Treatment of Abnormal Behavior

48 Pages·2014·4.13 MB·English

Unit XIII
Treatment of Abnormal Behavior
Unit Overview
PPPDDD
Psychologists work hard to identify the causes and symptoms of psycho- • Evaluate the pros and cons of using operant conditioning
logical disorders. But the goal of that hard work is not just identification. principles in therapy.
Psychologists hope that such identification of causes and symptoms will • Distinguish the goals and techniques of cognitive therapy and
lead to the development of treatments for disorders. The treatments dis- cognitive-behavioral therapy.
cussed in this unit cover the gamut of perspectives described throughout • Analyze the goals and benefi ts of group and family therapy.
this book. From psychoanalysis to biological therapies, these treatments
• Analyze the eff ectiveness of psychotherapy from the perspective
highlight the underlying theories of what causes some people to struggle
of the client, the clinician, and the outcome.
with psychological illness. Some disorders are treated more effectively with
• Evaluate which psychotherapies are most eff ective for specifi c
certain treatments and not others. Knowledge of all these treatments could
disorders.
help you or someone you care for get the kind of help needed to address
a potential struggle with mental illness. Receiving the right treatment can • Analyze alternative therapies using scientifi c inquiry.
make a positive difference in someone’s life. After reading this unit, stu- • Determine the 3 elements shared by all forms of psychotherapy.
dents will be able to: • Analyze how culture, gender, and values infl uence the therapist–
• Diff erentiate among psychotherapy, biomedical therapy, and an client relationship.
eclectic approach to therapy. • Identify some guidelines for selecting a therapist.
• Explain the goals and techniques of psychoanalysis and how • Explain the rationale of preventive mental health programs.
they’ve been adapted to psychodynamic therapy. • Describe the various drug therapies.
• Describe the basic themes of humanistic therapy, specifi cally the • Explain how double-blind studies work to evaluate the
goals and techniques of Rogers’ client-centered approach.
eff ectiveness of drug therapies.
• Contrast behavior therapy with psychodynamic and humanistic • Describe how psychosurgery and brain stimulation techniques
therapies.
treat disorders.
• Describe how exposure therapies and aversive conditioning work. • Analyze how a healthy lifestyle’s eff ect on depression refl ects the
• Explain how operant conditioning principles can inform biopsychosocial systems.
therapeutic techniques.
Alignment to AP® Course Description
Topic 13: Treatment of Abnormal Behavior (7–9% of AP® Examination)
Module Topic Essential Questions
Module 70 Introduction to Therapy • What does it mean to be mentally well?
Psychoanalysis and • Can mental illnesses be treated by exploring our unconscious?
Psychodynamic Therapy
Humanistic Therapies • How important are listening and support to effective therapy?
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Module Topic Essential Questions
(cid:129)
Module 71 Behavior Therapies How can we unlearn maladaptive behaviors?
(cid:129)
Cognitive Therapies How can changing our thoughts change our maladaptive behavior?
(cid:129)
Group and Family Therapies How important are family members and other people to effective
therapy?
(cid:129)
Module 72 Evaluating Psychotherapies How do we know a therapy is effective?
(cid:129)
Preventing Psychological Disorders How do we prevent mental illness?
(cid:129)
Module 73 Drug Therapies Are drug therapies effective?
(cid:129)
Brain Stimulation How does altering the brain’s electrochemistry affect mental health?
(cid:129)
Psychosurgery How important to our mental health are different parts of the brain?
(cid:129)
Therapeutic Lifestyle Change How important is it to change our lifestyles to promote mental health?
Unit Resources
Module 70 Module 72
STUDENT ACTIVITIES STUDENT ACTIVITY
(cid:129) (cid:129)
Attitudes Toward Seeking Professional Psychological Help Fact or Falsehood?
(cid:129)
Fact or Falsehood?
FLIP IT VIDEOS
(cid:129) The Self-Concealment Scale (cid:129) Evidence-Based Practice: Applying Science to Therapy
(cid:129)
Role-Playing to Demonstrate Client-Centered Therapy
Module 73
Module 71
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STUDENT ACTIVITY
STUDENT ACTIVITIES (cid:129) Fact or Falsehood?
(cid:129)
Fact or Falsehood?
