Therapeutic Approaches Class 12 Ch.5 Notes, QnA 2023

Last updated on August 20th, 2023 at 07:54 am

Therapeutic Approaches

Nature and Process of Psychotherapy

Psychotherapy is a voluntary relationship between the one seeking treatment or the client and the one who treats or the therapist.

Aim: The aim of psychotherapy is at changing the maladaptive behaviors, decreasing the sense of personal distress and helping the client to adapt better to her/his environment. All psychotherapies aim at a few or all of the following goals:

• Reinforcing client’s resolve for betterment
• Lessening emotional pressure
• Unfolding the potential for positive growth
• Modifying habits
• Changing thinking patterns
• Increasing self-awareness
• Improving interpersonal relations and communication
• Facilitating decision-making
• Becoming aware of one’s choices in life
• Relating to one’s social environment in a more creative and self-aware manner

> All psychotherapies aim at a few or all of the following goals:

▪︎ There is systematic application of principles underlying the different theories of therapy.

▪︎ Persons who have received practical training under expert supervision can practice psychotherapy and not everybody.

▪︎ The therapeutic situation involves a therapist and a client who seeks and receives help for her/his emotional problems (this person is the focus of attention in the therapeutic process).

The interaction of these two persons, the therapist and the client-results in the consolidation/formation of the therapeutic relationship. This is a confidential, interpersonal and dynamic relationship.

Therapeutic Relationship

The two major components of a therapeutic alliance are as follows:

● The first component is the contractual nature of the relationship in which two willing individuals, the client and the therapist, enter into a partnership which aims at helping the client overcome her/his problems.

● The properties of therapeutic alliance are: The second component of therapeutic alliance is the limited duration of the therapy.

Trust: This relationship is a trusting and confiding relationship. The high level of trust enables the client to unburden herself/himself to the therapist and confide her/his psychological and personal problems to the latter. The therapist encourages this by being: -Accepting – Empathic – Genuine – Warm to the client.

Unconditional positive regard: The therapist conveys by her/his words and behaviors that s/he is not judging the client and will continue to show the same positive feelings towards the client even if the client is rude or confides all the ‘wrong things that s/he may have done or thought about. This is the unconditional positive regard which the therapist has for the client.

Empathy: The therapist has empathy for the client. Empathy is present when one is able to understand the plight of another person and feels like the other person. It means understanding things from the other person’s i.e., putting oneself in the other person’s shoes. Empathy enriches the therapeutic relationship and transforms it into a healing relationship.

Confidentiality: The therapeutic alliance also requires that the therapist must keep strict confidentiality of the experiences, events, feelings or thoughts disclosed by the client. The therapist must not exploit the trust and the confidence of the client in any way.

Professional: Finally, it is a professional relationship and must remain so.

Sympathy: In sympathy, one has compassion and pity towards the suffering of another but is not able to feel like the other person.

Types of Chronological Order of Therapies

• Psycho dynamic therapy emerged first
• Behavior therapy came next
• Existential therapies which are also called the third force, emerged last.

> Classification of Therapies

> Agents of change leading to the alleviation of psychological distress:

• The therapist

• The therapeutic relationship
• The process of therapy (which begins by formulating the client’s problem)

> The following sections explain representative therapies from each of the three major systems of psychotherapy mentioned earlier.

Behaviour Therapy

[A] Postulates

▪︎ Behavior therapies postulate that psychological distress arises because of faulty behavior patterns or thought patterns.

▪︎ It is, therefore, focused on the behavior and thoughts of the client in the present.

▪︎ The past is relevant only to the extent of understanding the origins of the faulty behavior and thought

[B] Principles

● The clinical application of learning theory principles constitutes behavior therapy. The foundation of behavior therapy is on formulating dysfunctional or faulty behaviors, the factors which reinforce and maintain these behaviors, and devising methods by which they can be changed.

● It is not a unified theory, which is applied irrespective of the clinical diagnosis or the symptoms present.

● The symptoms of the client and the clinical diagnosis are the guiding factors in the selection of the specific techniques or interventions to be applied.

