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Psychotherapy

Purpose of Course  showclose

Psychotherapy refers to the practices clinical psychologists use to treat mental disorders. While “therapy” can denote any intervention undertaken with the goal of healing someone (including medicinal treatments for physical problems), psychotherapy is specific in that it uses certain cognitive, behavioral, and emotional regulation techniques. Based on pop culture portrayals of psychotherapy, you may be imagining a patient lying on a couch, talking freely about whatever is on his or her mind, while a doctor scribbles notes. While there is some truth to this portrait, it is an obvious oversimplification. Psychotherapy often involves a pre-defined set of techniques that a counselor will use in order to solve the problems that his patient is encountering. These techniques often vary from therapist to therapist and depend on which school of thought the therapist subscribes to, that is, which perspectives he or she has adopted in order to explain the causes of and appropriate treatments for various disorders. For example, therapists from the schools of Psychoanalysis and Behaviorism will differ greatly in terms of how they approach and treat an individual suffering from anxiety. We will spend a substantial amount of time addressing each of these schools of thought, acknowledging that each has its own strengths and weaknesses.

Psychotherapeutic treatments will also vary based on the nature of the patient’s disorder. While it may seem obvious that a therapist will treat Schizophrenia differently than he would Depression, it should be noted that different mood disorders are treated differently. We will discuss various approaches to these disorders, familiarizing ourselves with the theories that support their practice. You should also be aware that while a therapist may recommend a particular treatment, it is often the patient that has the final say in how he will be treated. Therapy is, after all, a personal process for both the patient and clinician.

This course will provide you with an introduction to the theories, styles, and methods of psychotherapy that you would need to know in a clinical situation. Feel free to look back on PSYCH304 (“Clinical Psychology”) as it will help remind you of the mental disorders referenced in this course.

Course Information  showclose

Welcome to PSYCH206. Below, please find some general information on the course and its requirements.

Course Designer: Helena (Mimi) Martin

Primary Resources: This course is composed of a range of different free, online materials. However, the course makes primary use of the following materials:

  • PubMed Central (provides open access to a variety of journals in the area of science/psychology)
  • Stanford Encyclopedia of Philosophy
  • Lerner’s TV’s version of University of Houston: Dr. Richard Kasschau’s Lecture Series Introduction to Cognitive Psychology 
  • Wikibook’s Cognitive Psychology and Cognitive Neuroscience
  • Zain Books’s version of Virtual University of Pakistan’s Cognitive Psychology
  • Oakland University: Professor Cindy Sifonis’s Cognitive Psychology Lecture Series

Requirements for Completion: In order to complete this course, you will need to work through each unit and all of its assigned materials. You will also need to complete a final exam.

In order to “pass” this course, you will need to earn a 70% or higher on the Final Exam. Your score on the exam will be tabulated as soon as you complete it. If you do not pass the exam, you may take it again.

Time Commitment: This course should take you a total of 86 hours to complete. Each unit includes a “time advisory” that lists the amount of time you are expected to spend on each subunit. These should help you plan your time accordingly. It may be useful to take a look at these time advisories and to determine how much time you have over the next few weeks to complete each unit, and then to set goals for yourself. For example, Unit 1 should take you 11 hours. Perhaps you can sit down with your calendar and decide to progress through/complete subunits 1.1  and 1.2 (a total of 6 hours) on Monday/Tuesday night; subunit 1.3 (a total of 5 hours) on Wednesday/Thursday night; etc.



Learning Outcomes  showclose

Upon successful completion of this course, the student will be able to:
  • define psychotherapy and describe the historical development of its practice;
  • identify the qualities most useful in a psychotherapist;
  • discuss the different ways in which psychotherapy affects both patient/client and counselor/therapist;
  • describe how each theory/therapy conceptualizes a) human nature, b) psychopathology, and c) the therapeutic change process;
  • identify the major therapeutic techniques used to promote change in each type of therapy;
  • compare and contrast individual theories/therapies with family theories/therapies; and
  • describe a) the important historical figures associated with each theory and b) the historical context in which the theory emerged.