FLIP IT VIDEO
(cid:129)
Practicing Systematic Desensitization (cid:129)
How Drug Therapy Works
(cid:129)
Modifying a Phobia (cid:129)
Positive and Negative Symptoms
(cid:129)
Frequency of Self-Reinforcement Questionnaire
TEACHER DEMONSTRATION
(cid:129)
Using Systematic Desensitization to Treat Eraser Phobia
FLIP IT VIDEO
(cid:129)
Counterconditioning: How It Works
Unit XIII
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Unit XIII
TEACH
TTTRRRMMMM Common Pitfalls
Some of your students may currently
Treatment of Abnormal be seeing a psychotherapist, coun-
selor, psychiatrist, or clinical psycholo-
gist for any number of personal or
Behavior
family issues. Be sensitive to this pos-
sibility as you teach this module.
Use Student Activity: Attitudes
Modules Toward Seeking Professional Psy-
chological Help from the TRM to
70 Introduction to Therapy, and Psychodynamic and
assess student attitudes toward
Humanistic Therapies
psychotherapy.
71 Behavior, Cognitive, and Group Therapies
72 Evaluating Psychotherapies and Prevention Strategies
73 The Biomedical Therapies
K
ay Redfi eld Jamison, an award-winning clinical psychologist and world ex-
pert on the emotional extremes of bipolar disorder, knows her subject fi rst-
hand. “For as long as I can remember,” she recalled in An Unquiet Mind, “I
was frighteningly, although often wonderfully, beholden to moods. Intensely emo-
tional as a child, mercurial as a young girl, fi rst severely depressed as an adolescent,
and then unrelentingly caught up in the cycles of manic-depressive illness [now
known as bipolar disorder] by the time I began my professional life, I became, both
by necessity and intellectual inclination, a student of moods” (1995, pp. 4–5). Her
life was blessed with times of intense sensitivity and passionate energy. But like her
father’s, it was also at times plagued by reckless spending, racing conversation, and
sleeplessness, alternating with swings into “the blackest caves of the mind.”
Then, “in the midst of utter confusion,” she made a sane and profoundly help-
ful decision. Risking professional embarrassment she made an appointment with a
therapist, a psychiatrist she would visit weekly for years to come.
He kept me alive a thousand times over. He saw me through madness, despair, won-
derful and terrible love affairs, disillusionments and triumphs, recurrences of illness,
an almost fatal suicide attempt, the death of a man I greatly loved, and the enormous
pleasures and aggravations of my professional life. . . . He was very tough, as well
707
Pacing Guide
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Module Topic Standard Schedule Days Block Schedule Days
Module 70 Introduction to Therapy
Psychoanalysis and Psychodynamic Therapy 1
Humanistic Therapies
1
Module 71 Behavior Therapies
Cognitive Therapies 1
Group and Family Therapies
Module 72 Evaluating Psychotherapies
Preventing Psychological Disorders
Module 73 Drug Therapies
1 1/2
Brain Stimulation
Psychosurgery
Therapeutic Lifestyle Change
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708 Unit XIII Treatment of Abnormal Behavior
as very kind, and even though he understood more than anyone how much I felt I
was losing—in energy, vivacity, and originality—by taking medication, he never was
seduced into losing sight of the overall perspective of how costly, damaging, and life
threatening my illness was. . . . Although I went to him to be treated for an illness, he
taught me . . . the total beholdenness of brain to mind and mind to brain (pp. 87–88).
“Psychotherapy heals,” Jamison reports. “It makes some sense of the confusion,
reins in the terrifying thoughts and feelings, returns some control and hope and
possibility from it all.”
TEACH Module 70
TTTRRRMMMM Discussion Starter
Use the Module 70 Fact or Falsehood?
activity from the TRM to introduce the Introduction to Therapy, and
concepts from this module.
Psychodynamic and Humanistic Therapies
ENGAGE
Enrichment
Module Learning Objectives
Abes gnaonte hde irn c rUunsiatd XeII ,f oDro trhoet hheuam Dainx e 7700--11 Dapispcruosasc hh otow t phesyracphyo tdhieffrearp.y, biomedical therapy, and an eclectic Image Source RF/Sydney Bourne/Getty Images
treatment of mentally ill patients
when she started to tutor inmates at 7700--22 Discuss the goals and techniques of psychoanalysis, and describe
how they have been adapted in psychodynamic therapy.
a women’s prison. Men and women
who were mentally ill or disabled were Identify the basic themes of humanistic therapy, and describe the
7700--33
being housed there with hardened specifi c goals and techniques of Rogers’ client-centered approach.
female criminals. Dix advocated for
reforms in all existing U.S. states and
throughout Europe. T
he long history of efforts to treat psychological disorders has included a bewildering
mix of harsh and gentle methods. Well-meaning individuals have cut holes in people’s
heads and restrained, bled, or “beat the devil” out of them. But they also have given
warm baths and massages and placed people in sunny, serene environments. They have ad-
ministered drugs and electric shocks. And they have talked with their patients about child-
hood experiences, current feelings, and maladaptive thoughts and behaviors.
