Chapter 15

Therapy (text definition)

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

Therapy (common snese view)

helping people overcome problems and emotional distress by comforting, assisting, or advising them

Psychotherapy

Therapy for mental disorders in which a person with a problem talks with a psychological professional

Eclectic

A common word in the English language meaning "drawn from many sources". In the context of therapy, it is common for therapists to draw from several different theoretical perspectives to generate the maximum benefit to their clients.

Broad categories of Psychotherapy

-Biomedical therapies

-Insight therapies

-Cognitive therapies

-Action therapy

Biomedical therapies

in the form of medications to assist

Insight therapies

to help people gain insight into their behaviors, thoughts, and feelings

Cognitive therapies

to help correct dysfunctional types of thinking

Action therapy

to change dysfunctional behaviors directly

Insight therapies (Freud & Rogers & Perls)

-Sigmund Freud (#3) (1856 - 1939): Psychoanalysis

-Carl Rogers (#6) (1902 - 1987): Person-centered therapy

-Fritz Perls (1893 - 1970) the founder of Gestalt therapy

Psychoanalysis (Sigmund Freud)

-Free association

-Dream interpretation

-Resistance

-Transference

-Psychodynamic therapy

Free association (psychoanalysis)

the effort to externalize damaging material

Explore setting where it works and where it doesn't work well

Dream interpretation (psychoanalysis)

-Latent content

-Manifest content

Resistance (psychoanalysis)

The client often has difficulty opening up and sharing relevant information with the therapist

Transference (psychoanalysis)

For the client, feelings toward an individual in their life will be transferred to the therapist:

-Example: Love felt toward a former partner may be transferred to the therapist

Psychodynamic therapy (psychoanalysis)

a more modern version of psychoanalysis, more direct

Person-centered therapy (Carl Rogers)

-Non-directive

-Authenticity

-Unconditional positive regard VERSUS conditions of worth

-Reflection

-Empathy

-The dynamic of working with The Real Self and The Ideal Self

Non-directive (person-entered therapy)

-a style of therapy in which the therapist remains relatively neutral (without interpretation or direct action). Drives some people insane because it moves so slowly

-Carl Rogers is burdened with this title, but his mode of therapy was very much goal-directed. He would ask question to allow the client to come up with insights and answers through their own thought processes.

Authenticity (person-centered therapy)

The need to be absolutely genuine in interactions with clients

Unconditional positive regard VERSUS conditions of worth (person-centered therqapy)

Unconditional positive regard means that I accept the person unconditionally even if I disagree with their choices. Conditions of worth mean that you accept a person . . . IF. "if you are nice to me" "if you tidy up your act" "if you believe the same thing that I do."

reflection (person-centered therapy)

Responding to the individual in a way that they are reassured that they are heard.

Empathy (person-centered therapy)

be able to experience the other person's experiences. Think as they think, feel as they feel.

The dynamic of working with The Real Self and the Ideal Self (person-centered therapy)

In therapy identify the "real self", that is, where exactly are you in your journey? Then you explore the "ideal self" where you would like to be or the image you would like to progress toward. Notice in class the extremely shy person who wants to interact normally in a social setting.

Fritz Peris (1893-1970)

-the founder of Gestalt therapy

-Similar to person-centered therapy but much more directive. Focuses on self-awareness and integration of the entire person, warts and all.

Behavior therapies

Action therapies based on the principles of classical & operant conditioning plus modeling to achieve their objectives

Behvaior & Cognitive therapies (Skinner & Pavlov & Bandura)

-B. F. Skinner (#1) (1904 - 1990): Operant Conditioning

-Ivan Pavlov (#24) (1849 - 1936): Classical Conditioning

-Albert Bandura (#4) (1925 - 2021): Social Learning Theory

Operant conditioning (Skinner)

We are conditioned by the consequences of our behavior through reinforcement and punishment. In therapy systematically reward (for the desired behavior) or punish (for the negative behaviors) to effect permanent change

Classical conditioning (Pavlov)

We form associations that cue innate or previously-learned behavior. In therapy we work to form new associations that predict effective functioning. Can be used to eliminate the negative (Antabuse for alcoholics) and encourage positive (exercising is fun!) behaviors

Social Learning Theory (Bandura)

-Accepts both classical and operant conditioning but adds observational learning, more commonly known as modeling. In therapy providing models for appropriate behavior can be greatly beneficial to those observing.

