psychology discussion paper, 6 hours due time!


Key Question

What is Therapy?

Therapy for psychological disorders takes a variety of forms, but all involve

some relationship focused on improving a person’s mental, behavioral, or

social functioning.

What is Therapy

• General term for any treatment process

• In psychology and psychiatry, therapy refers to a variety of psychological and biomedical techniques aimed at dealing with mental disorders or coping with problems of living

Modern Approaches to Therapy

Counseling psychologist

Clinical psychologist



Psychiatric nurse practitioner

Clinical social worker

Pastoral counselor

Modern Approaches to Therapy

Modern Therapies –

are based on psychological and biological theories of mind and behavior.

 Psychological therapies involve counseling.

 Biological therapies focus on altering the underlying biology of the brain usually through medication.

 Most disorders benefit from a combination of both treatment modalities.

Key Question

How Do Psychologists Treat Mental Disorders?

Psychologists employ two main forms of treatment: the insight therapies and the behavioral therapies.

Insight Therapies

Insight therapies –

• Psychotherapies in which the therapist helps patients/clients change people on the inside— changing the way they think and feel

• Aim at revealing and changing a patient’s disturbed mental processes through discussion and interpretation.

Insight Therapies

Freudian Psychoanalysis

• Psychodynamic therapies based on the assumption that psychological problems arise from tension created in the unconscious mind by forbidden impulses

• Major goal: To reveal and interpret the unconscious mind’s contents

Insight Therapies: Psychodynamic Therapies

Psychoanalysis –

• The form of psychodynamic therapy developed by Sigmund Freud

• Access to unconscious material through free association

• Help the patient understand the unconscious causes for symptoms

Insight Therapies: Psychodynamic Therapies

Psychoanalysis –

• Ego blocks unconscious problems from consciousness through defense mechanisms

 e.g., Transference; Repression

• Analysis of transference – Analyzing and interpreting the patient’s relationship with the therapist, based on the assumption that this relationship mirrors unresolved conflicts in the patient’s past

Insight Therapies: Psychodynamic Therapies

Neo-Freudian psychodynamic therapies

• Therapies developed by psychodynamic theorists who embraced some of Freud’s ideas, but disagreed with others

 Treat patients face-to-face

 See patients once a week

 Shift to conscious motivations

Insight Therapies: Humanistic Therapies

Humanistic therapies –

• Based on the assumption that people have a tendency for positive growth and self actualization, which may be blocked by an unhealthy environment

Client-centered therapy –

• Emphasizes healthy psychological growth through self- actualization (e.g. Carl Rogers )

 Reflection of feeling – Paraphrasing client’s words to capture the emotional tone expressed

 Unconditional positive regard

Insight Therapies: Cognitive Therapies

Cognitive therapy –

• Emphasizes rational thinking as the key to treating mental disorder and helps patients confront identify and change destructive thoughts

• Beck’s treatment for depression to change negative views of self, situation, and future.

Watch Video in this Module Depressive Thought Processes

Insight and Behavioral Therapies: Cognitive-Behavioral Therapy

Cognitive-behavioral therapy -

• Combines cognitive emphasis on thoughts with behavioral strategies that alter reinforcement contingencies

• Beck’s treatment for depression to change negative views of self, situation, and future.

 Even this very cognitive therapy

 Includes increasing participation in positive activities to elevate mood as a first step.

Insight Therapies: Group Therapies

Group therapy –

• Psychotherapy with more than one client

Self-help support groups –

• Groups that provide social support and an opportunity for sharing ideas about dealing with common problems; typically organized/run by laypersons – e.g. Alcoholics Anonymous

Pick the image that best represents Carl Rogers’ concept of unconditional positive regard.


