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Unit 13 AP Psychology
psychotherapy - ☑️ treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth psychotherapeutic talk therapies among the dozens of types of psychotherapies we will focus on the most influential each is built on one or more of psychology's major theories: psychodynamic, humanistic, behavioral, cognitive most of these techniques can be used one on one or in groups biomedical therapy - ☑️ prescribed medications or procedures that act directly on the person's physiology offers medication or other biological treatments eclectic approach - ☑️ an approach to psychotherapy that, depending on the client's problems, uses techniques from various forms of therapy many psychotherapists describe themselves as taking an eclectic approach, using a blend of psychotherapies and many patients also can receive psychotherapy along with meds many therapists combine techniques- a girl may receive psychotherapy in her meetings with her psychiatrist and she took meds to manage her mood swings psychoanalysis - ☑️ sigmund Freud's therapeutic technique. Freud believed the patient's free associations, resistances, dreams, and transferences- and the therapist's interpretations of them- released previously repressed feelings, allowing the patient to gain self insight first of the psychological therapies few clinicians today practice therapy as Freud did, but his work deserves discussion as part of the foundation for treating psychological disorders psychoanalytic theory presumes that healiter, less anxious living becomes possible when people release the energy they had previously decotes to id-ego-superego conflicts Freud assumed that we do not know ourselves fully: "there are threatening things that we seem to want not to know- that we disavow or deny" "we can have loving feelings and hateful feelings towards the same person" notes Jonathan Shedler "and we can desire something and also fear it Freud's therapy aimed to bring patients' repressed or disowned feelings into conscious awareness by helping them reclaim their unconscious thoughts and feelings and giving them insight into the origins of their disorders, he aimed to help them reduce growth-impending conflicts TECHNIQUES: psychoanalysis is historical reconstruction psychoanalytic theory emphasizes the formative power of childhood experiences and their ability to mold the adult thus it aims to unearth ones past in hope of unmasking the present after discarding hypnosis as an unreliable excavator, Freud turned to Free Association
relatively few US therapists offer psychoanalysis: most of its underlying theory is not supported by scientific research analyst's interpretations cannot be proven or disproven and psychoanalysis takes considerable time and memory, often years of several sessions per week some of these problems have been addressed in the modern psychodynamic perspect resistance - ☑️ in psychoanalysis, the blocking from consciousness of anxiety laden material in free association when saying whatever comes to mind you will notice how you edit your thoughts: you pause for a second before uttering an embarrassing thought, you omit what seems trivial, irrelevant, or shameful- sometimes your mind goes blank or you find yourself unable to remember important details, you may joke or change the subject to something less threatening to the analyst, these mental blocks indicate resistance: they hint that anxiety lurks and you are defending against sensitive material the analyst will note your resistance and then provide insight into their meaning if offered at the right moment, this interpretation of you not wanting to talk about your mother may illuminate the underlying wishes, feelings, and conflicts you are avoiding the analyst may also offer an explanation of how this resistance fits with other pieces of your psychological puzzle including those based on analysis of your dream content over many such sessions, your relationship patterns surface in your interaction with your therapist you may find yourself experiencing strong positive or strong negative feelings for your analyst transference - ☑️ in psychoanalysis, the patients' transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent) the analyst may suggest you are transferring feelings such as dependency or mingled love and anger, that you experienced in earlier relationships with family members or other important people by exposing such feelings, you may gain insight into your current relationships interpretation - ☑️ in psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight psychodynamic theory - ☑️ therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self insight Expect problems to subside as people gain insight into their unresolved and unconscious tensions therapists who use this don't talk much about the id, ego, superego instead they try to help people understand their current symptoms they focus on themes across important relationships, including childhood experiences and the therapist relationship instead of lying on a couch, out of the therapists line of vision, patients meet with their therapist face to face these meetings take place once or twice a week rather than several times per week and often for only a few weeks or months (rather than several years) in these meetings patients explore and gain perspective into defended against thoughts and feelings Therapist David Shapiro illustrates with the case of a young man who had told women that he loved them, when knowing well that he didn't- they expected it, so he said it
