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Chapter 1 - Introduction. Identify a thorough definition of psychotherapy Distinguish different views of how to live life espoused by different schools of psychotherapy Recognize the structure of the text. Orlinsky and Howard’s (1987) definition: Psychotherapy is:
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Identify a thorough definition of psychotherapy Distinguish different views of how to live life espoused by different schools of psychotherapy Recognize the structure of the text
Orlinsky and Howard’s (1987) definition: • Psychotherapy is: • A relation among persons, engaged in by • one or more individuals defined as needing special assistance to • improve their functioning as persons, together with • one or more individuals defined as able to render such help.
Optimistic / Comic: • View hard work and personal improvements as leading to good outcomes if the client participates as prescribed • E.g., Cognitive-Behavioral Therapy, Experiential therapy • Tragic: • Coming to terms with the limitations imposed by the troubled world • E.g., Psychoanalysis, Existential therapy
Emphasis on most widely practiced schools of psychotherapy Concern with theory To be used as a launching pad to further exploration
This book is NOT: • Focused on specific personal factors that make a good therapist • A training manual • A how-to guide to the specifics of each treatment • Focused on differences in treatments between adults and children/adolescents
Classical Conditioning: learning that occurs when two stimuli are presented in close temporal proximity and with some degree of contingency or correlation between them Instrumental Conditioning: learning that occurs when a response is consistently followed by either a positive or negative consequence
Generalization: when one stimulus comes to elicit an emotional response, other stimuli that resemble the original stimulus will also elicit a similar emotional response Extinction: a weakening of the strength of the learned response that occurs when the unconditioned stimulus or reinforcer is no longer contingent on the conditioned stimulus, instrumental response, or discriminative stimulus
Pavlov – classical conditioning • Unconditioned stimulus • Unconditioned response • Conditioned stimulus • Conditioned response • Extinction: of particular importance for behavior therapy • Watson – classical conditioning • Behavior can be understood without reference to mental constructs • Watson and Rayner: Little Albert • Mary Cover Jones: Peter, tx of phobia by in vivo exposure
Skinner – neobehaviorism • Operationalism: concepts should be defined via objective measurement • Psychology should focus on describing the relationships between responses and their outcomes • Functional Analysis – identification of reinforcers • Operant conditioning • Reinforcement • Positive • Negative • Punishment • Positive • negative • Problem behaviors can be modified by changing environmental contingencies
Mowrer – two-factor theory • Studied avoidance behavior, which can help in understanding many psychological disorders • Tried to explain avoidance behavior without relying on expectancies • Combined classical and operant conditioning • Relationship between a stimulus and a fear response is learned (classical) • Relationship is learned between avoidance and reduction in fear (operant)
Systematic Desensitization: Wolpe • Reciprocal inhibition: opposite emotional states cannot be experienced simultaneously • Fear hierarchy • Prolonged Exposure Therapy: Foa • Fear network – many stimuli associated with trauma, exposure to as many as possible - habituation • Flooding • Response prevention – prevent maladaptive response, e.g. avoidance • Behavioral Rehearsal • Patient and therapist act out various situations that are problematic • Social/observational learning – modeling: Bandura
prepare the client: give rationale, test alternative behaviors, discuss appropriate expectations Identify targets for change: hierarchy of situations to rehearse Role-play or behavioral rehearsal: should be as realistic as possible Carry out the behaviors in the real world
Behavioral Activation • Targeted toward depression, based on the notion that people with depression lack positive reinforcers for healthy behaviors in their lives, while depression may be reinforced • Positive reinforcement of healthy or pleasurable activities • Interoceptive Exposure in Panic Control Treatment • Exposure to bodily sensations associated with panic, e.g. hyperventilation, chair-spinning
Specific behavioral goals • Assessment • Functional assessment • Single case design • Process of Psychotherapy • Active and directive therapist • Short-term • Therapeutic alliance
Extinction Stimulus Control Contingency management Skill acquisition Shaping Homework- behavioral assignments are necessary and sufficient for improvement in therapy
Specific Strategies • Role of worry as avoidance strategies • Exposure to negatively valenced imagery • Empirical support for treatment of generalized anxiety disorder (GAD) • High end state functioning achieved in approximately 50% of cases