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Therapy Cognitive behavioral Therapy


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									Therapy-Chapter 15

The Psychological Therapies
Humanistic Therapies
Behavior Therapies
Cognitive Therapies
Group and Family Therapies
Evaluating Psychotherapies
Is Psychotherapy Effective?
The Relative Effectiveness of Different Therapies
Evaluating Alternative Therapies
Commonalities Among Psychotherapies
Culture and Values in Psychotherapy
The Biomedical Therapies
Drug Therapies
Brain Stimulation
Therapeutic Life-Style Changes
Preventing Psychological Disorders
     History of Insane Treatment- ___________________________ of the insane
        throughout the ages was the result of irrational views. Many patients were
        subjected to strange, debilitating, and downright dangerous
     __________________________ in France and ______________________ in
        America founded ______________________ movements to care for the mentally
     _______________________ involves an emotionally charged, confiding
        _______________________ between a trained therapist and a mental patient.
     Biomedical therapy uses _______________________ or other
        _______________________that act on the patient’s
        _______________________system, treating his or her psychological disorders.
     An _______________________ approach uses various forms of healing
        techniques depending upon the
Psychological Therapies
We will look at four major forms of psychotherapies based on different theories of human
    1. Psychoanalytic theory
    2. Humanistic theory
    3. Behavioral theory
    4. Cognitive theory

1. Psychoanalysis
The first formal psychotherapy to emerge was psychoanalysis, developed by
        Psychoanalysis: Aims
     Since psychological problems originate from childhood
        _______________________, the aim of psychoanalysis is to bring repressed
        feelings into conscious awareness where the patient can deal with them.
     When energy devoted
        ______________________________________________conflicts is released, the
        patient’s anxiety lessens.
        Psychoanalysis: Methods
     Dissatisfied with _______________________ Freud developed the method of
        ______________________________________________to unravel the
        unconscious mind and its conflicts.
     The patient lies on a couch and speaks about _______________________comes
        to his or her mind.
     During free association, the patient _______________________his thoughts,
        resisting his or her feelings to express emotions. Such
        _______________________becomes important in the analysis of conflict-driven
     Eventually the patient _________________________________and reveals his or
        her innermost private thoughts, developing positive or negative feelings
        (_______________________) towards the therapist.
        Psychoanalysis: Criticisms
     Psychoanalysis is hard to refute because it cannot be _______________________
        or _______________________.
     Psychoanalysis takes a _______________________and is very
        _______________________ Therapy
             Influenced by Freud, in a face-to-face setting, psychodynamic therapists
                understand symptoms and themes across important relationships in a
                patient’s life.
                _______________________ Therapies
                _______________________ psychotherapy, a variation of psychodynamic
                therapy, is effective in treating _______________________. It focuses on
                symptom relief ____________and ___________, not an overall
                _______________________ change.
2. Humanistic Therapies
        Humanistic therapists aim to boost __________-_____________by helping
        people grow in self-awareness and self-acceptance.
        _______________________Therapy- Developed by
        _______________________, client-centered therapy is a form of humanistic

       The therapist _______________________to the needs of the patient in an
       accepting and non-judgmental way, __________________________________in a
       productive way and building his or her __________-_____________.
       Humanistic Therapy
       The therapist engages in _______________________and echoes, restates, and
       clarifies the ______________________________________________,
       acknowledging expressed feelings.
3. Behavior Therapy-Therapy that applies
       ______________________________________________ to the elimination of
       unwanted behaviors.
       To treat ____________________ or _______________________, behavior
       therapists do not delve deeply below the surface looking for inner
            ______________________________________________is a procedure
               that conditions new _______________________ to stimuli that trigger
            It is based on classical conditioning and includes exposure therapy and
               aversive conditioning.
                       Exposure Therapy
                       Expose patients to things they _____________and __________.
                       Through repeated exposures, anxiety lessens because they
                       habituate to the things feared.
                       Exposure therapy involves exposing people to fear-driving objects
                       in _______________________or _______________________
                                       ______________________________-A type of
                                       exposure therapy that associates a pleasant, relaxed
                                       state with ________________ increasing anxiety-
                                       triggering _____________ commonly used to treat
                       Aversive Conditioning-A type of counterconditioning that
                       associates an __________________ with an unwanted
                       _________________. With this technique, temporary conditioned
                       aversion to alcohol has been reported.
       Operant Conditioning-Operant conditioning procedures enable therapists to use
       ________________________________________, in which desired behaviors are
       _____________________and undesired behaviors are either unrewarded or
       A number of withdrawn, uncommunicative 3-year-old autistic children have been
       successfully trained by giving and withdrawing reinforcements for desired and
       undesired behaviors.

