Gateway THEME Psychotherapies are based on a common core of therapeutic principles. Medical therapies treat the physical causes of psychological disorders. In many cases, these approaches are complementary.

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Joe stared at some ducks through the blinds in his psychology professor’s office. They were quacking as they explored the campus pond. As psychologists, we meet many students with personal problems. Still, Joe’s teacher was surprised to see him at her office door. His excellent work in class and his healthy, casual appearance left her unprepared for his first words. “I feel like I’m losing my mind,” he said. “Can I talk to you?”

Over the next hour, Joe described his own personal hell. In a sense, he was like the ducks outside, appearing peaceful on the surface, but madly paddling underneath. He was working hard to hide a world of crippling fear, anxiety, and depression. At work, he was deathly afraid of talking to coworkers and cus- tomers. His social phobia led to frequent absenteeism and embarrassing behavior. At school, Joe felt “dif- ferent” and was sure that other students could tell he was “weird.” Several disastrous romances had left him terrified of women. Lately, he had been so depressed that he thought of suicide.

Joe’s request for help was a turning point. At a time when he was becoming his own worst enemy, Joe realized he needed help. In Joe’s case, that person was a talented clinical psychologist to whom his teacher referred him. With psychotherapy (and some temporary help from an antidepression medication), the psy- chologist was able to help Joe come to grips with his emotions and regain his balance.

This chapter discusses methods used to alleviate problems like Joe’s. We will begin with a look at the origins of modern therapy before describing therapies that emphasize the value of viewing personal prob- lems with insight and changing thought patterns. Then, we will focus on behavior therapies, which directly change troublesome actions. After that, we will explore medical therapies, which are based on psychiatric drugs and other physical treatments. We conclude with a look at some contemporary issues in therapy.

Gateway QUESTIONS 15.1 How did psychotherapy originate? 15.2 Is Freudian psychoanalysis still used? 15.3 How do psychotherapies differ? 15.4 What are the major humanistic therapies? 15.5 How does cognitive therapy change thoughts

and emotions? 15.6 What is behavior therapy? 15.7 What role do operant principles play in

behavior therapy?

15.8 How do psychiatrists treat psychological disorders?

15.9 Are various psychotherapies effective, and what do they have in common?

15.10 What will therapy be like in the future? 15.11 How are behavioral principles applied to

everyday problems and how could a person find professional help?

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Therapies

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Chapter 15512

Origins of Therapy— Bored Out of Your Skull

Gateway Question 15.1: How did psychotherapy originate? Fortunately, the odds are that you will not experience problems as serious as those of Joe, the student we just met. But if you did, what help is available? In most cases, it would be some form of psycho- therapy, a psychological technique that can bring about positive changes in personality, behavior, or personal adjustment. It might, as with Joe, also include a medical therapy. Let’s begin with a brief history of mental health care, including a discussion of psychoanaly- sis, the first fully developed psychotherapy.

Early treatments for mental problems give good reasons to appreciate modern therapies (Sharf, 2012). Archaeological find- ings dating to the Stone Age suggest that most primitive approaches were marked by fear and superstitious belief in demons, witchcraft, and magic. If Joe were unlucky enough to have been born several thousand years ago, his “treatment” might have left him feeling “bored.” You see, one of the more dramatic “cures” practiced by primitive “therapists” was a process called trepanning (treh-PAN- ing), also sometimes spelled trephining (Terry, 2006). In modern usage, trepanning is any surgical procedure in which a hole is bored in the skull. In the hands of primitive therapists, it meant boring, chipping, or bashing holes in a patient’s head. Presumably, this was done to relieve pressure or release evil spirits (• Figure 15.1).

Joe would not have been much better off during the Middle Ages. Then, treatments for mental illness in Europe focused on demonology, the study of demons and persons plagued by spirits. Medieval “therapists” commonly blamed abnormal behavior on supernatural forces, such as possession by the devil, or on curses from witches and wizards. As a cure, they used exorcism to “cast out evil spirits.” For the fortunate, exorcism was a religious ritual. More often, physical torture was used to make the body an inhospitable place for the devil to reside.

One reason for the rise of demonology may lie in ergot- ism (AIR-got-ism), a psychotic-like condition caused by ergot poisoning. In the Middle Ages, rye (grain) fields were often infested with ergot fungus. Ergot, we now know, is a natural source of LSD and other mind-altering chemicals. Eating tainted bread could have caused symptoms that were easily mistaken for bewitchment or madness. Pinch- ing sensations, muscle twitches, facial spasms, delirium, and hallucinations are all signs of ergot poisoning (Matossian, 1982). Modern analyses of “demonic possession” suggest that many victims may have been suffering from epilepsy, schizophrenia (Mirsky & Duncan, 2005), dissociative dis- orders (van der Hart, Lierens, & Goodwin, 1996), and depression (Thase, 2006). Thus, many people “treated” by demonologists may have been doubly victimized.

Then, in 1793, a French doctor named Philippe Pinel changed the Bicêtre Asylum in Paris from a squalid “mad- house” into a mental hospital by unchaining the inmates (Harris, 2003). Finally, the emotionally disturbed were

regarded as “mentally ill” and given compassionate treatment. Although it has been more than 200 years since Pinel began more humane treatment, the process of improving care continues today.

When was psychotherapy developed? The first true psychother- apy was created by Sigmund Freud little more than 100 years ago ( Jacobs, 2003). As a physician in Vienna, Freud was intrigued by cases of hysteria. People suffering from hysteria have physical symptoms (such as paralysis or numbness) for which no physical causes can be found.

Such problems are now called somatoform disorders, as discussed in Chapter 14, pages 499–501.

BRIDGES

• Figure 15.1 Primitive “treatment” for mental disorders sometimes took the form of boring a hole in the skull. This example shows signs of healing, which means the “patient” actually survived the treatment. Many didn’t.

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Therapies 513

Psychotherapy Any psychological technique used to facilitate positive changes in a person’s personality, behavior, or adjustment.

Demonology In medieval Europe, the study of demons and the treatment of persons “possessed” by demons.

Hysteria (now called somatoform disorders) An outdated term describing people with physical symptoms (such as paralysis or numbness) for which no physical causes can be found.

Psychoanalysis A Freudian therapy that emphasizes the use of free association, dream interpretation, resistances, and transference to uncover unconscious conflicts.

Free association In psychoanalysis, the technique of having a client say anything that comes to mind, regardless of how embarrassing or unimportant it may seem.

Resistance A blockage in the flow of free association; topics the client resists thinking or talking about.

Slowly, Freud became convinced that hysteria was related to deeply hidden unconscious conflicts and developed psychoanalysis in order to help patients gain insight into those conflicts (Knafo, 2009). Because it is the “granddaddy” of more modern therapies, let’s examine psychoanalysis in some detail.