Course Requirements  showclose

In order to take this course you must:

√    have access to a computer;

√    have continuous broadband Internet access;

√    have the ability/permission to install plug-ins or software (e.g.,Adobe Reader or Flash);

√    have the ability to download and save files and documents to a computer;

√    have the ability to open Microsoft files and documents (.doc, .ppt, .xls, etc.);

√    be competent in the English language;

√    have read the Saylor Student Handbook; and

√    have completed all courses listed in the Core Program of the Psychology Discipline. This requirement only applies to those students who are seeking the equivalency of a Full Psychology Degree. If taking this course as an elective, you must only have completed PSYCH101.

Unit Outline show close


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  • Unit 1: An Introduction to Psychotherapy  

    What is psychotherapy, who needs it, and how is it conducted? Is psychotherapy really only for “crazy” people? This unit will address these and other basic questions about the field. We will take a look at the historical development of its practice, identify the qualities most useful in a psychotherapist, and discuss the different ways in which psychotherapy affects both patient and counselor. 

    Unit 1 Time Advisory   show close
    Unit 1 Learning Outcomes   show close
  • 1.1 A Short History of Psychotherapy  
  • 1.1.1 Ancient Greeks and Primitive Techniques  
    • Reading: psychcentral.com: Jim Haggerty, MD’s “History of Psychotherapy”

      Link: psychcentral.com: Jim Haggerty, MD’s “History of Psychotherapy” (HTML)
       
      Instructions: Click on the link above and read through the brief overview of the history of psychotherapy. This reading will provide you with an overview of the history of the field. This introduction will be of use to you as you work through the more in-depth explanations of various types of therapy in later units. Note that this reading covers 1.1.1-1.1.7.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 1.1.2 Middle Ages and Demonic Possession  
  • 1.1.3 Walter Dendy and “Psycho-therapeia”  
  • 1.1.4 Sigmund Freud and the Development of Psychoanalysis  
  • 1.1.5 The Change from Psychoanalysis to Behaviorism  
  • 1.1.6 The Notion of Warmth: Rogerian and Interpersonal  
  • 1.1.7 Current and Future Notions of Therapy  
  • 1.2 The Counselor as a Person  
  • 1.2.1 Personal Characteristics of Effective Counselors  
  • 1.2.2 Challenges Faced by Counselors  
  • 1.2.3 Values in Counseling  
  • 1.2.4 Counselor Ethics  
  • 1.2.5 Cultural Issues in Therapy  
  • 1.3 Ethical Issues in Counseling  
  • 1.3.1 Ethical Decision Making  
  • 1.3.2 Informed Consent  
  • 1.3.3 Confidentiality  
  • 1.3.4 Ethical Decisions in Assessment  
  • 1.3.5 The Importance of Evidence-Based Practices  
  • Unit 2: Psychoanalytic Therapy  

    How many films and TV shows have you seen that present the image of an individual lying on a couch, talking to his therapist about his dreams and the influence of his mother? Thanks to its prominent place in pop culture, this form of therapy – psychoanalytic therapy – is perhaps the best-known in contemporary society. Though the principles of psychoanalysis were first developed over 100 years ago and are attributed to the legendary and highly controversial figure of Sigmund Freud, psychologists continue to draw from them today. Psychoanalytics were the first practitioners to attempt to explain mental disorders and design specific therapies in order to treat patients. This unit will introduce you to the principles of psychoanalysis and psychoanalytic therapy, discussing many of Freud’s findings, which, though hotly contested, remain influential.