                In institutional settings, therapists may create a token economy in which
                patients ________________________ a token of some sort, earned for
                exhibiting the _____________________________________, for various
                privileges or treats.
4. _______________________Therapy- Teaches people adaptive ways of
______________________ and acting based on the assumption that thoughts intervene
between events and our emotional reactions.
       Beck’s Therapy for ____________________________
     Aaron Beck (1979) suggests that depressed patients ___________________that
       they can never be happy (_____________________) and thus associate minor
       failings (e.g. failing a test [event]) in life as major causes for their depression.
     Beck believes that cognitions such as “I can never be happy” need to change in
       order for depressed patients to recover. This change is brought about by
       _____________________ _____________________________patients.
       Stress Inoculation Training
     Meichenbaum (1977, 1985) trained people to ___________________________
       their thinking in _____________________ situations.
     “Relax, the exam may be hard, but it will be hard for everyone else too. I studied
       harder than most people. Besides, I don’t need a
       ___________________________ to get a good grade.”
       ____________________-_____________________ Therapy
     Cognitive therapists often combine the reversal of self-defeated
       _____________________ with efforts to modify
     Cognitive-behavior therapy aims to alter the way people _________ (behavior
       therapy) and alter the way they ___________________ (cognitive therapy).
Group & Family Therapies-
     Group therapy -normally consists of _________________ people attending a
       90-minute session that can help more people and costs less. Clients benefit from
       knowing others have similar problems.
     Family Therapy-Family therapy treats the family as a __________________.
       Therapy guides family members toward positive _______________________ and
       improved _________________________.
Evaluating Therapies-Who do people turn to for help with psychological difficulties?
       Is Psychotherapy Effective?
       It is difficult to gauge the effectiveness of psychotherapy because there are
       different ___________________upon which its effectiveness can be measured.
    1. Does the _______________________sense improvement?
    2. Does the ______________________________ feel the patient has improved?
    3. How do _____________________ and _______________________ feel about
       the patient’s improvement?
       Client’s Perceptions
       If you ask clients about their experiences of getting into therapy, they often
       _______________________________ its effectiveness. Critics however remain

   1. Clients enter therapy in crisis, but crisis may subside over the
      _____________________________________ of time (regression to normalcy).
   2. Clients may need to _________________________ the therapy was worth the
   3. Clients generally ____________________________________ of their therapists.
      Clinician’s Perceptions
      Like clients, clinicians believe in therapy’s success. They believe the client is
      better off ______________________ therapy than if the client had not taken part
      in therapy.
   1. Clinicians are aware of failures, but they believe failures are the problem of other
   2. If a client seeks another clinician, the former therapist is more likely to argue that
      the client has developed __________________________psychological problem.
   3. Clinicians are likely to testify to the ______________________________of their
      therapy regardless of the outcome of treatment.
      Outcome Research
      How can we objectively measure the effectiveness of psychotherapy?
    ___________________________________ of a number of studies suggests that
      thousands of patients benefit more from therapy than those who did not go to
    Research shows that treated patients were __________________ better than
      untreated ones.

The Relative Effectiveness of Different Therapies
Which psychotherapy would be most effective for treating a particular problem?
Disorder         Therapy





Bed Wetting

Evaluating Alternative Therapies
57% of those who have had ______________________________ and 54% who have had
_______________________________ have used _____________________________
treatments such as herbal medicines, massage, and spiritual healing (Kessler & others,
2001). Do alternative therapies hold up under scientific scrutiny?

