The Psychological Therapies

Psychological therapy, or psychotherapy, is an emotionally charged,

confiding interaction between a trained therapist and someone suffering
from psychological difficulties. The major psychotherapies derive from
the familiar psychoanalytic, humanistic, behavioral, and cognitive
perspectives on psychology.
Psychoanalysis
Those influenced by the psychoanalytic perspective try to help people
gain insight into the unconscious origins of their disorders and to work
through the accompanying feelings. To do so, an analyst may draw on
techniques such as free association and dream analysis, and interpret
resistance and the transference to the therapist of long-repressed
feelings.
Traditional psychoanalysis, which is no longer practiced widely, is
criticized for assuming repression, for after-the-fact interpretations, and
for being time-consuming and costly. The more common
psychodynamic therapy is influenced by the psychoanalytic
perspectives concern for providing insight into childhood experiences
and defense mechanisms. But it offers a briefer treatment form and
often incorporates other techniques into the therapy sessions.
Humanistic Therapies
Unlike psychoanalysts, humanistic therapists focus on clients current
conscious feelings and on their taking responsibility for their own
growth. Carl Rogers, in his client-centered therapy, used active listening
to express genuineness, acceptance, and empathy.
Behavior Therapies
Behavior therapists do not attempt to explain the origin of problem
behaviors or to promote self-awareness. Instead, they attempt to modify
the problem behaviors themselves. Thus, they may countercondition
behaviors through systematic desensitization or aversive conditioning.
Or they may apply operant conditioning principles with behavior
modification techniques, such as token economies.
Cognitive Therapies

The cognitive therapies, such as Aaron Becks cognitive therapy for

depression, aim to change self-defeating thinking by training people to
look at themselves in new, more positive ways.
Group and Family Therapies
Many therapeutic techniques can also be applied in a group context.
Self-help and support groups, such as AA, engage many millions of
people. Family therapy treats the family as an interactive system from
which problems may arise.

Evaluating Psychotherapies
Is Psychotherapy Effective?
Because the positive testimonials of clients and therapists cannot prove
that therapy is actually effective, psychologists have conducted
hundreds of studies of psychotherapys outcomes. Meta-analyses of
these studies reveal that (1) people who remain untreated often
improve; (2) those who receive psychotherapy are more likely to
improve, regardless of what kind of therapy they receive and for how
long; (3) people with clear-cut specific problems often receive the
greatest benefits from therapy; but (4) placebo treatments or the
sympathy and friendly counsel of paraprofessionals also tend to
produce more improvement than occurs when people receive no
treatment.
The Relative Effectiveness of Different Therapies
Although no one type of therapy can be said to be most effective
overall, some therapies are particularly well-suited to specific disorders.
Behavioral conditioning, for example, is effective in treating phobias and
compulsions.
Evaluating Alternative Therapies
Of the three alternative therapies consideredtherapeutic touch,
EMDR, and light exposure therapyonly light exposure therapy has
held up under scientific testing.

Commonalities Among Psychotherapies

All types of psychotherapy seem to offer three benefits: new hope, a
fresh perspective, and an empathic, trusting, caring relationship.
Therapists do, however, differ in the values that influence their aims.

The Biomedical Therapies

Drug Therapies
The most widely used biomedical therapies are the antipsychotic,
antianxiety, and antidepressant drugs. A few drugs, such as lithium for
bipolar disorder, have proven very effective in double-blind studies,
though many drugs are hardly more effective than placebo treatments
and some have serious side effects.
Electroconvulsive Therapy
ECT is a biomedical therapy in which a brief electric current is sent
through the brain of an anesthetized patient. Although controversial,
ECT remains an effective, last-resort treatment for many people with
severe depression who have not responded to drug therapy.
Researchers are also exploring newer alternatives, such as magnetic
brain stimulation.
Psychosurgery
Although radical psychosurgical procedures such as lobotomy were
once popular, neurosurgeons now rarely perform brain surgery to
alleviate specific problems. Even when MRI-guided precision surgery is
considered, it is a treatment of last resort because its effects are
irreversible.

Preventing Psychological Disorders

Advocates of preventive mental health argue that many psychological
disorders could be prevented. Their aim is to change oppressive,

esteem-destroying environments into more benevolent, nurturing

environments that foster individual growth and self-confidence.