Psychoanalysis—Expedition into the Unconscious

Gateway Question 15.2: Is Freudian psychoanalysis still used? Isn’t psychoanalysis the therapy for which the patient lies on a couch? Freud’s patients usually reclined on a couch during therapy, while Freud sat out of sight taking notes and offering interpretations. This procedure was supposed to encourage a free flow of thoughts and images from the unconscious. However, it is the least impor- tant element of psychoanalysis, and many modern analysts have abandoned it.

How did Freud treat emotional problems? Freud’s theory stressed that “neurosis” and “hysteria” are caused by repressed memories, motives, and conflicts—particularly those stemming from instinctual drives for sex and aggression. Although they are hidden, these forces remain active in the personality and cause some people to develop rigid ego defenses and compulsive, self- defeating behavior. Thus, the main goal of psychoanalysis is to reduce internal conflicts that lead to emotional suffering (Fayek, 2010).

Freud developed four basic techniques to uncover the uncon- scious roots of neurosis (Freud, 1949). These are free association, dream analysis, analysis of resistance, and analysis of transference.

Free Association The basis for free association is saying whatever comes to mind without worrying whether ideas are painful, embarrassing, or illogical. Thoughts are simply allowed to move freely from one idea to the next, without self-censorship. The purpose of free associa- tion is to lower defenses so that unconscious thoughts and feelings can emerge (Hoffer & Youngren, 2004).

Dream Analysis Freud believed that dreams disguise consciously unacceptable feel- ings and forbidden desires in dream form (Rock, 2004). The psy- choanalyst can use this “royal road to the unconscious” to help the patient work past the obvious, visible meaning of the dream (its manifest content) to uncover the hidden, symbolic meaning (its latent content). This is achieved by analyzing dream symbols (images that have personal or emotional meanings).

Suppose that a young man dreams of pulling a pistol from his waistband and aiming at a target as his wife watches. The pistol repeatedly fails to discharge, and the man’s wife laughs at him. Freud might have seen this as an indication of repressed feelings of sexual impotence, with the gun serving as a disguised image of the penis.

See Chapter 5, pages 178–179 and 198–199, for more information of Freudian dream theory.

BRIDGES

Analysis of Resistance When free associating or describing dreams, patients may resist talking about or thinking about certain topics. Such resistances (blockages in the flow of ideas) reveal particularly important unconscious conflicts. As analysts become aware of resistances, they bring them to the patient’s awareness so the patient can deal with them realistically. Rather than being roadblocks in therapy, resistances can be clues and challenges (Engle & Arkowitz, 2006).

Pioneering psychotherapist Sigmund Freud’s famous couch.

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Chapter 15514

Analysis of Transference Transference is the tendency to “transfer” feelings to a therapist similar to those the patient had for important persons in his or her past. At times, the patient may act as if the analyst is a rejecting father, an unloving or overprotective mother, or a former lover, for example. As the patient re-experiences repressed emotions, the therapist can help the patient recognize and understand them. Troubled persons often provoke anger, rejection, boredom, criti- cism, and other negative reactions from others. Effective therapists learn to avoid reacting as others do and playing the patient’s habit- ual resistance and transference “games.” This, too, contributes to therapeutic change (Fayek, 2010).

Psychoanalysis Today What is the status of psychoanalysis today? Traditional psychoanalysis was open-ended, calling for three to five therapy sessions a week, often for many years. Today, most patients are seen only once or twice per week, but treatment may still go on for years (Friedman et al., 1998). Because of the huge amounts of time and money this requires, psychoanalysts have become relatively rare. Nevertheless, psycho- analysis made a major contribution to modern therapies by highlight- ing the importance of unconscious conflicts (Friedman, 2006).

Many therapists have switched to doing time-limited brief psy- chodynamic therapy, which uses direct questioning to reveal unconscious conflicts (Binder, 2004). Modern therapists also actively provoke emotional reactions that will lower defenses and provide insights. Interestingly, brief therapy appears to accelerate recovery. Patients seem to realize that they need to get to the heart of their problems quickly (Messer & Kaplan, 2004).

Interpersonal Psychotherapy One example of a brief dynamic therapy is interpersonal psycho- therapy (IPT), which was first developed to help depressed people improve their relationships with others (Teyber & McClure, 2011). Research has confirmed that IPT is effective for depressive disorders, as well as eating disorders, substance abuse, social pho- bias, and personality disorders (Fiore et al., 2008; Hoffart, 2005; Prochaska & Norcross, 2010; Talbot & Gamble, 2008).

Liona’s therapy is a good example of IPT (Brown & Barlow, 2011). Liona was suffering from depression that a therapist helped her trace to a conflict with her parents. When her father was absent, Liona adopted the role of her mother’s protector and friend. How- ever, when her father was home, she was expected to resume her role as a daughter. She was angry with her father for frequently abandon- ing her mother and upset about having to switch roles so often. Liona’s IPT sessions (which sometimes included her mother) focused on clarifying Liona’s family roles. Her mood improved a lot after her mother urged her to “stick to being herself.”

Is Traditional Psychoanalysis Effective? The development of newer, more streamlined dynamic therapies is in part due to questions about whether traditional psychoanalysis “works.” In a classic criticism, Hans Eysenck (1994) suggested that

psychoanalysis simply takes so long that patients experience a spontaneous remission of symptoms (improvement due to the mere passage of time).

How seriously should the possibility of spontaneous remission be taken? It’s true that problems ranging from hyperactivity to anxiety do improve with the passage of time. Regardless, researchers have confirmed that psychoanalysis does, in fact, produce improvement in a majority of patients (Doidge, 1997).

The real value of Eysenck’s critique is that it encouraged psy- chologists to try new ideas and techniques. Researchers began to ask, “When psychoanalysis works, why does it work? Which parts of it are essential and which are unnecessary?” Modern therapists have given surprisingly varied answers to these questions. Let’s move on to survey some of the ways modern therapies differ. Later, we will acquaint you with some of the therapies currently in use.

Dimensions of Therapy— Let Me Count the Ways

Gateway Question 15.3: How do psychotherapies differ? In contrast to medical therapies, which are physical in nature, psychotherapy refers to any psychological technique that can bring about positive changes in personality, behavior, or personal adjustment. Psychotherapy is usually based on a dialogue between therapists and their clients, although some therapists also use learning principles to directly alter troublesome behaviors (Corsini & Wedding, 2011).

Therapists have many approaches to choose from: psycho- analysis, which we just discussed, as well as client-centered ther- apy, Gestalt therapy, cognitive therapy, and behavior therapy—to name but a few. As we will see throughout the chapter, each therapy emphasizes different concepts and methods. For this reason, the best approach for a particular person or problem may vary (Prochaska & Norcross, 2010).

Dimensions of Psychotherapy The terms in the list that follows describe some basic aspects of various psychotherapies (Prochaska & Norcross, 2010; Sharf, 2012). Notice that more than one term may apply to a particular therapy. For example, it is possible to have a directive, action- oriented, open-ended group therapy or a nondirective, individual, insight-oriented, time-limited therapy:

• Insight vs. action therapy: Does the therapy aim to bring clients to a deeper understanding of their thoughts, emotions, and behavior? Or is it designed to bring about direct changes in troublesome thoughts, habits, feelings, or behavior, without seeking insight into their origins or meanings?