● Treatment of phobias or excessive and crippling fears would require the use of one set of techniques, while that of anger outbursts would require another.

● A depressed client would be treated differently from a client who is anxious.

[C] Method of Treatment

● The client with psychological distress or with physical symptoms, which cannot be attributed to physical disease, is interviewed with a view to analyze her/his behavior patterns.

● Behavioral analysis is conducted to find malfunctioning behaviors, the antecedents of faulty learning and the factors that maintain or continue faulty learning.

● Malfunctioning behaviors are those behaviors which cause distress to the client.

● Antecedent factors are those causes which predispose the person to indulge in that behavior.

● Maintaining factors are those factors which lead to the persistence of faulty behavior. An example would be a young person who smokes. 

Behavioral analysis conducted by interviewing the client and the family members reveals that the person started smoking when he was preparing for the annual examination. Thus, anxiety-provoking situations become the causative or antecedent factor. 

The feeling of relief becomes the main factor for him to continue smoking. The client has acquired the operant response of smoking, which is maintained by the reinforcing value of relief from anxiety.

Establishment of Treatment Package

● Once the faulty behaviors which cause distress have been identified, a treatment package is chosen.

● The aim of the treatment is to extinguish or eliminate the faulty behaviors and substitute them with adaptive behavior patterns. The therapist does this through establishing antecedent operations and consequent operations. Antecedent operations control behavior by changing something that precedes that behavior.

● The change can be done by increasing or decreasing the reinforcing value of a particular consequence. This is called establishing operation. 

For example, if a child gives trouble in eating dinner, an establishing operation would be to decrease the quantity of food served at tea time. 

This would increase the hunger at dinner and thereby, increase the reinforcing value of food at dinner. The antecedent operation is the reduction of food at tea time and the consequent operation is praising the child for eating dinner.

[E] Behavioural Techniques

A range of techniques is available for changing behavior. The principles of these techniques are to reduce the arousal level of the client, alter behavior through classical conditioning or operant conditioning with different contingencies of reinforcements, as well as to use vicarious learning procedures, if necessary.

Cognitive Therapy

Cognitive therapies locate the cause of psychological distress in irrational thoughts and beliefs. Albert Ellis formulated the Rational Emotive Therapy (RET). The central basis of this therapy is that irrational beliefs mediate between the antecedent events and their consequences.

(a) ABC analysis: The first step in RET is the antecedent- belief-consequence (ABC) analysis.

● Antecedent events, which caused the psychological distress, are noted.

● The client is also interviewed to find the irrational beliefs, which are distorting the present reality. Irrational beliefs may not be supported by empirical evidence in the environment. 

These beliefs are characterized by thoughts with ‘musts’ and ‘shoulds’, i.e., things ‘must’ and ‘should be in a particular manner. Examples: “One should be loved by everybody all the time”, etc.

● This distorted perception of the antecedent event due to the irrational belief leads to the consequence, i.e., negative emotions and behaviors.

(b) Non directive questioning: In the process of RET, the irrational beliefs are refuted by the therapist through a process of non-directive questioning. The nature of questioning is gentle, without probing or being directive. The questions make the client think deeper into her/his assumptions about life and problems.

(c) Change: Gradually, the client is able to change the irrational beliefs by making a change in her/his philosophy about life. The rational belief system replaces the irrational belief system and there is a reduction in psychological distress.

Aaron Beck’s Therapy

1. Core Schemas: Childhood experiences provided by the family and society develop core Schemas or systems, which include beliefs and action patterns in the individual. E.g., A client, who was neglected by the parents as a child, develops the core schema of “I am not wanted”.

2. Critical Incident: During the course of life, a critical incident occurs in her/his life. This critical incident triggers the core schema leading to the development of negative automatic thoughts.

3. Dysfunctional Cognitive Structures: Negative thoughts are persistent irrational thoughts, such as “nobody loves me”. “I am ugly”, “I am stupid”, “I will not succeed”, etc. Such negative automatic thoughts are characterized by cognitive distortions. 