The present and future are more important than the past: the goal is to explore feelings as they occur, rather than achieve insights into the childhood origins of the feelings client centered therapy - ☑️ Carl Rogers developed the widely used humanistic technique called client-centered therapy: a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to facilitate clients' growth (also called person centered therapy) Focuses on the person's conscious self perceptions non-directive therapy - ☑️ the therapist listens, without judging or interpreting and seeks to refrain from directing the client toward certain insights Believing that most people possess the resources for growth, Rogers encouraged therapists to exhibit acceptance, genuineness, and empathy and when they do this the clients may deepen their self understanding and self acceptance active listening - ☑️ empathetic listening in which the listener echoes, restates, and clarifies. A feature of Roger's client-centered therapy They echo, restate, and seek clarification of what the person expresses (verbally or nonverbally) and acknowledge the expressed feelings This is now an accepted part of therapeutic counseling practices in many high schools, colleges, and clinics The counselor listens attentively and interrupts only to restate and confirm feelings, to accept what is being expressed, or to seek clarification unconditional positive regard - ☑️ a caring, accepting, non judgemental attitude, which Carl rogers believed would help clients to develop self awareness and self acceptance Given a non judgemental, grace filled environment that provides this people may accept even their worst traits and feel valued and whole three rogeria hints to listen more actively in your own relationship - ☑️ Paraphrase: rather than saying "I know how you feel" check your understanding by summarizing the person's words in your own words Invite clarification: "what might be an example of that?" may encourage the person to say more Reflect feelings: "it sounds frustrating" might mirror what you're sensing rom the person's body language and intensity behavior therapy - ☑️ therapy that applies learning principles to the elimination of unwanted behaviors Proponents of behavior therapy doubt the healing power of self awareness (you can become aware of why you are highly anxious during tests and still be anxious) They assume that problem behaviors are the problems and the application of learning principles can eliminate them
Rather than delving deeply below the surface for inner causes, therapies using behavioral techniques view maladaptive symptoms such as phobias or sexual dysfunctions as learned behaviors that can be replaced by constructive behaviors counterconditioning - ☑️ behavior therapy procedures that use classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; include exposure therapies and aversive conditioning If a claustrophobic fear of elevators is a learned aversion to the stimulus of being in a confined space, then might one unlearn that association by undergoing another round of conditioning to replace the fear response? This pairs the trigger stimulus (in this case, the enclosed space of the elevator) with a new response (relaxation) that is incompatible with fear Indeed behavior therapists have successfully counter conditioning people with such fears 2 specific counterconditioning techniques exposure therapy and aversive conditioning replace unwanted responses exposure therapy - ☑️ behavioral techniques, such as systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imagination or actual situations) to the things they fear and avoid Mary Cover Jones plans to replace 3 year old Peter's fear of rabbits and other furry objects with a conditioned response incompatible with fear Her strategy is to associate the fear evoking rabbit with the pleasurable, relaxed response associated with eating As Peter begins his mid afternoon snack, Jones introduces a caged rabbit on the other side of the huge room- Peter while eating hardly notices On succeeding days she gradually moves the rabbit close and closer and within 2 months, Peter is tolerating the rabbit in his lap, even stroking it while he eats Moreover, his fear of other furry objects subsides as well, having been countered, or replaced, by a relaxed state that cannot coexist with fear Jones' story of Peter and the rabbi did not immediately become part of psychology's lore- it was more than 30 years later that psychiatrist Joseph Wolpe refined Jones' technique into what are now the most widely used types of behavior therapies: exposure therapies which expose people to what they would normally avoid or escape (behaviors that get reinforced by reduced anxiety) Exposure therapies have them face their fear, and thus overcome their fear of the fear response itself As people can habituate to the sound of a train passing their new apartment, so, with repeated exposure can they become less anxious responsible to things that once petrified them systematic dessensitization - ☑️ a type of exposure therapy that associates a pleasant, relaxed state with gradually increasing anxiety triggering stimuli. Commonly used to treat phobias One widely used exposure therapy Wolpe assumed, as did Jones, that you cannot be simultaneously relaxed and anxious so therefore, if you can repeatedly relax when facing anxiety provoking stimuli, you can gradually eliminate your anxiety The trick is to proceed gradually If you are afraid of public speaking as in social anxiety disorder- a therapist might first ask for your help in constructing a hierarchy of anxiety triggering speaking situations, yours might range from
