REVIEW Introduction to Therapy and the Psychological Therapies

592

Learning Objectives

Test Yourself by taking a moment to answer each of these Learning Objective Questions (repeated here from within the module). Research suggests that trying to answer these questions on your own will improve your long-term memory of the concepts (McDaniel et al., 2009).

Question

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ANSWER: Psychotherapy is treatment involving psychological techniques; it consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth. The major psychotherapies derive from psychology's psychodynamic, humanistic, behavioral, and cognitive perspectives. Biomedical therapy treats psychological disorders with medications or procedures that act directly on a patient's physiology. An eclectic approach combines techniques from various forms of therapy.

Question

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ANSWER: Through psychoanalysis, Sigmund Freud tried to give people self-insight and relief from their disorders by bringing anxiety-laden feelings and thoughts into conscious awareness. Psychoanalytic techniques included using free association and interpretation of instances of resistance and transference. Psychodynamic therapy has been influenced by traditional psychoanalysis but differs from it in many ways, including the lack of belief in id, ego, and superego. This contemporary therapy is briefer, less expensive, and more focused on helping the client find relief from current symptoms. Psychodynamic therapists help clients understand how past relationships create themes that may be acted out in present relationships.

Question

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ANSWER: Both psychoanalytic and humanistic therapists are insight therapies—they attempt to improve functioning by increasing clients' awareness of motives and defenses. Humanistic therapy's goals have included helping clients grow in self-awareness and self-acceptance; promoting personal growth rather than curing illness; helping clients take responsibility for their own growth; focusing on conscious thoughts rather than unconscious motivations; and seeing the present and future as more important than the past. Carl Rogers' client-centered therapy proposed that therapists' most important contributions are to function as a psychological mirror through active listening and to provide a growth-fostering environment of unconditional positive regard, characterized by genuineness, acceptance, and empathy.

Question

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ANSWER: Behavior therapies are not insight therapies. Their goal is to apply learning principles to modify problem behaviors. Classical conditioning techniques, including exposure therapies (such as systematic desensitization or virtual reality exposure therapy) and aversive conditioning, attempt to change behaviors through counterconditioning—evoking new responses to old stimuli that trigger unwanted behaviors.

Question

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ANSWER: Operant conditioning operates under the premise that voluntary behaviors are strongly influenced by their consequences. Therapy based on operant conditioning principles uses behavior modification techniques to change unwanted behaviors through positively reinforcing desired behaviors and ignoring or punishing undesirable behaviors. Critics maintain that (1) techniques such as those used in token economies may produce behavior changes that disappear when rewards end, and (2) deciding which behaviors should change is authoritarian and unethical. Proponents argue that treatment with positive rewards is more humane than punishing people or institutionalizing them for undesired behaviors.

Question

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ANSWER: The cognitive therapies, such as Aaron Beck's cognitive therapy for depression, assume that our thinking influences our feelings, and that the therapist's role is to change clients' self-defeating thinking by training them to view themselves in more positive ways. The widely researched and practiced cognitive-behavioral therapy (CBT) combines cognitive therapy and behavior therapy by helping clients regularly act out their new ways of thinking and behaving in their everyday life. A newer CBT variation, dialectical behavior therapy (DBT), combines cognitive tactics for tolerating distress and regulating emotions with social skills training and mindfulness meditation.

Question

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ANSWER: Group therapy sessions can help more people and cost less per person than individual therapy would. Clients may benefit from exploring feelings and developing social skills in a group situation, from learning that others have similar problems, and from getting feedback on new ways of behaving. Family therapy views a family as an interactive system and attempts to help members discover the roles they play and to learn to communicate more openly and directly.

Question

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ANSWER: Clients' and therapists' positive testimonials cannot prove that psychotherapy is actually effective, and the placebo effect makes it difficult to judge whether improvement occurred because of the treatment. Using meta-analyses to statistically combine the results of hundreds of randomized psychotherapy outcome studies, researchers have found that those not undergoing treatment often improve, but those undergoing psychotherapy are more likely to improve more quickly, and with less chance of relapse.

