Psychotherapy (Chapter 19)
Second Lecture Outline:
Humanistic therapies
Drug and behavior therapies
Cognitive-behavioral approaches
Video 101: Cognitive-behavioral
Humanistic Therapies
• “Clients” in stead of “Patients” moves away
from medical model
• Client-centered therapy is non-directive,
assumes free-will
• Clients will sort out their problems if
therapists are genuine (honest), give
unconditional positive regard (self-worth),
and acknowledge client feelings (empathy)
Psychotropic drug therapies
• Antipsychotic drugs: Phenothiazines
– Cloropromazine: Block’s dopamine reuptake
• Antidepressant drugs: MAO Inhibitors and
tricylics (e.g., Prozac)
– increase serotonin & norepinephrine in synapse
• Barbituates and Benzodiazepines
– valium, librium: relax muscles and tranquilize
– barbituates: CNS depressant, addictive, lethal
• Concerns: Side effects, toxicity, latency
Behavior therapy
• Treatment of symptoms, objective
behaviors, scientific methods
– single subject designs
• Counterconditioning: stimulus response is
replaced by alternative response
– Aversion therapy: e.g., anta-abuse
– Systematic desensitization: Relaxation paired
with gradually more threatening images and
experiences, e.g., dog phobia, sex therapy
Behavior therapy (continued)
• Extinction procedures
– Flooding: Exposure to threatening stimuli, e.g.,
fear of flying
– Implosion therapy: Imagine you are confronted
with very threatening stimuli
• Operant conditioning
– token economy: earned tokens based on a
system of rewards and punishers
– behavioral contract: e.g., gain weight to earn
privilege
Modeling
• People can learn adaptive behaviors by
having them modeled
• Age, credentials, similarity of the model is
important
• Example: Social skills training videotapes
function by having appropriate behavior
demonstrated
• Example: Parent training with “bug in the
ear”
Behavior Therapy
Begin with comprehensive assessment, using BASIC ID
diagnosis
Behavior - Overt behaviors and habits
Affect - Emotions, moods, strong feelings
Sensation - The five senses, unpleasant sensations, aches,
pains, dizziness
Imagery - how does client view self, dreams and memories
Cognition - Insights, philosophies, ideas judgments
Interpersonal relationships - interactions with other people
Drugs / biology - Drugs, prescription, non-prescription,
health and nutrition, concerns about health
Cognitive-Behavioral
Approaches
• Clients change their behavior by changing
their cognitions
• Goal: change how people think about things
• Rational-emotive behavior therapy
– Cognition precedes emotion and irrational
thoughts therefore cause emotional distress
– “I need to be a perfect student”
– Therapist needs to challenge irrational
cognitions
Cognitive-Behavior (video 101)
• Cognitive Therapy of Beck
– Maladaptive schemas need to be changed
because they interfere wth your life
• Stress Inoculation Training
– Stress management., adaptive cognitions, how
did I do?
• Social Problem Solving
– Identify problem, choose alternatives, choose,
implement, evaluate outcome