Cognitive distortions are ways of thinking which are general in nature but which distort the reality in a negative manner. These patterns of thoughts are called dysfunctional cognitive structures. They lead to errors of cognition about social reality, anxiety and depression.

4. Anxiety and Depression: Repeated occurrence of these thoughts leads to the development of feelings of

5. Therapist’s Approach: The therapist uses questioning, which is gentle, non-threatening disputation of the client’s beliefs and thoughts. Examples of such questions would be, “Why should everyone love you?”, “What does it mean for you to succeed?”, etc.

The questions make the client think in a direction opposite to that of the negative automatic thoughts whereby s/he gains insight into the nature of her/his dysfunctional schemas and is able to alter her/his cognitive structures.

6. Goals: The aim of the therapy is to achieve this cognitive restructuring which, in turn, reduces anxiety and depression. It focuses on solving a specific problem of the client.

7. Duration: It is short, lasting between 10-20 sessions.

Cognitive Behaviour Therapy

The most popular therapy presently is the Cognitive Behaviour Therapy (CBT).

● CBT adopts a biopsychosocial approach to the delineation of psychopathology. It combines cognitive therapy with behavioral techniques.

● The rationale is that the client’s distress has its origins in the biological, psychological and social realms. It seeks to address: – The biological aspects through relaxation procedures. The psychological aspects through behavior therapy – Cognitive therapy techniques and the social ones with environmental manipulations.

● Research into the outcome and effectiveness of psychotherapy has conclusively established CBT to be a short and efficacious treatment for a wide range of psychological disorders such as anxiety, depression, panic attacks, and borderline personality, etc.

Humanistic-Existential Therapy

1. Principles

● Human beings are motivated by the desire for personal growth and self-actualisation, and an innate need to grow emotionally.

● When these needs are curbed by society and family, human beings experience psychological distress.

● The humanistic-existential therapies postulate that psychological distress arises from feelings of loneliness, alienation and an inability to find meaning and genuine fulfillment in life.

2. Self Actualisation

● Self-actualisation is defined as an innate or inborn force that moves the person to become more complex, balanced and integrated, i.e., achieving the complexity and balance without being fragmented; integrated means a sense of whole, being a complete person, being in essence the same person in spite of the variety of experiences that one is subjected to. Frustration of self-actualisation causes distress.

3. Healing Process

● Self-actualisation requires free emotional expression. The family and the society curb emotional expression, as it is feared that a free expression of emotions can harm society by unleashing destructive forces. This curb leads to destructive behavior and negative emotions by thwarting the process of emotional integration.

● Healing occurs when the client is able to perceive the obstacles to self- actualisation in her/his life and is able to remove them.

● Therefore, the therapy creates a permissive, non-judgmental and accepting atmosphere in which the client’s emotions can be freely expressed and the complexity, balance and integration could be achieved.

4. Role of Therapist

The fundamental assumption is that the client has the freedom and responsibility to control her/his own behavior. The therapist is merely a facilitator and guide. It is the client who is responsible for the success of therapy.

5. Aim

● The chief aim of the therapy is to expand the client’s awareness. Healing takes place by a process of understanding the unique personal experience of the client by herself/himself.

Existential Therapy: Logotherapy

1. Origin: Victor Frankl, a psychiatrist and neurologist propounded the Logotherapy. Logos is the Greek word for soul and L Logotherapy means treatment for the soul. Frankl calls this process of finding meaning even in life-threatening circumstances as the process of meaning making.

2. Basis: The basis of meaning making is a person’s quest for finding the spiritual truth of one’s existence. Just as there is an unconscious, which is the repository of instincts, there is a spiritual unconscious, which is the storehouse of love, aesthetic awareness and values of life. 

Neurotic anxieties arise when the problems of life are attached to the physical, psychological or spiritual aspects of one’s existence. 

3. Spiritual Anxieties: Frankl emphasized the role of spiritual anxieties leading to meaninglessness and hence, it may be called an existential anxiety, i.e., neurotic anxiety of spiritual origin.

