Therapy
Psychology · Section 4.4 · 18 study cards
Psychodynamic, humanistic, behavioural and cognitive therapies, how outcomes are evaluated, and the biomedical treatments alongside them.
Practice this set → Spaced repetition, card by card. No account needed.
Method
Map each therapy back to its theory of the problem
Every technique follows from an assumption about what is wrong. Psychoanalysis assumes unresolved unconscious conflict, so it uses free association and interpretation. Humanistic therapy assumes blocked growth and conditional acceptance, so it supplies acceptance and empathy. Behaviour therapy assumes the symptom is the problem and was learned, so it retrains it. Cognitive therapy assumes distorted thinking drives feeling, so it tests thoughts against evidence. If you can state the assumption, you can reconstruct the technique.
Answer any treatment question in this order
- Name the disorder and the mechanism that maintains it, for example avoidance in a phobia or rumination in depression.
- Choose the therapy whose mechanism directly counters it, and say why.
- Describe the procedure concretely: a hierarchy and relaxation, a thought record, a disputation of a demand.
- State the evidence, distinguishing randomised trial support from clinical impression.
- Say whether medication is indicated alongside, and note any interaction.
Separate the two cognitive therapies by style, not by content
Beck and Ellis both claim that beliefs generate feelings. Beck questions and tests collaboratively, with worksheets and behavioural experiments; Ellis disputes and confronts absolute demands. Test items nearly always turn on that difference in manner.
Treat evaluation as a topic in its own right
Know why testimonials mislead, what regression to the mean is, what the meta-analyses found, what evidence-based practice means and which factors are common across therapies. This is the part of the unit that connects to research methods, and it is frequently where the long-answer question comes from.
Definitions and theorems
Worked example
Amara has avoided lifts for six years after becoming trapped in one. She now refuses jobs above the second floor, is highly distressed when a lift is unavoidable, and asks her doctor for something to calm her down. Her doctor offers a benzodiazepine and a referral for psychological treatment.
Identify the disorder, select and describe an appropriate therapy, explain the mechanism by which it works, comment on the medication, and state what evidence would justify your recommendation.
Identify the disorder. Intense fear of a specific situation with avoidance and impairment over six years is a specific phobia, situational type; it is not generalised anxiety, because the fear is attached to one clearly defined object.
State the maintaining mechanism. Each avoidance reduces anxiety immediately and is therefore negatively reinforced, so the fear never has an opportunity to extinguish. That mechanism is what the therapy must counter.
Select the therapy. Exposure-based behaviour therapy, delivered as systematic desensitisation or graded in vivo exposure, with virtual reality as an option if staging real lifts is impractical.
Describe the procedure: train relaxation, build a hierarchy from looking at a photograph of a lift up to riding several floors alone, and move up a step only once the current step produces no anxiety, never allowing escape at the point of peak arousal.
Give the mechanism in learning terms: exposure without escape allows extinction of the conditioned response, and relaxation counterconditions a response incompatible with anxiety.
Comment on the medication. A benzodiazepine reduces arousal quickly but risks tolerance and dependence, and taken before exposure sessions it can undermine them, because Amara may attribute her calm to the drug rather than learning that the lift is safe.
Cite the evidence level. Exposure treatments for specific phobia have strong randomised trial support with large effects and few sessions, which meets the research-evidence component of evidence-based practice; add that her own preferences and the alliance also enter the decision.
Common mistakes
- Beck and Ellis interchanged. Beck tests automatic thoughts collaboratively using thought records and behavioural experiments. Ellis disputes irrational demands directly and confrontationally. Questions here are decided by the therapist's manner, not by the shared premise.
- Calling client-centred therapy a technique for giving advice. It is non-directive. The therapist reflects and clarifies rather than instructing, and describing Rogers as guiding the client to the right conclusion misses the whole point of the approach.
- Systematic desensitisation described without the hierarchy or the relaxation. Both elements are required, as is the rule that the client moves up only when the current step no longer arouses anxiety. Simply confronting the fear is flooding, which is a different procedure.
- Reading therapy outcome findings as all therapies are equally effective. That holds only on average across problems. For phobias, obsessive-compulsive disorder and post-traumatic stress disorder, exposure-based and cognitive-behavioural treatments clearly outperform the alternatives.
- Describing electroconvulsive therapy in its mid-century form. Current practice uses general anaesthesia and a muscle relaxant, is reserved mainly for severe depression that has not responded to other treatment, and is not a first-line option.
Practice it
Reading the method is not the same as being able to recall it under pressure. This set drills 18 cards one at a time and schedules each card separately, so the ones you keep missing come back sooner.