Reformers Philippe Pinel and Dorothea Dix pushed for gentler, more humane treat-
ments and for constructing mental hospitals. Since the 1950s, the introduction of effec-
tive drug therapies and community -b ased treatment programs have emptied most of those
hospitals.
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Unit XIII
708 Treatment of Abnormal Behavior
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Introduction to Therapy, and Psychodynamic and Humanistic Therapies Module 70 709
Introduction to Therapy
ENGAGE
How do psychotherapy, biomedical therapy, and an eclectic approach
7700--11 Critical Questions
to therapy differ?
Today’s therapies can be classifi ed into two main categories. In psychotherapy, a trained Insurance coverage for mental health
AP® Exam Tip
therapist uses psychological techniques to assist someone seeking to overcome diffi cul- limits the amount of time a person
ties or achieve personal growth. Biomedical therapy offers medication or other biological Most of the treatments discussed
in this unit come from the can spend in therapy. Have students
treatments.
perspectives you’ve been learning
Many therapists combine techniques. Jamison received psychotherapy in her meetings about since Unit I. As you reach fi nd out what mental health coverage
with her psychiatrist, and she took medications to control her wild mood swings. Many each major section—like the
psychotherapists describe themselves as taking an eclectic approach, using a blend of upcoming one on psychoanalytic they have through their parents or
psychotherapies. Like Jamison, many patients also can receive psychotherapy combined aton da nptsicyipchaoted yhnoawm sico mtheeoranpe yf—romtry legal guardians, or what coverage is
with medication. that perspective would approach generally provided to employees in
Let’s look fi rst at the psychotherapeutic “talk therapies.” Among the dozens of types of therapy (for example, “What
would Freud do?”). This should the professions they’re considering
psychotherapy, we will look at the most infl uential. Each is built on one or more of psychol- help you organize and retain the
ogy’s major theories: psychodynamic, humanistic, behavioral, and cognitive. Most of these information as you read. after graduation.
techniques can be used one-on-one or in groups. We’ll explore psychodynamic and human-
(cid:2) How much time in outpatient
istic therapies in this module, and behavior, cognitive, and group therapies in Module 71.
therapy can a person spend in a
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therapy they will cover?
(cid:2) What kind of coverage does the
state offer through Medicaid?
psychotherapy treatment involving
psychological techniques; consists
of interactions between a trained TEACH
therapist and someone seeking to
overcome psychological diffi culties or Concept Connections
Psychoanalysis and Psychodynamic Therapy
achieve personal growth.
biomedical therapy prescribed Before Freud, psychology was a
7700--22 Wthehya tb aereen t haed agpotaelds ainn pds tyecchhondiqyuneasm oicf pthseyrcahpoya?nalysis, and how have mdireedcitclayt oionn tsh oer pperroscoend’us rpehs ytshiaotl oagcyt . new science concerned more with
Sigmund Freud’s psychoanalysis was the fi rst of the psychological therapies. Few clini- eclectic approach an approach describing the human experience
cians today practice therapy as Freud did, but his work deserves discussion as part of the to psychotherapy that, depending on than developing eff ective therapeutic
the client’s problems, uses techniques
foundation for treating psychological disorders. from various forms of therapy. techniques.
Goals psychoanalysis Sigmund
(cid:2) Structuralism, the school founded
Freud’s therapeutic technique.
Psychoanalytic theory presumes that healthier, less anxious living becomes possible when Freud believed the patient’s by Wilhelm Wundt in 1879, sought
people release the energy they had previously devoted to id - ego - superego confl icts (see free associations, resistances,
Module 55). Freud assumed that we do not fully know ourselves. There are threatening dreams, and transferences—and to describe what consciousness
things that we seem to want not to know—that we disavow or deny. “We can have loving the therapist’s interpretations was, positing that people shared
of them—released previously
feelings and hateful feelings toward the same person,” notes Jonathan Shedler (2009), and repressed feelings, allowing the common experiences and
“we can desire something and also fear it.” patient to gain self - insight.
perceptions about the world.
(cid:2) Functionalism, a school favored by
G. Stanley Hall in the United States,
stated that describing sensations
was not as important as knowing
MyersAP_SE_2e_Mod70_B.indd 708 1/21/14 9:36 AM MyersAP_SE_2e_Mod70_B.indd T 709EACH 1/21/14 9:36 AM
how the mind worked.