4. Goal: The goal of logotherapy is to help the patients find meaning and responsibility in their life irrespective of their life circumstances. The goal is to facilitate the client to find the meaning of her/his being.

5. Role of Therapist: In Logotherapy, the therapist is open and shares her/his feelings, values and his/her own existence with the client. The emphasis is on the here and now. Transference is actively discouraged.

The therapist reminds the client about the immediacy of the present.

Existential Therapy: Client-Centered Therapy

1. Origin: Client-centered therapy was given by Carl Rogers. Rogers combined scientific rigor with the individualized practice of client-centered psychotherapy. Rogers brought into psychotherapy the concept of self, with freedom and choice as the core of one’s being.

2. Basic Principle: The therapy provides a warm relationship in which the client can reconnect with her/his disintegrated feelings. 

The therapist shows:- Empathy, which sets up an emotional resonance between

the therapist and the client. – Unconditional positive regard, which indicates that the positive warmth of the therapist is not dependent on what the client reveals or does in the therapy sessions. 

This unique unconditional warmth ensures that the client feels secure and can trust the therapist.

3. Role of Therapist

• The therapist reflects the feelings of the client in a non-judgmental manner.
• The reflection is achieved by rephrasing the statements of the client, i.e., seeking simple clarifications to enhance the meaning of the client’s statements.
• This process of reflection helps the client to become integrated.
• Personal relationships improve with an increase in adjustment.

4. Goal: In essence, this therapy helps a client to become her/his real self with the therapist working as a facilitator.

Existential Therapy: Gestalt Therapy

1. Origin: The German word gestalt means ‘whole’. This therapy was given by Freiderick (Fritz) Perls together with his wife Laura Peris.

2. Goal: The goal of Gestalt therapy is to increase an individual’s self-awareness and self- acceptance.

3. Therapist’s Role: The client is taught to recognise the bodily processes and the emotions that are being blocked out from awareness. The therapist does this by encouraging the client to act out fantasies about feelings and conflicts. This therapy can also be used in group settings.

Factors Contributing to Healing in Psychotherapy

● Techniques Adopted With the Patient/Client: A major factor in the healing is the techniques adopted by the therapist and the implementation of the same with the patient/client. 

If the behavioral system and the CBT therapy are adopted to heal an anxious client, the relaxation procedures and the cognitive restructuring largely contribute to the healing.

● Establishment of Therapeutic Alliance Between Client and Therapist: The therapeutic alliance, which is formed between the therapist and the patient/client, has healing properties, because of the regular availability of the therapist and the warmth and empathy provided by the therapist.

● Process of Catharsis and Emotional Unburdening: At the outset of therapy while the patient/client is being interviewed in the initial sessions to understand the nature of the problem, she unburdens the emotional problems being faced. This process of emotional unburdening is known as catharsis, and it has healing properties.

● Patient Variables, Non Specific Factors, Therapist Variables

> There are several non-specific factors associated with psychotherapy. These factors are called non-specific because they occur across different systems of psychotherapy and across different clients/patients and different therapists.

> Non-specific factors attributable to the client/patient are motivation for change, expectation of improvement due to the treatment, etc. These are called patient variables.

> Non-specific factors attributable to the therapist are positive nature, absence of unresolved emotional conflicts, presence of good mental health, etc. These are called therapist variables.

Ethics in Psychotherapy

Some of the ethical standards that need to be practiced by professional psychotherapists are:

• Informed consent needs to be taken.
• Confidentiality of the client should be maintained.
• Alleviating personal distress and suffering should be the goal of all attempts of the therapist.
• Integrity of the practitioner-client relationship is important.
• Respect for human rights and dignity.
• Professional competence and skills are essential.

Alternative Therapies

Alternative therapies are so called because they are alternative treatment possibilities (especially in case medication side effects are severe) to the conventional drug treatment or psychotherapy. 

