The effectiveness of cognitive therapy and drug therapy for depression were compared.
They found that cognitive therapy was at least as effective as antide pressant drugs.
If cognitive therapy helps clients learn new skills that can be useful in warding off the return of symptoms, it may prevent the return of depression.
Current factors such as reinforcers that are maintaining maladaptive behaviors are what behavior therapists focus on.
The application of behavioral techniques to behaviors in nonclinical settings is behavior modification.
Programs to reduce litter or increase the use of seat belts are examples of behavior modification.
In clinical settings, behavior therapy involves applying behavioral principles to change maladaptive behaviors.
Most behavioral techniques come from the work of psychologists.
The most frequently used behavioral techniques are systematic desensitization, aversion therapy, modeling, extinction, pun ishment, and the token economy.
The case of Little Albert was used to demonstrate how classical principles can be used to create an emotional response.
Peter received his favorite food from Jones.
The child's fear diminished as the pleasant feelings evoked by the behavioral technique became associated with the rabbit.
A procedure that counteracts the relaxation with exposure to imagined scenes related to a fear of snakes is the first step in desensitization.
Drug use has been used to counter anxiety, but progressive relaxation is the most popular choice.
Most people can reach a state of calm that they may not have known they could achieve with instruction in progressive relaxation and practice outside of therapy sessions.
The client and therapist work together to make a list of scenes related to the phobic object.
It's possible that you walk into a room with a dozen snakes on the floor and hear the door lock behind you.
The scenes are arranged in a hierarchy, starting with one that causes no fear and progressing to one that causes great fear.
Write down a procedure that you think might work on the question.
The scenes start with the one that causes the least fear and end with the one that causes the greatest fear.
The plane made a stop at the terminal.
For times and flight numbers, I call a travel agent.
The day before the trip, I pack my suitcase.
I entered the terminal with my bags in hand.
I walk to the counter and wait for the agent to check my bags.
I am waiting in the lounge for my flight to arrive.
I enter the door of the plane after walking down the ramp.
I sit in my assigned seat after walking down the aisle.
I walk to the restroom when the plane is in the air.
The seat belt signs are illuminated and the pilot is about to land.
The plane is on the runway.
There is a Copyright in 1995 by Joseph pear.
The relaxed client is asked to imagine US (Antabuse) UR one scene at a time, starting with the scene that arouses no anxiety.
There are scenes that create more and more anxiety when the client moves through the hierarchy.
As the scenes are imagined, the client is likely to experience some degree of anxiety.
When this happens, the therapist goes back to the instructions for relaxation in order to make sure the client is completely relaxed.
The client learns that relaxation is associated with scenes for alcoholics.
The repeated related to the phobias as he or she proceeds through the list to the scene that arouses the most fear.
The nausea caused by the drug is replaced with more relaxed feelings as the fear is reduced or completely eliminated.
More fear reduction is achieved with real objects than with imagined scenes, which is why some courts rely more on real objects.
Although there is debate about the theoretical explanation of the success of systematic with alcohol to undergo this form desensitization, there is little doubt that it is very effective in reducing a number of phobias.
Aversion therapy is based on classical conditioning principles and involves aversive stimuli.
In treating alcoholism, a person is given a drug that will induce nausea.
The sight, smell, and taste of the drink are followed by nausea.
The alcohol and drug combination is repeated over and over again.
The person may avoid alcohol in the future due to the nausea caused by the alcohol.
There is a problem with this treatment when clients fail to take the drug.
Aversion therapy can be used to reduce cigarette smoking, alcoholism, and sexual deviations.
Only qualified personnel should carry out this procedure because it involves aversive stimulation.
We may miss the potential of modeling as a therapeutic technique because it is so common.
A per son procedure shows gradual contact with a feared object under controlled or protected circumstances.
The client can engage in similar behaviors if they observe them.
Albert Bandura explained the success of this therapy as the result of providing experiences that enhance the perception of self-efficacy.
The behavior is likely to be zero under these circumstances.
The amount of reinforcement that was given in the past affects the speed with which a behavior is extinguished.
Intermittent or partial rein forcement schedules and larger reinforcements result in greater resistance to extinction.
The use of extinction in the case of Bruce, Classical conditioning technique for reducing or eliminating behavior an institutionalized, severely retarded adolescent who constantly demanded his attention, was described by Richard Foxx.
Bruce exposed himself in order to get their attention.
Are you one of Bruce's instructors?
To extinguish a behavior, you need to know what reinforcer is maintaining it.
