Chapter 17 Flashcards
Counselling and clinical psychologists
psychologists, who typically hold a Ph.D. (Doctor of Philosophy) or Psy.D. (Doctor of Psychology) degree, have received five or more years of intensive training and supervision in a variety of psychotherapeutic techniques as well as training in research and psychological assessment techniques.
psychiatrists
medical doctors who specialize in psychotherapy and biomedical treatments, such as drug therapy
psychiatric social workers
often work in community agencies
marriage and family counsellors
special- ize in problems arising from family relations
pastoral counsellors
who tend to focus on spiritual issues
abuse counsellors
work with substance and sexual abusers and their victims
psychodynamic approach to psychotherapy focuses on
internal conflict and unconscious fac-tors that underlie maladaptive behaviour.
- The historical roots of psychodynamic approaches are to be found in Sigmund Freud’s development of psychoanalysis.
psychoanalysis
refers not only to Freud’s theory of personality, but also to the specific approach to treatment that he developed
insight
the conscious awareness of the psychodynamics that underlie their problems
free association
- In his technique of free association, Freud asked his clients to recline on a couch and to report verbally without censorship any thoughts, feelings, or images that entered awareness.
- Freud sat out of sight behind the client so that the client’s thought processes would be determined primarily by internal factors
resistance
defensive manoeuvres that hinder the process of therapy
Transference
- occurs when the client responds irrationally to the analyst as if he or she were an important figure from the client’s past
- considered a most important process in psychoanalysis, for it brings out into the open repressed feelings and maladaptive behaviour patterns that the therapist can point out to the client
Positive transference
occurs when a client transfers feelings of intense affection, dependency, or love to the analyst
negative transference
involves irrational expressions of anger, hatred, or disappointment
interpretation
any statement by the therapist intended to provide the client with insight into his or her behaviour or dynamics
Brief psychodynamic therapies
have become increasingly popular alternatives to lengthy psychoanalysis. Their goal is also to promote insight, but they tend to focus more on current life events
interpersonal therapy
- This therapy, which is highly structured and seldom takes longer than 15 to 20 sessions, focuses on the client’s current interpersonal problems
- The therapist collaborates very actively with the client in finding solutions to these problems
psychodynamic theorists
- view behaviour as a product of unconscious processes, humanistic theorists view humans as capable of consciously controlling their actions and taking responsibility for their choices and behaviour
- believe that everyone possesses inner resources for self-healing and personal growth, and that dis- ordered behaviour reflects a blocking of the natural growth process
- This blocking is brought about by distorted perceptions, lack of awareness about feelings, or a negative self-image
Humanistic psychotherapy
- seen as a human encounter between equals
- the therapist’s goal is to create an environment in which clients can engage in self-exploration and remove the barriers that block their natural tendencies toward personal growth
- focus primarily on the present and future instead of the past
client-centred/person-centred
The best-known and most widely used form of humanistic therapy
- developed by Carl Rogers
Rogers’s three important and interrelated therapist attributes:
- Unconditional positive regard
- Empathy
- Genuineness
- Rogers believed that when therapists can express these three critical therapeutic attri- butes, they create a situation in which the client feels accepted, understood, and free to explore basic attitudes and feelings without fear of being judged or rejected
Unconditional positive regard
when therapists show clients that they genuinely care about and accept them, without judgment or evaluation
Empathy
- willingness and ability to view the world through the client’s eyes
- The therapist does this by reflecting back to the client what he or she is communicating—perhaps by rephrasing something the client has just said in a way that captures the meaning and emotion involved
Genuineness
- the third important therapist attribute
- A therapist must be open enough to honestly express feelings, whether positive or negative
Frederick S. (Fritz) Perls
- developed another humanistic approach to treatment, gestalt therapy
gestalt
(“organized whole”) refers to perceptual principles through which people actively organize stimulus elements into meaningful “whole” patterns
Gestalt therapy
- goal: bring them into immediate awareness so that the client can be “whole” once again
- is often carried out in groups, and Gestalt therapists have developed a variety of imaginative techniques to help clients “get in touch with their inner selves.”
empty-chair technique of Gestalt therapy
- a client may be asked to imagine his mother sitting in the chair, and then carry on a conversation in which he alternatively role-plays his mother and himself, changing chairs for each role and honestly telling her how he feels about important issues in their relationship
Cognitive approaches to psychotherapy focus on
the role of irrational and self-defeating thought patterns, and therapists who employ this approach try to help clients discover and change the cognitions that underlie their problems
cognitive therapists
- do not emphasize the importance of unconscious psychodynamic processes
- They do, however, point out that, because our habitual thought patterns are so well-practised and ingrained, they tend to “run off” almost automatically
- Thus, clients often need help in identifying the beliefs, ideas, and self-statements that trigger maladaptive emotions and behaviours
cognitive behaviour therapy (CBT)
focus on both thoughts and behaviours
Albert Ellis
became convinced that irrational thoughts, rather than unconscious dynamics, were the most immediate cause of self-defeating emotions
Ellis’s ABCD Model
• A stands for the activating event that seems to trigger the emotion.
• B stands for the belief system that underlies the way in which a person appraises the event.
• C stands for the emotional and behavioural consequences of that appraisal.
• D is the key to changing maladaptive emotions and behaviours: disputing, or challenging, an erroneous belief system.
- Ellis pointed out that people are accustomed to viewing their emotions (C’s) as being caused directly by events (A’s)
Rational-emotive therapists (RET)
- introduce clients to common irrational ideas and then train them to ferret out the particular ideas that underlie their maladaptive emotional responses
- Clients are given homework assignments to help them analyze and change self-statements.
Beck’s Cognitive Therapy
- In treating depressed clients, a first step is to help clients realize that their thoughts, not the situation, cause their maladaptive emotional reactions.
- This realization sets the stage for identifying and changing the maladaptive thoughts.
behaviour therapy insists that
(1) behaviour disorders are learned in the same ways normal behaviours are
(2) these maladaptive behaviours can be unlearned by application of principles derived from research on classical conditioning and operant conditioning.
Classical conditioning procedures have been used in two major ways
- used to reduce, or decondition, anxiety responses
- used in attempts to condition new anxiety responses to a particular class of stimuli, such as alcoholic beverages or inappropriate sexual objects
