therapeutic approaches class 12 psychology cbse

Psychotherapy is a voluntary relationship between the one seeking treatment or the

client and the one who treats or the therapist.

1. Purpose: To help the client to solve the psychological problems being faced by her or him.

2. Aim: To change the maladaptive behaviours, decrease the sense of personal distress, and help the client to adapt better to his/her environment.

3. The relationship is conducive for building the trust of the client so that problems may be freely discussed.

Characteristics:

1. There is systematic application of principles underlying the different theories of therapy.

2. Only persons who have received practical training under expert supervision can practise psychotherapy.

3. The situation involved a therapist and client who seeks and receives help for his/her emotional problems (this person is the focus of attention in the therapeutic process).

4. The interaction of the therapist and the client results in the consolidation or formation of the therapeutic relationship. This is a confidential, interpersonal, and dynamic relationship.

Goals:

(i) Reinforcing client’s resolve for betterment.

(ii) Lessening emotional pressure.

(iii) Unfolding the potential for positive growth.

(iv) Modifying habits.

(v) Changing thinking patterns.

(vi) Increasing self-awareness.

(vii) Improving interpersonal relations and communication.

(viii) Facilitating decision-making.

(ix) Becoming aware of one’s choices in life.

(x) Relating to one’s social environment in a more creative and self-aware manner.

Therapeutic Relationship:

The special relationship between the client and the therapist is known as the therapeutic

relationship or alliance.

Components:

1. Contractual Nature of the Relationship: Two willing individuals, the client and the therapist, enter into a partnership which aims at helping the client overcome his/ her problems.

2. Limited Duration of the Therapy: This alliance lasts until the client becomes able to deal with his/her problems and take control of his/her life.

Properties:

(i) It is a trusting and confiding relationship.

(ii) The high level of trust enables the client to unburden herself/himself to the therapist and confide her/his psychological and personal problems to the latter.

Classification of Psychotherapies

B. BEHAVIOUR THERAPY

• Focused on the behaviour and thoughts of the client in the present.

• The past is relevant only to the extent of understanding the origins of the faulty behaviour and thought patterns, not relieved.

• Behaviour therapies are clinical application of learning theories.

• Consists of a large set of specific techniques and interventions—symptoms of the client and the clinical diagnosis are the guiding factors in the selection of the specific techniques or interventions to be applied.

• Open therapy, i.e., the therapist shares his/her method with the client.

Method of Treatment:

(i) The client is interviewed with a view to analyse his/her behaviour patterns.

(ii) Behavioural analysis is conducted to find:

(a) Malfunctioning Behaviours: Behaviours which cause distress to the client.

(b) Antecedent Factors: Those causes which predispose the person to indulge in that behaviour

(c) Maintaining Factors: Those factors which lead to the persistence of the faulty behaviour.

(iii) Aim: To eliminate the faulty behaviours and substitute them with adaptive behaviour patterns.

(a) Antecedent Operations: Control behaviour by changing something that precedes such a behaviour.

(b) Establishing Operations: Induce a change in behaviour by increasing or decreasing the reinforcing value of a particular consequence.

(c) Consequent Operation: i.e., Giving reinforcement eg. Praise.

Behavioural Techniques:

1. Negative Reinforcement: Following an undesired response with an outcome that is painful or not liked.

2. Aversive Conditioning: Repeated association of undesired response with an aversive consequence present reality.

3. Positive Reinforcement: Given to increase the deficit if an adaptive behaviour occurs rarely.

4. Token Economy: Give a token as a reward every time a wanted behaviour occurs, which can be collected and exchanged for a reward.

5. Differential Reinforcement: Unwanted behaviour can be reduced (negative reinforcement) and wanted behaviour (positive reinforcement) can be increased simultaneously.

The other method is to positively reinforce the wanted behaviour and ignore the unwanted behaviour—less painful and equally effective.

6. Systematic Desensitization: A technique introduced by Wolpe for treating phobias or irrational fears.

(i) The client is interviewed to elicit fear provoking situations.

(ii) With the client, the therapist prepares a hierarchy of anxiety—provoking stimuli with the least anxiety-provoking stimuli at the bottom.