    Unit 2 Time Advisory   show close
    Unit 2 Learning Outcomes   show close
  • 2.1 Psychoanalytic Theory  
  • 2.1.1 Human Nature: The Importance of the First Six Years of Life  
  • 2.1.2 Instincts: Libido, Life Instincts, Death Instincts  
  • 2.1.3 ID and the Pleasure Principle  
  • 2.1.4 Ego and the Reality Principle  
  • 2.1.5 Superego, the Conscience, and the Ego Ideal  
  • 2.1.6 Parapraxes or “Freudian Slips”  
  • 2.1.7 Projective Tests  
  • 2.1.8 Hypnosis and Posthypnotic Suggestions  
  • 2.1.9 The Three Anxieties (i.e., moral, neurotic, and realistic)  
  • 2.1.10 Ego Defense Mechanisms  

    Note: While defense mechanisms play an important role in psychoanalysis, and while you should know how they function, you needn’t memorize each of them. You may find it useful to take a close look at a few examples, but a general understanding of how these mechanisms work as a whole is far more important.

  • 2.2 Psychoanalysis  
  • 2.2.1 Deterministic  
  • 2.2.2 Free-Association  
  • 2.2.3 The Importance of Dreams  
  • 2.3 Development of Personality  
  • 2.3.1 The Importance of Early Development  
  • 2.3.2 Comparing Freud’s and Erikson’s Models  
  • 2.4 The Therapeutic Process  
  • 2.4.1 Function and Role: Transference Relationships and Projections  
  • 2.4.2 Countertransference  
  • 2.4.3 Interpretation of Transference  
  • 2.4.4 Interpretation of Resistance  
  • Unit 3: Existential Therapy  

    Existential theory grew out of the existential philosophy movement. This model views mental disorders as problems relating to the basic condition of human existence. This may sound vague and daunting, but the approach is generally used only to treat problems that individuals have with creating meaning, assuming responsibility, and handling freedom or choice. While not highly favored in the United States, where other forms of therapy (like psychoanalytic therapy) are more popular, existential therapy is often practiced in Europe. This unit will discuss the tenets of existential philosophy and explain how practitioners derive therapy approaches from them in order to treat mental disorders.

    Unit 3 Time Advisory   show close
    Unit 3 Learning Outcomes   show close
  • 3.1 The Existential Philosophical Approach  
  • 3.1.1 The Rejection of Determinism  
  • 3.1.2 The Importance of Choice  
  • 3.1.3 The Responsibility of Freedom  
  • 3.1.4 The Search for Value and Meaning in Life  
  • 3.1.5 The Capacity for Self-Awareness  
  • 3.2 Existential Theory  
  • 3.2.2 Freedom and Responsibility  
  • 3.2.3 Death and Anxiety  
  • 3.2.4 The Search for Connection  
  • 3.2.5 Meaningless vs. Meaning  
  • 3.2.6 Emotions  
  • 3.3 The Therapeutic Process  
  • 3.3.1 Relevance of Themes to Practice  
  • 3.3.2 Underlying Anxiety in Clients  
  • 3.3.3 Restricted Existence  
  • 3.3.4 Integration of Other Approaches  
  • 3.3.5 Importance of Genuineness in Existential Therapy  
  • 3.3.6 Existential Therapy and Short-Term Therapy, Group Work  
  • Unit 4: Client-Centered Therapy  

    Client-Centered Therapy (also known as person-centered therapy) developed as a reaction to the “colder” psychoanalytic therapy models. While the psychoanalytic approach views the therapist as a guide to the patient, client-centered therapy empowers the patient to take a more prominent role in his/her treatment by having him use the therapeutic relationship in order to realize his potential and solve his own problems. Accordingly, client-centered therapy sees the therapist as a nurturer, encouraging the patient to develop certain skills while allowing him to come to his own decisions. Practitioners see this as an important distinction from psychoanalytic models, where a patient is led to accept the decision the therapist has made for him. In this unit, we will review different aspects of client-centered theory, exploring its differences from psychoanalysis in order to identify the different clinical applications that result.

