-be as it may, I’m gonna impose a schedule,

anyway.

APRIL important schedules

4/21 Monday Ch 15 & 16 test (no comprehensive)

4/23-4/24 block day 2 free response

4/28-4/29 Mon-Tues Review activities

4/30-5/1 block day Final exam (multiple choice)

MAY important schedules 5/5 Monday

AP exam 5/6 Tuesday

class potluck 5/7-5/8 block day

Careers in psychology project due 5/13-5/16 Tues-Fri

Work on final project 5/19-5/30 Mon-Fri

Present final projects

HW of the week 4/14-4/18 Monday

Ch 16 p.673-679 ½ Tuesday

Ch 16 p. 679-683 Block day

Ch 16 p.684-685 Study for vocab quiz

Friday Lunch review for Monday test

Agenda Monday 4/14

Return free response Therapy

Approaches (handout)

Objectives 1. Describe psychoanalytic therapeutic techniques (e.g., free

association, interpretation)2. Discuss Roger’s client-centered therapy3. Identify counterconditioning techniques4. Describe the goals of cognitive therapies5. Discuss the benefits of group therapy and family therapy6. Differentiate between antianxiety, antidepressant and

antipsychotic medication7. Describe electroconvulsive therapy and lobotomies8. Discuss the effectiveness of the psychotherapies

Things we will learn Treatment approaches Modes of therapy (individual, group,

community, preventive) Effectiveness

THERAPY

Therapy

Psycho(logical) therapy : an emotionally charged, confiding interaction between a therapist and patient (treats learned behaviors; phobia)

Biomedical therapy: use drugs or other procedures that act directly on the patient’s nervous system.

Eclectic approach: combination of various techniques.

Psychological TherapiesWe will look at four major forms of psychotherapies

based on different theories of human nature:

1. Psychoanalytical theory

2. Humanistic theory

3. Behavioral theory

4. Cognitive theory

PsychoanalysisThe first formal psychotherapy to emerge was

psychoanalysis, developed by Sigmund Freud.

Sigmund Freud's famous couch

Edm

un

d En

gle

ma

n

Therapy- Psychoanalysis

Psychoanalysis Aims to gain awareness/insight

of repressed feelings Therapist interprets patient’s

free associations, resistances, dreams, and transferences

use has rapidly decreased in recent years

Causes of Psychological Problems Undesirable urges and conflicts are

“repressed” or pushed to the unconscious Unconscious conflicts exert influence on

behaviors, emotions, and interpersonal dynamics

Psychoanalysis: Aims

Now the patient can deal with the issue (recognition, resolution); when energy devoted to id-ego-superego conflicts is released, anxiety lessens.

Psychoanalysis: MethodsFree association: saying aloud anything that comes to mind.

Analyst watches for “resistance”

Analyst interprets resistance, dreams, other behaviors (e.g., transference) and provides insight

Resistance: the defensive blocking of anxiety-laden material from the conscious

Transference: transferring to the therapist the strong feelings harbored against a family member or other significant person

Criticism relied on after-the fact interpretations and

repressed memories it is time-consuming and very costly.

Other Dynamic Therapies

Psychodynamic/interpersonal therapies

Focus: current symptoms (e.g., depression), recurring patterns in interpersonal relations

Goal: insight. client’s self awareness and understanding of past on present behavior

Shorter-term, less expensive

Humanistic Therapies People have the power to control their fate, ideas, and

movements as they move towards self-actualization.

Instead of curing a disorder, seeks to promote growth, fulfillment and self-acceptance

Humanistic Therapy Client-Centered Therapy

Carl Rogers active listening and unconditional positive

regard within a genuine, non-judgmental, empathic environment

Therapist and client are equal partners Client directs the topic and direction of the

discussion

http://www.youtube.com/watch?v=Ew8CAr1v48M

Humanistic Therapy Active Listening-empathic listening in which the listener

echoes, restates, and clarifies http://www.youtube.com/watch?v=TA-RaDNVKpw http://www.youtube.com/watch?v=4VOubVB4CTU

QW #1 Compare psychoanalytic and humanistic

theories in terms of their:1) understanding of the source of the

problem, 2) treatment techniques, and 3) therapy goals.

Joe has been seeing a psychoanalyst for four years for treatment of the fear that he had monsters under his bed. His progress was very poor, and he knew it. So, one day he stops seeing the psychoanalyst and decides to try something different.

A few weeks later, Joe's former psychoanalyst meets his old client in the supermarket, and is surprised to find him looking well-rested, energetic, and cheerful. "Doc!" Joe says, "It's amazing! I'm cured!""That's great news!" the psychoanalyst says. "you seem to be doing much better. How?""I went to see another doctor," Joe says enthusiastically, "and he cured me in just ONE session!""One?!" the psychoanalyst asks incredulously."Yeah," continues Joe, "my new doctor is a behaviorist.""A behaviorist?" the psychoanalyst asks. "How did he cure you in one session?""Oh, easy," says Joe. "He told me to cut the legs off of my bed."

Behavior TherapyApplies learning principles to eliminate/change behaviors.