the problem is that cognitive influences conditioning- people know that outside the therapist's office they can drink without fear of nausea their ability to discriminate between the aversive conditioning situations and all other situations can limit the treatments effectiveness thus, therapists often use this in combo with other treatments token economy - ☑️ an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats in institutional settings, therapists may create this token economies have been successfully applied in various settings (homes, classrooms, hospitals, institutions for juvenile offenders) and among members of various populations (including disturbed children and people with schizophrenia and other mental disabilities) behavior modification - ☑️ reinforcing desired behaviors and withholding reinforcement for undesired behaviors using operant conditioning to solve specific behavior problems has raised hopes for some otherwise hopeless cases: children with intellectual disabilities have been taught to care for themselves socially withdrawn children with autism spectrum disorder have learned to interact people with schizophrenia have been helped to behave more rationally in their hospital ward cognitive therapy - ☑️ therapy that teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions assume that our thinking colors our feelings: between the event snd out response lies the mind self blaming and overgeneralized explanations of bad events are often an integral part of the vicious cycle of depression the depressed person interprets a suggestion as criticism, disagreement as dislike, praise as flattery, friendliness as pity ruminating on such thoughts sustains the negative thinking if such patterns can be learned then surely they can be replaced cognitive therapists therefore try in various ways to teach people new, more constructive ways of thinking if people are miserable, they can be helped to change their minds rational emotive behavior therapy - ☑️ a confrontational cognitive therapy, developed by Albert Ellis, that vigorously challenges people's illogical, self-defeating attitudes and assumptions Albert Ellis believes many problems arise from irrational thinking change people's thinking by revealing the absurdity of their self defeating ideas, the sharp tongued Ellis believed and you will change their self defeating feelings and enable healthier behaviors Aaron Beck's theory of depression - ☑️ cognitive therapist Aaron Beck also believes that changing people's thinking can change their functioning, though he has a gentler approach originally trained in Freudian techniques, Beck analysed the dreams of depressed people he found recurring negative themes of loss, rejection, and abandonment that extended into their waking thoughts
such negativity even extends into therapy as cliente tefall and rehearse their failings and worst impulses with cognitive therapy, Beck and his colleagues have sought to reverse clients catastrophizing beliefs about themselves, their situations, and their futures. gentle questioning seeks to reveal irrational thinking and then to persuade people to remove the dark glasses through which they view life we often think in words so therefore getting people to change what they say to themselves is an effective way to change their thinkin stress inoculation training - ☑️ Donald Meichenbaum teaching people to restructure their thinking in stressful situations sometimes it may be enough to simply say positive things to oneself after being trained to dispute their negative thoughts, depression prone children, teens and college students exhibit a grateful reduced rate of future depression to a large extent, it id the thought that counts cognitive behavioral therapy - ☑️ a popular integrative therapy that combines cognitive therapy (changing self defeating thinking) with behavior therapy (changing behavior) it seeks to make people aware of their irrational thinking, to replace it with new ways of thinking, and to practice the more positive approach in everyday settings behavioral change is typically addressed first, followed by sessions on cognitive change; the therapy concludes with a focus on maintaining both and preventing relapses anxiety and mood disorders share a common problem; emotion regulation an effective CBT program for these emotional disorders trains people both to replace their catastrophizing thinking with more realistic appraisals and as homework, to practice behaviors that are incompatible with their problem a person might