• Directive vs. nondirective therapy: Does the therapist provide strong guidance and advice? Or does the therapist merely assist clients, who are responsible for solving their own problems?

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Therapies 515

Transference The tendency of patients to transfer feelings to a therapist that correspond to those the patient had for important persons in his or her past.

Brief psychodynamic therapy A modern therapy based on psychoanalytic theory but designed to produce insights more quickly.

Interpersonal psychotherapy (IPT) A brief dynamic psychotherapy designed to help people by improving their relationships with other people.

Spontaneous remission Improvement of symptoms due to the mere passage of time.

• Individual vs. group therapy: Does the therapy involve one therapist with one client? Or do several clients participate at the same time?

• Open-ended vs. time-limited therapy: Is the therapy open- ended? Or is it begun with the expectation that it will last only a limited number of sessions?

Myths Psychotherapy has often been depicted as a complete personal transformation—a sort of “major overhaul” of the psyche. But therapy is not equally effective for all problems. Chances of improvement are fairly good for phobias, low self-esteem, some sexual problems, and marital conflicts. More complex problems can be difficult to solve and may, as in Joe’s case, require medical treatment as well. The most extreme cases may not respond to psychotherapy at all, leaving a medical therapy as the only viable treatment option.

In short, it is often unrealistic to expect psychotherapy to undo a person’s entire past. For many people, the major benefit of psy- chotherapy is that it provides comfort, support, and a way to make constructive changes (Bloch, 2006; Burns, 2010). Yet, even when problems are severe, therapy may help a person gain a new perspec- tive or learn behaviors to better cope with life. Psychotherapy can be hard work for both clients and therapists, but when it succeeds, few activities are more worthwhile.

It’s also a mistake to think that psychotherapy is used only to solve problems or end a crisis. Even if a person is already doing well, therapy can be a way to promote personal growth (Bloch, 2006). Therapists in the positive psychology movement are developing ways to help people make use of their personal strengths. Rather than trying to fix what is “wrong” with a person, they seek to nur- ture positive traits and actively solve problems (Compton, 2005). ■ Table 15.1 lists some of the elements of positive mental health that therapists seek to restore or promote. Before we dig deeper into some of the different types of psychotherapy, let’s enhance your positive academic health with a short review.

Elements of Positive Mental Health

• Personal autonomy and independence

• A sense of identity

• Feelings of personal worth

• Skilled interpersonal communication

• Sensitivity, nurturance, and trust

• Genuineness and honesty with self and other

• Self-control and personal responsibility

• Committed and loving personal relationships

• Capacity to forgive others and oneself

• Personal values and a purpose in life

• Self-awareness and motivation for personal growth

• Adaptive coping strategies for managing stresses and crises

• Fulfillment and satisfaction in work

• Good habits of physical health

■ TABLE 15.1

Adapted from Bergin, 1991; Bloch, 2006.

Knowledge Builder Treating Psychological Distress

RECITE 1. One modern scientific explanation of medieval “possessions” by

“demons” is related to the effects of a. ergot poisoning b. trepanning c. exorcism

d. unconscious transference 2. Pinel is famous for his use of exorcism. T or F? 3. In psychoanalysis, an emotional attachment to the therapist is

called: a. free association b. manifest association c. resistance

d. transference Match:

4. _____ Directive therapies A. Change behavior 5. _____ Action therapies B. Place responsibility on the client 6. _____ Insight therapies C. The client is guided strongly 7. _____ Nondirective therapies D. Seek understanding

8. An approach that is incompatible with insight therapy is a. individual therapy b. action therapy c. nondirective

therapy d. time-limited psychotherapy

REFLECT Think Critically

9. According to Freud’s concept of transference, patients “transfer” their feelings onto the psychoanalyst. In light of this idea, to what might the term countertransference refer?

Self-Reflect

The use of trepanning, demonology, and exorcism all implied that the mentally ill are “cursed.” To what extent are the mentally ill rejected and stigmatized today?

Try to free associate (aloud) for 10 minutes. How difficult was it? Did anything interesting surface?

Can you explain, in your own words, the role of dream analysis, resistances, and transference in psychoanalysis?

Make a list describing what you think it means to be mentally healthy. How well does your list match the items in ■ Table 15.1?

Answers: 1. a 2. F 3. d 4. C 5. A 6. D 7. B 8. d 9. Psychoanalysts (and therapists in general) are also human. They may transfer their own unresolved, unconscious feelings onto their patients. This sometimes hampers the effectiveness of therapy (Kim & Gray, 2009).

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Chapter 15516

Humanistic Therapies— Restoring Human Potential

Gateway Question 15.4: What are the major humanistic therapies? When most people picture psychotherapists at work, they imagine them talking with their clients. Let’s sample a variety of talk- oriented approaches. Humanistic therapies tend to be insight thera- pies intended to help clients gain deeper insight into their thoughts, emotions, and behavior. In contrast, cognitive therapies tend to be action therapies less concerned with insight than with helping peo- ple change harmful thinking patterns. Let’s start with some insight.

Better self-knowledge was the goal of traditional psychoanaly- sis. However, Freud claimed that his patients could expect only to change their “hysterical misery into common unhappiness”! Humanistic therapists are more optimistic, believing that humans have a natural urge to seek health and self-growth. Most assume that it is possible for people to use their potentials fully and live rich, rewarding lives. In this section, we’ll discuss three of the most common humanistic therapies: client-centered therapy, existential therapy, and Gestalt therapy.

Client-Centered Therapy What is client-centered therapy? How is it different from psychoanaly- sis? Whereas psychoanalysis is directive and based on insights from the unconscious, client-centered therapy (also called person- centered therapy) is nondirective and based on insights from con- scious thoughts and feelings (Brodley, 2006; Wampold, 2007). The psychoanalyst tends to take a position of authority, stating what dreams, thoughts, or memories “mean.” In contrast, Carl Rogers (1902–1987), who originated client-centered therapy, believed that what is right or valuable for the therapist may be wrong for the cli- ent. (Rogers preferred the term “client” to “patient” because “patient” implies that a person is “sick” and needs to be “cured.”) Conse- quently, in client-centered therapy, the client determines what will be discussed during each session.

If the client runs things, what does the therapist do? The therapist cannot “fix” the client. Instead, the client must actively seek to solve his or her problems (Whitton, 2003). The therapist’s job is to create a safe “atmosphere of growth” by providing opportunities for change.

How do therapists create such an atmosphere? Rogers believed that effective therapists maintain four basic conditions. First, the therapist offers the client unconditional positive regard (unshak- able personal acceptance). The therapist refuses to react with shock, dismay, or disapproval to anything the client says or feels. Total acceptance by the therapist is the first step to self-acceptance by the client.

Second, the therapist attempts to achieve genuine empathy by trying to see the world through the client’s eyes and feeling some part of what the client is feeling.

As a third essential condition, the therapist strives to be authen- tic (genuine and honest). The therapist must not hide behind a professional role. Rogers believed that phony fronts destroy the growth atmosphere sought in client-centered therapy.