To treat phobias or sexual disorders, behavior therapists do not seek to explain the origin of a behavior (psychoanalytic), or to promote self-acceptance and awareness (humanistic)

Classical Conditioning Techniques

Behaviorists assume that abnormal behaviors are the result of faulty (inappropriate) learning.

Counterconditioning: pairs new response with old stimuli (that used to trigger maladaptive behaviors)

Example: exposure therapy,

aversive conditioning

Exposure TherapyExpose patients to things they fear and avoid. Through repeated exposures, anxiety lessens because they habituate to the things feared.

The F

ar Side ©

1986 FA

RW

OR

KS

. Reprinted w

ith Perm

ission. All R

ights Reserved.

Exposure TherapyExposure therapy involves exposing people to fear-driving

objects in real or virtual environments.

*arachnophobia

N. R

ow

n/ T

he Im

age

Wo

rks

Both

Ph

otos: B

ob

Ma

ho

ney/ T

he Im

age

Wo

rks

Behavior Therapy: classical conditioning Systematic Desensitization

type of counterconditioning associates a pleasant, relaxed state with gradually

increasing anxiety-triggering stimuli commonly used to treat phobias

Uses three steps:1. Progressive relaxation

2. Development of anxiety hierarchy and control the scene

3. Combination of progressive relaxation with anxiety hierarchy

http://www.youtube.com/watch?v=lMZ5o2uruXY

http://www.youtube.com/watch?v=omYECykyQWE

Behavior Therapy Aversive Conditioning

type of counterconditioning that associates an unpleasant state with an unwanted behavior

nausea ---> alcohol

Agenda Tuesday 4/15

• Behavior and cognitive therapies

• Effectiveness of psychotherapies

Behavior Therapy

Aversion therapy for alcoholics

Operant ConditioningOperant conditioning (rewarded or punished) procedures enable therapists to use behavior modification.

* Success in training 3 year old autistic children

Behavior Therapy Token Economy

an operant conditioning procedure that rewards desired behavior

client exchanges a token for various privileges or treats

Cognitive Therapy

Cognitive Therapy

Cognitive Therapy Source: emotional disturbance comes

from cognitive bias and distorted perceptions (e.g., self-blame)

Goal: new, more adaptive ways of thinking

Cognitive Therapy for Depression

Aaron 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 gently questioning patients.

Cognitive Therapy for Depression

Rabin et al., (1986) trained depressed patients to record positive events each day, and relate how they contributed to

these events.

Stress Inoculation Training

Meichenbaum (1977, 1985) trained people to restructure their thinking in stressful 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 perfect score to get a good grade.”

• https://www.youtube.com/watch?v=95SNt21Jyyk

CBT therapists believe that emotional upsets occur when people hold irrational/negative ideas.

Cognitive Behavioral Therapy

The pioneering form is Rational-Emotive therapy, developed by Albert Ellis.

The treatment is directive and structured; involves a therapist who challenges/changes clients’ thinking

Cognitive Therapy

The Cognitive Revolution

QW #2 Compare and contrast behavior therapy,

cognitive therapy, and cognitive behavioral (rational-emotive) therapy in terms of their:

1) origin/source of the problem 2) treatment techniques 3) goals

Group TherapyGroup therapy normally consists of 6-9 people attending

a 90-minute session that can help more people and costs less. Clients benefit from knowing others have

similar problems.

© M

ary Kate D

enny/ PhotoE

dit, Inc.

Group treatment is especially helpful when members share similar (stigmatized) problems. https://www.youtube.com/watch?v=uxeR95aYer0 (~ 1:00)

p. 604

Group and Family Therapies

Family Therapy

Focus: family as a system

Origin of problem: behavior is influenced by or directed at other family members

Goal: positive relationships and improved communication

Group and Family Therapy

Couple therapy— relationship therapy that helps with difficulty in marriage or other committed relationships

Is Psychotherapy Effective?

Who can sense improvement?

Patient/clientTherapistFamily and friends

Client’s Perceptions

Clients often overestimate effectiveness of therapies.

1. We enter therapy in crisis, but crisis subsides over time (regression toward the mean).

2. Clients may need to believe the therapy was worth the effort.

3. Clients generally speak kindly of their therapists.

Evaluating Psychotherapies

Regression toward the mean tendency for extremes of unusual scores to

fall back (regress) toward their average

Outcome Research

Randomized clinical trials

Meta-analysis procedure for statistically combining the

results of many different research studies

Meta-analysis results Untreated people improve Treated people more likely to improve People who received psychotherapy spent less time and money later on medical treatment

Which psychotherapy?

Do not write on the paper!

Solve the sheet with a partner

Factors in Successful Therapy Therapeutic relationship—caring and respectful Therapist characteristics—caring, active listener,

sensitive, shared values (**no connection to training, experience, supervision, licensing)

Client characteristics—motivated, actively involved, mature

Common Benefits of Psychotherapies

1. New hope.

2. A fresh perspective.

3. An empathic, trusting and caring relationship.

© M

ary Kate D

enny/ PhotoE

dit, Inc.

