Ch. 13 Psych

Any psychological technique used to facilitate positive changes in personality, behavior, or adjustment

• Involves only one client & one therapist
• Client (patient)- the one who participates in psychotherapy
• Rogers used "client" to equalize therapist-client relationship & de-emphasize doctor-patient concept

Several clients participate at the same time

Goal is for clients to gain deeper understanding of their thoughts, emotions, and behaviors

Goal is to change maladaptive behaviors, thoughts, or habits without seeking insight into origins or meanings

Therapist provides strong guidance

Clients are largely responsible for solving their own problems with limited assistance from the therapist

Unlimited amount of time and/or sessions

• Any therapy that limits numbers of sessions
• Partial response to managed care and to ever-increasing caseloads
• Caseload: number of clients a therapist actively sees

• Therapy is not equally effective for all problems
• Major benefit of therapy is to provide comfort, support, & a way to make constructive changes
• Unrealistic to expect therapy to undo a person's past
• Positive Therapy- designed to enhance personal strengths rather than "fix" weaknesses

• For primitive "therapists," refers to boring, chipping, or bashing holes into a patient's head
• Goal presumably to relieve pressure or rid the person of evil spirits
• In primitive times it was unlikely the patient would survive; this may have been a goal
• For modern usage, refers to any surgical procedure in which a hole is bored into the skull

• Study of demons & people plagued by spirits
• People were possessed, & they needed an exorcism to be cured
• Exorcism: practice of driving off an "evil spirit"

• Psychotic-like condition due to ergot poisoning
• Ergot: 
• Natural source of LSD
• Grew on rye (grain) fields in Middle Ages
• Eating tainted bread would have produced symptoms of "madness" or "bewitchment"
• May have given rise to demonology

• French physical who initiated humane treatment of mental patients in 1793
• Created the first mental hospital

• -Hysteria: Physical symptoms (like paralysis or numbness) occur without physiological causes; now called somatoform disorders
• -Became convinced that hysterias were caused by deeply hidden unconscious conflict
• -Developed therapy to help patients gain insight into those conflics

• Developed by Sigmund Freud
• Individual, directive, insight therapy
• "Neurosis" and "hysteria" were caused by repressed memories, motives, & conflict
• Goal: reduce internal conflicts

• Based on psychoanalytic theory but designed to produce insights more quickly
• Uses direct questioning to reveal unconscious conflicts

Designed to help depressed people improve relationships with others

• Carl Rogers; also known as Person-Centered
• Individual, nondirective, & based on insights from conscious thoughts & feelings
• Therapist creates a safe "atmosphere of growth"
• Emphasizes accepting one's true self
• Rogers used "client" to equalize therapist-client relationship & de-emphasize doctor-patient concept

Unshakable acceptance of another person, regardless of what they tell the therapist or how they feel

Ability to feel what another person is feeling; capacity to take another person's point of view

Ability of a therapist to be genuine & honest about his or her feelings

• Rephrasing or repeating thoughts & feelings of the clients'
• Helps clients to become aware of what they are saying & to see themselves more clearly

• Insight therapy that focuses on problems of existence
• Existence, realities of death, burden of responsibility, choice, & meaninglessness create anxiety
• Emphasis on Free Will
• Gives clients courage to make rewarding & socially constructive choices

• Fritz Perls
• Focuses on immediate awareness to help clients rebuild thinking, feeling, & acting into connected wholes
• Clients are taught to expand their personal awareness & to accept responsibility for their thoughts, feelings, & actions
• Emphasizes integration of fragmented experiences (filling in the gaps)

• More directive than client centered or existential therapy
• Emphasizes present experiences
• According to Fritz Perls, emotional health comes from knowing what you want to do, not dwelling on what you should do, ought to do, or should want to do

• Use of learning principles to make constructive changes in behavior
• Deep insight is often not necessary
• Focus on the present; cannot change the past, and no reason to alter that which has yet to occur
• Behaviorists assume that people learned to be the way they are; they can relearn more appropriate behaviors

Learned dislike or negative emotional response to a stimulus

• Associate a strong aversion to an undesirable habit like smoking, overeating, or drinking alcohol.
• Example: Rapid Smoking
• Example: Response-contingent shocks for alcoholics

• Rank-ordered series of steps, amounts, or degrees
• Begin with least offensive & gradually move to more threatening stimuli

• One emotional state is used to block another
• Example: impossible to be anxious & relaxed at the same time

• Guided reduction in fear, anxiety, or aversion
• Attained by approaching a feared stimulus gradually while maintaining relaxation
• Best used to treat phobias: intense, unrealistic fears