There are many alternative therapies such as yoga, meditation, acupuncture, herbal remedies and so on. [In the past 25 years, yoga and meditation have gained popularity as treatment programmes for psychological distress)

(a) Yoga: Yoga is an ancient Indian technique detailed in the Ashtanga Yoga of Patanjali’s Yoga Sutra.

(b) Meditation: Meditation refers to the practice of focussing attention on breath or an object or thought or a mantra.

(c) Sudarshan Kriya Yoga:

(i) The rapid breathing techniques to induce hyperventilation as in Sudarshan Kriya Yoga (SKY) is found to be a beneficial, low risk, low-cost adjunct to the treatment of stress, anxiety, post-traumatic stress disorder (PTSD), depression, stress related medical illnesses, substance abuse and rehabilitation of criminal offenders.

(ii) Yoga techniques enhance well-being, mood, attention, mental focus and stress tolerance.

(iii) Proper training by a skilled teacher and a 30-minute practice every day will maximise the benefits.

(iv) Kundalini Yoga- Kundalini Yoga combines pranayama or breathing techniques with chanting of mantras

(v) Zen-Zen/Zen Buddhism refers to a school of Mahayana Buddhism that asserts that enlightenment can be attained through meditation, self-contemplation and intuition rather than through faith and devotion. It is practiced mainly in China, Japan, Korea and Vietnam.

Rehabilitation of the Mentally Ill

Treatment of Psychological disorder:

(a) Reduction of Symptoms

(b) Improvement of the quality of life

1. The treatment of psychological disorders has two components, Le., reduction of symptoms and improving the level of functioning or quality of life.

2. In the case of milder disorders, such as generalized anxiety, reactive depression or phobia, reduction of symptoms is associated with an improvement in the quality of life. However, in the case of severe mental disorders such as schizophrenia, reduction of symptoms may not be associated with an improvement in the quality of life.

3. Many patients suffer from negative symptoms such as disinterest and lack of motivation to do work or to interact with people.

4. Rehabilitation is required to help such patients become self-sufficient. The aim of rehabilitation is to empower the patient to become a productive member of society to the extent possible.

5. In rehabilitation, the patients are given:

● Occupational therapy (the patients are taught skills such as candle making, paper bag making and weaving to help them to form a work discipline) – Social skills training (the patients develop interpersonal skills through role play, imitation and instruction. The objective is to teach the patient to function in a social group)

● Cognitive retraining is given to improve the basic cognitive functions of attention, memory and executive functions (cognitive restructuring occurs).

● Vocational therapy (the patient is helped to gain skills necessary to undertake productive employment).

NCERT Class 12 Psychology Textbook Chapter 5 Questions And Answers

Q.1. Describe the nature and scope of psychotherapy. Highlight the importance of therapeutic relationship in psychotherapy.

Ans. (A) Nature and scope of psychotherapy: (i) Psychotherapy is a voluntary relationship between the client and the therapist. 

(ii) (a) The aim is to help the client to solve his psychological problems. 

(b) Psychotherapies aim at changing the maladaptive behaviors and helping the client to adapt better to his environment. 

(c) All psychotherapeutic approaches have common characteristics.

(B) Importance of therapeutic relationship in psychotherapy: (1) The special relationship between the client and therapist is known as the known as the therapeutic relationship or alliance. 

(ii) It has two components. The first is contractual nature of the relationship between the client and the therapist. The second is that this contract is for limited period of time.

(iii) (a) The main unique features of the

relationship are high level of trust and confidence in the therapist. On the other hand, the therapist shows the unconditional positive regard for the client. 

The therapist has empathy for the client. At the same time the therapist must keep strict confidentiality of the experiences, events, feelings or thoughts disclosed by the client. 

(b) The therapist must not exploit the trust and confidence of the client in anyway. 

(c) It is a professional relationship and must remain so. Thus, all these features make the relationship very important in psychotherapy.

Q.2. What are the different types of psychotherapy ? On what basis are they classified?

Ans. (a) There are three broad groups of psychotherapies viz psychodynamic, behavior and existential psychotherapies.

(b) The classification of psychotherapies is based on the following parameters

(1) What is the cause, which has led to the problem ?