for example keep a log of daily situations associated with negative and positive emotions and engage more in activities that lead them to feeling good or those who fear social situations might be assigned to practice approaching people CBT may also be useful with OCD- in one study people learned to prevent their compulsive behaviors by relabeling their obsessive thoughts: feeling the urge to wash their hands again they would tell themselves "im having a compulsive urge" and attribute it to their brains abnormal activity as previously viewed in their PET scans instead of giving into the urge they would then spend 15 min in an enjoyable alternative behavior such as practicing an instrument gardening or walking this helped unstick the brain by shifting attention and engaging other brain areas for 2-3 months the weekly therapy sessions continued with relabeling and refocusing practice at home by the study's end most participants symptoms had diminished and their PET scans revealed normalized brain activity many other stidied confirm CBTs effectiveness f group therapy - ☑️ therapy conducted with grouped rather than individuals, permitting therapeutic benefits from group interaction except for traditional psychoanalysis most therapies may also occur in small groups
the more meetings members attend, the greater their alcohol abstinence in one study of 2300 veterans who sought treatment for alc use disorder, a hugh legel of AA involvement was followed by diminished alcohol problems in an individualistic age with more and more people living alone or feeling isolated, the popularity fornsupport groups seemd tonreflect a linging for community ajd connectedness more than 100 million americans belong to small religious, interest, or self jelp groups thats meet regulary and 9 in 10 report thay group members "support wach other emotionall6" meta analysis - ☑️ The best are randomized clinical trials in which researchers randomly assign people on a waiting list to therapy or to no therapy and later evaluate everyone using tests and assessments by others who don't know whether therapy was given The results of many such studies are then digested by means of meta-analysis: a procedure for statistically combining the results of many different research studies Simply said, it gives us the bottom line results of lots of studies evidence based practice - ☑️ clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences To encourage this in psychology, the American Psychology Association and others have followed the Institute of Medicine's lead, advocating that clinicians integrate the best available research with clinical expertise and with patient preferences and characteristics Available therapies should be rigorously evaluated and then applied by clinicians who are mindful of their skills and of each patient's unique situation Increasingly, insurer and government support for mental health services requires evidence based practice alternative therapies - ☑️ clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences To encourage this in psychology, the American Psychology Association and others have followed the Institute of Medicine's lead, advocating that clinicians integrate the best available research with clinical expertise and with patient preferences and characteristics Available therapies should be rigorously evaluated and then applied by clinicians who are mindful of their skills and of each patient's unique situation Increasingly, insurer and government support for mental health services requires evidence based practice light exposure therapy - ☑️ Treats seasonal affective disorder (SAD); scientifically proven to be effective, exposure to daily doses of intense light. Increases activity in the adrenal gland and the superchiasmatic nucleus. From 20 carefully controlled trials we have a verdict: morning bright light does indeed dim depression symptoms for many of those suffering in a seasonal pattern Moreover it does so as effectively as taking antidepressant drugs or undergoing cognitive behavioral therapy The effects are clear in brain scans; light therapy sparks activity in a brain region that influences the body's arousal and hormones
commonalities among psychotherapies - ☑️ Jerome Frank Marvin Goldfried and Padawer, Hans strupp, and Bruce Wampold have studied the common ingredients of various therapies- they suggest that all therapies offer at least 3 benefits Hope for demoralized people: people seeking therapy typically feel anxious, depressed, devoid of self esteem, and incapable of turning things around What any therapy offers if the expectation that, with commitment from the therapy seeker, things can and will get better This belief, apart from any therapeutic technique, may function as a placebo, improving morale, creating feelings of self efficacy, and diminishing symptoms A new perspective: every therapy also offers people a plausible explanation of their symptoms and an alternative way of looking at themselves or responding to their world Armed with a believable fresh perspective, they may approach lfe with a new attitude, open to making changes in their behaviors and their views of themselves An empathetic, trusting, caring relationship: to say that therapy outcome is unrelated