Fourth, the therapist does not make interpretations, propose solutions, or offer advice. Instead, the therapist reflects (rephrases, summarizes, or repeats) the client’s thoughts and feelings. This enables the therapist to act as a psychological “mirror” so clients can see themselves more clearly. Rogers theorized that a person armed with a realistic self-image and greater self-acceptance will gradually discover solutions to life’s problems.

Existential Therapy According to the existentialists, “being in the world” (existence) creates deep anxiety. Each of us must deal with the realities of death. We must face the fact that we create our private world by making choices. We must overcome isolation on a vast and indif- ferent planet. Most of all, we must confront feelings of meaning- lessness (Schneider, Galvin, & Serlin, 2009).

What do these concerns have to do with psychotherapy? Existen- tial therapy focuses on the problems of existence, such as meaning, choice, and responsibility. Like client-centered therapy, it pro- motes self-knowledge. However, there are important differences. Client-centered therapy seeks to uncover a “true self ” hidden behind a screen of defenses. In contrast, existential therapy empha- sizes free will, the human ability to make choices. Accordingly, existential therapists believe you can choose to become the person you want to be.

Existential therapists try to give clients the courage to make rewarding and socially constructive choices. Typically, therapy focuses on death, freedom, isolation, and meaninglessness, the “ulti- mate concerns” of existence (van Deurzen & Kenward, 2005). These universal human challenges include an awareness of one’s mortality, the responsibility that comes with freedom to choose, being alone in your own private world, and the need to create meaning in your life.

One example of existential therapy is Victor Frankl’s logother- apy, which emphasizes the need to find and maintain meaning in

Psychotherapist Carl Rogers, who originated client- centered therapy.

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Therapies 517

Client-centered (or person-centered) therapy A nondirective therapy based on insights gained from conscious thoughts and feelings; emphasizes accepting one’s true self.

Unconditional positive regard An unqualified, unshakable acceptance of another person.

Empathy A capacity for taking another’s point of view; the ability to feel what another is feeling.

Authenticity In Carl Rogers’s terms, the ability of a therapist to be genuine and honest about his or her own feelings.

Reflection In client-centered therapy, the process of rephrasing or repeating thoughts and feelings expressed by clients so they can become aware of what they are saying.

Existential therapy An insight therapy that focuses on the elemental problems of existence, such as death, meaning, choice, and responsibility; emphasizes making courageous life choices.

Gestalt therapy An approach that focuses on immediate experience and awareness to help clients rebuild thinking, feeling, and acting into connected wholes; emphasizes the integration of fragmented experiences.

Cognitive therapy A therapy directed at changing the maladaptive thoughts, beliefs, and feelings that underlie emotional and behavioral problems.

life. Frankl (1904–1997) based his approach on experiences he had as a prisoner in a Nazi concentration camp. In the camp, Frankl saw countless prisoners break down as they were stripped of all hope and human dignity (Frankl, 1955). Those who sur- vived with their sanity did so because they managed to hang on to a sense of meaning (logos). Even in less dire circumstances, a sense of purpose in life adds greatly to psychological well-being (Prochaska & Norcross, 2010).

What does the existential therapist do? The therapist helps clients discover self-imposed limitations in personal identity. To be suc- cessful, the client must fully accept the challenge of changing his or her life (Bretherton & Orner, 2004). Interestingly, Buddhists seek a similar state that they call “radical acceptance” (Brach, 2003).

A key aspect of existential therapy is confrontation, in which clients are challenged to be mindful of their values and choices and to take responsibility for the quality of their existence (Claessens, 2009). An important part of confrontation is the unique, intense, here-and-now encounter between two human beings. When existential therapy is successful, it brings about a renewed sense of purpose and a reappraisal of what’s important in life. Some clients even experience an emotional rebirth, as if they had survived a close brush with death. As Marcel Proust wrote, “The real voyage of discovery consists not in seeing new landscapes but in having new eyes.”

Gestalt Therapy Gestalt therapy is based on the idea that perception, or awareness, is disjointed and incomplete in maladjusted persons. The German word Gestalt means “whole,” or “complete.” Gestalt therapy helps people rebuild thinking, feeling, and acting into connected wholes. This is achieved by expanding personal awareness; by accepting responsibility for one’s thoughts, feelings, and actions; and by fill- ing in gaps in experience (Masquelier, 2006).

What are “gaps in experience”? Gestalt therapists believe that we often shy away from expressing or “owning” upsetting feelings. This creates a gap in self-awareness that may become a barrier to personal growth. For example, a person who feels anger after the death of a parent might go for years without fully expressing it. This and similar threatening gaps may impair emotional health.

The Gestalt approach is more directive than client-centered or existential therapy, and it is less insight-oriented and instead emphasizes immediate experience. Working either one-to-one or in a group setting, the Gestalt therapist encourages clients to become more aware of their moment-to-moment thoughts, per- ceptions, and emotions (Staemmler, 2004). Rather than discussing why clients feel guilt, anger, fear, or boredom, the therapist encour- ages them to have these feelings in the “here and now” and become fully aware of them. The therapist promotes awareness by drawing attention to a client’s posture, voice, eye movements, and hand gestures. Clients may also be asked to exaggerate vague feelings until they become clear. Gestalt therapists believe that expressing such feelings allows people to “take care of unfinished business” and break through emotional impasses (O’Leary, 2006).

Gestalt therapy is often associated with the work of Fritz Perls (1969). According to Perls, emotional health comes from knowing what you want to do, not dwelling on what you should do, ought to do, or should want to do (Brownell, 2010). In other words, emo- tional health comes from taking full responsibility for one’s feel- ings and actions. For example, it means changing “I can’t” to “I won’t,” or “I must” to “I choose to.”

How does Gestalt therapy help people discover their real wants? Above all else, Gestalt therapy emphasizes present experience (Yontef, 2007). Clients are urged to stop intellectualizing and talking about feelings. Instead, they learn to live now; live here; stop imagining; experience the real; stop unnecessary thinking; taste and see; express rather than explain, justify, or judge; give in to unpleasantness and pain just as to pleasure; and surrender to being as you are. Gestalt therapists believe that, paradoxically, the best way to change is to become who you really are (Brownell, 2010).

Cognitive Therapy—Think Positive!

Gateway Question 15.5: How does cognitive therapy change thoughts and emotions? Whereas humanistic therapies usually seek to foster insight, cogni- tive therapies usually try to directly change what people think, believe, and feel, and, as a consequence, how they act. In general, cognitive therapy helps clients change thinking patterns that lead to troublesome emotions or behaviors (Davey, 2008; Power, 2010).

In practice, how does cognitive therapy differ from humanistic therapy? Janice is a hoarder whose home is crammed full with things she has acquired over two decades. If she seeks help from a therapist concerned with insight, she will try to better understand why she began collecting stuff. In contrast, if she seeks help from a cognitive

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Chapter 15518

therapist, she may spend little time examining her past. Instead, she will work to actively change her thoughts and beliefs about hoard- ing. With either approach, the goal is to give up hoarding. Further, in practice, humanistic therapies often also result in active change and cognitive therapies often also yield deeper insight.

