Invitation to Psychology

442 Chapter 12 Approaches to Treatment and Therapy

love, or self-esteem in 30 days. (Sorry.)
Look for those based on research, not the
author’s pseudoscientific theories or per-
sonal opinions. People who have survived
difficulties can tell inspirational stories,
of course, but an author’s vague advice to,
say, “take charge of your life” won’t go far.
In contrast, when self-help books propose a

step-by-step empirically supported program

for readers to follow, they can actually be

as effective as treatment administered by a

therapist, if the reader follows through with

the program (Rosen, Glasgow, & Moore,

2003). One such book is Changing for

Good (Prochaska, Norcross, & DiClemente,

1994), which describes the ingredients of

effective change that apply to people in and

out of therapy.

It takes knowledge and critical thinking

to know how to tell good therapies from

potentially harmful ones, the real from the

phony, and the phony from the fraudulent.

Choose carefully.

Biological Treatments

• Biological treatments for mental disorders are in the ascen-
dance because of research findings on genetic and biological
contributions to some disorders and because of economic and
social factors. The medications most commonly prescribed for
mental disorders include antipsychotic drugs, used in treat-
ing schizophrenia and other psychotic disorders and, often
inappropriately, in treating dementia, PTSD, and aggression
disorders; antidepressants, used in treating depression, anxiety
disorders, and obsessive-compulsive disorder; antianxiety drugs
(tranquilizers), often prescribed for anxiety and other emotional
problems; and lithium carbonate, a salt used to treat bipolar
disorder.

• Because of the publication bias, studies that find positive
results are more likely to be published than those that find no
improvement or negative effects. Drawbacks of drug treatment
include the placebo effect; high dropout and relapse rates
among people who take medications without also learning how
to cope with their problems or who have been given the incorrect
dose (a person’s ethnicity, sex, and age can influence a drug’s
effectiveness); the tendency to overlook nonmedical treat-
ments that may be as effective or even better; unknown risks
of prolonged use of medication and from possible drug interac-
tions when several are being taken; and the potential harms of
increased doses and untested off-label uses. Medication can
be helpful and can even save lives, but in an age in which com-
mercial interests are heavily invested in promoting drugs for
psychological problems, the public is largely unaware of drugs’
limitations and potential risks.

• When drugs and psychotherapy have failed to help seriously
disturbed people, some psychiatrists have intervened directly
in the brain (psychosurgery). Prefrontal lobotomy never had any
scientific validation, yet was performed on many thousands of
people. Nonsurgical forms of brain intervention include elec-
troconvulsive therapy (ECT), in which a brief current is sent
through the brain. ECT has been used successfully to treat sui-
cidal depression, although its benefits rarely last. Transcranial
magnetic stimulation (TMS) and transcranial direct current
stimulation (tDCS), two newer methods of electrically stimu-
lating the brain, are being studied as ways of treating severe
depression.

Major Schools of Psychotherapy

•   Psychodynamic (“depth”) therapies include Freudian psycho-

analysis and its modern variations. These therapies explore

unconscious dynamics and emotions, childhood experiences,

and fantasies, and focus on the process of transference to break

through the patient’s defenses.

•   Behavior therapists draw on classical and operant principles of

learning. They use such methods as graduated exposure and

flooding; systematic desensitization, based on countercondi-

tioning; behavioral self-monitoring; and skills training. Some

behavior therapists use virtual reality techniques for systematic

desensitization.

•   Cognitive therapists aim to change the irrational thoughts that

give rise to negative emotions and self-defeating actions. Aaron

Beck’s cognitive therapy and Albert Ellis’s rational emotive be-

havior therapy were pioneering forms of cognitive therapy. Today

cognitive and behavioral techniques are commonly combined in

the practice of cognitive-behavior therapy (CBT). Some cogni-

tive-behavioral therapists teach clients to pay mindful attention

to their negative emotions and “irrational” thoughts, learn to ac-

cept them, and act despite these feelings rather than constantly

fighting to eradicate them.

•   Humanist therapy holds that human nature is essentially good

and attempts to help people feel better about themselves by fo-

cusing on here-and-now issues and on their capacity for change.

Carl Rogers’s client-centered therapy emphasizes the impor-

tance of the therapist’s empathy and ability to provide uncondi-

tional positive regard. Existential therapy helps people cope with

the dilemmas of existence, such as the meaning of life and the

fear of death.

•   Family therapy is based on the view that individual problems

develop in the context of the whole family. The family-systems

perspective helps families understand that any one person’s

behavior in the family affects everyone else. In couples therapy,

the therapist usually sees both partners in a relationship to help

them resolve ongoing disputes or to help them accept and live

with qualities of the partner that are unlikely to change.

•   In practice, most therapists draw on various methods and ideas.

They aim to replace a client’s pessimistic or unrealistic life story

with one that is more hopeful and attainable.

Summary

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