(2) How did the cause come into existence ?

(3) What is the chief method of treatment?

(4)What is the nature of the therapeutic relationship between the client and therapist?

(5) What is the chief benefit to the client?

(6) What is the duration of treatment?

Q.3. A therapist asks the client to reveal all her/his thoughts including early childhood experiences. Describe the technique and type of therapy being used.

Ans. (a) Psychoanalysis technique and psychodynamic therapy pioneered by Sigmund Freud is used in cases where a therapist asks the client to reveal all his thoughts including childhood.

(b) Its techniques/stages are as mentioned below:

(i) Eliciting the nature of Intrapsychic conflict: Free association and dream interpretation:

(1) The free association method is for understanding client’s problems and to establish a therapeutic relationship. 

(2) There is verbal narrative by the client. The client is also asked to write down his dreams.

(ii) Modality of treatment: 

(1) Transference and interpretation are means of treating the patient.

(2) In transference, the client starts identifying the therapist with the authority figures of the past, usually childhood. 

(3) Under transference neurosis the therapist becomes a substitute. 

(4) There are two types of transference Le, positive transference and negative transference. 

(5) In positive transference, the client idolizes the therapist whereas in negative transference the client has feelings of hostility and anger towards the therapist. 

(6) Resistance: Then comes the stage of resistance in which the client resists transference) He opposes the progress of therapy in order to protect himself from the recall of painful unconscious memories 

(7) Resistance can be conscious or unconscious. 

(8) Interpretation : It is the fundamental mechanism by which change is effected. Its two techniques are confrontation and clarification. The repeated process of using confrontation, clarification and interpretation is known as working through. 

(9) The outcome of working through is insight in which the client starts to understand himself better at an intellectual and emotional level.

It is the end point of therapy as the client has gained a new understanding of himself. The client becomes a psychologically healthy person. Psychoanalysis is terminated at this stage. a

Q.4. Discuss the various techniques used in behavior therapy.

Ans. (a) There are various techniques used in behavior therapy. The principles of these techniques are as mentioned below.

(i) To reduce the arousal level of the client.

(ii) To alter behavior through classical conditioning or operant conditioning with different contingencies of reinforcements, as well as to use vicarious learning procedures.

(b) Negative reinforcements and aversive conditioning are two major techniques of behavior modification

(i) Negative reinforcement: The responses that lead organisms to get rid of painful stimuli or cold weather. avoid and escape from them is negative reinforcement e.g., to wear woolen clothes to avoid unpleasant

(ii) Aversive conditioning is repeated association of undesired response with an aversive consequence. It uses an unpleasant stimulus to change a deviant behaviour e.g., an alcohlic is given a mild electric shock and asked to smell the alcohol.

With repeated pairings the smell of alcohol is aversive as the pain of shock is associated with it and the person will give up alcohol.

(c) Positive reinforcements: 

(i) It is given to increase the deficit. For example, if a child does not do his homework regularly, the mother may prepare child’s favourite dish whenever he does homework at the appointed time.

(ii) Persons with behavioural problems can be given a token as a reward every time a wanted behaviour occurs. Tokens are collected and exchanged for a reward. This is known as token economy.

(d) Differential reinforcement: 

(i) Under it, unwanted behaviour can be reduced and wanted behaviour can be increased simultaneously through differential reinforcement. 

(i) Positive reinforcement for the wanted behaviour and negative reinforcement for the unwanted behaviour are attempted.

(e) Another method is to positively reinforce the wanted behaviour and ignore the unwanted behaviour. The latter method is less painful and equally effective.

(f) Systematic desensitisation: It is technique introduced by Wolpe for treating phobias or irrational fears. Relaxation procedures used are given below:

Relaxation Procedures : Anxiety is a manifestation of the psychological distress for which the client seeks treatment. The behavioural therapist views anxiety as increasing the arousal level of the acting as an antecedent factor in causing the faulty behaviour. 

The client may smoke to decrease anxiety, may indulge in other activities such as eating, or be unable to concentrate for long hours on her/his study because of the anxiety. 