Cognitive therapy has been successfully used as a remedy for many problems, ranging from generalized anxiety disorder and post- traumatic stress disorder to marital distress and anger (Butler et al., 2006). For example, compulsive hand washing can be greatly reduced by changing a client’s thoughts and beliefs about dirt and contamina- tion (Jones & Menzies, 1998). Cognitive therapy has been especially successful in treating depression (Hollon, Stewart, & Strunk, 2006). Joe’s clinical psychologist relied on cognitive therapy to help lift Joe (who could forget Joe?) out of his depression.

Cognitive Therapy for Depression As you may recall from Chapter 13, cognitive psychologists believe that negative, self-defeating thoughts underlie depression. According to Aaron Beck (1991), depressed persons see them- selves, the world, and the future in negative terms because of major distortions in thinking. The first is selective perception, which refers to perceiving only certain stimuli in a larger array. If five good things and three bad things happen during the day, depressed people focus only on the bad. A second thinking error in depression is overgeneralization, the tendency to think that an upsetting event applies to other, unrelated situations. An example would be Joe’s considering himself a total failure, or completely worthless, if he were to lose a part-time job or fail a test. To com- plete the picture, depressed persons tend to magnify the impor- tance of undesirable events by engaging in all-or-nothing think- ing: they see events as completely good or bad, right or wrong, and themselves as either successful or failing miserably (Lam & Mok, 2008).

How do cognitive therapists alter such patterns? Cognitive thera- pists make a step-by-step effort to correct negative thoughts that lead to depression or similar problems. At first, clients are taught to recognize and keep track of their own thoughts. The client and therapist then look for ideas and beliefs that cause depression, anger, and avoidance. For example, here’s how Joe’s therapist began to challenge his all-or-nothing thinking:

Joe: I’m feeling really depressed today. No one wants to hire me, and I can’t even get a date. I feel completely incompetent!

Therapist: I see. The fact that you are currently unemployed and don’t have a girlfriend proves that you are completely and utterly incompetent?

Joe: Well…I can see that doesn’t add up.

Next, clients are asked to gather information to test their beliefs. For instance, a depressed person might list his or her activities for a week. The list is then used to challenge all-or-nothing thoughts, such as “I had a terrible week” or “I’m a complete failure.” With more coaching, clients learn to alter their thoughts in ways that improve their moods, actions, and relationships.

Cognitive therapy is at least as effective as drugs for treating many cases of depression (Butler et al., 2006; Eisendrath, Chartier, & McLane, 2011). More importantly, people who have adopted new thinking patterns are less likely to become depressed again—a benefit that drugs can’t impart (Dozois & Dobson, 2004; Hollon, Stewart, & Strunk, 2006).

In an alternate approach, cognitive therapists look for an absence of effective coping skills and thinking patterns, not for the presence of self-defeating thoughts (Dobson, Backs-Dermott, & Dozois, 2000). The aim is to teach clients how to cope with anger, depression, shyness, stress, and similar problems. Stress inocula- tion, which was described in Chapter 13, is a good example of this approach. Joe used it to weaken his social phobia.

Cognitive therapy is a rapidly expanding specialty. Before we leave the topic, let’s explore another widely used cognitive therapy.

Rational-Emotive Behavior Therapy Rational-emotive behavior therapy (REBT) attempts to change irrational beliefs that cause emotional problems. According to Albert Ellis (1913–2007), the basic idea of REBT is as easy as A-B-C (Ellis, 1995, Ellis & Ellis, 2011). Ellis assumes that people become unhappy and develop self-defeating habits because they have unrealistic or faulty beliefs.

How are beliefs important? Ellis analyzes problems in this way: The letter A stands for an activating experience, which the person assumes to be the cause of C, an emotional consequence. For instance, a person who is rejected (the activating experience) feels depressed, threatened, or hurt (the consequence). Rational-emotive behavior therapy shows the client that the real problem is what comes between A and C: In between is B, the client’s irrational and unrealistic beliefs. In this example, an unrealistic belief leading to unnecessary suffering is, “I must be loved and approved by every- one at all times.” REBT holds that events do not cause us to have feelings. We feel as we do because of our beliefs (Dryden, 2011; Kottler & Shepard, 2011). (For some examples, see “Ten Irrational Beliefs—Which Do You Hold?”)

The REBT explanation of emotional distress is related to the effects of emotional appraisals. See Chapter 10, pages 359–360.

BRIDGES

Ellis (1979, Ellis & Ellis, 2011) says that most irrational beliefs come from three core ideas, each of which is unrealistic:

1. I must perform well and be approved of by significant others. If I don’t, then it is awful, I cannot stand it, and I am a rotten person.

2. You must treat me fairly. When you don’t, it is horrible, and I cannot bear it.

3. Conditions must be the way I want them to be. It is terrible when they are not, and I cannot stand living in such an awful world.

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Therapies 519

Selective perception Perceiving only certain stimuli among a larger array of possibilities.

Overgeneralization Blowing a single event out of proportion by extending it to a large number of unrelated situations.

All-or-nothing thinking Classifying objects or events as absolutely right or wrong, good or bad, acceptable or unacceptable, and so forth.

Rational-emotive behavior therapy (REBT) An approach that states that irrational beliefs cause many emotional problems and that such beliefs must be changed or abandoned.

It’s easy to see that such beliefs can lead to much grief and needless suffering in a less than perfect world. Rational-emotive behavior therapists are very directive in their attempts to change a client’s irrational beliefs and “self-talk.” The therapist may directly attack clients’ logic, challenge their thinking, confront them with evidence contrary to their beliefs, and even assign “homework.” Here, for instance, are some examples of statements that dispute irrational beliefs (adapted from Dryden, 2011; Ellis & Ellis, 2011; Kottler & Shepard, 2011):

• “Where is the evidence that you are a loser just because you didn’t do well this one time?”

• “Who said the world should be fair? That’s your rule.” • “What are you telling yourself to make yourself feel so upset?” • “Is it really terrible that things aren’t working out as you would like? Or is

it just inconvenient?”

Many of us would probably do well to give up our irrational beliefs. Improved self-acceptance and a better tolerance of daily annoyances are the benefits of doing so (see “Overcoming the Gambler’s Fallacy”).

The value of cognitive approaches is further illustrated by three techniques (covert sensitization, thought stopping, and covert rein- forcement) described in this chapter’s Psychology in Action section. A little later you can see what you think of them.

Ten Irrational Beliefs—Which Do You Hold?Discovering Psychology

Rational-emotive behavior therapists have identified numerous beliefs that com- monly lead to emotional upsets and con- flicts. See if you recognize any of the following irrational beliefs:

1. I must be loved and approved by almost every significant person in my life or it’s awful and I’m worthless.

Example: “One of my classmates doesn’t seem to like me. I must be a big loser.”

