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Introduction to Therapy and the Psychological Therapies

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Introduction to Therapy and the Psychological Therapies (part 1)

Treating psychological disorders

Main categories of modern Western therapies

Psychotherapy

Treatment involving psychological techniques; someone seeking to overcome psychological difficulties or achieve personal growth

Biomedical therapy

Prescribed medications or procedures that act directly on the person’s physiology

Eclectic approach

Approach to psychotherapy that uses techniques from various forms of therapy

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Introduction to Therapy and the Psychological Therapies (part 2)

Psychoanalysis therapies

Sigmund Freud’s therapeutic techniques

Patient’s free associations, resistances, dreams, and transferences (and therapist’s interpretations) released previously repressed feelings, allowing the patient to gain self-insight.

Helped form the foundation for psychological disorders treatment

Continues to influence modern therapists (psychodynamic)

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Introduction to Therapy and the Psychological Therapies (part 3)

Psychoanalysis and psychodynamic therapies

Goals of psychoanalysis

Energy release

Conscious awareness of repressed feelings

Insights into origins of personal disorders and reduction of inner conflicts

Techniques

Historical reconstruction

Resistance

Interpretation

Transference

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Psychoanalysis was Freud’s method of 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.

Introduction to Therapy and the Psychological Therapies (part 4)

Psychodynamic therapy

Goals of psychodynamic therapy

Understand symptoms by focusing on important relationships and events.

Explore defended-against thoughts and feelings.

Therapy derived from psychoanalytic tradition

Views individuals as responding to unconscious forces and childhood experiences

Seeks to enhance self-insight

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Introduction to Therapy and the Psychological Therapies (part 5)

Humanistic therapies (insight therapies)

Goal

Emphasizes innate potential for self-fulfillment through growth in self-awareness and self-acceptance

Seeks to reduce inner conflicts that interfere with natural development and growth

Focuses on growth, the present, and the conscious mind

Techniques (Rogers)

Person-centered, nondirective therapy

Active listening

Unconditional positive regard

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Introduction to Therapy and the Psychological Therapies (part 6)

Rogers-inspired active listening hints

Paraphrase

Invite clarification

Reflect feelings

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Carl Rogers (right) empathized with a client during this group therapy session.

Introduction to Therapy and the Psychological Therapies (part 7)

Behavior therapies

Assume behaviors are the problem.

Apply learning principles to eliminate unwanted behaviors.

Classical conditioning techniques

Counterconditioning

Exposure therapies

Systematic desensitization

Virtual reality exposure therapy

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Within the confines of a room, virtual reality technology exposes people to vivid simulations of feared stimuli, such as walking across a rickety bridge high off the ground.

Insight therapies assume that self-awareness and psychological well-being go hand in hand.

Psychodynamic therapists expect people’s problems to diminish as they gain insight into their unresolved and unconscious tensions.

Humanistic therapists expect problems to diminish as people get in touch with their feelings.

Behavior therapies, however, doubt the healing power of self-awareness. Rather than delving deeply below the surface looking for inner causes, behavior therapists assume that problem behaviors are the problems.

Introduction to Therapy and the Psychological Therapies (part 8)

Aversive conditioning

Associates an unpleasant state with unwanted behavior

Helps to learn what not to do

Creates a negative response to harmful stimulus

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Exposure therapy enables a more relaxed, positive response to upsetting, harmless stimulus.

Introduction to Therapy and the Psychological Therapies (part 9)

After repeatedly imbibing an alcoholic drink mixed with a drug that produces severe nausea, some people with a history of alcohol use disorder develop at least a temporary conditioned aversion to alcohol.

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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US = unconditioned stimulus

UR = unconditioned response

NS = neutral stimulus

CS = conditioned stimulus

CR = conditioned response

Introduction to Therapy and the Psychological Therapies (part 10)

Operant conditioning techniques

Learning occurs through rewards and punishments for behavior

Behavior modification

Token economy

Behavior modification concerns

How durable are the behaviors?

Is it right for one human to control another’s behavior?

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Introduction to Therapy and the Psychological Therapies (part 11)

Cognitive therapies

Teach people new, more adaptive ways of thinking.

Based on the assumption that thoughts intervene between events and our emotional reactions

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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The person’s emotional reactions are produced not directly by the event but rather by the person’s thoughts in response to the event.

Introduction to Therapy and the Psychological Therapies (part 12)

Beck’s therapy for depression

Goals

Reverse clients’ negativity about themselves, their situations, and their futures.

Use gentle questioning seeks to reveal irrational thinking.

Persuade clients to change the way life is viewed.

Techniques

Stress inoculation training

Positive self-talk

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Introduction to Therapy and the Psychological Therapies (part 13)

Selected Cognitive Therapy Techniques

Aim of Technique	Technique
Reveal beliefs	Question your interpretations. Rank thoughts and emotions.
Test beliefs	Examine consequences. Decatastrophize thinking.
Change beliefs	Take appropriate responsibility. Resist extremes.