Reduction in fear that takes place secondhand when a client watches models perform the feared behavior

Live or filmed person who serves as an example for observational learning

• Uses computer-generated, 3D "world"
• Presents computerized fear stimuli to patients in a controlled fashion

• Reduces fear & anxiety by holding upsetting thoughts in your mind while rapidly moving your eyes from side to side
• Highly controversial
• Some argue it is effective
• Some argue that eye movement is ineffective; vale comes from gradual exposure to upsetting stimuli

Responses that are followed by a reward tend to occur more frequently

A response that is not followed by a reward will occur less frequently

If response is NOT followed by reward after it has been repeated many times, it will go away

If a response if followed by a discomfort or an undesirable effect, the response will decrease/ be suppressed (but not necessarily extinguished)

Rewarding actions that are closer & closer approximations to a desired response

Controlling responses in the situation in which they occur

Removing individual from a situation in which reinforcement occurs

• Symbolic rewards like poker chips, gold stars, or stamps that can be exchanged for real rewards
• Can be used to reinforce positive responses immediately
• Effective in psychiatric hospitals & sheltered care facilities

• Aaron Beck
• Therapy that helps clients change thinking patterns that lead to problematic behaviors or emotions
• Cognitive therapy is VERY effective in treating depression

• Cognitive therapists make a step-by-step effort to correct negative thoughts leading to depression
• Clients are taught to keep track of thoughts
• Client & therapist challenge ideas & beliefs
• Clients gather information to test their beliefs
• Look for the absence of effective coping skills, not presence of self-defeating thoughts

• Selective perception: perceiving only certain stimuli in a larger group of possibilities
• Overgeneralization: allowing upsetting events to apply to unrelated situations
• All-or-Nothing Thinking: seeing objects and events as absolutely right or wrong, good or bad, & so on

• Albert Ellis
• Attempts to change irrational beliefs that cause emotional problems
• Example: Anya thinks, "I must be liked by everyone; if not, I'm a rotten person."

• Analyzes ABCs of behavior:
•  -A= Activating Experience
•  -B= Beliefs (often irrational & unrealistic)
•  -C= Consequence
• General pattern (example):
•  -Person who is rejected (A)
•  -Feels depressed or hurt (C)
•  -Because of (B)

• 1. I must perform well & be approved of by significant others. If I don't, then it is awful, I cannot stand it, & I am a rotten person.
• 2. You must treat me fairly. When you don't, it is horrible, & I cannot bear it.
• 3. Conditions must be the way I want them to be. it is terrible when they are not, & I cannot stand living in such an awful world.

• Chronic Gamblers often hold several irrational beliefs or cognitive distortions
•   -Magnified gambling skill
•   -Attribution errors
•   -Gambler's fallacy
•   -Selective memory
•   -Overinterpretation of cues
•   -Luck as a trait
•   -Probability biases

• Therapeutic Alliance: caring relationship between the client & therapist
• Work to "solve" client's problems
• Therapy offers a protected setting where emotional catharsis (release) can occur
• Provides clients with a new perspective about themselves & their situations, & a chance to practice new behaviors

• Major mental disorders are often treated medically
• Somatic (bodily) therapies include:
• Pharmacotherapy
• Electrical stimulation therapy
• Psychosurgery
• Often done in a psychiatric hospitalization context
• Typically administered by psychiatrists

• Use of drugs to alleviate emotional disturbance
• Three classes--
• Anxiolytics: produce relaxation or reduce anxiety
• Antidepressants: elevate mood & combat depression
• Antipsychotics/Major Tranquilizers: Tranquilize & also reduce hallucinations & delusions in larger dosages

• Work to alter the electrical activity of brain
• Electroconvulsive Therapy (ECT):
• 150 volt electric shock is passed thru brain for about 1 sec, inducing a convulsion
• Based on belief that seizure alleviates depression by "resetting" biochemical & hormonal balance

• Any surgical alteration of the brain
• Cannot be reversed
• Prefrontal Lobotomy: (1) Frontal lobes i brain are surgically cut from other brain areas. (2) Supposed to calm people who did not respond to other forms of treatment. (3) Was not very successful & has undesirable side effects.
• Deep Lesioning: (1) Small target areas in the brain are destroyed by using an electrode. (2) Can help specific disorders.

• Reduced use of full-time commitment to mental institutions
• Limited success:
• (1) Done to save money
• (2) Chronic patients discharged without adequate care

Individual who works in a near-professional capacity under supervision of a more highly trained person