Bruce's instructors believed that their attention kept this behavior going.
They recorded the behavior for a week and found that Bruce engaged in it about 14 times a day.
They told him to raise his pants without looking at him.
On the first day of extinction training, Bruce exposed himself 30 times, on the second day he exposed himself 40 times, and on the third day he exposed himself 40 times.
Bruce stopped exposing himself after two and a half weeks.
Another procedure used by behavior therapists is punishment, which can be either the withdrawal of a positive stimuli (such as candy) or event or the presenta tion of a negative stimuli or event.
When used as a technique for altering maladaptive behaviors, punishment can have serious drawbacks and is not always effective.
Less distressing forms of treatment should be tried before punishment is considered.
Some maladaptive behaviors are so resistant to change that they may be used as a last resort.
A profoundly retarded girl hit herself thousands of times each day.
One of the side effects of medication was that the girl cried.
The hitting increased when the medication was stopped.
Changing the dose did not change the behavior.
extinction with no success was tried by psychologists.
An electrical shock was delivered to the child's leg when she hit herself.
The rate of hitting dropped so much that the psychologist was able to end the treatment.
Over the next five years, there were only 250 hits compared to the 5 million that would have been anticipated.
There are a number of factors that influence the effectiveness of punishment.
She didn't find hitting herself to be aversive, but when control of the punisher was in the therapist's hands, it became aversive.
A number of patients in mental hospitals lose their social skills.
Social skills such as knowing how to greet another person and respond when spoken to are important for getting along outside the hospital.
It is important for psychologists to reward patients for displaying skills immediately after desired behaviors occur.
Patients can exchange their token for food once they have earned them.
Poker chips, gold stars, and check marks can be called a token.
It is unlikely that awarding poker chips will alter maladaptive behaviors.
If you recall our dis reinforcers, you can redeem them in Chapter 6.
Write down your answers and give these questions some thought.
There are three important steps in establishing a token economy.
The psychologist needs to identify the target behaviors and then establish contingencies for each of them.
As soon as they are earned, points are usually awarded.
The exchange rules for using the token must be set by the developer.
Patients can exchange token for desired reinforcers such as candy, television time, and grounds privileges.
Money is used outside the hospital in the same way that the token is used.
Patients would lose their reinforcing value if psychol ogists used primary reinforcers to reward each occurrence of a desired behavior.
Patients can accumulate them and exchange them later for the primary reinforcers they want, so they are less likely to lose their value.
The behavior therapy techniques are summarized in the study chart.
CBT has been used by clinicians for many years, but it always seems to be changing.
The importance of understanding language and cognitive skills is emphasized in this theory.
We either directly or indirectly associate words and events to form frames.
When you were a child, you may have said the word "bee" and learned that bees are insects.
You formed a frame that included the word "bee", seeing a bee and seeing an insect.
If you are stung by a bee on a later date, you may fear seeing bees, but also fear hearing the word "bee" and seeing other insects, even though you didn't hear the word or see any other insects.
Understanding and modifying human behavior is dependent on an understanding of language and cognitive skills.
Write down your answer before you read further.
Specific techniques have been developed to treat specific problems, which is the main reason for the large number of CBT techniques.
This record can be used to provide information to the client and propose an intervention.
It works well with obsessive-compulsive behaviors.
The client learns how to test the validity of their thoughts.
The goal is to bring the client's thoughts in line with reality.
Depression and eating disorders can be treated with this technique.
The therapist teaches clients how to observe their own thoughts without judging them.
People with posttraumatic stress disorder often experience recurring trauma-related thoughts.
One way to treat post traumatic stress disorder is for the client to learn how to not have these thoughts.
This approach doesn't have very good long-term results.
A more effective solution to the problem can be found in the fact that clients learn how to experience trauma related thoughts without judging them as good or bad.
There are many other CBT techniques designed for use with specific disorders.
A therapist and a client interact in most forms of therapy.
Life outside thera pist's office may not reflect therapy sessions.
A behavior therapist will not be able to reinforce appropriate behaviors, nor will a client-centered therapist be present to offer positive regard, because they are not likely to have a psychoanalyst available to offer interpretations of their actions.
Problems that bring clients to therapists don't happen in a vacuum, they reflect the clients' difficulties in interacting with family, friends, coworkers, and even strangers.
Group therapy can be used to treat a number of psychological disorders.
It's useful in reducing stress and anger, as well as resolving difficulties in social behavior that can cause distress.
