CHAPTER 16

• Therapists


  Someone with training or skills to help with a problem
• Psychotherapists


  Someone who helps with psychological problems
• Psychiatrists


  • Physicians who specialize in the treatment of people with psychological disorders
  • Have 8 years of training beyond a bachelor’s degree
  • Can prescribe prescription medications and often work with people with severe psychological disorders
• Clinical Psychologists

  • Typically have a Ph.D. or Psy.D.
  • Have 5 to 7 years of training beyond a bachelor’s degree
  • Assess, diagnose, and treat individuals with psychological disorders
  • Passed a licensing examination
  • Training typically occurs at a university with 1 to 2 years of internship
  • Can prescribe medication in five states if completed specialized training
• Counseling Psychologists

  • Typically have a Ph.D. or Psy.D., but could also have an Ed.D
  • Passed a licensing examination
  • May work in fields like family counseling, school counseling, etc.
• Insight Therapies


  Verbal interactions intended to enhance clients’ self-knowledge and promote healthful changes in personality and behavior
• Approaches under insight therapies

  • Psychodynamic therapy
  • Client-centered therapy
  • Cognitive therapy
• Psychoanalysis


  • First form of psychodynamic therapies
  • Based on conflicts among the id, ego, and superego
  • Goal is to make the unconscious conscious to resolve conflicts
• Psychoanalytical Methods

  1. Free Association

  2. Dream Analysis
• Dream Interpretation


  • Manifest Content—what is remembered from the dream
  • Latent Content—underlying content and meaning of the dream
  • Symbols represent deeper meanings
• Therapy Progression

  1. Interpretation of underlying meanings

  2. Possible resistance and transference experienced by the patient
• Psychoanalysis is a slow, painful process of self-examination
• Classical psychoanalysis, as done by Freud, is not widely practiced anymore
• Variations of psychoanalysis known as psychodynamic approaches exist
• Client-Centered Therapy

  • Also known as person-centered therapy
  • Focuses on a client’s potential for personal growth
  • Believes in the potential for a happy life and normalcy
• Client-Centered Techniques

  • Therapist does not judge or analyze client’s behavior
  • Reflects back what the patient says
  • Shows congruence and unconditional positive regard
• Cognitive Therapy

  Focusing on a person’s thoughts to alter them to something more adaptive
• Cognitive Errors

  • Dichotomous Thinking
  • The Mental Filter
  • Catastrophic Exaggeration
  • Self-references
• Cognitive Therapy

  • Associated with Albert Ellis and Aaron Beck
  • Focusing on a person’s thoughts, not their feelings and behaviors
  • Looks to alter a person’s thoughts to something more adaptive by removing cognitive distortions
• Cognitive Errors

  • Dichotomous Thinking—black and white thinking
  • The Mental Filter—blocking out positive aspects and focusing on negative aspects
  • Catastrophic Exaggeration (Catastrophizing)—assuming the worst possible thing will likely come true
  • Self-references—Feeling you are the center of everyone’s attention, especially when something has gone wrong
  • Mind Reading—the feeling that you think you know what others are thinking (especially about you)
  • Control Beliefs—either feeling you have no control over your life or feeling that you need to maintain a tight control
• Behavior Therapies


  • Involves the application of the principles of learning to direct efforts to change clients’ maladaptive behaviors
  • Teaches clients to learn new, more adaptive behaviors through operant and classical conditioning
• Behavioral Techniques

  • Aversion Therapy (Aversion Conditioning)
  • Behavior Modification
• Aversion Therapy (Aversion Conditioning)


  An aversive stimulus is paired with a stimulus that elicits an undesirable response
• Behavior Modification

  Using reinforcement, punishment, and extinction to alter behaviors
• Systematic Desensitization

  1. Used to reduce clients’ anxiety responses through counterconditioning

  2. Stages: Train client in deep muscle relaxation, Create an anxiety hierarchy, Imagine a step in the hierarchy while using relaxation, Starting at least anxiety provoking stage
• Cognitive-Behavioral Therapy (CBT)


  • The blending of Behavioral Therapy with Cognitive Therapy
  • Works on both the behaviors and the thought processes
  • A cognitive therapist often uses “homework assignments” that focus on patterns of behavior
  • Procedure has risen in popularity in recent years
• Biomedical Therapies


  • Physiological interventions intended to reduce symptoms associated with psychological disorders
• Psychopharmacotherapy

  • Antianxiety drugs: Relieve tension, apprehension, and nervousness (e.g., Valium, Xanax)
  • Antipsychotic drugs: Gradually reduce psychotic symptoms, including hyperactivity, mental confusion, hallucinations, and delusions (e.g., Chlorpromazine, Mellaril, Haldol)
  • Antidepressant drugs: Gradually elevate mood and help bring people out of a depression (e.g., Prozac, Zoloft, Paxil)
  • Mood-Stabilizer Drugs: Can prevent future episodes of mania and stabilizes mood swings (e.g., Lithium Carbonate)
• Electroconvulsive therapy (ECT)


  1. Electric shock is used to produce a cortical seizure accompanied by convulsions

  2. Usage peaked in the 1940s and 1950s, declined in the 1970s and 1980s, but is still used for treatment of severe depression

  3. Risks include some cognitive deficits (such as to memory)
• Psychosurgery

  1. Control disorders by altering the brain through surgery

  2. Early attempt was the prefrontal lobotomy developed by Antônio Egas Moniz in 1935

  3. Prefrontal lobotomy consists of cutting the connection to and from the frontal lobes, used to control violent, aggressive behavior

  4. Psychosurgery today can be localized to very small areas of the brain, used rarely as it is irreversible

  5. Severe obsessive-compulsive disorder