Chapter 13
4th Edition
Therapy
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Therapy Through The Ages
• Throughout history, prevailing views of the
causes of psychological disorders have
influenced treatments.
• Some people believed in "possession" by
evil spirits, so they used treatments such
as exorcism.
• The ancient Greeks proposed natural
causes and treatments.
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Therapy Through The Ages
• Belief in demon possession was common
during the sixteenth and seventeenth
centuries.
• Some accused witches may have suffered
from psychological disorders.
• Asylums and hospitals did not always
provide a humane refuge for afflicted
people.
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Therapy Through The Ages
• Jean-Baptiste Pussin removed the chains
from mental patients in France.
• Philippe Pinel and Benjamin Rush
advocated kind treatment (moral therapy)
of individuals with psychological disorders.
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Therapy Through The Ages
• Dorothea Dix spearheaded a movement
that led to state operated custodial
institutions.
• As state mental hospitals grew larger,
however, their effectiveness declined.
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Therapy Through The Ages
• The community mental health movement
recommended community-based
treatment and emphasized prevention.
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Therapy Through The Ages
• Use of drugs coupled
with growing
awareness of the
ineffectiveness of
large institutions led
to a policy of
deinstitutionalization
the release of patients
from mental hospitals.
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Therapy Through The Ages
• About 30% of individuals
with a psychological
disorder seek treatment.
• Those with
schizophrenia, bipolar
disorder, or panic
disorder are more likely to
seek treatment than
individuals with
substance-use disorders.
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Therapy Through The Ages
• There are two treatment categories for
psychological disorders: biomedical and
psychological therapies.
• Psychotherapy is a general term for
psychological treatments designed to help
people resolve behavioral, emotional, and
Interpersonal problems.
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Therapy Through The Ages
• Among the licensed
practitioners who
provide therapy for
psychological
disorders are clinical
psychologists and
psychiatrists.
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Psychologically Based Therapies
• Psychotherapy involves a special
relationship between a distressed person
and a therapist in which the therapist helps
the client make changes in his or her
thinking, feeling, and behavior.
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Psychologically Based Therapies
• Psychoanalytic therapy aims to help the
patient develop insight into unconscious
feelings and conflicts by using free
association, dream interpretation, and
interpretation of resistance and
transference.
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Psychologically Based Therapies
• Humanistic therapies emphasize the ability
of each person to solve his or her
problems.
• Client-centered therapy seeks to develop
an accepting environment for the client.
• Gestalt therapy helps clients develop selfacceptance, but Gestalt therapists are
more directive than client-centered
therapists.
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Psychologically Based Therapies
• Cognitive therapies are designed to
change the way the client thinks.
• Albert Ellis, the founder of rational-emotive
behavior therapy (REBT), assumes that
people are disturbed by the way they
Interpret events.
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Psychologically Based Therapies
• Therefore, the role of the therapist is to
challenge the client's irrational beliefs.
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Psychologically Based Therapies
• Aaron Beck's cognitive therapy has been
applied to depression with promising
results.
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Psychologically Based Therapies
• Behavior therapists view maladaptive
behaviors as learned and rely on classical
and operant conditioning and modeling to
teach the client new behaviors.
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Psychologically Based Therapies
• Systematic
desensitization is an
effective treatment for
phobias in which
clients are taught
relaxation techniques
and then asked to
imagine or approach
feared situations
gradually.
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Psychologically Based Therapies
• Modeling is also an
effective treatment for
phobias.
• Aversion therapy
reduces undesirable
behaviors by pairing
them with an aversive
(unpleasant) stimulus.
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Psychologically Based Therapies
• Extinction is an operant conditioning
technique used to reduce the occurrence
of maladaptive behaviors.
• Reinforcers are withheld after the
maladaptive behavior has occurred.
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Psychologically Based Therapies
• Ethical and legal concerns restrict the use
of punishment to cases in which a
maladaptive behavior is highly resistant to
other forms of therapy.
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Psychologically Based Therapies
• Token economies are used to provide
secondary reinforcement of desired
behaviors.
• The tokens can be exchanged for primary
reinforcers.
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Psychologically Based Therapies
• Group therapy is based on the
assumptions that behavior does not occur
In a vacuum and that behaviors learned in
group settings are more likely to
generalize to everyday situations.
• Marital therapy and family therapy are two
forms of group therapy.
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The Effectiveness of Psychotherapy
• After Eysenck concluded that
psychotherapy clients are just as likely to
improve without it, psychotherapists
sought to provide better information about
the success of therapy.
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The Effectiveness of Psychotherapy
• Meta-analysis allows researchers to
combine the results of a number of
studies.
• Using this technique, researchers have
found that therapy does lead to greater
improvement than no treatment and that
differences among the various forms of
therapy are not great.
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The Effectiveness of Psychotherapy
• The search for the keys to successful
therapy has led researchers to focus on
factors such as the therapist's ability to
communicate empathy, which can lead to
improvement in distressed individuals.
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The Effectiveness of Psychotherapy
• Therapists are becoming increasingly
aware of the influence of ethnic and
cultural factors on psychotherapy.
• Members of many ethnic groups drop out
early from psychotherapy, in part because
there is a dearth of therapists who share
their native language as well as a failure to
provide appropriate forms of therapy.
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The Effectiveness of Psychotherapy
• The decision to enter psychotherapy
should involve asking questions about;
– the degree of distress one is experiencing
– one's ability to cope with that distress,
– the effect of the symptoms on oneself, one's
family, and one's work.
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