflicts between the psychic structures into conscious awareness and “work through” them.

Psychoanalysis Terms and Psychoanalysis Terms and TechniquesTechniques

• Free Association: In psychoanalysis, the uncensored uttering of all thoughts that come to mind.

• Resistance: The tendency to block the free expression of impulses and primitive ideas—a reflection of the defense mechanism of repression.

• Interpretation: An explanation of a client’s utterance according to psychoanalytic theory.

Psychoanalysis Terms and Psychoanalysis Terms and TechniquesTechniques

• Transference: Responding to one person (such as a spouse or the psychoanalyst) in a way that is similar to the way one responded to another person (such as a parent) in childhood.

• Dream Analysis: Freud believed that unconscious impulses tend to be expressed in dreams as a form of wish fulfillment. Dreams consist of both manifest (the reported content) content and latent (the symbolized or underlying meaning) content.

Humanistic-Existential TherapiesHumanistic-Existential Therapies

Client-Centered TherapyClient-Centered Therapy

• Client-centered therapy: Carl Rogers’s method of psychotherapy, which emphasizes the creation of a warm, therapeutic atmosphere that frees clients to engage in self-exploration and self-expression.

• Frame of Reference: One’s unique patterning of perceptions and attitudes, according to which one evaluates events.

• An effective client-centered therapist has several qualities: Unconditional positive regard (unconditional respect for clients regardless of their behavior), Empathic understanding (accurate recognition of the client’s experiences and feelings) and Genuineness (open expression of the therapist’s own feelings)

Gestalt TherapyGestalt Therapy

• Gestalt Therapy: Fritz Perls’s form of psychotherapy, which attempts to integrate conflicting parts of the personality through directive methods designed to help clients perceive their whole selves.

• Gestalt exercises include The dialogue (client undertakes verbal confrontations between opposing wishes and ideas to heighten awareness of internal conflict), I take responsibility (clients end statements about themselves by adding, “and I take responsibility for it”) and Playing the projection (clients role-play people with whom they are in conflict).

Behavior TherapyBehavior Therapy

Behavior TherapyBehavior Therapy

• Behavior Therapy: Systematic application of the principles of learning to the direct modification of a client’s problem behaviors.

• Behavior therapists draw upon the principles of classical and operant conditioning as well as observational learning.

Behavior Therapy Behavior Therapy (Fear Reduction Methods)(Fear Reduction Methods)

• Flooding: A person is exposed for prolonged intervals to a fear-evoking but harmless stimulus until fear is extinguished.

• Gradual exposure: Similar to flooding, but works upward in a hierarchy of progressively more fearful stimuli.

• Systematic Desensitization: Wolpe’s method for reducing fears by associating a hierarchy of images of ear-evoking stimuli with deep muscle relaxation.

• Modeling: A technique in which a client observes and imitates a person who approaches and copes with feared objects or situations.

Behavior Therapy Behavior Therapy (Aversive Conditioning)(Aversive Conditioning)

• Aversive Conditioning: A behavior therapy technique in which stimuli associated with undesired responses become aversive by pairing noxious stimuli with them. An example would be rapid smoking.

• Rapid Smoking: An aversive conditioning method for quitting smoking in which the smoker inhales every 6 seconds, thus rendering once-desirable cigarette smoke undesireable.

Behavior Therapy Behavior Therapy (Operant Conditioning Principles)(Operant Conditioning Principles)

• The Token Economy: A controlled environment in which people are reinforced for desired behaviors with tokens (such as poker chips) that may be exchanged for later privileges.

• Social Skills Training: Behavior therapists help people alleviate social anxiety and build social skills through having participants rehearse social behaviors in a group setting.

• Biofeedback Training: The systematic feeding back to an organism of information about a bodily function so that the organism can gain control of that function.

Cognitive TherapiesCognitive Therapies

Cognitive TherapiesCognitive Therapies

• Cognitive therapists focus on helping people change the beliefs, attitudes and automatic types of thinking that are believed to underlie psychological problems such as anxiety and depression.

• The two most common cognitive therapies are Aaron Beck’s cognitive therapy and Albert Ellis’s rational-emotive behavior therapy.

