Talk Therapies
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"Talk therapies," shown in the diagram, are forms of psychotherapy that seek to increase insight into clients' difficulties.
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Figure 14.1
Study Organizer
An overview of the three major approaches to therapy
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In psychoanalysis, the therapist seeks to identify the patient's unconscious conflicts and to help the patient resolve them. In modern psychodynamic therapy, treatment is briefer and the therapist takes a more
directive approach (and puts less emphasis on unconscious childhood memories) than in traditional psychoanalysis.
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Humanistic therapy, such as Rogers's client-centered therapy, seeks to maximize personal growth, encouraging people to actualize their potential and relate to others in genuine ways.
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Cognitive therapy seeks to help clients challenge faulty thought processes and adjust maladaptive behaviors. Ellis's rational-emotive behavior therapy (REBT) and Beck's
cognitive-behavior therapy are important examples of cognitive therapy.
2.
Behavior Therapies
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In behavior therapy, the focus is on the problem behavior itself, rather than on any underlying causes. The therapist uses learning principles to change behavior.
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Classical conditioning techniques include systematic desensitization and aversion therapy, shown in the diagram.
Figure 14.9
Aversion therapy
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Operant conditioning techniques used to
increase adaptive behaviors include shaping and reinforcement.
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In modeling therapy, clients observe and imitate others who are performing the desired behaviors.
3.
Biomedical Therapies
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Biomedical therapies are based on the premise that chemical imbalances or disturbed nervous system functioning contribute to problem behaviors.
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Psychopharmacology is the most common form of biomedical therapy. Major classes of drugs used to treat psychological disorders
are antianxiety drugs, antipsychotic drugs, mood stabilizer drugs, and antidepressant drugs (shown in the diagram).
Figure 14.11
How antidepressants affect the brain
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In electroconvulsive therapy (ECT), an electrical current is passed through the brain, stimulating convulsions that produce changes in the central and peripheral nervous systems. ECT is used primarily in cases of severe depression that do not respond to other treatments.
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The most extreme biomedical
therapy is psychosurgery. Lobotomy, an older form of psychosurgery, is now outmoded. Recently, psychiatrists have been experimenting with a more limited and precise surgical procedure called deep brain stimulation (DBS).
4.
Psychotherapy in Perspective
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All major forms of therapy are designed to address disturbed thoughts, disturbed emotions, disturbed behaviors, interpersonal and life situation difficulties, and biomedical disturbances. Research indicates that, overall,
therapy does work (as shown in the graph).
Figure 14.13
Is therapy generally effective?
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In group therapy, multiple people meet together to work toward therapeutic goals. A variation is the self-help group, which is not guided by a professional. Therapists often refer their patients to group therapy and self-help groups to supplement individual therapy.
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In family therapy, the aim is to change maladaptive family interaction patterns. All members of the family attend
therapy sessions, though at times the therapist may see family members individually or in twos or threes.
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Therapies in all cultures have certain key features in common; however, there are also important differences among cultures. Therapists must recognize cultural differences in order to build trust with clients and effect behavioral change. Therapists must also be sensitive to possible gender issues in therapy.
psychopharmacology, the study of drug effects on mind and behavior, has helped make drug therapy the most widely used biomedical therapy. Antipsychotic drugs, used in treating schizophrenia, block dopamine activity. Side effects may include tardive dyskiesia (with involuntary movements of facial muscles, tongue, and limbs) or increased risk of obesity and diabetes. Antianxiety drugs, which depress central nervous system activity, are used to treat anxiety disorders. These drugs can be physically and psychologically addictive. Antidepressant drugs, which increases the availability of serotonin and norepinephrine, are used for depression, with modest effectiveness beyond that of a placebo drug. The antidepressants known as selective serotonin re uptake inhibitors (often called SSRI drugs) are now used to treat other disorders, including strokes and anxiety disorders. Lithium and Depakote are mood stabilizers prescribed for those with bipolar disorder. Studies may use a double blind procedure to avoid the placebo effect and researcher's bias.