Invitation to Psychology

Chapter 12 Approaches to Treatment and Therapy 443

Evaluating Psychotherapy

• Successful therapy begins with an alliance between the thera-
pist and the client. When the therapist and client are of dif-
ferent ethnicities or cultures, the therapist must be able to
distinguish normal cultural patterns from signs of mental ill-
ness, and both parties must be aware of potential prejudice and
misunderstandings.

• A scientist–practitioner gap has developed because of the differ-
ent assumptions that researchers and many clinicians hold re-
garding the value of empirical research for doing psychotherapy
and for assessing its effectiveness. The gap has led to a prolif-
eration of scientifically unsupported psychotherapies.

• In assessing the effectiveness of psychotherapy, researchers
need to control for the placebo effect and the justification of
effort effect. They rely on randomized controlled trials to deter-
mine which therapies are empirically supported, which are not,
and which may even delay recovery.

• Some psychotherapies are better than others for specific prob-
lems. Behavior and cognitive therapies are often the most
effective for depression, anxiety disorders, anger problems,
certain health problems, and childhood and adolescent behav-
ior problems. Family-systems therapies are especially helpful
for children with behavior problems and young adults with
schizophrenia.

• The length of time needed for successful therapy depends
on the problem and the individual. Some methods, such as

motivational interviewing, produce benefits in only a session

or two; long-term psychodynamic therapy can be helpful for

people with severe disorders and personality problems. Some

problems and individuals respond best to combined therapeutic

approaches.

•   In some cases, therapy is harmful. The therapist may use em-

pirically unsupported and potentially harmful techniques, such

as “rebirthing”; inadvertently create new disorders in the client

through undue influence or coercion; hold a prejudice about the

client’s gender, ethnicity, religion, or sexual orientation; or be-

have unethically, for example by permitting a sexual relationship

with the client.

Psychology in the News, Revisited

•   Animal-assisted therapies are being studied empirically to as-

sess their benefits and limitations, just as all psychotherapies

should be.

Taking Psychology With You

•   To protect themselves, consumers need to know how to find a

therapist and the kind of therapy best suited to their problems.

They need to be wary of Internet promotions for medications

or fad therapies; choose a therapist who is reputable and well

trained; and select an empirically validated therapy. People

seeking therapy should also be cautious about online therapy

and choose self-help groups or books carefully.

antipsychotic drugs

(neuroleptics) 420

antidepressant drugs 421

monoamine oxidase inhibitors

(MAOIs) 421

tricyclic

antidepressants 421

selective serotonin reuptake

inhibitors (SSRIs) 421

antianxiety drugs

(tranquilizers) 421

beta blockers 421

lithium carbonate 422

publication bias 422

placebo effect 423

prefrontal lobotomy 424

electroconvulsive therapy

(ECT) 425

transcranial magnetic

stimulation (TMS) 425

transcranial direct current

stimulation (tDCS) 425

psychoanalysis 426

psychodynamic (“depth”)

therapies 426

transference 426

behavior therapy 427

graduated

exposure 427

flooding 427

systematic

desensitization 427

counterconditioning 427

behavioral

self-monitoring 427

skills training 428

cognitive therapy 428

Aaron Beck 429

Albert Ellis 429

rational emotive behavior

therapy 429

cognitive-behavior therapy

(CBT) 429

humanist therapy 430

client-centered

therapy 430

Carl Rogers 430

unconditional positive

regard 430

existential

therapy 430

family therapy 431

family-systems

perspective 431

couples therapy 431

scientist–practitioner

gap 435

justification of

effort 435

randomized controlled

trials 435

motivational

interviewing 437

Key Terms