to training and experiece is not to say all therapists are equally effective No matter what therapeutic techniwue they use, effective therapists are empathetic people who seek to understand another's experience; who communicate their care and concern to the client; and who earn the client's trust through respectful listening, reasurane, and advice Marvind Goldfried and his associates found these qualities in recorded herapy sessions from 36 recognized master therapists Some took a cognitive behavioral approach, others emphasized psychodyanmic teachings but regardless, the striking finding was how similar they were At key moments, the empathetic therapists of both persuasions would help clients evaluate themselves, linke one aspect of their life with another, and gain isnight into their interactions with ot therapeutic alliance - ☑️ a bond of trust and mutual understanding between a therapist and client, who work together constructively to overcome the client's problem The emotional bond between therapist and client that is a key aspect of effective therapy One US national institute of Mental Health depression treatment study confirmed that the most effective therapists were those who were perceived as most empathetic and caring and who established the closest therapeutic bonds with their clients That all therapies offer hope through a fresh perspective offered by a caring person is what also enables paraprofessionals (briefly trained caregivers) to assist so many troubled people so effectively resilience - ☑️ the personal strength that helps most people cope with stress and recover from adversity, even trauma We have seen that lifestyle change can help reverse some of the symptoms of psychological disorders Might such change also prevent some disorders by building individual's resilience Faced with unforeseen trauma, most adults exhibit resilience This was true of new yorkers in the aftermath of 911, especially those who enjoyed supportive close relationships and who had no recently experienced other stressful events More than 9 in 10 new yorkers although stunned and grief stricken did not have a dysfunctional stress reaction By the following January, the stress symptoms of those who did were merely gone
these drugs are often used in combination with psychological therapy one antianxiety drug, the antibiotic D cumycloserinenl acts upon a receptor that, in combo with behavioral treatments, facilitates the extinction of learned fears experiments indicate that the frug enhanced the benefits of exposure therapy and helps relieve the symptoms of posttraumatic stress disorder and ocd a criticism sometimes made of the behavior therapies, that they reduce symptoms without resolving underlying problems, id also made of drug therapies unlike the behavior therapies, these dubstances may be used as an ongoing treatment popping a xanax ar the first sign of tension can create w learner response, rhe immediate relief reinforces a person's tendency to take drugs when anxious antianxiety drugs can also be addicting: after heavy use, people who stop taking them may experience increased anxiety, insomnia, and other withdrawal symptoms over the dozen years at the end of the twentieth century, the rate of outpatient treatment for anxiety disorders, ocd, and ptsd nearly doubled the proportion of psychiatric patients receiving meds during that time increased frpm 52 to 70 percent and the new standard frug for treatment or andiety disorders is antidepressants antidepressants - ☑️ drugs used to treat depression, anxiety disorders, obsessive compulsive disorder, and post traumatic stress disorder. (several widely used antidepressant drugs are selective serotonin reuptake inhibitors- SSRIs named for their ability to life people up from a state of depression and this was their main use until recently this label is a bit of a misnomer now that these frugs are increasingpy being used to successfully treat anxiety disorders, ocd, and ptsd these drugs are agonisst, they work by increasing the abailablity of certain neurotransmitters, euch as norepinephrine and serotonin, which elevate arousal and lood and appear scarce when a person rxperienced feelings of depression or anxiety Fluoxetine which tens of millions of users worldwide have known as Prozac, falls into this category of drugs Prozac and its cousins Zoloft and Paxil, work by blocking the reasportion and removal of serotonin from synapses Given their use in treating disorders other than depression, from axneity to storkes, this group of drugs is moft often called SSRIs rather than antidepressants Some of the older antidepressant drgus work by blocking the reabsorption or breakdown of both norepinephrine and srotonin Though effective, these dual action drugs have more potential side effects, such as dry mouth, weight gain, hypertension, or dizzy spells Administering them by means of a patch, bypassing the intestines and liver, helps reduce such side effects After the introduction of SSRI drugs, the percentage of patients receiving medication for depression jumped dramatically from 70% in 1987 the year before SSRIs were introducted to 89% in 2001 From 1996 to 2005, the number of americans prescribed antidepressant drugs doubled from 13- million Between 2002 and 2007 in Australia, antidepressant drug use increased 41% Be advised: patients with d lithium -