Insight Therapies: Group Therapies

Couples and family counseling

• Learn about relationships

• Can be more effective than individual therapy with one individual at a time

Focused Behavioral Therapies

Behavior therapy –

Any form of psychotherapy based on the principles of behavioral learning, especially operant conditioning and classical conditioning

Systematic desensitization

Contingency management

Aversion therapy

Token economies

Participant modeling

Classical Conditioning Therapies

Systematic desensitization –

• Technique to extinguish anxiety by gradually exposing the client to feared stimuli while teaching client to pair relaxation with increasing levels of fear provoking situations

– e.g. for phobia

Watch Videos in this Module Phobias

Classical Conditioning Therapies

Exposure therapy –

• Desensitization therapy in which patient directly confronts the anxiety-provoking stimulus

– e.g. for PTSD or Obsessive-Compulsive Disorder

Classical Conditioning Therapies

Aversion therapy – Involves presenting individuals with an attractive stimulus paired with unpleasant stimulation in order to condition a repulsive reaction

Operant Conditioning Therapies

Contingency management –

• Approach to changing behavior by altering the consequences of behaviors

• Effective in numerous settings

 e.g., families, schools, work, prisons

 Often used to treat behavioral problems like Attention Deficit Hyperactivity Disorder (ADHD)

Operant Conditioning Therapies

Contingency management:

Token economies – • Applied to groups (e.g. classrooms, mental hospital


• Involves distribution of “tokens” contingent on desired behaviors

• Tokens can later be exchanged for privileges, food, or other reinforcers

Participant Modeling: An Observational learning Therapy

Participant modeling –

• Therapist demonstrates and encourages a client to imitate a desired behavior

• Draws on concepts from both operant and classical conditioning

• e.g. therapist pets dog with dog phobic person.

Evaluating the Psychological Therapies

Psychotherapy is effective:

• Therapy is better than no therapy.

• Matching specific therapies with specific conditions helps.

• Client’s desire = motivation to change is very important in predicting success.

• A positive relationship between therapist and client is a key to success.

Key Question

How is the Biomedical Approach Used to Treat Psychological Disorders?

Biomedical therapies seek to treat psychological disorders by changing the brain’s chemistry with drugs, its circuitry with surgery, or its patterns of activity with pulses of electricity or powerful magnetic fields.

Drug Therapy

Antipsychotic drugs

• E.g., chlorpromazine, haloperidol, and clozapine

• Reduce dopamine transmission, e.g. schizophrenia

• May have side effects:

 Tardive dyskinesia or Agranulocytosis

Watch Videos in this Module Schizophrenia

Drug Therapy

Antidepressant drugs

• Tricyclic compounds (Tofranil, Elavil)

• SSRIs (Prozac, Zoloft)

• Monoamine oxidase (MOA) inhibitors

Antibipolar drugs/Mood stabilizers

• Lithium, Depakote (anti-seizure drugs)

Drug Therapy

Antianxiety drugs

• Include barbiturates and benzodiazepines

• May include some antidepressant drugs which work on certain anxiety disorders

• Should not be used to relieve ordinary anxieties of everyday life

• Should not be taken for more than a few days at a time

• Should not be combined with alcohol

Drug Therapy

Stimulants (caffeine, nicotine, cocaine)

• Produces excitement or hyperactivity

• Suppresses activity level in persons with ADHD

• Controversy exists for use of these stimulants for children

 Side effects

 Growth slowed

 Concern for ADHD overdiagnosis of ADHD


The general term for surgical intervention in the brain to treat psychological disorders

• The infamous prefrontal lobotomy is no longer performed

• Severing the corpus callosum, however, can reduce life-threatening seizures

Brain-Stimulation Therapies

Used to treat severe depression

• Electroconvulsive therapy (ECT)

Apply an electric current to temples briefly

Patient is put to “sleep”

Side effects = Memory deficits

• Transcranial magnetic stimulation (TMS)

High powered magnetic stimulation to the brain

Also effective for bipolar disorder

• Deep brain stimulation

Surgical implants of a micro electrode directly in the brain

Still highly experimental

Hospitalization and the Alternatives

Therapeutic community

• Designed to bring meaning to patients’ lives

• Hospital setting to help patients cope with the world outside



• Removing patients, whenever possible, from mental hospitals

Community mental health movement

• Effort to deinstitutionalize mental patients and to provide

therapy from outpatient clinics

Key Question

How do the Psychological Therapies and Biomedical Therapies Compare?

While a combination of psychological and medical therapies is better than either alone for treating some (but not all) mental disorders, most people who suffer from unspecified “problems in living” are best served by psychological treatment alone.