2. I should be completely competent and achieving in all ways to be a worthwhile person.

Example: “I don’t understand my physics class. I guess I really am just stupid.”

3. It’s terribly upsetting when things don’t go my way.

Example: “I should have gotten a B in that class. The teacher is a total creep.”

4. It’s not my fault I’m unhappy; I can’t control my emotional reactions.

Example: “You make me feel awful. I would be happy if it weren’t for you.”

5. I should never forget it if something un- pleasant happens.

Example: “I’ll never forget the time my boss insulted me. I think about it every day at work.”

6. It is easier to avoid difficulties and re- sponsibilities than to face them.

Example: “I don’t know why my girl- friend is angry. Maybe it will just pass if I ignore it.”

7. A lot of people I have to deal with are bad. I should severely punish them for it.

Example: “The students renting next door are such a pain. I’m going to play my stereo even louder the next time they complain.”

8. I should depend on others who are stronger than me.

Example: “I couldn’t survive if she left me.”

9. Because something once strongly af- fected me, it will do so forever.

Example: “My girlfriend dumped me during my junior year in college. I can never trust a woman again.”

10. There is always a perfectly obvious solu- tion to human problems, and it is im- moral if this solution is not put into practice.

Example: “I’m so depressed about poli- tics in this country. It all seems hopeless.”*

If any of the listed beliefs sound familiar, you may be creating unnecessary emotional distress for yourself by holding on to unreal- istic expectations.

*Adapted from Dryden, 2011; Ellis & Ellis, 2011; Teyber & McClure, 2011).

Knowledge Builder Humanistic and Cognitive Therapies

RECITE Match: 1. _____ Client-centered therapy A. Changing thought patterns 2. _____ Gestalt therapy B. Unconditional positive regard 3. _____ Existential therapy C. Gaps in awareness 4. _____ REBT D. Choice and becoming 5. The Gestalt therapist tries to reflect a client’s thoughts and feelings.

T or F? 6. Confrontation and encounter are concepts of existential therapy.

T or F? 7. According to Beck, selective perception, overgeneralization, and

_________________________ thinking are cognitive habits that underlie depression.

Continued

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Chapter 15520

Therapies Based on Classical Conditioning—Healing by Learning

Gateway Question 15.6: What is behavior therapy? Jay repeatedly and vividly imagined himself going into a store to steal something. He then pictured himself being caught and turned over to the police, who handcuffed him and hauled him off to jail. Once there, he imagined calling his wife to tell her he had been arrested for shoplifting. He became very distressed as he faced her anger and his son’s disappointment (Kohn & Antonuccio, 2002).

Why would anyone imagine such a thing? Jay’s behavior is not as strange as it may seem. His goal was self-control: Jay is a kleptoma- niac (a compulsive thief ). The method he chose (called covert sensitization) is a form of behavior therapy (Prochaska & Norcross, 2010).

In general, how does behavior therapy work? A breakthrough occurred when psychologists realized they could use learning principles to solve human problems. Behavior therapy is an action therapy that uses learning principles to make constructive changes in behavior. Behavior therapists believe that deep insight into one’s problems is often unnecessary for improvement. Instead, they try to directly alter troublesome actions and thoughts. Jay

Overcoming the Gambler’s FallacyThe Clinical File

Seventeen-year-old Jonathan just lost his shirt again. This time, he did it playing on- line Blackjack. Jonathan started out making $5 bets and then doubled his bet over and over. Surely, he thought, his luck would eventually change. However, he ran out of money after just eight straight hands, having lost more than $1000. Last week, he lost a lot of money playing Texas Hold ‘Em. Now Jonathan is in tears—he has lost most of his summer earnings, and he is worried about having to drop out of school and tell his par- ents about his losses. Jonathan has had to admit that he is part of the growing ranks of underage gambling addicts (LaBrie & Shaf- fer, 2007; Wilber & Potenza, 2006).

Like many problem gamblers, Jonathan suffers from several cognitive distortions re- lated to gambling. Here are some of his mis- taken beliefs (adapted from adapted from Toneatto, 2002; Wickwire, Whelan, & Meyers, 2010):

Magnified gambling skill: Your self- confidence is exaggerated, despite the fact that you lose persistently.

Attribution errors: You ascribe your wins to skill but blame losses on bad luck.

Gambler’s fallacy: You believe that a string of losses soon must be followed by wins.

Selective memory: You remember your wins but forget your losses.

Overinterpretation of cues: You put too much faith in irrelevant cues such as bodily sensations or a feeling that your next bet will be a winner.

Luck as a trait: You believe that you are a “lucky” person in general.

Probability biases: You have incorrect beliefs about randomness and chance events.

Do you have any of these mistaken beliefs? Taken together, Jonathan’s cognitive distor- tions created an illusion of control. That is, he believed that if he worked hard enough, he could figure out how to win. Fortunately, a cog- nitive therapist helped Jonathan cognitively restructure his beliefs. He now no longer be- lieves he can control chance events. Jonathan still gambles a bit, but he does so only recre- ationally, keeping his losses within his budget and enjoying himself in the process.

Gambling addiction is a growing problem among young people (LaBrie & Shaffer, 2007).

8. The B in the A-B-C of REBT stands for a. behavior b. belief c. being d. Beck

REFLECT Think Critically

9. How might using the term patient affect the relationship between an individual and a therapist?

1 0. In Aaron Beck’s terms, a belief such as “I must perform well or I am a rotten person” involves two thinking errors. What are they?

Self-Reflect

You are going to play the role of a therapist for a classroom demonstration. How would you act if you were a client-centered therapist? An existential therapist? A Gestalt therapist?

What would an existential therapist say about the choices you have made so far in your life? Should you be choosing more “courageously”?

We all occasionally engage in negative thinking. Can you remember a time recently when you engaged in selective perception? Overgeneralization? All-or-nothing thinking?

Answers: 1. B 2. C 3. D 4. A 5. F 6. T 7. all-or-nothing 8. b 9. The terms doctor and patient imply a large gap in status and authority between the individual and his or her therapist. Client-centered therapy attempts to narrow this gap by making the person the final authority concerning solutions to his or her problems. Also, the word patient implies that a person is “sick” and needs to be “cured.” Many regard this as an inappropriate way to think about human problems. 10. Overgeneralization and all-or-nothing thinking.

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Therapies 521

Behavior therapy Any therapy designed to actively change behavior. Behavior modification The application of learning principles to change

human behavior, especially maladaptive behavior. Aversion therapy Suppressing an undesirable response by associating it

with aversive (painful or uncomfortable) stimuli.

didn’t need to probe into his past or his emotions and conflicts; he simply wanted to break his shoplifting habit. This and the next section describe some innovative—and very successful—behav- ioral therapies.

Behavior therapists assume that people have learned to be the way they are. If they have learned responses that cause problems, then they can change them by relearning more appropriate behav- iors. Broadly speaking, behavior modification refers to any use of classical or operant conditioning to directly alter human behavior (Miltenberger, 2011; Spiegler & Guevremont, 2010). (Some therapists prefer to call this approach applied behavior analysis.) Behavioral approaches include aversion therapy, desen- sitization, token economies, and other techniques (Forsyth & Savsevitz, 2002).

