Summary of Concepts
LO 1 Outline the history of the treatment of psychological disorders.
One theory suggests that during the Stone Age, trephination, in which holes were drilled through the skull, was used to open up the skull to allow evil spirits to exit the body. Pinel was horrified by the conditions of asylums in Paris. He removed the inmates’ chains and insisted they be treated more humanely. In the mid- to late 1800s, Dix supported the “mental hygiene movement,” a campaign to reform asylums in America. Appalled by the conditions she witnessed in “mental” institutions, Dix helped establish and upgrade many state mental hospitals. A movement to reduce the social isolation of people with psychological disorders, deinstitutionalization resulted in patients integrating into the community.
LO 2 Discuss how the main approaches to therapy differ and identify their common goal.
Insight therapies include psychoanalysis, psychodynamic therapy, and humanistic therapy, which aim to increase awareness of self and the environment. Behavior therapies focus on behavioral change, with the belief that the key to resolving problems is not understanding their origins, but changing the thoughts and behaviors that precede them. Biomedical therapy targets the biological basis of disorders, often using medications. All these approaches share a common goal: They aim to reduce symptoms and increase the quality of life for individuals, whether they seek help for debilitating psychological disorders or simply want to lead happier lives.
LO 3 Describe how psychoanalysis differs from psychodynamic therapy.
Psychoanalysis, the first formal system of psychotherapy, attempts to increase awareness of unconscious conflicts, making it possible to address and work through them. The therapist’s goal is to uncover these unconscious conflicts. Psychodynamic therapy is an updated form of psychoanalysis; it incorporates many of Freud’s core themes, including the notion that personality characteristics and behavior problems often can be traced to unconscious conflicts. With psychodynamic therapy, therapists see clients once a week for several months rather than many times a week for years. And instead of sitting quietly off to the side, therapists engage clients in a two-way dialogue.
LO 4 Explain the concepts that form the basis of humanistic therapy.
Humanistic therapy concentrates on the positive aspects of human nature: our powerful desires to form close relationships, treat others with warmth and empathy, and grow as individuals. Humanistic therapists concentrate on current problems and the everyday factors that may contribute to them. Instead of digging up unconscious thoughts and feelings, humanistic therapy emphasizes conscious experience.
LO 5 Summarize person-centered therapy.
Person-centered therapy focuses on achieving one’s full potential. The focus is not therapeutic techniques, but rather creating a warm and accepting client–therapist relationship using a nondirective approach. Sitting face-to-face with the client, the therapist’s main job is to “be there” for the client through empathy, unconditional positive regard, genuineness, and active listening, all important components of building a therapeutic alliance. The main goal of treatment is to reduce the incongruence between the ideal self and the real self.
LO 6 Describe the concepts that underlie behavior therapy.
Using the learning principles of classical conditioning, operant conditioning, and observational learning, behavior therapy aims to replace maladaptive behaviors with more adaptive behaviors. It incorporates a variety of techniques, including exposure therapy, aversion therapy, systematic desensitization, and behavior modification. Behavior therapy covers a broad range of treatment approaches, and focuses on observable behaviors in the present.
LO 7 Outline the concepts of cognitive therapy.
The goal of cognitive therapy is to identify potentially maladaptive thinking and help individuals change the way they view the world and relationships. Aaron Beck believed patterns of automatic thoughts and cognitive distortions, such as overgeneralization (thinking that self-contained events will have major repercussions in life), are at the root of psychological disturbances. The aim of cognitive therapy is to help clients recognize and challenge cognitive distortions and illogical thought in short-term, action-oriented, and homework-intensive therapy sessions. Albert Ellis created rational-emotive behavior therapy (REBT), another form of cognitive therapy, to help people identify their irrational or illogical thoughts and convert them into rational ones.
LO 8 Identify the benefits and challenges of group therapy.
Some of group therapy’s benefits include cost-effectiveness, identification with others, accountability, support, encouragement, and a sense of hope. Challenges include potential conflict among group members and discomfort in expressing oneself in the presence of others. But such feelings are not necessarily bad when it comes to therapy (group or otherwise), because they often motivate people to reevaluate how they interact with others, and perhaps try new approaches.
