5.5a: Introduction to Therapy, Psychodynamic, and Humanistic Theories

5.5a: Introduction to Therapy, Psychodynamic, and Humanistic Theories

• Main Goals of Psychotherapy: Promote growth, relieve suffering, and help people function more effectively.

• Deinstitutionalization: Movement to treat people in the community instead of in psychiatric hospitals; prompted by better drug treatments and concern for human rights.

• Eclectic Approach: Blending techniques from multiple types of therapy to fit the client’s needs.

• Ethical Principles: Confidentiality, informed consent, professional competence, and avoiding harm.

Psychoanalysis (Freud):

• Goals: Bring unconscious thoughts to consciousness to resolve internal conflict.

• Tools: Free association, dream interpretation, resistance, transference. Free association is the primary method.

• Resistance: Blocking anxiety-provoking material (e.g., hesitating during free association).

• Transference: Patient redirects feelings for someone else onto the therapist (e.g., anger toward a parent shown to therapist).

• Psychodynamic Therapy: Similar to psychoanalysis but shorter, less intensive, and more focused on current issues.

Humanistic Therapy:

• Person-Centered Therapy: Developed by Carl Rogers. Focus on self-actualization and growth.

• Insight Therapy: Increases self-awareness of underlying motives.

• Goals: Promote personal growth via self-acceptance.

• Active Listening: Empathetic listening technique.

• Carl Rogers’ 3 Cornerstones: Genuineness, unconditional positive regard, empathy.

5.5b: Behavior, Cognitive, and Group Therapies

Behavioral Therapy:

• Goal: Change behavior through learning principles.

• Classical Conditioning: Phobia explained as learned association:

  • US → UR

  • CS (previously neutral) + US → UR

  • CS → CR

• Counterconditioning: Replacing unwanted response with a positive one; pioneered by Mary Cover Jones.

• Exposure Therapies: Gradual exposure to fear.

  • Systematic Desensitization: Relaxation + gradual exposure (can use VR).

  • Aversive Conditioning: Pairs unpleasant stimulus with unwanted behavior (e.g., nausea with alcohol).

• Operant Conditioning: Reinforcement and punishment shape behavior.

  • Token Economy: Reinforces good behavior with tokens that can be exchanged.

Cognitive Therapy:

• Cause of Emotional Disturbance: Illogical, negative thoughts.

• Cognitive Restructuring: Replacing irrational thoughts with realistic ones; pioneered by Aaron Beck.

• Stress Inoculation Training: Prepares clients to cope with future stress.

• CBT vs. CT: CBT combines thought-change with behavior-change; CT focuses on thoughts only.

Group and Family Therapy:

• Group Therapy Strengths: Cost-effective, social feedback, less isolation.

• Family Therapy: Focuses on family dynamics.

• Self-Help (e.g., AA): Peer support and shared experience.

5.5c: Evaluating Psychotherapies

• Client Perception Limitations: Biased by placebo effect, desire to feel better.

• Placebo Effect: Feeling better due to expectations, not the therapy itself.

• Meta-Analysis: Combines many studies; shows therapy is generally effective.

Best Treatments:

• Depression: CBT, medication (SSRIs)

• Phobias: Exposure therapy

• Anxiety: CBT

• SAD (Seasonal Affective Disorder): Light therapy

• Schizophrenia: Antipsychotic medication + therapy

• Best Overall: CBT

• Therapeutic Alliance: Trust and bond between therapist and client—strong predictor of success.

5.5d: Biomedical Therapies and Prevention

• Biomedical Therapies: Medications or medical procedures.

• Double-Blind Studies: Help test drugs while reducing placebo bias.

• Pharmacology: Study of how drugs affect the mind and behavior.

Medications:

• Antipsychotics: Treat schizophrenia (e.g., Thorazine); may cause Tardive Dyskinesia.

• SSRIs: Treat depression/anxiety by increasing serotonin (e.g., Prozac).

• Lithium: Stabilizes mood in bipolar disorder.

Other Medical Treatments:

• Lobotomy: Obsolete, destructive brain surgery once used for severe disorders.

• Electroconvulsive Therapy (ECT): For severe depression.

• Transcranial Magnetic Stimulation (TMS): Non-invasive brain stimulation, treats depression.

Prevention:

• Assumption: Addressing social and environmental factors can reduce psychological disorders.

• Lifestyle Changes: Exercise, sleep, nutrition, social connection, mindfulness.

• Hypnosis: Used to treat pain, addiction, phobias by increasing suggestibility.

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