Chapter 15 Psychological Therapies Textbook Notes Section 1 15 1 How have psychological disorders been treated throughout history and what are two modern ways they are treated today Mentally ill people began to be confined to institutions called asylums in the mid 1500s Treatments were harsh and often damaging Philippe Pinel became famous for demanding that the mentally ill be treated with kindness personally unlocking the chains of inmates at Bic tre Asylum in Paris France Psychotherapy involves a person talking to a psychological professional about the person s problems Psychotherapy for the purpose of gaining understanding into one s motives and actions is called insight therapy whereas psychotherapy aimed at changing disordered behavior directly is called action therapy Biomedical therapy uses a medical procedure to bring about changes in behavior 15 2 What were the basic elements of Freud s psychoanalysis and how do psychodynamic approaches differ today Sigmund Freud developed a treatment called psychoanalysis that focused on releasing a person s hidden repressed urges and concerns from the unconscious mind Psychoanalysis uses interpretation of dreams free association positive and negative transference and resistance to help patients reveal their unconscious concerns Freud s original therapy technique is criticized for its lack of scientific research and his own personal biases that caused him to misinterpret much of what his patients revealed Modern psychodynamic therapists have modified the technique so that it takes less time and is much more direct and they do not focus on the id and sexuality as Freud did Section 3 Humanistic Therapy To Err Is Human 15 3 What are the basic elements of the humanistic therapies known as person centered therapy and Gestalt therapy Humanistic therapies focus on the conscious mind and subjective experiences to help clients gain insights Person centered therapy is very nondirective allowing the client to talk through problems and concerns while the therapist provides a supportive background The three basic elements of person centered therapy are authenticity of the therapist in the client s perception unconditional positive regard given to the client by the therapist and the empathy of the therapist for the client Gestalt therapy is more directive helping clients to become aware of their feelings and to take responsibility for their choices in life Gestalt therapists try to help clients deal with things in their past that they have denied and will use body language and other nonverbal cues to understand what clients are really saying Humanistic therapies are also not based in experimental research and work best with intelligent highly verbal persons A Rogerian person centered therapist listens with calm acceptance to anything the client says A sense of empathy with the client s feelings is also important 1 In Gestalt therapy it is not unusual to find a client talking to an empty chair The chair represents some person from the past with whom the client has unresolved issues and this is the opportunity to deal with those issues Psychological Therapies continued Humanistic therapy focuses on the conscious subjective experience of emotion and people s sense of self promotes insight and emphasizes the importance of individual choice and the potential to change one s behavior Person centered therapy developed by Carl Rogers focuses on match between real self and ideal self maladjustment is result of not matching unconditional positive regard is important for congruence between real and ideal selves Therapist uses a nondirective approach and four basic elements to develop the person therapist relationship Reflection Unconditional positive regard Empathy Authenticity Evaluation little scientific support for basic premises and requires client to be fairly intelligent and verbally expressive Gestalt therapy developed by Friz Perls focuses on match between actual and ideal self focuses on the gestalt or whole picture Therapist uses a very directive approach to lead the client through a number of planned experiences e g self dialogue empty chair technique with the goal of increasing self awareness Although aspects of the individual s past are examined the focus is on denied past not hidden past everything is conscious but possibly not in the here and now Evaluation little scientific support for basic premises and requires client to be fairly intelligent and verbally expressive Motivational interviewing client centered with a twist has specific goals to reduce ambivalence about change and increase intrinsic motivation Section 4 Behavior Therapies Learning One s Way to Better Behavior 15 4 How do behavior therapists use classical and operant conditioning to treat disordered behavior and how successful are these therapies Behavior therapies are action therapies that do not look at thought processes but instead focus on changing the abnormal or disordered behavior itself through classical or operant conditioning Classical conditioning techniques for changing behavior include systematic desensitization aversion therapy and exposure therapy Therapies based on operant conditioning include modeling reinforcement and the use of token economies and extinction Behavior therapies can be effective in treating specific problems such as bed wetting drug addictions and phobias and can help improve some of the more troubling behavioral symptoms associated with more severe disorders 2 This boy is sitting in the time out corner at his school By removing the attention that he found rewarding the teacher is attempting to extinguish the behavior that earned the boy a time out Do you see anything in this time out corner that might make it less effective Section 5 Cognitive Therapies Thinking is believing 15 5 What are the goals and basic elements of cognitive therapies such as cognitive behavioral therapy and rational emotive behavior therapy Cognitive therapy is oriented toward teaching clients how their thinking may be distorted and helping clients to see how inaccurate some of their beliefs may be Some of the cognitive distortions in thinking include arbitrary inference selective thinking overgeneralization magnification and minimization and personalization Cognitive behavioral therapies are action therapies that work at changing a person s illogical or distorted thinking The three goals of cognitive behavioral therapies are to relieve the symptoms and solve the problems