Group therapies share many of the same features.
Group therapy advantages are given by these features.
One can tell the group about their problems and concerns.
Being valued by the other group members is a feeling of belongingness.
One's problems are not unique or more serious than those of other group members.
Being able to relate in a constructive way to the group.
Through the observation of other group members, the therapist can learn about themselves.
It is possible to find out about one's behavior in the group setting.
Different types of therapists can use group therapy, such as psychodynamic, humanis tic, cognitive, and behavioral therapists.
Two forms of group therapy--marital and family therapy--are based on the assumption that problems presented for treatment should be addressed within a larger family unit.
Therapists from all mental health professions use these therapies to treat a variety of problems.
Sometimes a child is brought in for therapy for a specific problem, such as school difficulties, delinquency, or aggressive behavior, and the therapist finds that the problems exist in the context of the family setting, especially in the ways parents and children interact.
The problems are not alleviated by returning the child to the family.
Parents, spouses, and children should be involved in therapy for the client's problems.
Incorporating spirituality into family therapy is beneficial to the treatment process according to a growing number of psychologists.
A person who feels overwhelmed by life's problems may turn to friends, relatives, or teachers for help.
There are other sources of assistance for people in need.
The need for mental health ser vices was not met by therapists alone.
Paraprofessionals can be found in a variety of roles, such as staffing telephone crisis lines.
An estimated 7 to 15 million people are helped by the self-help group.
Some self-help groups invite professional therapists to help with unusual cases, but most are run by laypersons.
Compassion and understanding don't need advanced degrees according to a guiding principle.
The people in these groups pool their knowledge.
Self-help groups have the ability to prevent more serious problems by providing social support during a time of need and by helping people develop cope skills.
For people suffering from specific medical conditions, for people facing acute crises, and for individuals with mental illness, some of the best known are designed.
The parent of an adult child with a mental illness is a typical member of the National Alliance for the Mentally Ill.
The oldest and largest self-help group is Alcoholics Anonymous, with over 1.5 million members worldwide.
Two rapidly expanding sources of self-help are telephone- and Internet-based groups.
Requests for information and emotional support are the focus of the electronic communications of online groups.
Internet self-help groups can be found at times when traditional sources of support are not always available.
John Grohol's PsychCentral is one of the Internet sites we recommend.
Users of telephone self-help programs like the flexibility, accessibility, and autonomy afforded by telephone-based guidance for problems such as binge eating.
Table 13-6 shows contact data for self-help groups.
The managed health care system was brought about by the health care reforms of the 1970s.
The quality of care in managed care of mental health ser vices has generated a lot of debate.
It is easy for con sumers to use their home PC.
The Internet is seen as a means to improve the bottom line by managed-care firms.
The files of local self-help groups are maintained by most of the national organizations.
Literature can be provided on the problem.
There is a chapter on the internet for mental health services.
Consumers need to be very careful about the services they receive on the internet.
The information given by the pro-anorexia sites has the potential to be very dangerous.
Mental health services on the internet aren't the only new forms of mental health service that come under close scrutiny.
Some forms of therapy have been sensationalized and their presentation by the media may strain our credibility.
The use of pets to reduce psychological problems falls into this category for some critics.
According to advertisements featuring winsome puppies and kittens, having a pet can cure everything from loneliness to hypertension and heart disease.
The presence of a pet dog kept blood pressure from rising, while the presence of the person's best friend increased blood pressure.
A researcher was led to investigate further after finding something odd.
People who were experiencing a stressor in the presence of other people had large increases in blood pressure.
The people who only had their pet present showed slight increases.
Researchers conducted a study in which half the participants were randomly selected to adopt a pet cat or dog from an animal shelter.
The participants were stockbrokers with high blood pressure.
The participants had not owned a pet in the previous five years.
The partici pants were supposed to begin drug therapy with a drug that reduces resting blood pressure but does not reduce responses to stress.
Pets provide social support, according to the results.
Indi viduals who acquired pets had blood pressure increases that were less than half the increases of their counterparts without pets, despite the fact that Lisinopril reduced resting blood pressure in all participants.
People who reported the least social contacts benefited the most from their pets.
Independent mechanisms affect resting blood pressure and stress-related blood pressure.
Adding a pet to the environment can affect stress responses and affect resting blood pressure.
Pets can be a healthy pleasure for people with few social con tacts.
Maybe pet therapy should be considered more seriously by the scientific community.
The primary reinforcers can use the token.
The occurrence of maladaptive behaviors is reduced by Mari.