       ______________________________ Desensitization and Reprocessing
     In EMDR therapy, the therapist attempts to _____________ and reprocess
       previous frozen _______________________________________ by waving a
       finger in front of the eyes of the client.
     EMDR has not held up under _______________________ testing.
       ____________________________________ Therapy-
       _________________________________________ Disorder (SAD), a form of
       depression, has been effectively treated by _____________exposure therapy. This
       form of therapy has been _______________________________validated.
Commonalities Among Psychotherapies
Three commonalities shared by all forms of psychotherapies are the following:
    1. A __________________ for demoralized people.
    2. A new ________________________________.
    3. An _________________________, trusting and caring relationship.
Culture and Values in Psychotherapy
             Psychotherapists may ___________________ from each other and from
               clients in their personal beliefs, values, and cultural backgrounds.
             A ____________________________________ should include visiting
               two or more therapists to judge which one makes the client feel more
Therapists & Their Training
     __________________________ psychologists: They have PhDs mostly. They are
       experts in _____________________, __________________________and
       ___________________________, all of which is verified through a supervised
     ____________________________ psychologists: They have PhDs mostly. They
       are experts in research, assessment, and therapy, all of which is verified through a
       supervised _____________________________________.
     _____________________________: __________________________counselors
       or __________________________counselors work with problems arising from
       ________________________________________, spouse and child
       _____________________________ and their _________________________, and
       _____________________________________ abusers.
     _______________________________________: They are
       _________________________________ who specialize in the treatment of
       psychological disorders. Not all psychiatrists have extensive training in
       _________________________________, but as MDs they can
       ____________________________ __________________________.
The Biomedical Therapies-These include physical, medicinal, and other forms of
biological therapies.
    1. Drug Therapies
    2. Brain Stimulation
    3. Psychosurgery

Drug Therapies-
    ___________________________________ is the study of drug effects on
      mind and behavior.
    With the advent of drugs, ______________________________ in mental
      institutions has rapidly ______________________________.
    However, many patients are left ________________________ on the
      streets due to their ill-preparedness to __________________
      independently outside in society.
      ___________________________ Procedures- To test the effectiveness of
      a drug, patients are tested with the drug and a placebo. ______________
      groups of patients and medical health professionals are
      ________________________ of who is taking the drug and who is taking
      the _____________________________.
      Antipsychotic Drugs
           Classical antipsychotics [chlorpromazine (Thorazine)]: Remove a
               number of positive symptoms associated with schizophrenia such
               as __________________, _____________________, and
           Atypical antipsychotics [clozapine (Clozaril)]: Remove negative
               symptoms associated with schizophrenia such as
               _______________, ________________________thoughts,
               ______________________________ difficulties, and difficulties
               in ____________________________ with others. Clozapine
               (Clozaril) _______________________ receptors for
               _________________ and _________________________ to
               remove the negative symptoms of schizophrenia.
      Antianxiety Drugs
                    Antianxiety drugs (_______________________ and
                      Ativan) depress the ________________________ and
                      reduce anxiety and tension by elevating the levels of the
                      Gamma-aminobutyric acid
                      (__________________________) neurotransmitter.
      Antidepressant Drugs
                    Antidepressant drugs like ______________,
                      ___________________, and ________________________
                      ______________ (SSRIs) that improve the mood by
                      elevating levels of ______________________ by inhibiting
      Mood-Stabilizing Medications
                    ____________________________________, a common
                      salt, has been used to stabilize
                      __________________episodes in bipolar disorders. It
                      moderates the levels of norepinephrine and glutamate

Brain Stimulation- ___________________________________________ (ECT)
ECT is used for severely __________________________________ patients who do not
respond to drugs. The patient is anesthetized and given a muscle relaxant. Patients
usually get a ___________________________________________ that relieves them of
       Alternatives to ECT-
       ___________________________________________________________ (rTMS)
       In rTMS, a pulsating _______________________________l is placed over
       __________________________ regions of the brain to treat
       ____________________with minimal side effects.
Psychosurgery-Psychosurgery was popular even in Neolithic times. Although used
sparingly today, about 200 such operations do take place in the US alone.
                            Psychosurgery is used as a _________________ in
                              alleviating psychological disturbances. Psychosurgery is
                              irreversible. Removal of brain tissue
                              _________________the mind.
Preventing Psychological Disorders- Preventing psychological disorders means
removing the factors that affect _____________________________. Those factors may
be ____________________________, meaningless ___________________________,
constant _____________________________________,
______________________________, ________________________________, and


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