Concept Connections
Review the stages of development in Freud’s (cid:2) The phallic stage continues until school
theory (from Unit X): starts. Young children face such Freudian
(cid:2) The oral stage lasts from birth to about 18 issues as the Oedipus complex, penis envy,
months. Infants are gratified by activities and castration anxiety.
like sucking and biting. Early weaning may (cid:2) The latency stage, occurring during the
lead to bad habits such as overeating or elementary school years, occurs when
smoking. children learn gender roles by associating
(cid:2) The anal stage spans the potty-training with same-sex friends.
years. Children have to balance societal (cid:2) The genital stage starts at puberty. Freud
demands with their own desires. If a child is believed that if people do not have sexual
trained too early, he or she may develop an experiences, they will develop problems
anal-retentive personality. later in life.
Module 70
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710 Unit XIII Treatment of Abnormal Behavior
Freud’s therapy aimed to bring patients’ repressed or disowned feelings into conscious
ENGAGE
awareness. By helping them reclaim their unconscious thoughts and feelings and giving
Enrichment them insight into the origins of their disorders, he aimed to help them reduce growth-
impeding inner confl icts.
Traditional Freudian analysis calls for
Techniques
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“I’m more interested in hearing about the eggs
association or doesn’t share his or her lax, perhaps by lying on a couch. As the psychoanalyst sits out of your
you’re hiding from yourself.”
line of vision, you say aloud whatever comes to mind. At one moment,
innermost thoughts, then the analyst
you’re relating a childhood memory. At another, you’re describing a dream or recent
will perceive that patient as resisting AP® Exam Tip experience. It sounds easy, but soon you notice how often you edit your thoughts as
treatment, which is also viewed as Psychoanalytic treatment is the you speak. You pause for a second before uttering an embarrassing thought. You omit
public image of psychology. If you what seems trivial, irrelevant, or shameful. Sometimes your mind goes blank or you fi nd
refl ecting a deep-seated psychologi- were to ask people to sketch a
psychologist at work, you would yourself unable to remember important details. You may joke or change the subject to
cal problem. see lots of sketches of therapists something less threatening.
taking notes while they were seated To the analyst, these mental blocks indicate resistance. They hint that anxiety
behind patients on couches. Keep
lurks and you are defending against sensitive material. The analyst will note your resis-
ENGAGE in mind that most modern therapy
is very different from this image, tances and then provide insight into their meaning. If offered at the right moment, this
Critical Questions and psychology careers stretch well interpretation—of, say, your not wanting to talk about your mother—may illuminate
beyond therapy. the underlying wishes, feelings, and confl icts you are avoiding. The analyst may also
Freudian analysis remains contro- offer an explanation of how this resistance fi ts with other pieces of your psychological
puzzle, including those based on analysis of your dream content.
versial because the therapist tries “I haven’t seen my analyst in 200 Over many such sessions, your relationship patterns surface in your interaction with
years. He was a strict Freudian.
to probe the unconscious, which is If I’d been going all this time, your therapist. You may fi nd yourself experiencing strong positive or negative feelings for
supposedly full of locked, painful I’d probably almost be cured your analyst. The analyst may suggest you are transferring feelings, such as dependency or
by now.” -WOODY ALLEN, AFTER mingled love and anger, that you experienced in earlier relationships with family members
childhood memories. Critics contend AINW TAHKEE NMINOGVI EF RSOLME ESPUESRPENDED ANIMATION or other important people. By exposing such feelings, you may gain insight into your current
that therapists can actually create relationships.
Relatively few U.S. therapists now offer traditional psychoanalysis. Much of its under-
such memories in clients, leading such
lying theory is not supported by scientifi c research (Module 56). Analysts’ interpretations
clients to believe they have experi- resistance in psychoanalysis, cannot be proven or disproven. And psychoanalysis takes considerable time and money,
enced repressed childhood trauma. the blocking from consciousness of often years of several sessions per week. Some of these problems have been addressed in
anxiety- laden material. the modern psychodynamic perspective that has evolved from psychoanalysis.
(cid:2) How has the research of Elizabeth interpretation in psychoanalysis,
the analyst’s noting supposed Psychodynamic Therapy
Loftus raised doubts about the
dream meanings, resistances, and
existence of repressed memories? other signifi cant behaviors and Therapists who use psychodynamic therapy techniques don’t talk much about id, ego,
events in order to promote insight. and superego. Instead they try to help people understand their current symptoms. They
(See Unit VII.)
transference in psychoanalysis, focus on themes across important relationships, including childhood experiences and the
(cid:2) How might modern psychoanalysts the patient’s transfer to the analyst therapist relationship. Rather than lying on a couch, out of the therapist’s line of vision,
of emotions linked with other patients meet with their therapist face to face. These meetings take place once or twice
work to avoid creating memories relationships (such as love or hatred
a week (rather than several times per week), and often for only a few weeks or months
for a parent).