LO 9 Compare and contrast biomedical interventions and identify their common goal.
Psychopharmacology is the scientific study of how psychotropic medications alter perception, mood, behavior, and other aspects of psychological functioning. Psychotropic drugs include antidepressant, mood-stabilizing, antipsychotic, and antianxiety drugs. When severe symptoms do not improve with medication and psychotherapy, other biomedical options are available: electroconvulsive therapy (ECT), which causes seizures in the brain, for cases of severe depression; and neurosurgery, which destroys some portion of the brain or connections between different areas of the brain, only as a last resort. The common goal of biomedical interventions is to treat the biological basis of psychological disorders through physical interventions.
LO 10 Describe how culture interacts with the therapy process.
One challenge of providing therapy is to meet the needs of clients from vastly different cultures. Within any group, there is variation from one individual to the next, but it is still necessary for therapists to know the cultural context in which they work. The therapist must keep in mind the client’s cultural experience. This includes being respectful of cultural norms and sensitive to the many forms of prejudice and discrimination that people can experience. Every client has a unique story and a singular set of psychological needs. Responding to those needs and determining which approach will be most effective are key to successful therapy.
LO 11 Summarize the effectiveness of psychotherapy.
In general, therapy “works,” especially if it is long-term. All approaches to psychotherapy perform equally well across all disorders. But individuals who are limited by their insurance companies in terms of their choice of therapists and how long they can attend therapy do not see the same improvement as those who are less restricted by their insurance. In addition, people who start therapy but then decide to stop it experience less successful outcomes. The Mental Health Parity and Addiction Equity Act of 2010 requires group health insurance plans to provide mental health treatment benefits as part of their insurance plan—with benefits equal to those provided for medical treatment.
LO 12 Evaluate the strengths and weaknesses of online psychotherapy.
As more people gain access to the Internet and as more therapists try to specialize and make themselves marketable, online therapies have multiplied. E-therapy can mean anything from an email communication between client and therapist to real-time sessions via a webcam. These digital tools are valuable for serving rural areas and providing services to those who would otherwise have no access. Videoconferencing is useful for consultation and supervision. However, online psychotherapy raises many concerns, including licensing and privacy issues, lack of nonverbal cues, and potential problems with developing therapeutic relationships key terms
active listening
antianxiety drugs
antidepressant drugs
antipsychotic drugs
aversion therapy
behavior modification
behavior therapy
biomedical therapy
cognitive therapy
cognitive behavioral therapy
deinstitutionalization
eclectic approach to therapy
electroconvulsive therapy (ECT)
empathy
e-therapy
exposure
family therapy
free association
genuineness
humanistic therapy
insight therapies
interpretation
mood-stabilizing drugs
neurosurgery
nondirective
overgeneralization
person-centered therapy
psychoanalysis
psychodynamic therapy
psychotherapy
rational emotive behavior therapy (REBT)
resistance
systematic desensitization
therapeutic alliance
token economy
transference
1. Which of the following changes did Pinel introduce when he reformed the treatment of individuals with psychological disorders?
A. |
B. |
C. |
D. |
c. removed the inmates’ chains and listened to their complaints
2. Although most therapies share the common goal of reducing symptoms and increasing quality of life, they do this in various ways. One dimension in which they may differ is theoretical perspective. Psychotherapists who aim to increase awareness of self and the environment tend to use
A. |
B. |
C. |
D. |
c. insight therapy.
3. Free association and interpretation are used by __________ in their treatment of patients.
A. |
B. |
C. |
D. |
a. psychoanalysts
4. What are some of the weaknesses of Freud’s theories?
A. |
B. |
C. |
D. |
b. difficult to test through experimentation
5. A friend told you about his therapist, who is nondirective, uses active listening, and shows empathy and unconditional positive regard. It sounds as if your friend’s therapist is conducting
A. |
B. |
C. |
D. |
d. person-centered therapy.