(iii) The therapist relaxes the client and asks the client to think about the least anxiety-provoking situation.

(iv) The client is asked to stop thinking of the situation if tension is felt.

(v) Over sessions, the client is able to imagine more severe fear provoking situations while maintaining the relaxation.

(vi) The client gets systematically desensitized to the fear.

Operates on the principle of reciprocal inhibition—the presence of two mutually opposing forces (relaxation response vs. anxiety-provoking scene) at the same time, inhibits the weaker force.

The client is able to tolerate progressively greater levels of anxiety because of his/her relaxed state.

7. Modelling: The procedure wherein the client learns to behave in a certain way by observing the behaviour of a role model or the therapist who initially acts as the rok; model. Vicarious learning, learning by observing others, is used and through a process of rewarding small changes in the behaviour, the client gradually learns to acquire the behaviour of the model.

C. COGNITIVE THERAPY

1. Rational Emotive Therapy (RET) (Albert Ellis):

• Irrational beliefs mediate between the antecedent events and their consequences.

• The first step in RET is the antecedent-belief-consequence (ABC) analysis.

Antecedent events, which caused the psychological distress, are noted.

(ii) Client is interviewed to find out irrational beliefs, which distorting the

(iii) The therapist encourages this by being accepting, empathic, genuine and warm to the client.

(iv) The therapist conveys by his/her words and behaviours that he/she is not judging the client and will continue to show the same positive feelings towards the client even if the client is rude or confides all the ‘wrong’ things that he/she may have done or thought about. This is the unconditional positive regard which the therapist has for the client.

The clinical formulation is an ongoing process. Formulations may require reformulations as clinical insights are gained in the process of therapy. Distorted perception of the antecedent event due to the irrational belief leads to the consequence, i.e., negative emotions and behaviours.

• Non-directive questioning: Process by which irrational beliefs are refuted by the therapist.

(i) Nature of questioning is gentle, without probing or being directive.

(ii) Make the client think deeper into his/her assumptions about life and problems.

• Client changes the irrational beliefs by making a change in his/her philosophy about life—rational belief system replaces the irrational belief system.

2. Aaron Beck’s Cognitive Therapy:

(i) Childhood experiences provided by the family and society develop core schemes or systems, which include beliefs and action patterns in the individual.

(ii) Critical events in the individual’s life trigger the core, leading to the development of negative automatic thoughts.

(iii) Negative thoughts are persistent irrational thoughts characterised by cognitive distortions.

(iv) Dysfunctional Cognitive Structures: Patterns of thought which are general in nature but which distort the reality in a negative manner.

(v) Repeated occurrence of these thoughts leads to the development of feelings of anxiety and depression.

• The therapist uses questioning, which is gentle, non-threatening disputation of the client’s beliefs and thoughts.

• The questions make the client think in a direction opposite to that of the negative automatic thoughts whereby she/he gains insight into the nature of her/his dysfunctional schemas, and is able to alter her/his cognitive structures.

3. Cognitive Behaviour Therapy (CBT):

• Short, comprehensive, effective treatment for a wide range of psychological disorders such as anxiety, depression, panic attacks and borderline personality.

• Adopts a biopsychosocial approach to the delineation of psychopathology.

• Combines cognitive therapy with behavioural techniques.

• Rationate—distress has its origins in the biological, psychological, and social realms.

• Addresses the biological (relaxation procedures), psychological (behaviour and cognitive therapy) and social (environmental manipulations) aspects.

D. Humanistic-Existential Therapy

Self-actualizationn is defined as an innate force that moves the person to become more complex, balanced, and integrated; integrated means a sense of whole, being a complete person.

1. Self-actualization requires free emotional expression:

(a) The family and society curb emotional expression, as it is feared that a free expression of emotions can harm society by unleashing destructive forces.

(b) When emotionally expression is curbed, destructive behaviour and negative emotions by thwarting the process of emotional integration.

2. Healing occurs when the client is able to perceive the obstacles to self-actualization in his/her life and is able to remove them.

3. Therapy creates a permissive, non-judgemental and accepting atmosphere in which the client’s emotions can be freely expressed.