CHAPTER 13 Therapy LECTURE NOTES Ch 13 Therapy What is Therapy o A systematic interaction between a therapist and a client that applies psychological principles to affect the client s thought feelings or behaviors in order to develop themselves to adjustment problems o Systematic Interaction How the client and therapist interact and relate o Psychological Principles Therapy is based on theory and research o Targets of therapy Thoughts Feelings Behaviors o Reasons for therapy Psychological Disorder History o Demonological thinking Asylums Originated in European monasteries First institutions meant for the mentally unstable Function was to warehouse not to treat o Bedlam Turmoil or confusion Reforms o History Mental Hospitals Replaced Asylums Over 1 million residents by the mid 50 s Treatment as the primary focus o Community Mental Health Movement Focus is to Still some concerns Traditional Psychoanalysis o Psychoanalysis o Typical couch therapy o Assumes problems reflect Early childhood experiences internal conflict Allows the client to self explore with little to no intervention from the therapist Can last months or years Designed to provide insight into the conflicts that are presumed to lie at the root of a person s problems Psychoanalysis Components o Catharsis expression of repressed feelings and impulses o Free Association Uncensored uttering of all thoughts o Resistance Tendency to block the free expression of impulses o Transference Responding to one person in a way that is similar to the way one responded to another person in childhood o Dream analysis Content of dreams determined by unconscious processes and daily events o Freud Royal road to Unconscious o Manifest Content Reported content of dream o Latent Content Symbolized or underlying content of the dream Defense Mechanisms Denial o refusal to accept reality and to act as if a painful event thought or feeling did not exist Displacement o redirecting of feelings impulses from an anxiety provoking object to a safer more acceptable one Fantasy o channeling of or desires into imagination Intellectualization o use of a cognitive approach with suppression of emotions Projection o attribution of one s undesired impulses onto another Rationalization o cognitive reframing of one s perceptions in the face of changing realities Reaction Formation o converting of dangerous impulses that are perceived to be dangerous into their opposites Regression o reversion to an earlier stage of development in the face of unacceptable impulses Modern Psychoanalysis Psychodynamic o Sit face to face o Briefer o Less intense o More available to those who do not have a lot of time or money o Therapist is more directive o more focus on the ego than the id Client Centered Therapy o Carl Rogers o We are free to make choices and control our destinies despite the past o Disorders arise when there are roadblocks on our path to selfactualization o Provides insight into the parts that we have disowned Unconditional Positive Regard Empathic Understanding Genuineness open and honest Non directive Not tell the client what to do support them and reach their own decisions Humanistic Therapy o Focus on subjective conscious experience Here and Now Does not entirely ignore a client s past but emphasizes the current state of functioning Gestalt Therapy o Fritz Perls o Disowns parts of self that might be disapproved o People also wear social masks to hide who they truly are o Aims to help people integrate conflicting parts of their personality o It is Gestalt because it focuses on giving the conflicting parts of the personality an integrated form or shape Focuses on here and now o Free to make choices and direct their personal growth o Not gentle and accepting o Highly directive Behavior Therapy o Focuses on what people Do o Applies principles of learning to promote behavior change o Heavy focus on conditioning and observational learning Hypothesis testing approach Fear Reduction Methods o Systematic Desensitization Reduces fears by associating a hierarchy of images of fear evoking stimuli with deep muscle relaxation Gradual process where clients learn to handle increasingly anxiety provoking stimuli o Based on the assumption that phobias are learned unconditioned and reduced through extinction Modeling o Observe and imitate people who approach situations that the client fears Aversive Conditioning o A technique in which undesired responses are inhibited by pairing an offensive stimuli with them Rapid Smoking Designed to help people quit smoking o An overexposure to smoke designed to lead people to avoid cigarettes Operant Conditioning o Token Economies People are reinforced for desired behaviors with token that can be exchanges for privileges Successive Approximations o Much like shaping o Increase a behavior with gradual steps Social Skills Training o Decrease social anxiety through Self monitoring Coaching Modelling Role Playing Behavioral Rehearsal Feedback o Effective in groups Self Control Methods Functional Analysis of Behavior o A systematic study of behavior Cognitive Therapies o Assumes that people engage in cognitive distortions Focuses on changing problems occur because of beliefs attitudes and automatic thoughts Selective Perceptions See world as dangerous and ignore evidence to the contrary Overgeneralization Magnification blow out of proportion the importance of negative events Absolutist Thinking world is always black and white Rational Emotive Behavior Therapy o Beliefs about events shape our responses to them Most of us harbor irrational beliefs that can lead to problems Active directive therapy designed to challenge these beliefs Group Therapies o Economical o Provides more examples of life experiences and information for the patients o Peer approval o Affiliation to people who have the same problems o Hope o Social skills training o Not for everyone Some people don t want to disclose to a group Encounter groups A group that aims to foster self awareness o How group members relate to each other o Encourages open expression of feeling Couples therapy o Helps enhance communication skills and manage conflicts in couples Family therapy o The family unit is treated as the client o Family system scapegoat o Encourages communication growth and autonomy Problems in Conducting Research on Therapy o Difficult to develop an experiment on therapy o Difficult to measure outcomes Are clinical judgments valid Is the method working or another factor