Myers Unit 13: Treatment of Abnormal Behavior
Psychotherapy
treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth.
Goal oriented: Psychotherapy typically involves setting specific, measurable goals for therapy and working towards achieving these goals over the course of treatment.
Therapeutic Relationship: the client and patient must develop a trusting, healthy relationship
Focus on Psychological Processes: Psychotherapy focuses on understanding and addressing psychological processes, such as thoughts, emotions, behaviors, and interpersonal relationships.
social statues, culture, and gender all can affect the likelihood of someone seeking treatment
(talk therapy)
Biomedical therapy
prescribed medications or procedures that act directly on the person’s physiology.
Example:
A person with severe depression may receive antidepressants, electroconvulsive shock therapy (ECT), or deep-brain stimulation.
Eclectic Approach
an approach to psychotherapy that uses techniques from various forms of therapy.
A mixture of psychotherapy and biomedical therapy
No-Wrong-Door Model
a system ensuring individuals receive appropriate mental health services regardless of the entry point, promoting access and continuity of care.
Sigmund Freud
Father of psychoanalysis, developed theories on the unconscious mind, dream interpretation, and the role of sexuality in human behavior.
Psychosexual Stages of Development
the childhood stages of development (oral, anal, phallic, latency, genital) during which, according to Freud, the id’s pleasure-seeking energies focus on distinct erogenous zones.
Psychoanalysis
Sigmund Freud’s therapeutic technique. Freud believed the patient’s free associations, resistances, dreams, and transferences—and the therapist’s interpretations of them—released previously repressed feelings, allowing the patient to gain self-insight.
Goal: achieve healthier, less anxious living by releasing the energy they had previously devoted to id-ego-superego conflicts
Ideology: We repress threatening things we don’t want to know. Psychoanalysis was the method for helping people to bring these repressed feelings into conscious awareness. By helping them reclaim their unconscious thoughts and feelings, and by giving them insight into the origins of their disorders, the therapist (analyst) could help them reduce growth-impeding inner conflicts.
Technique and Methodology:
Patient is lying on couch relaxing
The psychoanalyst, who sits out of line of vision, asks to say aloud whatever comes to mind.
Soon patient notice how often they edit their thoughts as they speak. (resistance)
The analyst will note your resistance and then provide insight into its meaning. (interpretation)
Free Association
in psychoanalysis, a method of exploring the unconscious in which the person relaxes and says whatever comes to mind, no matter how trivial or embarrassing.
Resistance
in psychoanalysis, the blocking from consciousness of anxiety-laden material.
Interpretation
in psychoanalysis, the analyst’s noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight.
Transference
in psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent).
Example:
Let's say a client, Sarah, grew up with a critical and emotionally distant father. Throughout therapy sessions, Sarah finds herself becoming increasingly frustrated with her therapist, Dr. Jones, whenever he challenges her thoughts or behaviors. She notices that she starts to feel defensive and angry during these moments, even though Dr. Jones is offering support and guidance in a caring manner.
In this scenario, Sarah's feelings of frustration and defensiveness toward Dr. Jones may stem from her unresolved issues with her father. She may be projecting her father's critical and distant behavior onto Dr. Jones, leading her to react to the therapist as if he were her father.
Psychodynamic Therapy
therapy deriving from the psychoanalytic tradition; views individuals as responding to unconscious forces and childhood experiences, and seeks to enhance self-insight.
Some key differences between psychodynamic and psychoanalytic therapy:
Psychodynamic therapy may involve fewer sessions per week, often ranging from once to twice weekly.
Psychodynamic therapy also explores unconscious processes but may be less intensive and directive than psychoanalysis.
In the psychodynamic therapy the therapeutic relationship is also important, but the therapist may take a more active and supportive role. The therapist may offer empathy, validation, and encouragement, while also exploring the client's internal experiences and relational patterns.
Psychodynamic therapy has evolved to incorporate a broader range of theoretical perspectives and therapeutic techniques
(You don’t need to name the differences, but essentially psychodynamic therapy is an evolved version of psychoanalytic)
Interpersonal Therapy
therapy that focuses on improving relationships and communication skills to help individuals manage their mental health issues.