How does classical conditioning work? I’m not sure I remember. Perhaps a brief review would be helpful. Classical conditioning is a form of learning in which simple responses (especially reflexes) are associated with new stimuli. In classical conditioning, a neutral stimulus is followed by an unconditioned stimulus (US) that consis- tently produces an unlearned reaction, called the unconditioned response (UR). Eventually, the previously neutral stimulus begins to produce this response directly. The response is then called a condi- tioned response (CR), and the stimulus becomes a conditioned stimulus (CS). Thus, for a child the sight of a hypodermic needle (CS) is followed by an injection (US), which causes anxiety or fear (UR). Eventually, the sight of a hypodermic (the conditioned stimulus) may produce anxiety or fear (a conditioned response) before the child gets an injection.

For a more thorough review of classical conditioning, return to Chapter 6, pages 207–212.

BRIDGES

What does classical conditioning have to do with behavior modi- fication? Classical conditioning can be used to associate discom- fort with a bad habit, as Jay did to deal with his kleptomania. More powerful versions of this approach are called aversion therapy.

Aversion Therapy Imagine that you are eating an apple. Suddenly, you discover that you just bit a large green worm in half. You vomit. Months later, you cannot eat an apple again without feeling ill. It’s apparent that you have developed a conditioned aversion to apples. (A condi- tioned aversion is a learned dislike or negative emotional response to some stimulus.)

How are conditioned aversions used in therapy? In aversion therapy, an individual learns to associate a strong aversion to an undesirable habit such as smoking, drinking, or gambling. Aver- sion therapy has been used to cure hiccups, sneezing, stuttering, vomiting, nail-biting, bed-wetting, compulsive hair-pulling, alco- holism, and the smoking of tobacco, marijuana, or crack cocaine. Actually, aversive conditioning happens every day. For example, not many physicians who treat lung cancer patients are smokers, nor do many emergency room doctors drive without using their seat belts (Eifert & Lejuez, 2000).

Puffing Up an Aversion The fact that nicotine is toxic makes it easy to create an aversion that helps people give up smoking. Behavior therapists have found that electric shock, nauseating drugs, and similar aversive stimuli are not required to make smokers uncomfortable. All that is needed is for the smoker to smoke—rapidly, for a long time, at a forced pace. During rapid smoking, clients are told to smoke con- tinuously, taking a puff every 6 to 8 seconds. Rapid smoking con- tinues until the smoker is miserable and can stand it no more. By then, most people are thinking, “I never want to see another ciga- rette for the rest of my life.”

Rapid smoking has long been known as an effective behavior therapy for smoking (McRobbie & Hajek, 2007). Nevertheless, anyone tempted to try rapid smoking should realize that it is very unpleasant. Without the help of a therapist, most people quit too soon for the procedure to succeed. In addition, rapid smoking can be dangerous. It should be done only with professional supervi- sion. (An alternative method that is more practical is described in the Psychology in Action section of this chapter.)

Aversive Therapy for Drinking Another excellent example of aversion therapy was pioneered by Roger Vogler and his associates (1977). Vogler worked with alco- holics who were unable to stop drinking and for whom aversion therapy was a last chance. While drinking an alcoholic beverage, clients receive a painful (although not injurious) electric shock to the hand. Most of the time, these shocks occur as the client is beginning to take a drink of alcohol.

These response-contingent shocks (shocks that are linked to a response) obviously take the pleasure out of drinking. Shocks also

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Chapter 15522

cause the alcohol abuser to develop a conditioned aversion to drinking. Normally, the misery caused by alcohol abuse comes long after the act of drinking—too late to have much effect. But if alco- hol can be linked with immediate discomfort, then drinking will begin to make the individual very uncomfortable.

Is it really acceptable to treat clients this way? People are often disturbed (shocked?) by such methods. However, clients usually volunteer for aversion therapy because it helps them overcome a destructive habit. Indeed, commercial aversion programs for over- eating, smoking, and alcohol abuse have attracted many willing customers. More important, aversion therapy can be justified by its long-term benefits. As behaviorist Donald Baer put it, “A small number of brief, painful experiences are a reasonable exchange for the interminable pain of a lifelong maladjustment.”

Desensitization How is behavior therapy used to treat phobias, fears, and anxieties? Suppose you want to help Curtis overcome fear of the high diving board. How might you proceed? Directly forcing Curtis off the high board could be a psychological disaster. A better approach would be to begin by teaching him to dive off the edge of the pool. Then he could be taught to dive off the low board, followed by a platform 6 feet above the water and then an 8-foot platform. As a last step, Curtis could try the high board.

Who’s Afraid of a Hierarchy? This rank-ordered series of steps (called a hierarchy) allows Curtis to undergo adaptation. Gradually, he adapts to the high dive and overcomes his fear. When Curtis has conquered his fear, we can say that desensitization (dee-SEN-sih-tih-ZAY-shun) has occurred (Spiegler & Guevremont, 2010).

Desensitization is also based on reciprocal inhibition (using one emotional state to block another) (Heriot & Pritchard, 2004).

For instance, it is impossible to be anxious and relaxed at the same time. If we can get Curtis onto the high board in a relaxed state, his anxiety and fear will be inhibited. Repeated visits to the high board should cause fear to disappear in this situation. Again, we would say that Curtis has been desensitized. Typically, systematic desen- sitization (a guided reduction in fear, anxiety, or aversion) is attained by gradually approaching a feared stimulus while main- taining relaxation.

What is desensitization used for? Desensitization is used primar- ily to help people unlearn phobias (intense, unrealistic fears) or strong anxieties. For example, each of these people might be a can- didate for desensitization: a teacher with stage fright; a student with test anxiety; a salesperson who fears people; or a newlywed with an aversion to sexual intimacy.

Feeling a Little Tense? Relax!Discovering Psychology

The key to desensitization is relaxation. To inhibit fear, you must learn to relax. One way to voluntarily relax is by using the tension-release method. To achieve deep muscle relaxation, try the following exercise:

Tense the muscles in your right arm until they tremble. Hold them tight as you slowly count to ten and then let go. Allow your hand and arm to go limp and to relax completely. Repeat the procedure. Releasing tension two or three times will allow you to feel whether your arm

muscles have relaxed. Repeat the tension– release procedure with your left arm. Compare it with your right arm. Repeat until the left arm is equally relaxed. Apply the tension–release technique to your right leg; to your left leg; to your abdomen; to your chest and shoulders. Clench and release your chin, neck, and throat. Wrinkle and release your forehead and scalp. Tighten and release your mouth and face mus- cles. As a last step, curl your toes and tense your feet. Then release.

If you carried out these instructions, you should be noticeably more relaxed than you were before you began. Practice the tension- release method until you can achieve com- plete relaxation quickly (5 to 10 minutes). After you have practiced relaxation once a day for a week or two, you will begin to be able to tell when your body (or a group of muscles) is tense. Also, you will begin to be able to relax on command. This is a valuable skill that you can apply in any situation that makes you feel tense or anxious.