in their clients? (rather than several years).
psychodynamic therapy therapy In these meetings, patients explore and gain perspective into defended-against thoughts
deriving from the psychoanalytic
and feelings. Therapist David Shapiro (1999, p. 8) illustrates with the case of a young man
tradition that views individuals as
responding to unconscious forces who had told women that he loved them, when knowing well that he didn’t. They expected
and childhood experiences, and that it, so he said it. But later with his wife, who wishes he would say that he loves her, he fi nds
seeks to enhance self-insight. he “cannot” do that—“I don’t know why, but I can’t.”
EMyeNrsAPG_SE_A2e_MGod70E_B.indd 710 TEACH 1/21/14 9:36 AM MyersAP_SE_2e_Mod70_B.indd 711 1/21/14 9:36 AM
Active Learning Concept Connections
Have students collect cartoons, advertise- Students may wonder why never losing an argu-
ments, and movie or TV references to Freudian ment is not good for establishing the credibility of
ideas and bring them to class. Students can psychoanalysis. Remind students that confi r-
work in groups to identify the concepts in play, mation bias (Unit VII) poses a danger to critical
analyzing whether each depiction is posi- thinking. People tend to look for evidence that
tive or negative. Students can also determine confi rms their preconceptions rather than search-
whether the depiction is presented in a factual ing for evidence that disputes their ideas, mean-
or farcical way. ing that they will often miss even glaring evidence
that refutes strongly held beliefs. With Freudian
analysis, no alternative explanations for behavior
are accepted since all resistance to treatment is
simply confi rmation of a repressed problem.
Unit XIII
710 Treatment of Abnormal Behavior
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Introduction to Therapy, and Psychodynamic and Humanistic Therapies Module 70 711
Therapist: Do you mean, then, that if you could, you would like to?
ENGAGE
Patient: Well, I don’t know. . . . Maybe I can’t say it because I’m not sure it’s true.
Maybe I don’t love her. Enrichment
Further interactions reveal that he can’t express real love because it would feel “mushy”
Interpersonal psychotherapy (IPT) is
atttthhhhneeeed mmi rnP“ as asstetwyooulc vfarttheerh”eos eo,nad mfneyt htsnsdhseea ,arlt mvahat especi scoirw.s e nttWfehsflol eleiru,cre aotcs .apiuf”n ni ntegSh msr hee piamasrspnt yraoilecryyroahe. ac o Hnttldshioeooyet n neiihrssda e am a“ltwpgihnia caar irtecnt evowesnenctie ahtfltsh lhni sc po istqoasu ufewsc t ethw ihstr he epis“l iaahrhat terioiiemeoswn nasitnsnnesh l, dw fiwa, p fi aseh pthneoroledo isasn ui hrtgbaeieosnl e .end”isss t fatrceoasue nttliihg nnoeetgfrd foso ,ffdr rraiuoogncmminde Véronique Burger/Science Source asdinh estophewrropernset s-trtiosoeo rnbnm.e aD let eheff pevererceantspitsvsyie o at nfhloo airnst t nehr,’et ab ascut abitnu eigstee unds ub-y
of current diffi culties. Jonathan Shedler (2010a) recalls his patient Jeffrey’s complaints of dif-
ally has an interpersonal component,
fi culty getting along with his colleagues and wife, who saw him as hypercritical. Jeffrey then
“began responding to me as if I were an unpredictable, angry adversary.” Shedler seized this aff ecting relationships. The types of
opportunity to help Jeffrey recognize the relationship pattern, and its roots in the attacks interpersonal events that IPT focuses
and humiliation he experienced from his alcohol-abusing father—and to work through and
let go of this defensive responding to people. on include the following:
Interpersonal psychotherapy, a brief (12- to 16-session) variation of psychodynamic ther-
(cid:2) Interpersonal disputes and
apy, has effectively treated depression (Cuijpers, 2011). Although interpersonal psychother-
apy aims to help people gain insight into the roots of their diffi culties, its goal is symptom conflicts
relief in the here and now. Rather than focusing mostly on undoing past hurts and offering (cid:2) Role transitions (such as becoming
interpretations, the therapist concentrates primarily on current relationships and on helping
people improve their relationship skills. a parent or losing a parent)
afterT rheece ciavsine go fa A pnronma, oat 3io4n-y, ewairt -h o aldc cmomarpriaendy pinrogf einssciroenasael,d il rluessptroantessib thilietsiees g aonadls l. oFnivgee mr hoonuthrss, Face -t o -face therapy (cid:2) Grief that goes beyond the normal
Anna experienced tensions with her husband over his wish for a second child. She began In contemporary psychodynamic bereavement period
therapy, the couch has disappeared.