☑️ mood stabilizing medication:In additing to antipsychotic, antianxiety, and antidepressant drugs, psychiatrists have mood stablizing drugs in their arsenal For those suffering the emotional highs and lows of bipolar disorder, the simple salt lithium can be an effective mood stablizer Australian pysician John Cade discovered this in the 1940s when he administered lithium to a patient with severe mania and the patient becomes perfectly well in less than a week After suffering mood swings for years, about 7 in 10 people with bipolar disorder benefit from a long term daily dose of this cheat saltt, which helps prevent or ease manic episoders and to a lesser extent, lifts depression It also protects neural health, thus reducing bipolar patients' vulnerability to significant cognitive decline Lithium also reducses bipolar patients' risk of suicide to about one sixth of bipolar patients not taking lithium Lithium amounts in drinking water have also correlated with lower suicide rates and lower crime rates Although we do not fully understand why, lithium works and dso does Depakote, a drug originalyl used to treat epilepsy and more recently found effective in the control of manic episodes associated with bipolar disorder electroconvulsive therapy (ECT) - ☑️ a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient This is a more controversial brain manipulation offers through shock treatment When it was first introduced in 1938, the wide awake patient was strapped to a table and jolted with roughly 100 volts of electricity to the brain, producing racking convulsion and breif unconsciousness ECTtherefore gained a barbaric image, one that lingers Today, however, the patient receives a general anesthetic and a muscle relaxant to prevent injury from seizures before a psychiatrist delivers 30-60 seconds of electrical cuyrrent Within 30 min, the patient awakens and remembers nothing of the treatment or of the preceding hours After 3 such sessions each week for two or four weeks, 80% or more of people receiving ECT improve markedly, showing some memory loss for the treatment period but no discernible brain damage Study after study confirms that ECT is an effective treatment for severe depression in "treatment- resistant" patients who have not responded to drug therapy An editorial in the Journal of the American Medical Association concluded that "the results of ECT in treating severe depression are among the most positive treatment effects in all of medicine How does ECT alleviate severe depression? After more than 70 years, no one knows for sure One recpient likened ECT to the smallpox vaccine, which was saving lives before we knew how it worked Others think of it as rebooting their cerebral computer Perahps the shock induced seizures calm neural centers where oberactivity produces depression making it therapeutic ECT like antidepressant drugs and excercise, also appears to boost the production of new brain cells Skeptics have raqised on other possible explanation for how ECT works; as a placebo ef
carl rogers - ☑️ 1902-1987; Field: humanistic; Contributions: founded person-centered therapy, theory that emphasizes the unique quality of humans especially their freedom and potential for personal growth, unconditional positive regard, fully functioning person, active listening sigmund freud - ☑️ Austrian physician whose work focused on the unconscious causes of behavior and personality formation; founded psychoanalysis. Joseph wolpe - ☑️ Used classical conditioning theory in psychotherapy and introduced Systematic Desensitatization and concepts of reciprocal inhibition which he applied to reduce anxiety. In treatment he paired relaxation with an anxiety -provoking stimulus until the stimulus no longer produced anxiety. bf skinner - ☑️ 1904-1990; Field: behavioral; Contributions: created techniques to manipulate the consequences of an organism's behavior in order to observe the effects of subsequent behavior; Studies: Skinner box Albert ellis - ☑️ pioneer in Rational-Emotive Therapy (RET), focuses on altering client's patterns of irrational thinking to reduce maladaptive behavior and emotions Aaron beck - ☑️ pioneer in Cognitive Therapy. Suggested negative beliefs cause depression. Philippe Pinel - ☑️ French physician who worked to reform the treatment of people with mental disorder Dorothea Dix - ☑️ A reformer and pioneer in the movement to treat the insane as mentally ill, beginning in the 1820's, she was responsible for improving conditions in jails, poorhouses and insane asylums throughout the U.S. and Canada. She succeeded in persuading many states to assume responsibility for the care of the mentally ill. She served as the Superintendant of Nurses for the Union Army during the Civil War. Eye Movement Desensitization and Reprocessing (EMDR) - ☑️ : francine shapiro, eyes dart to and fro and is supposed to relieve anxiefy, the person thinkfs of a traumatic experience and eyes move back wnd forth -skeptics say it does nothing and that is magnifies the placebo effect -edmr is effective but it could also be effective doing any other task that aids the placebo effect doesnt have to be eye movement