Therapists and their Training

Clinical psychologists Most are psychologists with a Ph.D. and

expertise in research, assessment, and therapy, supplemented by a supervised internship

About half work in agencies and institutions, half in private practice

Therapists and their Training

Clinical or Psychiatric Social Worker A two-year Master of Social Work graduate

program plus postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems

About half have earned the National Association of Social Workers’ designation of clinical social worker

Therapists and their Training

Counselors Marriage and family counselors specialize in

problems arising from family relations Pastoral counselors provide counseling to

countless people Abuse counselors work with substance

abusers and with spouse and child abusers and their victims

Therapists and their Training

Psychiatrists Physicians who specialize in the treatment of

psychological disorders Not all psychiatrists have had extensive

training in psychotherapy, but as M.D.s they can prescribe medications. Thus, they tend to see those with the most serious problems

Many have a private practice

Agenda block day 4/16-4/17 Biomedical therapies Cinderella’s therapist

The Relative Effectiveness of Different Therapies

Which psychotherapy would be most effective for treating a particular problem?

Disorder Therapy

Depression Behavior, Cognition, Interpersonal

Anxiety Cognition, Exposure, Stress Inoculation (CBT)

Bulimia CBT

Phobia Behavior (counterconditioning)

Bed Wetting Behavior Modification

Eye Movement Desensitization and Reprocessing (EMDR)

Therapist attempts to unlock and reprocess clients’ traumatic memories by triggering eye movements (waving a finger in front of the eyes).

https://www.youtube.com/watch?v=GTLLfdcJE0Q

*EMDR has not held up under scientific testing.

Placebo effect?

Light Exposure Therapy

For Seasonal Affective Disorder (SAD), light exposure therapy has

valid effect.

Courtesy of C

hristine Brune

Biomedical Therapies

Psychopharmacology study of the effects of drugs on mind and

behavior

Antipsychotics => schizophrenia

Occupies dopamine receptor sites and dampens responsiveness to irrelevant stimuli

* side effects: Tardive dyskinesia

On the news: http://health.usnews.com/health-news/articles/2014/04/10/too-many-foster-kids-with-adhd-treated-with-antipsychotic-drugs-study

Antianxiety Drugs Antianxiety Drugs

Depress nervous system activity.

Valium, Xanax, Lithium

*side effect: drowsiness, depression, dependence

Antidepressants=> depression, anxiety Increases the availability of the scarce

neurotransmitters (serotonin), which elevate arousal and mood

Anti-Depressant Medication

• First generation—tricyclics and MAO inhibitors Effective for about 75% of patients Produce troubling side effects

MAO inhibitors can have serious physiological side effects when taken with some common foods

Tricyclics caused weight gain, dry mouth, dizziness, sedation

https://www.youtube.com/watch?v=m4PXHeHqnmE

Anti-Depressant Medication Second generation—chemically different but no

more effective than earlier drugs (Wellbutrin, Desyrel)

Selective serotonin reuptake inhibitors (SSRI)— have fewer undesirable side effects than earlier drugs

(Prozac, Paxil, Zoloft)

Fig. 15-12, p. 612

Biomedical Therapies

Antidepressant Drugs Lithium— a chemical that provides an effective drug

therapy for the mood swings of bipolar (manic-depressive) disorders.

Prozac—blocks the reabsorption and removal of serotonin from synapses.

Zoloft— cousin to Prozac; blocks reabsorption of serotonin. https://www.youtube.com/watch?v=6vfSFXKlnO0

Paxil— cousin to Prozac; serotonin-uptake-inhibitor.https://www.youtube.com/watch?v=Wt7Xq4TwOjg

Biomedical Therapies The emptying of U.S. mental hospitals

Biomedical Therapies

Biomedical Therapies Electroconvulsive Therapy (ECT)

therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient

Side effects: memory loss https://www.youtube.com/watch?v=TvXlxW-JP6Y

Psychosurgery surgery that removes or destroys brain tissue in an

effort to change behavior lobotomy

now-rare psychosurgical procedure once used to calm uncontrollably

emotional or violent patients

Preventing Psychological Disorders

Problem source: disorders result from stressful social situations

Aim: change oppressive, esteem-destroying environments into more nurturing ones.

Strategies: reduce abuse and illiteracy. Alleviate poverty, increase parenting and teaching skills

Cinderella therapists activity Form groups of 5 people Decide who will take which role

Moderator, therapist (team of 2; divvy up script), Cinderella, fairy

Each group will be reading their script. As you hear other groups, write down: (1) the correct therapy approach (2) the specific treatment technique

Activity continued- your turn http://www.buzzfeed.com/leonoraepstein/

disney-characters-who-really-need-to-see-a-psychiatrist

Select a character Write a short script with a moderator,

therapist, characters (2~3) based on one of the therapy approaches and treatment

If time Anti-depressant:Makes shrimps too calmhttps://www.youtube.com/watch?v=D1WFfTVmmOMDuring pregnancyhttp://www.cbsnews.com/videos/antidepressants-during-

pregnancy-linked-to-new-risks/

Friday agenda Vocab quiz Practice disorder and treatment Placebo effect

Lunch review today