Cognitive TherapiesCognitive Therapies

• Beck’s Cognitive Therapy: A form of therapy that focuses on how clients’ cognitions (expectations, attitudes, beliefs, etc.) lead to distress and may be modified to relieve distress and promote adaptive behavior.

• Ellis’s Rational-emotive Behavior Therapy (REBT): A form of therapy that encourages clients to challenge and correct irrational expectations and maladaptive behaviors.

Convergence of ApproachesConvergence of Approaches

• Today, many therapists don’t adhere to a single approach.

• As the graph shows, many therapists utilize an eclectic approach.

• These therapists tend to be older and more experienced.

Group, Couples and Group, Couples and Family TherapiesFamily Therapies

Group TherapyGroup Therapy• When a therapist has several clients with similar problems, it often

makes sense to treat them together in a group rather than individually. Group therapy has several advantages:

• It’s economical. Therapists can work with several clients at once.

• It can provide more information and life experience for clients to draw upon.

• Appropriate behavior receives support from the group.

• Affiliating with people with similar problems is reassuring that we’re not alone.

• Group members who improve provide hope for other group members,.

• Group therapy can help those who are seeking therapy because of problems in relating to other people.

Couples TherapyCouples Therapy

• Couples therapy focuses on helping distressed couples resolve their conflicts and improve their communication skills.

• Couples therapy helps correct power imbalances in the relationship so that partners can explore alternative ways of relating to one another.

• The leading contemporary approach to couples therapy is based on cognitive-behavioral principles.

Family TherapyFamily Therapy

• A form of therapy in which the family unit is treated as the client.

• In a systems approach to family therapy, the therapist helps the family change the system by which the family functions in order to enhance growth of individual family members and of the family as a whole.

Effectiveness of Effectiveness of PsychotherapyPsychotherapy

Effectiveness of PsychotherapyEffectiveness of Psychotherapy

• There are several problems that researchers must address when evaluating the effectiveness of psychotherapy. These problems include comparing different forms of psychotherapy, measuring outcomes of therapy and determining whether effectiveness is due to nonspecific factors or the therapeutic alliance. However…

• Meta-analyses by Smith and Glass (1977) and Shadish (2000) have found that psychotherapy is effective.

• Smith and Glass: Those who receive psychodynamic therapy showed better results, on average, than 70-75% of those who did not receive treatment. Similarly, nearly 75% of those who received client-centered therapy were better off than control groups.

Psychotherapy and Psychotherapy and Human DiversityHuman Diversity

Psychotherapy and Human DiversityPsychotherapy and Human Diversity

• In general: Psychotherapists must attend to and respect their client’s sociocultural and individual differences. Therapists must also recognize their own ethical responsibilities if they are not comfortable with, or lack the skills to work with, a particular client.

Psychotherapy and Ethnic Psychotherapy and Ethnic Minority GroupsMinority Groups

• African Americans: African Americans are often reluctant to seek psychological help because of cultural assumptions that people should manage their own problems. African Americans may also be suspicious of their therapists (especially if the therapist is European American).

• Asian Americans: Asian Americans tend to stigmatize people with psychological disorders. As a result, they may deny problems and refuse to seek help. Also, recent immigrants may not believe in, or understand western approaches.

• Latino and Latina Americans: Therapists need to be aware of the potential conflicts between the traditional Latino and Latina American value of interdependency in the family and the typical European American belief in independence and self-reliance.

• Native Americans: Many psychological disorders experienced by Native Americans involve the disruption of their traditional culture. This loss of identity has lead to several problems (such as alcoholism). Therapists who wish to help, must be sensitive to Native American culture, customs and values.

Feminist Psychotherapy and Psychotherapy Feminist Psychotherapy and Psychotherapy for Gay Males and Lesbians.for Gay Males and Lesbians.

• Feminist Psychotherapy: An approach to therapy rooted in feminist theory and philosophy. Feminist therapists note that many women experience depression and other psychological problems as a result of being treated as second class citizens.