6. Systematic desensitization uses __________ that represent(s) a gradual increase in a client’s anxiety.
A. |
B. |
C. |
D. |
a. hierarchies
7. Which of the following statements would not be among Beck’s collection of cognitive errors?
A. |
B. |
C. |
D. |
b. Getting fired once does not mean my career is over.
8. The key advantage of behavior therapy is that it
A. |
B. |
C. |
D. |
a. it tends to work quickly.
9. Which of the following claims about group therapy is true?
A. |
B. |
C. |
D. |
d. Seeing others improve offers hope and inspiration.
10. One specific type of group therapy is __________. The goal is to understand each family member’s unique role in an integrated system, often exploring relationship problems rather than symptoms of particular disorders.
A. |
B. |
C. |
D. |
d. family therapy
11. __________ therapy emphasizes the positive nature of humans. With a focus on the present, it seeks to identify current problems and emphasizes conscious experience.
A. |
B. |
C. |
D. |
d. Humanistic
12. __________ is the scientific study of how medication alters perceptions, moods, behaviors, and other aspects of psychological functioning.
A. |
B. |
C. |
D. |
d. Psychopharmacology
13. Overall, psychotherapy is cost-effective and helps to decrease disability, hospitalization, and problems at work. Which of the following factors seems to reduce its effectiveness?
A. |
B. |
C. |
D. |
b. limitations on choice of therapist as mandated by a health insurance policy
14. Electroconvulsive therapy (ECT) is a technique that essentially causes __________ in the brain.
A. |
B. |
C. |
D. |
c. seizures
15. One factor a therapist needs to consider is how __________ may interact with the therapy process: whether a client is from a group that is collectivist or one that values individualism.
A. |
B. |
C. |
D. |
a. culture
16. Compare cognitive behavioral therapy to insight therapies.
Answers will vary, but may be based on the following information. Cognitive behavior therapy is an action-oriented type of therapy that requires clients to confront and resist their illogical thinking. Insight therapies aim to increase awareness of self and the environment. These approaches share common features: The relationship between the client and the treatment provider is of utmost importance, as is a sense of hope that things will get better. And these approaches generally seek to reduce symptoms and increase the quality of life, whether a person is struggling with a psychological disorder or simply wants to be more fulfilled.
17. Beck identified a collection of common cognitive distortions. Describe two of these distortions and give examples of each.
Answers will vary (see Table 14.2).
18. How would a behavior therapist help someone overcome a fear of rats?
Answers will vary, but may be based on the following information. Exposure is a therapeutic technique that brings a person into contact with a feared object or situation while in a safe environment, with the goal of extinguishing or eliminating the fear response. An anxiety hierarchy (a list of activities ordered from least to most anxiety-provoking) can be used to help with exposure. Aversion therapy is an approach that uses principles of classical conditioning to link problematic behaviors to unpleasant physical reactions.
19. How does culture influence and interact with the therapeutic process?
Answers will vary, but may be based on the following information. One challenge of providing therapy is to meet the needs of clients from vastly different cultures. Within any group, there is great variation from one individual to the next, but it is still necessary for the therapist to keep in mind the client’s cultural experience. This includes being respectful of cultural norms and sensitive to the many forms of prejudice and discrimination that people can experience. Every client has a unique story and a singular set of psychological needs. Responding to those needs and determining which approach will be most effective are key to successful therapy.
20. Describe several strengths and weaknesses of online psychotherapy.
Answers will vary, but may be based on the following information. As more people gain access to the Internet and as more therapists try to specialize and market their services, online therapies have multiplied. E-therapy can mean anything from e-mail communications between client and therapist to real-time sessions via a webcam. These digital tools are valuable for serving rural areas and providing treatment to those who would otherwise have no access. Videoconferencing is also useful for consultation and supervision. But online psychotherapy raises many concerns, including licensing and privacy issues, lack of nonverbal cues, and potential problems with developing therapeutic relationships.
Get personalized practice by logging into LaunchPad at http://www.worthpublishers.com/launchpad/sciam1e
to take the LearningCurve adaptive quizzes for Chapter 14.