Invitation to Psychology

COn

C

ept Map

Chap

t

er 12

a

pproaches to treatment and therapy

Chapter 12 Approaches to Treatment and Therapy 445

The Scientist–Practitioner Gap

Problems in Assessing Therapy

A scientist–practitioner gap has led to a proliferation of

scientifically unsupported therapies, such as Critical

Incident Stress Debriefing.

When Therapy Helps

Cognitive-behavior therapy is most

effective for:

• depression.


• suicide attempts.


• anxiety disorders.


• anger and impulsive violence.


• health problems.


• childhood and adolescent behavior
  problems.


• preventing relapse.

Successful therapy can be brief, as in

motivational interviewing, or need more

time, depending on the individual and

problem being treated. Combined

methods (such as medication and

psychotherapy) may be necessary to

help particular individuals or address

difficult problems, such

asschizophrenia.

When Therapy Harms

Psychotherapy can be risky for

clients if the therapist:

• uses empirically unsupported
  and potentially harmful
  techniques.


• creates disorders or new
  symptoms through
  suggestion or coercion.


• is prejudiced against a
  client.


• is unethical.

Evaluating Psychotherapy

To determine whether a particular therapeutic

approach is beneficial or potentially harmful, clinical

scientists conduct randomized controlled trials.

The evaluation of any therapy must control for:

• the placebo effect.


• the justification of effort.

Therapists and clients must be

alert to prejudices and cultural

differences between them that

might cause misunderstandings.

TABLE 12.2 The Major Schools of Therapy Compared

Primary Goal Methods

Psychodynamic Insight into unconscious

motives and feelings that

create and prolong symptoms

Probing unconscious motives and fantasies,

exploring childhood experiences, examining

issues and emotions raised by transference

Cognitive-Behavioral

Behavioral Modification of self-defeating

behaviors

Graduated exposure and flooding, systematic

desensitization, behavioral records, skills training

Cognitive Modification of irrational or

unvalidated beliefs

Prompting the client to test beliefs against

evidence; exposing the faulty reasoning in

catastrophizing and mind-reading; sometimes

helping the client accept unpleasant thoughts

and feelings and live with them, instead of

trying to eradicate them

Humanist and Existential

Humanist Insight; self-acceptance and

self-fulfillment; new, more

optimistic perceptions of

oneself and the world

Providing empathy, unconditional positive

regard, and a nonjudgmental setting in which

to discuss issues

Existential Finding meaning in life and

accepting inevitable losses

Varies with the therapist; philosophic

discussions about the meaning of life, the

client’s goals, finding the courage to survive

loss and suffering

Family and Couples

Family Modification of family patterns May use any of the preceding methods to

change family patterns that perpetuate

problems and conflicts

Couples Resolution of conflicts,

breaking out of destructive

habits

May use any of the preceding methods to

help the couple communicate better, resolve

conflicts, or accept what cannot be changed