A。 Marital and Family Therapy
1。 Couples counseling seeks clarity in munication between partners；
and works to improve the quality of interaction。 It is more effective
in resolution of marital problems than individual therapy for only
one partner
2。 Family therapy client is the entire nuclear family； with each member
treated as a member of a system of relationships
a） Focus is on altering psychological space between people
b） The interpersonal dynamics of people acting as a unit
c） Most family therapists assume problems brought to therapy
to represent situational difficulties； rather than dispositional
aspects of individuals
d） Job of family therapist is understanding the structure of the
family and the forces acting on it
B。 munity Support Groups
1。 Self…help groups help many people obtain psychological support in
the munity setting
2。 Address four basic problem areas：
a） Addictive behavior
b） Physical and mental disorders
c） Life transition or other crises
d） Trauma of family and friends of those with specific
problems
VII。 Biomedical Therapies
A。 Psychosurgery and Electroconvulsive Therapy
1。 Psychosurgery is the general term for surgical procedures performed
on brain tissue to alleviate psychological disorders； with the
prefrontal lobotomy being best known
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2。 Electroconvulsive Therapy （ECT） is the use of electroconvulsive shock
to treat psychiatric disorders such as schizophrenia； mania； and；
most often； severe depression
a） ECT is successful in treatment of severe depression。 It works
quickly。
b） Potentially negative effects of ECT include temporary
disorientation and memory deficits
B。 Drug Therapy
1。 Psychopharmacology： the branch of psychology investigating the
effects of drugs on behavior
2。 The three major categories of drugs used today are：
a） Antipsychotics alter symptoms of schizophrenia。 Examples
include Thorazine； Haldol； and Clozaril。
b） Antidepressants increase the activity of the neurotransmitters
norepinephrine and serotonin。 Examples include Tofranil；
Prozac； Paxil； and Zoloft
c） Antianxiety agents （anxiolytics） adjust levels of
neurotransmitter activity in the brain。 Examples include
Valium and Xanax。
3。 Prescriptions for Psychoactive Drugs
a） The rate at which drugs are prescribed changes over time
b） From 1985 to 1994； prescription of antianxiety tranquilizers
decreased from 52 to 33 percent of all mental health doctors
visits； while prescriptions for antidepressants increased from
30 to 45 percent
4。 When Is Drug Therapy Necessary？
a） Although drugs can produce tremendous improvements in
psychological functioning； research suggests that some
forms of therapy may have the same effect on the brain as a
course of drug treatment
VIII。 Does Therapy Work？
A。 Evaluating Therapeutic Effectiveness
1。 Spontaneous…remission effect is one baseline criterion of naturally
occurring change against which effectiveness of therapies must be
assessed
2。 Placebo therapy： A neutral therapy that creates expectations of heating
3。 Meta…analysis： A statistical technique that evaluates general
conclusions from data across many different experiments or
evaluation studies
B。 Treatment Evaluations：
1。 A study by the National Institutes of Mental Health pared
treatments for depression
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a） Therapies evaluated were cognitive behavioral therapy；
interpersonal psychotherapy； and drug therapy
b） Evidence suggests that cognitive behavioral and
interpersonal therapies had an intermediate level of
effectiveness； and drug therapy had the greatest effect
c） Research indicates that virtually all therapies will bring
some relief
C。 Prevention Strategies
1。 Preventing a problem is the best solution。
2。 Goal of prevention can be realized at different levels
a） Primary prevention tries to prevent a condition from ever
beginning
b） Secondary prevention attempts to limit duration and severity
of a disorder； once it has begun
c） Tertiary prevention limits the long…term impact of a
psychological disorder by seeking to prevent a relapse
3。 Implementation of these three types of prevention focuses on
paradigm shifts in mental health care； with most important being：
a） Supplementing treatment with prevention
b） Going beyond a medical disease model to a public health
model
c） Focusing on situations and ecologies that put people at risk
and away from “at…risk” individuals
d） Looking for precipitating factors in life settings； rather than
predisposing factors in people
4。 Clinical ecology expands the boundaries of biomedical therapies by
relating disorder to environmental irritants
5。 Ultimate goal of prevention programs is to safeguard the mental
health of all members of society
DISCUSSION QUESTIONS
1。 Does your university have a psychological counseling center for students？ The years one
spends in college are often some of the more trying years of one’s entire life。 If your