-Systematic desensitization

-Flooding

-Cotingency contract

-Extinction

-Behavior activation

Systematic desensitization (Social learning theory)

-sometimes known as "exposure therapy"

-Used to overcome intense phobias of certain objects or situations:

-Complete relaxation

-Hierarchy of fear-inducing stimuli

-Inclusion of a vicarious component (modeling) as the client makes progress

-Models demonstrate the safety of the feared stimulus

flooding (social learning theory)

the client is immersed in the fear inducing stimuli and not allowed to make the usual escape. Clearly this needs to be handled by experts and performed with great caution

Contingency contract (social learning theory)

Contract with the therapist that rewards desirable behavior and/or punishes undesirable behavior. Black woman who wanted to kick her amphetamines addiction. She gave the therapist $1000 and every time she relapsed the therapist made a $50 contribution (out of her $1000) to the Ku Klux Klan.

Extinction (social learning theory)

example with children. Extinct negative behavior by systematic rewarding of positive and systematic punishment of negative behavior.

Behavior activation (social learning theory)

often used with depressives. Sitting there depressed is no solution. Often theraists will mandate certain daily activities to begin the move out of depression.

Cognitive Therapies (Beck & Ellis)

-The focus is on helping clients recognize distortions in their thinking and replacing distorted unrealistic beliefs with more realistic helpful thoughts

-Aaron Beck (1921 - 2021): Cognitive Therapy: focus on distortion of thinking

-Albert Ellis (1913 - 2007): Rational Emotive (Behavior) Therapy

Cognitive Therapy (Beck)

-Arbitrary inference

-selective thinking

-overgeneralization

-magnification/minimization

-personalization

Arbitrary inference (cognitive therapy)

Example: When a negative event occurs you always think it is your fault

Selective thinking (cognitive therapy)

Example: I focus on negative events and ignore positive events

Overgeneralization (cognitive therapy)

Example: If I do poorly on one test assume that I will do badly on all tests.

Magnification/minimization

Example: I magnify the insult someone gave me and pay no attention to the reality that I am blessed in a thousand ways: I can see, I can hear, I am healthy, I live in a free country, etc.

Personalization (cognitive therapy)

Example: Alabama loses to Georgia and I think it is my fault because I wasn't at the game to cheer them on.

Rational Emotive (Behavior) Therapy (Ellis)

-Similar in content to Aaron Beck but Ellis was much more directive (even abrasive) in how he drew client's attention to these dysfunctional forms of thinking.

Rational Emotive (Behavior) Therapy Example

-Woman who just experienced a devastating divorce comes to Ellis for counseling. These might be characteristic responses by Ellis to the woman:

Ellis: How do you feel?

Woman: absolutely devastated and in despair (the woman has stated an accurate reality)

Ellis: I know it has been really difficult

Ellis: How do you feel about your future?

Woman: I'll be scarred for life (the woman has created a self-fulfilling prophecy if she continues to hold that opinion)

Ellis: Get a grip, lady. You will be scarred for life if you choose to be and obsess about it every day. Then, you choose to grow and become a better person and live a magnificent life. It is a matter of your choices.

Ellis: How do you feel about men?

Woman: They are scum, a plague (the woman has created a self-fulfilling prophecy if she continues to hold that opinion)

Ellis: You were hurt badly by one man. There are evil men and wonderful men, just as there are evil women and wonderful women. While things are still raw it would probably be helpful to minimize contact with men. When the time is right you will re-establish relationships with others, regardless of gender.

Group therapies examples

-family counseling

-self-help groups

Family counseling (group therapy)

Sometimes the family dynamic is neurotic and a therapist must work with the entire family to resolve their dysfunctional interactive behavior.

Self-help groups (group therapy)

-Different settings of groups: Groups can be used for everything from learning better study techniques to resolving serious psychiatric disorders.

-Different objectives: As the setting for different groups varies, so the objectives will reflect those settings. Example: study more effectively; overcome depression; improve relationships