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

See Table 15.1 for additional information.

Introduction to Therapy and the Psychological Therapies (part 14)

Cognitive-behavioral therapy (CBT)

Goals

Use an integrated approach to alter the way clients think and act.

Make clients aware of irrational negative thinking and replace it with new ways of thinking.

Techniques

Training to practice a more positive, more realistic approach to everyday settings; replace catastrophizing thinking.

Online CBT

Dialectical behavioral therapy

Mindfulness meditation

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Anxiety, depressive, and bipolar disorders share a common problem: unhealthy emotion regulation.

Introduction to Therapy and the Psychological Therapies (part 15)

Group therapy

Aims

Similar to individual therapy; occurs in a small group; less therapist involvement

Benefits

Saves therapists’ time and clients’ money

Offers a social laboratory for exploring social behaviors and developing social skills

Enables people to see that others share their problems

Provides feedback as clients try out new ways of thinking

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Introduction to Therapy and the Psychological Therapies (part 16)

Family therapy

Aims

Utilize preventive mental health strategy.

Help people differentiate self from family while connecting with family members emotionally.

Heal relationships.

Techniques

Views the family as a system in which each person’s actions trigger reactions from others.

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Evaluating Psychotherapies

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Evaluating Psychotherapies (part 1)

Is psychotherapy effective?

Clients’ perceptions

Often enter therapy in crisis.

Believe that treatment will be effective.

Generally speak kindly of therapists.

Want to believe therapy was worth the effort.

Clinicians’ perceptions

Provide successful case studies and information.

Confirmation bias

Illusory correlation

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Evaluating Psychotherapies (part 2)

Outcome research

Which outcomes can be expected when the effectiveness of psychotherapy is objectively measured?

Eysenck: Outcomes summary of 24 studies, but later research revealed shortcomings

Meta-analyses

Cost-effectiveness

Those undergoing therapy are more likely to improve more quickly and with less risk of relapse than those not undergoing therapy.

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Those not undergoing therapy often improve, but those undergoing therapy are more likely to improve—and to improve more quickly and with less risk of relapse.

Evaluating Psychotherapies (part 3)

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

These two normal distribution curves based on data from 475 studies show the improvement of untreated people and psychotherapy clients. The outcome for the average therapy client surpassed the outcome for 80 percent of the untreated people. (Data from Smith et al., 1980.)

Evaluating Psychotherapies (part 4)

Which psychotherapies work best?

Clients can benefit from psychotherapy regardless of their clinicians’ experience, training, supervision, and licensing.

People with more specific problems are more likely to experience improvement than those with less-focused problems (relapse).

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Evaluating Psychotherapies (part 5)

Which psychotherapies work best?

Some pseudopsychological treatments are not only ineffective but also harmful.

Invisible energy fields

Reenactment of birth trauma

Some touch communication therapy

Conversion therapy

Scared Straight, D.A.R.E., some weight-reduction and pedophile rehabilitation efforts

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Evaluating Psychotherapies (part 6)

Research psychologists using scientific methods

Evidence-based practice

Nonscientist therapist viewing practice as art

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Ideal clinical decision making can be visualized as a three-legged stool, upheld by research evidence, clinical expertise, and knowledge of the client.

Evaluating Psychotherapies (part 7)

Some therapy forms are more effective for treating particular problems.

Cognitive and cognitive-behavioral therapies

Behavioral conditioning therapies

Psychodynamic therapy

Nondirective (client-centered) counseling

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Evaluating Psychotherapies (part 8)

Elements of all psychotherapies

Hope for demoralized people

New perspective

Therapeutic alliance: Empathic, trusting, caring relationship

This helps us understand why paraprofessionals (briefly trained caregivers) can assist many troubled people so effectively.

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

These three common elements—hope, a fresh perspective, and an empathic, caring relationship—help us understand why paraprofessionals (briefly trained caregivers) can assist many troubled people so effectively.

People who seek help usually improve. So do many of those who do not, which is a tribute to our human resourcefulness and our capacity to care for one another.

Evaluating Psychotherapies (part 9)

Culture and values in psychotherapy

Psychotherapists differ from one another and may differ from their clients.

Culture and values (client-therapist mismatch)

Personal differences (religion; LBGTQ identity)

Individualism versus collectivist perspective

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Evaluating Psychotherapies (part 10)

When should a mental health professional’s help be sought?

Feelings of hopelessness

Deep and lasting depression

Self-destructive behavior, such as substance abuse

Disruptive fears

Sudden mood shifts

Thoughts of suicide

Compulsive rituals, such as hand washing

Sexual difficulties

Hearing voices or seeing things that others don’t experience

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Evaluating Psychotherapies (part 11)

What should a person look for when selecting a therapist?