Therefore, reduction unwanted behaviours of excessive eating or smoking. Relaxation procedures are used to decrease the anxiety would decrease the anxiety levels. For instance, progressive muscular relaxation and meditation induce a state of relaxation.

In progressive muscular relaxation, the client is taught to contract individual muscle groups in order tobgive the awareness of tenseness or muscular tension. After the client has learnt to tense the muscle asked to let go the tension. The client is told that the tension is group such as the forearm, the client

what the client has at present and that s/he has to get into the opposite state. With repeated practice the client learns to relax all the muscles of body.

(g) Modelling: It is the procedure wherein the client learns to behave in a certain way by the behaviour of a role model

(h) Vicarious learning is used and through a process of rewarding small changes in the behaviour, the client gradually learns to the behaviour of the model.

Q.5. Explain with the help of an example how cognitive distortions take place.

Ans. (i) Theory relating to cognitive distortions was devised by Aaron Beck and is known as cognitive restructuring therapy.

(ii) The cognitive distortions take place as mentioned below:

(a) Cognitive distortions means ways of thinking which are general in nature but which distorts the reality in a negative manner.

(b) The childhood experiences develop core systems which include beliefs and action patterns in the individual.

(c) A client who was neglected by the parents as a child develops the core system of “I am not wanted. This leads to negative thoughts. Such thoughts are cognitive distortions and are called dysfunctional cognitive structures.

(d) Repeated occurance of these thoughts leads to the development of feelings of anxiety and depression.

(iii) Method of treatment: 

(a) The therapist uses questioning.

(b) The questions make the client think in a direction opposite to that of the negative automatic thoughts.

(c) The client gains insight of his dysfunctional schemas and able to restructure his thoughts in positive direction. This enables the client to change his cognitive structures.

Thus the specific problem of the client is solved. This method is short lasting between 10-20 sessions.

Q.6. Which therapy encourages the client to seek personal growth and actualise their potential ? Write about the therapies which are based on this principle.

Ans. (a) (i) Humanistic-existential therapy encourages the client to seek personal growth and actualise their potential.

(ii) Human beings are motivated by the desire for personal growth and self-actualisation and an innate need to grow emotionally.

(b) The theories which are based on humanistic-existential approach are as mentioned below:

(1) Logotherapy: 

(i) This theory was propounded by Victor Frankl, a psychiatrist and neurologist.

(ii) Frankl emphasised the role of spiritual anxieties in leading to meaningless and hence it may be called an existential anxiety i.e., neurotic anxiety of spiritual origin. 

(iii) The goal of logotherapy is to help the patients to find meaning and responsibility in their life irrespective of their life circumstances. 

(iv) The therapist emphasises the unique nature of the patient’s life and encourages them to find meaning in their life.

(v) The therapist is open and shares his feelings, values and his own existence with the client.

(2) Client-centred therapy: 

(i) It was developed by Carl Rogers 

(ii) He combined scientific rigour with the individualised practice of client-centred psychotherapy. 

(iii) He brought into psychotherapy the concept of self. 

(iv) The therapy provides a warm relationship in which the client can reconnect with his disintegrated feelings. 

(v) The therapist shows empathy and has unconditional positive regard.

(vi) The therapist reflects the feelings of the client in a non-judgmental manner. 

(vii) The process of reflection helps the client to become integrated. 

(viii) Personal relationships improve with an increase in adjustment. 

(ix) In essence, this therapy helps a client to become his real self with the therapist working as a facilitator.

(3) Gestalt therapy: 

(i) This therapy was given by Freiderick Perls and his wife Laura Perls.

(ii) The aim is to increase an individual’s self-awareness and self-acceptance. 

(iii) The client is taught to recognise the bodily processes and emotions that are being blocked out from awareness. 

(iv) The therapist does this by encouraging the client to act out fantasies about feelings and conflicts. 

(v) This therapy can also be used in group settings.

Q.7. What are the factors that contribute to healing in psychotherapy ? Enumerate some of the alternative therapies.