school is one that does provide counseling services for its students； check it out； in terms
of cost； usual duration of therapeutic intervention； treatment modality； and any
underlying philosophies。 You may wish to prepare a summary of this information for the
class。
2。 Ask the class what would be most frightening to them if it was learned that tomorrow all
the mental hospitals were to close； and all patients were to be released without
supervision； medications； or treatment。 Elaborate on and discuss your class’s concerns。
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3。 Have the class propose situations of transference and countertransference in the
therapeutic environment and in their own personal relationships outside of the
therapeutic milieu。 Help them to understand the dynamics of these manifestations。
4。 Phobias are a part of life for many of us； and many of us feel foolish in discussing them。
Ask students if they know someone who is phobic in some area （this lets them off the
hook； relative to self…identification） and ascertain what； if any； coping mechanisms may
be employed。 Is the individual in therapy？ Are they “toughing it out”？ Do they avoid
situations that might trigger the phobia？ How do various individuals deal with their
phobias？
5。 Is aversion therapy worth the “price”； in terms of the physical and emotional stress that it
may cause？ How effective does the class believe it to be？ Ask if any of the class would
engage in aversion therapy for a problem such as smoking or weight loss？ Why or why
not？ Have them be specific。
6。 Discuss with the class situations in which social…skills training might be beneficial。 What
about situations in which it may be less than effective？ Are social skills really something
that can be “learned” by an adult； or are we hopeless if we fail to learn these skills in
childhood？ Outline a treatment program for a shy friend。
7。 Ask the class if they think cognitive behavior modification might be more successful with
one segment of the population than with another？ Have them discuss the potential for
success with a 38…year…old attorney； as pared to a 75…year…old widower。 What might
be the motivations involved in accepting therapy； as displayed by these very different
individuals？ Why is this relevant？
8。 What is the class’s “take” on electroconvulsive （shock） therapy？ Many people have little
if any understanding of what the procedure entails。 Help the class develop an
understanding of this treatment modality； and the reasons for its success in certain
disorders； as well as why it is feared by some individuals。
9。 People with personality disorders do not respond well to most attempts at psychological
therapy。 Success rates in treating males with antisocial personality disorder have been
estimated to be as low as 2 to 5 percent。 Success rates with other types of personality
disorders vary； but are often not significantly higher。 Additionally； persons with
personality disorders rarely e in for treatment on their own。 Often； their only reason
for attempting therapy is external pressure； such as a court order or a demand by a
spouse who threatens to leave them。 Is it ethically justifiable to subject someone to an
intensive； expensive effort to alter his or her style of life； especially when that person
doesn't want to be there and the chances of success are often minimal？ One might argue
that if the person is not harming anyone else； such efforts are not ethically justifiable。 On
the other hand； people with certain types of personality disorders； such as antisocial；
narcissistic； and paranoid personality disorder； can represent a real danger to others in
some cases。 The duty to protect others might then justify “forced” therapy in these cases。
One might also argue； however； that since success rates in treatment are often so low； the
best way to protect others is to imprison people with these disorders when their behavior
harms others in an illegal manner。 What do students think about these issues？
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SUPPLEMENTAL LECTURE MATERIAL
The Role of Critical Thinking in Emotional Problems
Cognitive therapists feel that certain emotional disorders； like anxiety and depression； can be
traced to irrational and illogical ways of thinking。 Let us look at some of the fallacies that
cognitive psychologists have noted in the thought processes of some people with emotional
disorders。
Faulty generalization。 This is the tendency to use a particular event or item of information as
the basis for a general conclusion。 The man whose wife leaves him concludes that no one
could ever love him。 The student who fails a test concludes that she is a failure。 The woman
who gets an occasional headache concludes that she is an unhealthy person。
Polarized thinking。 This is the tendency to classify people； events； behavior； and thoughts
rigidly as polar opposites： right or wrong； good or bad。 This is also called dualistic thinking；
black…and…white thinking； and bifurcation。 This t