Judy's therapist doesn't say anything about evaluating or judging her.
The therapy is based on what happened in our sessions.
There are many reasons why these questions are hard to answer.
It is difficult to define what success is in therapy.
It's difficult to know when a person has insight.
Second, therapies can be used to treat a wide variety of problems that have little in common.
When people seek therapy, they make a decision to change an aspect of their lives that may differ from one person to another.
The first major study of the effectiveness of therapy was published in 1952 by a British psychologist.
More than 8,000 clients with moderate to severe disorders received either psycho analytic therapy, eclectic therapy or no therapy.
According to Eysenck, the results show that roughly two-thirds of a group.
The publica tion of Eysenck's report caused a furor, and his review was subjected to many appraisals.
Critics noted that the therapists who had published the studies Eysenck reviewed had different goals and orientations in evaluating ther apy and probably used different criteria when judging success.
Eysenck reviewed some studies and it appeared that he had overstated the rate of remission.
According to the results of several meta-analyses,psychotherapy is generally effective, although we are unsure as to why.
Their effectiveness is supported by testimonials from satisfied clients, which should give us pause.
It's not surprising that culture, ethnicity, and sex have profound effects on our behavior, values, and attitudes.
In Japan, a therapy called "look within at oneself" is used to discover how a client has been troublesome to people who have extended themselves, such as parents and teachers.
The primary goal of the therapy is to find ways for the client to show gratitude and alliance with these people.
We can't fully understand this therapy if we don't know Japanese culture, in which the focus is on the group rather than the individual.
The United States is a multicultural nation with a variety of ethnicities.
Patterns of therapy are affected by this reality.
In the United States, ethnic minority group members don't use or provide psychotherapy in the same way that the population does.
Do not confuse this pattern of use with the need for emotional help.
A higher proportion of poverty and social stressors can contribute to psychological disorders.
Men tal health services for U.S. minority groups are not good.
African Americans, Native Americans, Asian Americans, and Latinos average fewer sessions of therapy than whites.
Between 42% and 45% of minority clients failed to return after a single session, compared with 30% of white clients.
It is necessary for intimate conversations between socially distant people.
Communication patterns that are similar to their own and respectful of their values are what clients want.
Many ethnic groups and cultures don't allow intimate conversations with family members.
Formal and polite but non revealing patterns of communication are used with outsiders.
Latino clients are more comfortable with a therapist with the same sex or ethnic background.
Chapter thirteen clients use Spanish at home and English in therapy.
Clients may see the relationship as similar to previous formal relationships that minimized self-disclosure because of the formality of the therapy situation and the therapist's use of English.
Language differences between therapists and clients can affect treatment.
The way the client and therapist relate is influenced by identification with the therapist.
Clients may seek therapists of the same ethnic group, race, and sex because they anticipate a feeling of shared values and understanding that will make them more comfortable in revealing intimate details of their lives.
A lack of bilingual therapists and therapists' stereotypes about ethnic clients is one of the reasons why ethnic clients end therapy early.
The most important reason is that therapists don't provide culturally responsive forms of therapy.
They might be unaware of values and customs within a culture that would help them understand and treat certain behaviors.
A Latino went through training at the suggestion of his therapist.
The young man got a negative reaction when he asserted himself with his father.
In this case, proper respectful behavior toward one's father was included in therapy.
Some psychologists suggest that therapists develop cultural understanding and knowledge in order to counter the high rate of early termination of treatment by minority clients.
Ethnic-specific therapeutic services and therapists from diverse ethnic background are needed.
There is a need for more bilingual and bicultural personnel who can work with clients from different cultures and those for whom English is a second language.
Sue and his colleagues looked at the services, length of treatment, and out comes of therapy for several ethnic groups in Los Angeles.
The length and success of treatment for Mexican Americans was related to ethnic match.
When the therapist had the same ethnic background and spoke the same language as the client, treatment was more likely to last longer and be more successful.
Matching is important because of the length of treatment.
The ethnic and racial diversity of the U.S. population has led therapists to consider these factors in providing treatment.
The use of the humanistic approach provides a safe, open, and caring relationship with gay and lesbian clients.
Therapists should be sensitive to the physical limitations of elderly clients.
A range of considerations should be used to answer the question.
People may decide to enter therapy for a variety of reasons.
If you answer yes to any or all of the questions, you may want to consider entering therapy.
One of the best ways to start is to get recommendations from people you know.
It is a good idea to call the mental health center in your area.
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