Ans. (A) The factors that contribute to healing in psychotherapy are as mentioned below:

(i) Major factor is the techniques adopted by the therapist and the implementation of the same with the patient.

(ii) The therapeutic alliance if formed between the therapist and the patient. It has healing properties due to regular availability of the therapist and his warmth and empathy.

(iii) Catharis has healing properties because the patient, at the time of interview, unburdens the emotional problems being faced by him.

(iv) Non-specific factors: They occur across different systems of psychotherapy and across different clients and different therapists. Factors that are attributable to the patient i.e., motivation for change etc. are patient variables. The factors attributable to the therapist such as positive nature, presence of good mental health are called therapist variables.

(B) Alternative therapies are as mentioned below:

(i) Yoga

(ii) Meditation

(ii) Acupuncture

(iv) Herbal remedies.

Q.8. What are the techniques used in the rehabilitation of the mentally ill?

Ans. (i) In the case of milder disorders, reduction of symptoms is associated with an improvement in the quality of life. However, in the case of severe mental disorders such as schizophrenia, reduction of symptoms may not be associated with an improvement in the quality of life. 

Many patients suffer from lack of motivation to do work or to interact with people. In such a case rehabilitation is required to make them self-sufficient.

(ii) The aim of rehabilitation is to empower the patient to become a productive member of society. This is done in the following ways:

(a) Occupational therapy: The patients are taught skills such as candle making, paper bag making and weaving to help them to form a work discipline.

(b) Social skills training helps the patients to develop interpersonal skills through role play imitation and instruction functions.

(c) Cognitive retraining is given to improve the basic cognitive functions of attention, memory and executive funct

(d) After the patient improves sufficiently, vocational training is given wherein the patient is gain skills necessary to undertake productive employment. helped

Q.9. How would a social learning theorist account for a phobic fear of  lizards/cockroaches ? How would a psychoanalyst account for the same phobia ?

Ans. A social learning theorist accounts for a phobic fear of lizards/cockroaches in the ways as mentioned below

(i) Such phobia of lizards or cockroaches are the result of learning process which starts early in life/childhood.

(ii) Small children can play with snakes/lizards because they are unaware of the danger involved. However, as they grow, the fear of such animals etc. is instilled by the parents and society which is reinforced and accounts for reactions like phobia.

(iii) On the other hand, a psychoanalyst accounts for the similar unconscious or repressed experience such as torturing and killing of lizards/cockroaches by a group of rowdy boys in childhood.

Such incidents may remain in the back of your mind for ever as phobia for cockroaches/lizards etc.

Q.10 Should Electro-Convulsive Therapy (ECT) be used in the treatment of mental disorders ?

Ans. (i) In case the drugs are not effective in controlling the symptoms of the patient, then ECT must be used.

(ii) There is no other altenative except this for the improvement of the patient.

(iii) It is not a routine treatment and must be used in special cases in the interest of the patients.

(iv) It is another form of biomedical therapy. Mild electric shock is given via electrodes to the patient to induce convulsions. The shock is given by the psychiatrist only when it is necessary for the improvement of the patient.

Q.11. What kind of problems is cognitive behaviour therapy best suited for ?

Ans. (i) Cognitive Behaviour Therapy is the most popular therapy at present.

(ii) It is a short and efficacious treatment for a wide range of psychological disorders as anxiety, depression, panic attacks and borderline personality etc.

(iii) CBT adopts a bio-psychosocial approach to the delineation of psychopathology.

(iv) It combines cognitive therapy with behavioural techniques.

(v) Biological aspects are addressed through relaxation procedures, the psychological aspects through behaviour therapy and cognitive techniques and the social aspects are dealt with environmental manipulations.

(vi) This multi-axial approach makes CBT a comprehensive technique which is easy to use, applicable to a variety of disorders and has proven efficacy.

Final Words:

From the above article you have learnt cbse ncert class 12 Psychology Notes and question answers from chapter 5 therapeutic approaches for your exam preparation. All the best.