Humanistic Therapy
approach to psychotherapy that emphasizes the individual's capacity for self-awareness, self-growth, and self-actualization.
Methodology:
Aim to boost people’s self-fulfillment by helping them grow in self-awareness and self-acceptance.
Promoting this growth, not curing illness, is the therapy focus. Thus, those in therapy have become “clients” or just “persons” rather than “patients”
The path to growth is taking immediate responsibility for one’s feelings and actions, rather than uncovering hidden determinants.
Conscious thoughts are more important than the unconscious.
The present and future are more important than the past. Therapy thus focuses on exploring feelings as they occur, rather than on achieving insights into the childhood origins of those feelings.
Client-Centered Therapy
a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within an accepting, genuine, empathic environment to facilitate clients’ growth. (Also called person-centered therapy.)
Methodology:
Creating a Therapeutic Relationship: The therapist establishes a warm, empathetic, and nonjudgmental relationship with the client.
Active Listening: The therapist practices active listening, paying close attention to the client's verbal and nonverbal communication.
Empathetic Understanding: The therapist seeks to deeply understand the client's subjective experience, emotions, and perspectives helping the client feel validated
Unconditional Positive Regard: The therapist accepts them without judgment or evaluation. This fosters a sense of safety and trust in the therapeutic relationship, allowing the client to explore their thoughts and feelings openly.
Facilitating Self-Exploration: The therapist encourages the client to explore their thoughts, feelings, and experiences more deeply. This may involve asking open-ended questions, exploring areas of conflict or confusion, and encouraging the client to express themselves authentically.
Empowering the Client: Client-centered therapy emphasizes the client's autonomy and self-direction. The therapist supports the client in identifying their own goals, values, and aspirations, and encourages them to take ownership of their own growth and healing process.
Reflecting and Summarizing: Throughout the therapy session, the therapist provides reflections and summaries of the client's experiences, helping to clarify and deepen their understanding. This feedback loop allows the client to gain insight into their own thoughts and feelings.
Gestalt Therapy
humanistic approach to therapy that focuses on the present moment and emphasizes personal responsibility, awareness, and the integration of thoughts, feelings, and behaviors.
Insight Therapies
therapies that aim to improve psychological functioning by increasing a person’s awareness of underlying motives and defenses.
Active Listening
empathic listening in which the listener echoes, restates, and clarifies. A feature of Rogers’ client-centered therapy.
Three Components:
Reflective technique
Listener orientation
Questioning skills
Unconditional Positive Regard
a caring, accepting, nonjudgmental attitude, which Carl Rogers believed would help clients develop self-awareness and self-acceptance.
Behavior Therapy
therapy that applies learning principles to the elimination of unwanted behaviors.
Counterconditioning
behavior therapy procedures that use classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; include exposure therapies and aversive conditioning.
Example:
Let's say someone has a phobia of dogs (cynophobia) and experiences intense fear and anxiety whenever they encounter a dog. Through systematic desensitization, the therapist helps the individual gradually learn to associate dogs with relaxation and calmness instead of fear.
Establishing a Hierarchy of Fear: The therapist works with the individual to create a hierarchy of fear, ranking situations involving dogs from least to most anxiety-provoking. For example, seeing a picture of a dog might be the least anxiety-provoking, while being in close proximity to a dog might be the most anxiety-provoking.
Learning Relaxation Techniques: Before exposure to the feared stimulus (dogs), the individual learns relaxation techniques such as deep breathing, progressive muscle relaxation, or visualization. These techniques help the individual to induce a state of relaxation and calmness.
Exposure to Gradual Desensitization: The individual is gradually exposed to situations involving dogs, starting with the least anxiety-provoking scenarios from the hierarchy. For example, they might begin by looking at pictures of dogs while practicing relaxation techniques. Once they can do this without experiencing significant anxiety, they move on to more challenging situations, such as being in the presence of a small, calm dog.
Pairing Exposure with Relaxation: During each exposure, the individual practices relaxation techniques to counteract feelings of fear and anxiety. By repeatedly pairing the presence of dogs with a relaxed state, the individual learns to associate dogs with relaxation instead of fear.