feeling depressed, had trouble sleeping, became irritable, and was gaining weight. A thera- But the influence of psychoanalytic (cid:2) Deficits that patients have
pist using psychodynamic techniques might have helped Anna gain insight into her angry theory continues in some areas, as
impulses and her defenses against anger. A therapist applying interpersonal techniques the therapist seeks information from in initiating and maintaining
the patient’s childhood and helps the
would concur but would also engage her thinking on more immediate issues—how she person bring unconscious feelings into relationships
could balance work and home, resolve the dispute with her husband, and express her emo- conscious awareness.
tions more effectively (Markowitz et al., 1998).
TEACH
Humanistic Therapies
Concept Connections
What are the basic themes of humanistic therapy? What are the
7700--33 Link humanistic therapy to Abraham
specifi c goals and techniques of Rogers’ client-centered approach?
Maslow’s hierarchy of needs
The humanistic perspective (Module 57) has emphasized people’s inherent potential for
self - fulfi llment. Like psychodynamic therapies, humanistic therapies have attempted to re- (Unit VIII). Instead of explaining behav-
duce growth-impeding inner confl icts by providing clients with new insights. Indeed, the insight therapies a variety of ior in terms of buried unconscious
psychodynamic and humanistic therapies are often referred to as insight therapies. But therapies that aim to improve
psychological functioning by feelings and desires, Maslow believed
humanistic therapy differs from psychoanalytic therapy in many other ways: increasing a person’s awareness of
• Humanistic therapy aims to boost people’s self-fulfi llment by helping them grow in self- underlying motives and defenses. that full human potential could be
awareness and self-acceptance. achieved if certain basic needs were
• Promoting this growth, not curing illness, is the focus of therapy. Thus, those in therapy met. He theorized that people could
became “clients” or just “persons” rather than “patients” (a change many other
not appreciate beauty if they were
therapists have adopted).
• The path to growth is taking immediate responsibility for one’s feelings and actions, rather worried about where their next meal
than uncovering hidden determinants. was coming from or if they did not
• Conscious thoughts are more important than the unconscious. have a loving relationship with others.
• The present and future are more important than the past. The goal is to explore feelings as
they occur, rather than achieve insights into the childhood origins of the feelings.
MyersAP_SE_2e_Mod70_B.indd 710 1/21/14 9:36 AM MyersAP_SE_2e_Mod70_B.indd 711 1/21/14 9:36 AM
Module 70
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712 Unit XIII Treatment of Abnormal Behavior
TEACH Carl Rogers (1902–1987) developed the widely used humanistic technique he called
client - centered therapy, which focuses on the person’s conscious self - perceptions. In
TTTRRRMMMM Common Pitfalls this nondirective therapy, the therapist listens, without judging or interpreting, and seeks to
refrain from directing the client toward certain insights.
As noted in Unit XII, not much analysis AP® Exam Tip Believing that most people possess the resources for growth, Rogers (1961, 1980)
occurred in person-centered therapy. encouraged therapists to exhibit acceptance, genuineness, and empathy. When therapists
You can remember Acceptance, enable their clients to feel unconditionally accepted, when they drop their façades and
To facilitate unconditional positive Genuineness, and Empathy as genuinely express their true feelings, and when they empathically sense and refl ect their
“AGE.”
regard, genuineness, and empathy, clients’ feelings, the clients may deepen their self - understanding and self- acceptance (Hill
& Nakayama, 2000). As Rogers (1980, p. 10) explained,
Carl Rogers would answer questions
Hearing has consequences. When I truly hear a person and the meanings that are
with questions— “How does that
important to him at that moment, hearing not simply his words, but him, and when
make you feel?” was the most com- I let him know that I have heard his own private personal meanings, many things
happen. There is fi rst of all a grateful look. He feels released. He wants to tell me
mon. Rogers believed that if people
more about his world. He surges forth in a new sense of freedom. He becomes
received the attention and acceptance more open to the process of change.
I have often noticed that the more deeply I hear the meanings of the person,
they needed, they could cure them-
the more there is that happens. Almost always, when a person realizes he has been
selves. The therapist merely existed to deeply heard, his eyes moisten. I think in some real sense he is weeping for joy. It
is as though he were saying, “Thank God, somebody heard me. Someone knows
provide that support.
what it’s like to be me.”