Seek preliminary consultation with several therapists.

Learn treatment approach and training.

Question the therapist’s values, credentials, and fees.

Look for indications of a potential therapeutic alliance.

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Table 15.3 provides additional information about therapists and their training.

Evaluating Psychotherapies (part 12)

Ethical principles in psychotherapy (APA)

Seek to benefit others and do no harm.

Establish a feeling of trust and defined role as a therapist.

Be honest, truthful, and accurate.

Be fair and promote justice for you and others.

Respect dignity and worth of you and others, recognizing the right to privacy, confidentiality, and self-determination.

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

The Biomedical Therapies and Preventing Psychological Disorders

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

The Biomedical Therapies and Preventing Psychological Disorders (part 1)

Biomedical treatments can change brain chemistry.

Drugs, electrical stimulation, magnetic impulses, psychosurgery

Changes in lifestyle influences brain and body and positively affects mental health.

Exercise

Nutrition

Relationships

Recreation

Relaxation

Religion or spiritual engagement

Service to others

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Biomedical treatments can change brain chemistry with drugs; affect its circuitry with electrical stimulation, magnetic impulses, or psychosurgery; or influence responses with lifestyle changes.

See LOQ 15-14 Thinking Critically About: Therapeutic Lifestyle Change for additional information.

The Biomedical Therapies and Preventing Psychological Disorders (part 2)

Drug therapies

Most widely used biomedical treatment today

Revolutionized treatment related to psychopharmacology and drug research

Antipsychotic drugs: Used to treat schizophrenia and other forms of severe thought disorder

Antianxiety drugs: Used to control anxiety and depression

Antidepressant drugs (SSRIs): Used to treat depression, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder

Can you find examples of each of these in your text?

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

The Biomedical Therapies and Preventing Psychological Disorders (part 3)

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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Shown here is the action of Prozac, which partially blocks the reuptake of serotonin.

The Biomedical Therapies and Preventing Psychological Disorders (part 4)

Mood-stabilizing medications

Are used to stabilize mood disorders

Are effective in controlling manic episodes associated with bipolar disorder

Depakote; lithium

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

The Biomedical Therapies and Preventing Psychological Disorders (part 5)

Brain stimulation

Electroconvulsive therapy (ECT)

Alternative neurostimulation therapies

Transcranial direct current stimulation (tDCS)

Transcranial magnetic stimulation (TMS)

Deep brain stimulation (DBS)

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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The Biomedical Therapies and Preventing Psychological Disorders (part 6)

By comparing the brains of patients with and without depression, Helen Mayberg identified a brain area (highlighted in red) that appears active in people who are depressed or sad and whose activity may be calmed by deep-brain stimulation

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

The Biomedical Therapies and Preventing Psychological Disorders (part 7)

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

Today’s neurostimulation therapies apply strong or mild electricity, or magnetic energy, either to the skull’s surface or directly to brain neurons.

The Biomedical Therapies and Preventing Psychological Disorders (part 8)

Psychosurgery

Removes or destroys brain tissue; is irreversible

Most drastic and least-used biomedical intervention for changing behavior

Lobotomy has been replaced by microscale psychosurgery.

Uncontrollable seizures

Severe major depressive disorder and obsessive-compulsive disorder

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

The Biomedical Therapies and Preventing Psychological Disorders (part 9)

Therapy	Presumed Problem	Therapy Aim	Therapy Technique
Therapeutic lifestyle change	Stress and unhealthy Lifestyle	Restore healthy biological state.	Alter lifestyle through adequate exercise, sleep, nutrition, and other changes.
Drug therapies	Neurotransmitter malfunction	Control symptoms of psychological disorders.	Alter brain chemistry through drugs.
Brain stimulation	Depression (ECT is used only for severe, treatment-resistant depression.)	Alleviate depression, especially when it is unresponsive to drugs or other forms of therapy.	Stimulate brain through Electroconvulsive shock, mild electrical stimulation, magnetic impulses, or deep brain stimulation.
Psychosurgery	Brain malfunction	Relieve severe disorders.	Remove or destroy brain tissue.

Comparing biomedical therapies

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

MODULES

The Biomedical Therapies and Preventing Psychological Disorders (part 10)

Preventing psychological disorders and building resilience

Preventive mental health

Seeks to prevent psychological casualties by identifying and alleviating conditions that cause them

Develop support programs that alleviate demoralizing situations.

Empower those with learned helplessness and changing environments.

Harness positive psychology interventions to enhance human flourishing.

Prevention workers

Community psychologists

Resilience

Posttraumatic growth

EXPLORING PSYCHOLOGY

DAVID G. MYERS | C. NATHAN DEWALL | 12th edition

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chapter 14, 15 psych

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