• Therapy for Gay Males and Lesbians: Some therapists may be uncomfortable with the sexual orientation of their clients. Also, some gays and lesbians seek therapy to change their sexual orientation which raises the question: “Is it ethical to try to change sexual orientation?”

Biomedical TherapiesBiomedical Therapies

Biomedical TherapiesBiomedical Therapies

• Biomedical therapies are administered by doctors, such as psychiatrists. The three primary forms of biomedical therapy are drug therapy, electroconvulsive therapy and psychosurgery.

Drug TherapyDrug Therapy

• Psychotropic Drugs: Prescription drugs that are widely used to help relieve disturbing emotional states, such as anxiety or depression, or to control symptoms of severe disorders.

• There are three major classes of psychotropic drugs: antianxiety, antipsychotic, and antidepressants.

Drug TherapyDrug Therapy

• Antianxiety: Most antianxiety drugs belong to the chemical class known as benzodiazapenes. Common drugs include Valium and Xanax. These drugs depress the activity of the central nervous system. Many people quickly develop a tolerance to antianxiety drugs.

• Antipsychotic: Are a group of drugs that help relieve psychotic symptoms. These drugs are believed to act by blocking dopamine receptors in the brain.

• Antidepressants: A group of drugs that primarily help relieve depression, but also are used to treat obsessive-compulsive disorder, bulimia and panic disorder amongst others. Three major classes include Monoamine Oxidase (MAO) inhibitors (such as Nardil), Tricyclics (such as Tofranil) and Selective Serotonin-Reuptake Inhibitors (SSRIs) such as Prozac and Zoloft.

Electroconvulsive Therapy (ECT)Electroconvulsive Therapy (ECT)

• Treats disorders like major depression by passing an electric current (that causes a convulsion) through the head.

• People usually receive ECT in a series of 6 to 12 treatments spread over several weeks.

• Problems with ECT include potential memory loss and high relapse rates.

PsychosurgeryPsychosurgery

• Surgery intended to promote psychological changes or to relieve disordered behavior.

• Prefrontal Lobotomy: The severing or destruction of part of the frontal love of the brain.

• Prefrontal lobotomy is no longer practiced due to the multiple side effects.

Evaluating Biomedical TherapiesEvaluating Biomedical Therapies

• The introduction of antipsychotic drugs made it possible for hundreds of thousands of mental hospital patients to return home.

• However, psychiatric drugs are not a cure all. They can have troubling side effects.

• Also, psychotherapy has been found to be as effective (if not more so) than drug therapies for certain disorders (such as depression).

• Ultimately, a combination of psychotherapy and biomedical treatment may be the best course of action.

Coping with Emotional Coping with Emotional Responses to StressResponses to Stress

Coping with Anxiety and FearCoping with Anxiety and Fear

• 1. Define the feared object or situation.

• 2. List specific behaviors that make up a gradual approach of the target.

• 3. Create a hierarchy of fears.

• 4. Utilize gradual exposure, starting with the least threatening item of your hierarchy.

• 5. Pay attention to your cognitions.

Managing AngerManaging Anger

• Monitor your reactions in angering situations.• Stop and think• Practice competing responses and competing

thoughts.• Practice self-relaxation.• Don’t impose unrealistic expectations on others.• Replace anger with empathy.• Depersonalize the situation.• Keep your voice down.• Act assertively, not aggressively.• Express positive feelings.• Give yourself a pat on the back for keeping your cool.

Lifting your MoodLifting your Mood

• Engage in pleasant activities: Utilizing the list in your book, engage in at least three of these events each day. Record your activities in a diary and toward the end of each day, rate your response to each activity. After a week or so, check the items in your diary that received positive ratings and repeat successful activities while experimenting with new ones.

• Think Rationally: Recognize and change distorted thoughts into rational thoughts.

• Exercise: Exercise can enhance psychological well-being and help us cope with depression.

To the Instructor:To the Instructor:

• The preceding slides are intended to provide you a base upon which to build your presentation for Chapter 9 of Nevid’s Psychology and the Challenges of Life.

• For further student and instructor resources including images from the textbook, quizzes, flashcard activities and e-Grade plus, please visit our website: www.wiley.com/college/nevid

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