Use Student Activity: The Self-
“We have two ears and one “Hearing” refers to Rogers’ technique of active listening—echoing, restating, and
Concealment Scale from the TRM to mouth that we may listen the seeking clarifi cation of what the person expresses (verbally or nonverbally) and acknowl-
help students become more open 3m3o5r–e2 a6n3d Bt.aCl.kE .t,h De IOleGsEsN.E”S - ZLAEENROT,I US edging the expressed feelings. Active listening is now an accepted part of therapeutic coun-
seling practices in many high schools, colleges, and clinics. The counselor listens attentively
about therapy.
and interrupts only to restate and confi rm feelings, to accept what is being expressed, or to
seek clarifi cation. The following brief excerpt between Rogers and a male client illustrates
ENGAGE how he sought to provide a psychological mirror that would help clients see themselves
more clearly.
Critical Questions Rogers: Feeling that now, hm? That you’re just no good to yourself, no good to any-
body. Never will be any good to anybody. Just that you’re completely worthless,
Have students consider the eff ect of
huh?—Those really are lousy feelings. Just feel that you’re no good at all, hm?
referring to people as patients rather
Client: Yeah. (Muttering in low, discouraged voice) That’s what this guy I went to town
than as clients.
with just the other day told me.
(cid:2) How does the use of each term Rogers: This guy that you went to town with really told you that you were no good? Is
client - centered therapy
that what you’re saying? Did I get that right?
affect the whole therapeutic a humanistic therapy, developed
by Carl Rogers, in which the Client: M-hm.
relationship?
therapist uses techniques such as Rogers: I guess the meaning of that if I get it right is that here’s somebody that—meant
active listening within a genuine,
(cid:2) In what other situations have something to you and what does he think of you? Why, he’s told you that he thinks
accepting, empathic environment to
semantics (the meaning of facilitate clients’ growth. (Also called you’re no good at all. And that just really knocks the props out from under you. (Client
person - centered therapy.) weeps quietly.) It just brings the tears. (Silence of 20 seconds)
different words) affected how
active listening empathic Client: (Rather defi antly) I don’t care though.
different jobs, issues, and roles listening in which the listener Rogers: You tell yourself you don’t care at all, but somehow I guess some part of you
echoes, restates, and clarifi es. A
in society are viewed? (To get cares because some part of you weeps over it.
feature of Rogers’ client- centered
the conversation rolling, suggest therapy. (Meador & Rogers, 1984, p. 167)
that garbage collectors be called unconditional positive regard Can a therapist be a perfect mirror, without selecting and interpreting what is refl ected?
a caring, accepting, nonjudgmental Rogers conceded that one cannot be totally nondirective. Nevertheless, he believed that
sanitation engineers or that attitude, which Carl Rogers believed
the therapist’s most important contribution is to accept and understand the client. Given a
overthrowing a political leader wawoaurledn heeslsp a cnldie nsetslf -toa cdceevpetalonpc es.elf- nonjudgmental, grace - fi lled environment that provides unconditional positive regard,
be called regime change. Refer to people may accept even their worst traits and feel valued and whole.
one comedienne who calls herself
a “domestic goddess” rather than a
housewife.)
EMyeNrsAPG_SE_A2e_MGod70E_B.indd 712 1/21/14 9:36 AM MyersAP_SE_2e_Mod70_B.indd 713 1/21/14 9:36 AM
TTTRRRMMMM Active Learning
Have students create their own scripts that
utilize the principles of active listening. They
can present their “conversations” to the class,
discussing whether their interpretations of
Rogerian technique would be helpful.
Use Student Activity: Role-Playing to Dem-
onstrate Client-Centered Therapy from the
TRM to help students develop their own active
listening skills.
Unit XIII
712 Treatment of Abnormal Behavior
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Introduction to Therapy, and Psychodynamic and Humanistic Therapies Module 70 713
Warner, Inc. Aegmrcoptuiapvt ehth izleiesrdatp ewyn itishne gsas ciColienan.rlt Rdougrienrgs t(hriigsh t) ENGAGE
© Time Enrichment
Magazine, Virginia Axline, a student of Rogers,
LifeMichael Rougier, hainpa psp lreaoxyat etchhne dtroea dpth yt.eh S ethr ceela ihetmnaste- wcnertni otttfee crneh dil dren
Dibs: In Search of Self. This book can
be assigned in preparation for class
discussion of the humanistic therapies
and, in particular, Rogers’ nondirective
If you want to listen more actively in your own relationships, three Rogerian hints may
approach. The more general humanis-
help:
tic themes of becoming aware of one’s
1. Paraphrase. Rather than saying “I know how you feel,” check your understanding by
summarizing the person’s words in your own words. feelings as they occur, of emphasizing
2. Invite clarifi cation. “What might be an example of that?” may encourage the person conscious rather than unconscious
to say more.