Question

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ANSWER: No one type of psychotherapy is generally superior to all others. Therapy is most effective for those with clear-cut, specific problems. Some therapies—such as behavior conditioning for treating phobias and compulsions—are more effective for specific disorders. Psychodynamic therapy has been effective for depression and anxiety, and cognitive and cognitive-behavioral therapies have been effective in coping with anxiety, posttraumatic stress disorder, and depression. Evidence-based practice integrates the best available research with clinicians' expertise and patients' characteristics, preferences, and circumstances.

Question

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ANSWER: Abnormal states tend to return to normal on their own, and the placebo effect can create the impression that a treatment has been effective. These two tendencies complicate assessments of alternative therapies (nontraditional therapies that claim to cure certain ailments). Eye movement desensitization and reprocessing (EMDR) has shown some effectiveness—not from the eye movement but rather from the exposure therapy nature of the treatments. Light exposure therapy does seem to relieve depression symptoms for those with a seasonal pattern of major depressive disorder by activating a brain region that influences arousal and hormones.

Question

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ANSWER: All psychotherapies offer new hope for demoralized people; a fresh perspective; and (if the therapist is effective) an empathic, trusting, and caring relationship. The emotional bond of trust and understanding between therapist and client—the therapeutic alliance—is an important element in effective therapy.

Question

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ANSWER: Therapists differ in the values that influence their goals in therapy and their views of progress. These differences may create problems if therapists and clients differ in their cultural or religious perspectives.

Question

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ANSWER: A person seeking therapy may want to ask about the therapist's treatment approach, values, credentials, and fees. An important consideration is whether the therapy seeker feels comfortable and able to establish a bond with the therapist.

Terms and Concepts to Remember

Test yourself on these terms.

Question

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

Experience the Testing Effect

Test yourself repeatedly throughout your studies. This will not only help you figure out what you know and don’t know; the testing itself will help you learn and remember the information more effectively thanks to the testing effect.

Question 15.1

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Question 15.2

2. DQE5dV6VGANud/72 therapies are designed to help individuals discover the thoughts and feelings that guide their motivation and behavior.

Question 15.3

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Question 15.4

4. A therapist who restates and clarifies the client's statements is practicing JkAX5798NtLuCVZ4oW+S2PcKylxFk2j3 .

Question 15.5

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593

Question 15.6

6. Behavior therapies often use PNnDJnDApbmM/Mwf6cMvG2wtuFgQHgenWBw4xAuaJexnLD+kuYausQdxP3oh/B0g techniques, such as systematic desensitization and aversive conditioning, to encourage clients to produce new responses to old stimuli.

Question 15.7

7. The technique of xE9OwNou5aKFQjutJV5EvoxYPv1PJHibJ0hbX4nG3vk= teaches people to relax in the presence of progressively more anxiety-provoking stimuli.

Question 15.8

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ANSWER: Behavior therapies are often the best choice for treating phobias. Viewing Rico's fear of the freeway as a learned response, a behavior therapist might help Rico learn to replace his anxious response to freeway driving with a relaxation response.

Question 15.9

9. At a treatment center, people who display a desired behavior receive coins that they can later exchange for other rewards. This is an example of a(n) NoAQRiGlpGRm6UpRUo3dNZ4XtrU= .

Question 15.10

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Question 15.11

11. PVyd0dykNKqXrpF2VKk4Y+hrkywtE/yant4uxIXvXH7s6RRRFyqnJKQDTyFzyPCo therapy helps people to change their self-defeating ways of thinking and to act out those changes in their daily behavior.

Question 15.12

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Question 15.13

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Question 15.14

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Question 15.15

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ANSWER: research evidence, clinical expertise, and knowledge of the patient

Question 15.16

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ANSWER: The placebo effect is the healing power of belief in a treatment. When patients expect a treatment to be effective, they may believe it was.

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