    Unit 4 Time Advisory   show close
    Unit 4 Learning Outcomes   show close
  • 4.1 Client-Centered Theory  
  • 4.1.1 Nondirective Counseling  
    • Reading: The Sage of Asheville: Dr. Cecil H. Patterson’s “On Being NonDirective”

      Link: The Sage of Asheville: Dr. Cecil H. Patterson’s “On Being NonDirective” (PDF)
       
      Instructions: After clicking on the first link, choose the “click here” link near the top of the page to find a list of Dr. Patterson’s publications. Download the PDF listed above and read the associated article. As you read, pay attention to how the article defines “nondirective.” What does the term mean? What does it not mean? You will find a useful list of the goals of client-centered therapy near the end of the document; this will serve as a solid introduction to the goals of this theoretical orientation.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 4.1.2 The Notions of Congruence and Genuineness  
    • Reading: The Sage of Asheville: Dr. Cecil H. Patterson’s “Therapeutic Genuineness”

      Link: The Sage of Asheville: Dr. Cecil H. Patterson’s “Therapeutic Genuineness”(PDF)
       
      Instructions: After clicking on the first link, choose the “click here” link near the top of the page to find a list of Dr. Patterson’s publications. Download the PDF listed above and read the associated article. As you read, pay attention to the difference between genuineness and facilitative genuineness. Also take note that the aspects of genuineness have been found to facilitate change. 
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 4.1.3 Empathy  
  • 4.1.4 Unconditional Positive Regard  
  • 4.2 Existentialism and Humanism  
  • 4.2.2 The Difference Between Existentialism and Humanism  

    Note: While the basic concepts of Existentialism (see Unit 3) and Humanism are similar, there are some important distinctions. A strong grasp of how the two differ and influence one another will assist you in understanding the differences between the two therapeutic schools. 

  • 4.3 The Therapeutic Process  
  • 4.3.1 Therapeutic Goal: Growth and Actualization  
  • 4.3.2 Necessary Environmental Conditions  
  • 4.3.3 Active Role of Client  
  • 4.3.4 Therapist: Responsive not Directive  
  • Unit 5: Behavioral Therapy  

    Behavioral therapy grew out of the behaviorist movement of the 1950s. According to the principles of behaviorism, all learning and behaviors are the result of certain environmental stimuli; the cognitive processes that support them are unknown and unstudiable – and are therefore irrelevant. Behavioral therapy came about when behaviorists first realized that they could use the techniques they had developed for specific scientific research in order to change maladaptive behaviors, which are considered the cause of mental disorders. This form of therapy remains popular in certain areas of psychopathology, where many of the diagnoses relate to client behaviors. This unit will review the basic theories of behaviorism and discuss how practitioners apply these theories in order to treat mental disorders.

    Unit 5 Time Advisory   show close
    Unit 5 Learning Outcomes   show close
  • 5.1 Historical and Theoretical Background of Behaviorism  
  • 5.1.1 Reaction to Nonscientific Aspects of Psychology  
    • Reading: Bryn Mawr College: Robert Wozniak’s “Behaviourism: The Early Years” and Stanford Encyclopedia of Philosophy’s “Behaviorism”

      Link: Bryn Mawr College: Robert Wozniak’s “Behaviourism: The Early Years” (HTML) and Stanford Encyclopedia of Philosophy’s “Behaviorism” (HTML)
       
      Instructions: For the first reading, click on the link above and read the associated webpage in its entirety. As you read, note the aspects of psychology that behaviorists were attempting to improve, and identify their frustrations with the use of the concept of consciousness. For the second reading, click on the link above and read the entirety of the associated webpage. Although there will be some overlap in content with the first reading, the second reading focuses on the philosophical routes of behaviorism and provides new information on the key figures within behaviorism. Note that these readings apply to subunits 5.1.1 and 5.1.2.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 5.1.2 The Importance of Environment  
  • 5.1.3 Behaviorism vs. Psychoanalysis  
    • Lecture: iTunes Social Work Podcast: Jonathan B. Singer, PhD’s “Behavior Therapy”

      Link: iTunes Social Work Podcast: Jonathan B. Singer, PhD’s “Behavior Therapy” (iTunes)
       
      Instructions: After clicking on the above link, please listen to the associated lecture on behavior therapy, which is Number 61 on the page. Although this lecture also addresses Cognitive Behavior Therapy, its main focus is Behavior Therapy. Note that this lecture will apply to subunits 5.1.3 through 5.4.3. Pay special attention to Singer’s example of how a behavior therapist would address a specific problem in a therapy situation.