material, of encouraging responsibil-
3. Refl ect feelings. “It sounds frustrating” might mirror what you’re sensing from the
person’s body language and intensity. ity for one’s actions, and of promoting

growth and fulfi llment are also clearly
Before You Move On
evident in the book.
c ASK YOURSELF Ask your students to write a paper
Think of your closest friends. Do they tend to express more empathy than those you don’t identifying the important elements of
feel as close to? How have your own active listening skills changed as you’ve gotten older?
client-centered therapy (for example,
c TEST YOURSELF
active listening, genuineness, accep-
In psychoanalysis, what does it mean when we refer to transference, resistance, and
interpretation? tance, empathy) in Dibs.
Answers to the Test Yourself questions can be found in Appendix E at the end of the book.
ENGAGE
Critical Questions
Could too much unconditional
positive regard be a bad thing? Have
students consider the following
questions:
(cid:2) How might unconditional positive
regard lead to unwarranted self-
esteem?
(cid:2) Why would people in therapy
benefit most from unconditional
positive regard?
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Active Learning
Present case studies from various abnormal
psychology textbooks and have students
explain the person’s behavior from a particular
perspective. You may assign a particular per-
spective for study and have students come up
with a case study refl ecting common disorders
that therapists from that perspective would
likely treat. Then ask students to describe what
type of treatment that type of therapist would
recommend to this new “patient.”
Module 70
Introduction to Therapy, and Psychodynamic and Humanistic Therapies 713
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714 Unit XIII Treatment of Abnormal Behavior
Module 70 Review
CLOSE & ASSESS
Exit Assessment How do psychotherapy, biomedical therapy, What are the basic themes of humanistic
7700--11 7700--33
and an eclectic approach to therapy differ? therapy, and what are the specifi c goals
Provide students with a list of terms and techniques of Rogers’ client-centered
from this module—psychodynamic, • Psychotherapy is treatment involving psychological approach?
techniques; it consists of interactions between a trained
resistance, interpretation, transferring, therapist and someone seeking to overcome psychological • Both psychoanalytic and humanistic therapies are insight
client-centered therapy, unconditional diffi culties or achieve personal growth. therapies—they attempt to improve functioning by
positive regard, active listening—and • The major psychotherapies derive from psychology’s increasing clients’ awareness of motives and defenses.
have them match the term with either psychodynamic, humanistic, behavioral, and cognitive • Humanistic therapy’s goals have included helping clients
perspectives. grow in self-awareness and self-acceptance; promoting
Freud or Rogers. This activity will help
personal growth rather than curing illness; helping clients
• Biomedical therapy treats psychological disorders with
ensure they know which terms cor- take responsibility for their own growth; focusing on
medications or procedures that act directly on a patient’s
conscious thoughts rather than unconscious motivations;
respond to which founder. physiology.
and seeing the present and future as more important than
• An eclectic approach combines techniques from various the past.
forms of psychotherapy.
• Carl Rogers’ client-centered therapy proposed that
What are the goals and techniques of therapists’ most important contributions are to function
7700--22 psychoanalysis, and how have they been as a psychological mirror through active listening and to
adapted in psychodynamic therapy? provide a growth-fostering environment of unconditional
positive regard, characterized by genuineness, acceptance,
• Through psychoanalysis, Sigmund Freud tried to give and empathy.
people self-insight and relief from their disorders by
bringing anxiety-laden feelings and thoughts into
conscious awareness.
• Techniques included using free association and
interpretation of instances of resistance and transference.
• Contemporary psychodynamic therapy has been infl uenced
by traditional psychoanalysis but is briefer, less expensive,
and more focused on helping the client fi nd relief from
current symptoms.
• Therapists help clients understand themes that run
through past and current relationships.
• Interpersonal therapy is a brief 12- to 16-session form
of psychodynamic therapy that has been effective in
treating depression.
Answers to Multiple-Choice Multiple-Choice Questions
Questions
1. Many clinical psychologists incorporate a variety of 2. What do psychodynamic therapists call the blocking of
approaches into their therapy. They are said to take a(n) anxiety-laden material from the conscious?
1. d
___________ approach. a. Resistance
2. a a. transference b. Interpretation
b. biomedical c. Transference
c. psychoanalytic d. Face-to-face therapy
d. eclectic e. Interpersonal psychotherapy
e. psychodynamic
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Unit XIII
714 Treatment of Abnormal Behavior
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