Reinforcement and Practice: Successful exposures are reinforced with positive reinforcement, such as praise or rewards, to strengthen the new association between dogs and relaxation. The individual continues to practice exposure exercises until they can comfortably tolerate being around dogs without experiencing significant anxiety.
Exposure Therapies
behavioral techniques, such as systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imaginary or actual situations) to the things they fear and avoid.
Systematic Desensitization
a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias.
You cannot simultaneously be anxious and relaxed. Therefore, if you can repeatedly relax when facing anxiety-provoking stimuli, you can gradually eliminate your anxiety.
Virtual Reality Therapy
a counterconditioning technique that treats anxiety through creative electronic simulations in which people can safely face their greatest fears, such as airplane flying, spiders, or public speaking.
Aversive Conditioning
a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol).
Example:
A mother makes her kid smoke a pack of cigarettes so they’ll grow disgusted and not want to smoke anymore
O.H. Mowrer
Developed the Two-Factor Theory of classical conditioning therapy, which combines both classical and operant conditioning techniques to treat phobias.
Mary Cover Jones
Behavior therapist known for her work in desensitization therapy, particularly with a child named Peter.
John Wolpe
South African psychiatrist known for developing systematic desensitization, a form of behavior therapy used to treat phobias and anxiety disorders.
Token Economy
an operant conditioning procedure in which people earn a token for exhibiting a desired behavior and can later exchange tokens for privileges or treats.
Example:
Imagine a fifth-grade classroom where the teacher wants to promote positive behavior and academic engagement among students. The teacher decides to implement a token economy system to reinforce desired behaviors and create a more positive learning environment.
Token System Setup: The teacher introduces a token system where students can earn "tokens" for demonstrating ‘good’ behaviors.
Behavior Monitoring: Throughout the day, the teacher observes students' behavior and provides immediate feedback and reinforcement. Whenever a student demonstrates a desired behavior, such as raising their hand to ask a question or assisting a peer with a task, they receive a token as a reward.
Token Exchange: At the end of the day or week, students have the opportunity to exchange their tokens for rewards or privileges. The teacher creates a menu of rewards that students can "purchase" using their tokens, such as extra recess time, choosing a preferred activity, sitting in a special seat, or receiving a small prize or privilege.
The teacher consistently reinforces desired behaviors by consistently rewarding students with tokens when they occur. The token economy system is implemented consistently and fairly, ensuring that all students have equal opportunities to earn tokens and rewards, improving the amount of desired behaviors overtime
Controversy
Will people become so dependent on extrinsic rewards that the desired behaviors will stop when reinforcers stop?
Is it right for one human to control another’s behavior?
Time Out
Response Cost
Positive Reinforcement
increasing behaviors by presenting positive reinforcers. A positive reinforcer is any stimulus that, when presented after a response, strengthens the response.
Cognitive Therapy
therapy that teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions.
Belief that the person’s emotional reactions are produced not directly by the event but by the person’s thoughts in response to the event.
Rational Emotive Behavioral Therapy
a confrontational cognitive therapy, developed by Albert Ellis, that vigorously challenges people’s illogical, self-defeating attitudes and assumptions.
Change people’s thinking by revealing the “absurdity” of their self defeating ideas, the sharp-tongued Ellis believed, and you will change their self-defeating feelings and enable healthier behaviors.
Aaron Beck’s Therapy for Depression
focuses on identifying and changing negative thought patterns to alleviate symptoms and improve mental well-being.
Cognitive Behavioral Therapy (CBT)
a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior).
This widely practiced integrative therapy aims to alter not only the way people think but also the way they act.
CBT seeks to make people aware of their irrational negative thinking and to replace it with new ways of thinking.
it trains people to practice the more positive approach in everyday settings
How is this different from REBT?
CBT also tackles behavior
RBT is more direct and confrontational than CBT
Dialectical Behavioral Therapy
type of cognitive-behavioral therapy that helps individuals manage emotions, develop coping skills, and improve interpersonal relationships.