      Listening to this lecture should take approximately 45 minutes.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 5.1.4 Corey’s Ten Key Characteristics of Behavior Therapy  
  • 5.2 The Therapeutic Process  
  • 5.2.1 Client Specifies the Desired Change  
  • 5.2.2 Client’s Responsibility for Goals  
  • 5.2.3 Continual Appraisal of Therapy: Continue with Goals or Change  
  • 5.2.4 Active Role of Therapist  
  • 5.2.5 The Importance of Situational Antecedents and Consequences of Problem Behaviors  
  • 5.2.6 Assessment of Progress  
  • 5.3 Specific Applications of Behavioral Therapy  
  • 5.3.1 Systematic Desensitization and Relaxation Techniques  
    • Reading: California State University: Dr. Thomas G. Stevens’ “Desensitization” and Arizona State University: Dr. Kristine Goto’s “Relaxation Training”

      Link: California State University: Dr. Thomas G. Stevens’ “Desensitization” (HTML) and Arizona State University: Dr. Kristine Goto’s “Relaxation Training” (HTML)
       
      Instructions: For the first reading, click on the above link and read the entirety of these self-help instructions to gauge the steps required of desensitization. For the second reading, click on the above link and read the Progressive Muscle Relaxation Technique (i.e., PMRT) to gain an idea of how psychotherapists use relaxation techniques with their clients. Feel free to listen to the audio version if you would prefer and to read/listen to the guided imagery transcript/mp3. Note that there is a great deal of research evidence which supports the efficacy of desensitization in alleviating many symptoms associated with phobias. 
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 5.3.2 Exposure Therapies: In Vivo Desensitization and Flooding  
  • 5.3.3 Assertiveness Training  
  • Unit 6: Cognitive-Behavioral Therapy  

    Cognitive-behavioral therapy (CBT) is one of the more recent and frequently used therapy styles. It combines important findings from cognitive and behavioral research and uses it to diagnose and treat patients. As noted above, behavioral therapy focuses on observable behaviors while ignoring cognitions; cognitive theory, on the other hand, understands cognitions as the basis for behavior. Accordingly, CBT attempts to change both the maladaptive cognitions and maladaptive behaviors, as both may contribute simultaneously to a patient’s problem. CBT is also highly scientific in its approach, drawing from the significant research that both behaviorist and cognitive psychology fields have produced in order to justifying its therapeutic techniques. In this unit, we will learn the basics of CBT, learning how the approach makes use of cognitive and behavioral principles and identifying the techniques it frequently deploys.

    Unit 6 Time Advisory   show close
    Unit 6 Learning Outcomes   show close
  • 6.1 Cognitive-Behavioral Therapy  
    • Reading: Boundless: “Cognitive-Behavioral Therapy”

      Link: Boundless: “Cognitive-Behavioral Therapy” (PDF)
       
      Instructions: Read this article to learn about cognitive-behavioral therapy. Note what cognitive and behavioral therapies seek to accomplish individually and combined, as well as various psychologists’ – Beck, Skinner, and Pavlov – influence on the field.
       
      Reading this article should take approximately 1 hour.
       
      Terms of Use: This resource is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License. It is attributed to Boundless, and the original version can be found here.

    • Lecture: iTunes Social Work Podcast: Jonathan B. Singer, PhD’s “Cognitive-Behavioral Therapy”

      Link: iTunes Social Work Podcast: Jonathan B. Singer, PhD’s “Cognitive-Behavioral Therapy” (iTunes)
       
      Instructions: Listen to the lecture on cognitive-behavioral therapy, Number 59 on the page. As you listen to this lecture, pay special attention to Singer’s description of the structure of a Cognitive-Behavioral Therapy Session, and the similarities and differences between the different types of Cognitive-Behavioral Therapy. This lecture is 47 minutes long and there is a break in the middle. It may be helpful for you to take a break at this point in order to give yourself a chance to absorb all of the information included. Also, take notes and do a thorough review once the lecture is complete. Note that this lecture applies to subunits 6.1.1 through 6.2.8. 
       
