PSY 101 Lecture Notes - Lecture 12: Autism Spectrum, Intellectual Disability, Panic Disorder
29 Apr 2018
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Chapter 16: Psychotherapy
Lecture Notes:
-Conviction underlying psychotherapy: people with psychological problems can
change
-Why do people seek therapy? People seeking therapy may:
●Be in stressful current life circumstances
●Have long-standing problems
●Be reluctant and enter therapy at the request of a physician, spouse, or other
●Seek personal growth
●Need treatment of a psychiatric disorder/mental illness
-Who provides psychotherapy?
●Clinical psychologists (PhD)
●Psychiatrists (MD)
●Masters level clinicians
-Qualities that enhance therapy:
●Client’s motivation to change
●Client’s expectation of receiving help
●Protected setting
●Good match between client and therapist
-Estimated gains depend on:
●Therapist’s impression of changes that have occurred
●Client’s reports of change
●Reports from the client’s family or friends
●Comparison of pretreatment and posttreatment scores on personality tests
●Measures of change in selected overt behaviors
-Measuring change with quantitative measures:
●Reliable and valid self-reports or interviews
●Self-monitoring behaviors (keeping track of how many times you show a behavior, like
counting how many panic attacks you have in a week)
●Biologically-based indices (like fMRI)
-Would change occur anyway?
●Improvement often occurs without professional intervention
●Psychotherapy can accelerate improvement
-Can therapy be harmful?
●Some clients harmed by encounters with therapists….if the therapist isn’t experienced in
what your issue is
●5-10% deteriorate during treatment
●Responsibilities of therapists….boundary violation (not talking to/approaching you in
public). Also responsibility to refer you to another therapist if you’re not experienced
with the issue that the client has.
-What therapeutic approaches should be used?
●Evidence-based treatment
●Medication or psychotherapy?
●Combined treatments
-Advances in psychopharmacology:
●Allow many to remain un-hospitalized
●Include problems with side effects and matching drug and drug dosage to needs of
specific patient
●May reduce symptoms but not cure the disorder
-Combined Treatments: medication plus therapy:
●Clinical practice: medication and psychotherapy combined used for schizophrenia and
bipolar disorder
●Effectiveness: combined treatment often works better for chronic or recurrent depression
-The DSM:
●DSM-IV-TR (2000, “text-revision”)
●Multiaxial diagnosis
●Axis I: all psychological diagnostic categories except personality disorders and
intellectual disability
●Axis II: personality disorders, intellectual disability
●Axis III: medical conditions, physical disorders
●Axis IV: psychosocial and environmental factors
●Axis V: Global Assessment of Functioning (GAF) or Child Global Assessment Scale
(CGAS)
-DSM 5:
●Eliminated multiaxial system
○Separate notations (V-codes) for important psychosocial and contextual factors
○No GAF score–use of standardized assessments of symptom severity
recommended
○Functional status is kept separate from presenting symptoms
●Added disorders (like hoarding and binge eating)
●More dimensional approach to some diagnoses
○More flexibility to assess the severity of a disorder (like Autism spectrum
disorder)
○Implies disorders fall along a continuum
-Modern Psychotherapies:
●Psychodynamic
●Client-centered
●Behavior
●Cognitive-behavioral
●Group and family
-Psychodynamic Therapy:
●Derived from Freud and psychoanalytic tradition
○No talk about your id, ego, and superego
●Focus on themes across relationships
○Childhood, adulthood, client-therapist relationship
○Help the client gain self-insight by bringing unconscious conflicts into awareness
○Break down client’s defenses (denial, intellectualizing)
○Focus on the client’s affective experience
●Client-therapist relationship is a mechanism of change
-Psychodynamic Therapy:
●Presumed problem: unconscious conflicts from childhood experiences
●Therapy aim: reduce anxiety through self-insight
●Therapy technique: interpret client’s memories and feelings
●Long-term psychodynamic therapy:
○Limited research support
○Typically lasts years (heavily practiced in NYC)
●Short-term or time-limited psychodynamic therapy:
○Modest research support
○Probably effective, but need more research
○Typically lasts 12-24 sessions, with some flexibility
○Most successful when treatment is focused on a narrow set of issues
-Client-Centered Therapy:
●Carl Rogers: humanistic therapy
○Also called person-centered therapy
○Emerged in the 1940s as an alternative to psychoanalytic psychotherapy
●Emphasizes people’s potential for self-fulfillment, subjective experiences, and the power
of the client
●Grow towards self-awareness and self-acceptance
●4 major aspects:
○Curing mental illness is NOT the focus; promoting client growth is
○How do you grow? Take immediate responsibility for your feelings/actions
○Conscious thoughts are more important than unconscious ones
○Present and future are more important than the past
●Presumed problem: barriers to self-understanding, self-acceptance
●Therapy aim: enable growth via positive regard, genuineness, acceptance, and empathy
●Therapy technique: listen actively and reflect client’s feelings
-Necessary and Sufficient Conditions of Psychotherapy:
●Unconditional positive regard
Document Summary
Conviction underlying psychotherapy: people with psychological problems can change. Be reluctant and enter therapy at the request of a physician, spouse, or other. Need treatment of a psychiatric disorder/mental illness. Therapist"s impression of changes that have occurred. Reports from the client"s family or friends. Comparison of pretreatment and posttreatment scores on personality tests. Measures of change in selected overt behaviors. Self-monitoring behaviors (keeping track of how many times you show a behavior, like counting how many panic attacks you have in a week) Some clients harmed by encounters with therapists . if the therapist isn"t experienced in what your issue is. Responsibilities of therapists . boundary violation (not talking to/approaching you in public). Also responsibility to refer you to another therapist if you"re not experienced with the issue that the client has. Include problems with side effects and matching drug and drug dosage to needs of specific patient. May reduce symptoms but not cure the disorder.