Group Therapy
therapy conducted with groups rather than individuals, providing benefits from group interaction.
Benefits:
Saves therapists’ time and clients’ money, and often is just as effective
It offers a social laboratory for exploring social behaviors and developing social skills.
It enables people to see that others share their problems. It can be a relief to discover that others, experience some of the same troublesome feelings and behaviors
It provides feedback as clients try out new ways of behaving. Hearing that you look poised, even though you feel anxious and self-conscious, can be very reassuring.
Family Therapy
therapy that treats people in the context of their family system. Views an individual’s unwanted behaviors as influenced by, or directed at, other family members.
Self-Help Groups
voluntary associations of individuals who come together to share common experiences, concerns, or goals, and to provide mutual support, encouragement, and practical assistance to one another.
meta-analysis
a procedure for statistically combining the results of many different research studies.
Evidence-based Practice
clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences.
After rigorous evaluation, clinicians apply therapies suited to their own skills and their patients’ unique situations
Therapeutic Alliance
a bond of trust and mutual understanding between a therapist and client, who work together constructively to overcome the client’s problem.
Resilience
the personal strength that helps most people cope with stress and recover from adversity and even trauma.
Psychopharmacology
the study of the effects of drugs on mind and behavior.
Antipsychotic Drugs
drugs used to treat schizophrenia and other forms of severe thought disorder. Dampens responsiveness to irrelevant stimuli.
Side Effects: Sluggishness, tremors, and twitches similar to those of Parkinson’s disease.
Examples: Thorazine, risperidone, olanzapine
Antianxiety Drugs
drugs used to control anxiety and agitation. Depress central nervous system activity (and so should not be used in combination with alcohol).
Side Effects: Addictive, fatigue, dizziness, memory impairment, confusion/disorientation, muscle weakness, sexual dysfunction, weight changes.
Examples: Xanax or Ativan
Antidepressant
drugs used to treat depression, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. (Several widely used antidepressant drugs are selective serotonin reuptake inhibitors— SSRIs.) Increase the availability of neurotransmitters, such as norepinephrine or serotonin, which elevate arousal and mood and are scarce when a person experiences feelings of depression or anxiety.
Side Effects: Dry mouth, weight gain, hypertension, or dizzy spells.
Examples: Prozac
Select Seratonin Reuptake Inhibitors (SSRI)
Work by partially blocking the reabsorption and removal of serotonin from synapses. Having more serotonin remain in the synapses has been shown to help reduce the symptoms of depression.
Side Effects: Nausea, Headache, Insomnia, Sexual dysfunction, Weight gain, Fatigue, Anxiety, Sweating, Dizziness.
Examples: Zoloft, Paxil, and Prozac
Serotonin and Norepinephrine Reuptake Inhibitors (SNRI)
Work by increasing the levels of serotonin and norepinephrine in the brain, helping to improve mood and alleviate symptoms of depression.
Mood-Stabilizing Medications
Drugs used to treat mood disorders like bipolar disorder. They help regulate mood swings and prevent extreme highs and lows.
Side Effects: Weight gain, drowsiness, tremors, thyroid problems
Examples: Lithium, Valproic Acid, Lamotrigine
Electroconvulsive Therapy (ECT)
a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient.
Repetitive Transcranial Magnetic Stimulation (rTMS)
the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity.
psychosurgery
surgery that removes or destroys brain tissue in an effort to change behavior.
lobotomy
a psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain.
Usually decreases the person’s misery or tension, but also produces a permanently lethargic, immature, uncreative person
Stephen Illardi’s Model
holistic approach to treating depression, focusing on lifestyle factors like diet, exercise, sleep, and social connections.
Albert Ellis
Psychologist known for developing Rational Emotive Behavior Therapy (REBT), focusing on changing irrational beliefs to improve mental health and well-being.
Carl Rogers
Humanistic psychologist known for his person-centered approach, emphasizing empathy, genuineness, and unconditional positive regard in therapy.
B.F. Skinner
Psychologist known for operant conditioning. Believed behavior is shaped by consequences. Introduced concepts like reinforcement and punishment in behaviorism.