      Listening to this lecture and pausing to take notes should take approximately 1 hour.

      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 6.1.1 Change Thinking to Change Behavior  
  • 6.1.2 Reciprocal Relationship of Behavior, Mood and Thoughts  
  • 6.1.3 Thinking and Acting Cycle  
  • 6.1.4 Common Aspects to all Types of Cognitive Behavioral Therapy  
  • 6.1.5 Targeting Core Beliefs  
  • 6.1.6 The Importance of Psycho-Education  
  • 6.1.7 Transparency in CBT  
  • 6.1.8 A-B-C Technique  
  • 6.1.9 Structuring A CBT Session  
  • 6.2 Interventions in Behavior Cognitive Behavioral Therapies  
  • 6.2.1 Rational Emotive Behavior Therapy  
  • 6.2.2 Irrational Thoughts  
  • 6.2.3 D-E-F Technique  
  • 6.2.4 Changing Language  
  • 6.2.5 Aaron Beck’s Cognitive Therapy  
  • 6.2.6 Problems with Rigidity, Breadth, and Extremity of Thoughts  
  • 6.2.7 Automatic Thoughts and Core Beliefs  
  • 6.2.8 Downward Arrow Technique  
  • Unit 7: Family Systems Therapy  

    This final unit will focus on a less common but new and interesting approach known as family therapy. As the name implies, family therapy is based on the assumption that in order to change an individual’s behavior, you must target the different relationships and roles found in the patient’s family. Rather than focusing on the individual, therapists focus on problems within the family system and system interactions. The therapy acknowledges the fact that the family unit is important to psychological well-being. In fact, researchers have found that certain aspects of family life contribute to patient relapse and treatment success. In this unit, we will take a look at how this therapy targets different aspects of the family structure and identify the theories that support its treatment techniques.

    Unit 7 Time Advisory   show close
    Unit 7 Learning Outcomes   show close
  • 7.1 Introduction to Family Therapy  
  • 7.2 Systemic Family Therapy  
  • 7.2.1 Bowenian Family Therapy (i.e., Intergenerational Family Therapy)  
    • Reading: “Bowenian Family Therapy” and Western Michigan University School of Social Work: Professor Fritz McDonald’s “Nichols & Schwartz Bowenian”

      Links: Pschpage.com: “Bowenian Family Therapy” (HTML) and Western Michigan University School of Social Work: Professor Fritz McDonald’s “Nichols  & Schwartz Bowenian” (PowerPoint)
       
      Instructions: For the first reading, click on the above link and read the entirety of this webpage, which will provide an overview of Bowenian Family Therapy. For the second reading, click on the above link and download the power points entitled “Nichols & Schwartz Bowenian.” The second reading will overlap with the first reading; however, it will provide you with new information. Furthermore, it is often helpful for memory and your own knowledge base to read similar information presented in slightly different ways.  
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpages above.

    • Web Media: Western Michigan University School of Social Work: Professor Fritz McDonald’s “Genograms 70”

      Link: Western Michigan University School of Social Work: Professor Fritz McDonald’s “Genograms 70” (PowerPoint)

      Instructions: Click on the above link and download the PDF file labeled “Genograms 70.” This will provide you with detailed instructions for how genograms, a technique used in Bowenian Family Therapy, would be utilized in a therapeutic setting. Read over the slides to get an idea of how this intervention is used with families/individuals. Feel free to make a genogram if you are a kinetic learner and “doing” helps you to remember the material.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 7.2.2 Structural Family Therapy  
  • 7.2.3 Strategic Family Therapy (i.e., Problem-Solving Therapy)  
  • 7.3 Other Types of Family Therapy  
  • 7.3.1 Experiential Humanistic Therapy  
  • 7.3.2 Narrative Therapy  
  • Final Exam  

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