Programs for treating fears of flying combine relaxation, systematic desensitiza- tion, group support, and lots of direct and indirect exposure to airliners. Many such programs conclude with a brief flight, so that participants can “test their wings.”

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Therapies 523

Hierarchy A rank-ordered series of higher and lower amounts, levels, degrees, or steps.

Reciprocal inhibition The presence of one emotional state can inhibit the occurrence of another, such as joy preventing fear or anxiety inhibiting pleasure.

Systematic desensitization A reduction in fear, anxiety, or aversion brought about by planned exposure to aversive stimuli.

Tension-release method A procedure for systematically achieving deep relaxation of the body.

Vicarious desensitization A reduction in fear or anxiety that takes place vicariously (“secondhand”) when a client watches models perform the feared behavior.

Virtual reality exposure Use of computer-generated images to present fear stimuli. The virtual environment responds to a viewer’s head movements and other inputs.

Eye movement desensitization and reprocessing (EMDR) A technique for reducing fear or anxiety; based on holding upsetting thoughts in mind while rapidly moving the eyes from side to side.

Performing Desensitization How is desensitization done? First, the client and the therapist construct a hierarchy. This is a list of fear- provoking situations, arranged from least disturbing to most frightening. Second, the client is taught exer- cises that produce deep relaxation (see “Feeling a Little Tense? Relax!”). Third, once the client is relaxed, she or he tries to perform the least disturbing item on the list. For a fear of heights (acrophobia), this might be: “(1) Stand on a chair.” The first item is repeated until no anxiety is felt. Any change from complete relaxation is a signal that clients must relax again before continuing. Slowly, clients move up the hierar- chy: “(2) Climb to the top of a small stepladder”; “(3) Look down a flight of stairs”; and so on, until the last item is performed without fear: “(20) Fly in an airplane.”

For many phobias, desensitization works best when people are directly exposed to the stimuli and situa- tions they fear (Bourne, 2010; Miltenberger, 2011). For something like a simple spider phobia, this expo- sure can even be done in groups. Also, for some fears (such as fear of riding an elevator, or fear of spiders) desensitiza- tion may be completed in a single session (Müller et al., 2011; Sturges & Sturges, 1998).

Vicarious Desensitization What if it’s not practical to directly act out the steps of a hierarchy? For a fear of heights, the steps of the hierarchy might be acted out. However, if this is impractical, as it might be in the case of a fear of flying, the problem can be handled by having clients observe mod- els who are performing the feared behavior (Eifert & Lejuez, 2000; Bourne, 2010; • Figure 15.2). A model is a person (either live or filmed) who serves as an example for observational learning. If such vicarious desensitization (secondhand learning) can’t be used, there is yet another option. Fortunately, desensitization works almost as well when a person vividly imagines each step in the hierarchy (Yahnke, Sheikh, & Beckman, 2003). If the steps can be visualized without anxiety, fear in the actual situation is reduced. Because imagining feared stimuli can be done at a therapist’s office, it is the most common way of doing desensitization.

Virtual Reality Exposure Desensitization is an exposure therapy. Similar to other such thera- pies, it involves exposing people to feared stimuli until their fears extinguish. In an important recent development, psychologists are now also using virtual reality to treat phobias. Virtual reality is a computer-generated, three-dimensional “world” that viewers enter by wearing a head-mounted video display. Virtual reality expo- sure presents computerized fear stimuli to clients in a realistic, yet carefully controlled fashion (Wiederhold & Wiederhold, 2005; Riva, 2009). It has already been used to treat fears of flying, driv- ing, and public speaking as well as acrophobia (fear of heights),

claustrophobia, and spider phobias (Arbona et al., 2004; Giuseppe, 2005; Lee et al., 2002; Meyerbröker & Emmelkamp, 2010; Müller et al., 2011; see • Figure 15.3.). Virtual reality exposure has also been used to create immersive distracting environments for help patients reduce the experience of pain (Malloy & Milling, 2010).

Desensitization has been one of the most successful behavior therapies. A relatively new technique may provide yet another way to lower fears, anxieties, and psychological pain.

Eye Movement Desensitization Traumatic events produce painful memories. Disturbing flash- backs often haunt victims of accidents, disasters, molestations, muggings, rapes, or emotional abuse. To help ease traumatic mem- ories and post-traumatic stress, Dr. Francine Shapiro developed eye movement desensitization and reprocessing (EMDR).

• Figure 15.2 Treatment of a snake phobia by vicarious desensitization. These classic photo- graphs show models interacting with snakes. To overcome their own fears, phobic subjects observed the models (Bandura, Blanchard, & Ritter, 1969).

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Chapter 15524

In a typical EMDR session, the client is asked to visualize the images that most upset her or him. At the same time, a pencil (or other object) is moved rapidly from side to side in front of the person’s eyes. Watching the moving object causes the person’s eyes to dart swiftly back and forth. After about 30  seconds, clients describe any memories, feelings, and thoughts that emerged and discuss them with the therapist. These steps are repeated until troubling thoughts and emotions no longer surface (Shapiro, 2001; Shapiro & Forrest, 2004).

A number of studies suggest that EMDR lowers anxieties and takes the pain out of traumatic memories (Seidler & Wagner, 2006). However, EMDR is highly controversial (Albright & Thyer, 2010). Some studies, for example, have found that eye movements

add nothing to the treatment. The apparent success of EMDR may simply be based on gradual exposure to upsetting stimuli, as in other forms of desensitization (Davidson & Parker, 2001). On the other hand, some researchers continue to find that EMDR is superior to traditional therapies (Greenwald, 2006; Solomon, Solomon, & Heide, 2009).

Is EMDR a breakthrough? Given the frequency of traumas in modern society, it shouldn’t be long before we find out.

Operant Therapies—All the World Is a Skinner Box?

Gateway Question 15.7: What role do operant principles play in behavior therapy? Aversion therapy and desensitization are based on classical condition- ing. Where does operant conditioning fit in? As you may recall, oper- ant conditioning refers to learning based on the consequences of making a response. The operant principles most often used by behavior therapists to deal with human behavior are:

1. Positive reinforcement. Responses that are followed by re- inforcement tend to occur more frequently. If children whine and get attention, they will whine more frequently. If you get A’s in your psychology class, you may become a psychology major.

2. Nonreinforcement and Extinction. A response that is not followed by reinforcement will occur less frequently. If a response is not followed by reward after it has been repeated many times, it will extinguish entirely. After winning three times, you pull the handle on a slot machine 30 times more without a payoff. What do you do? You go away. So does the response of handle pulling (for that particular machine, at any rate).

3. Punishment. If a response is followed by discomfort or an undesirable effect, the response will be suppressed (but not necessarily extinguished).

4. Shaping. Shaping means reinforcing actions that are closer and closer approximations to a desired response. For example, to reward an intellectually disabled child for saying “ball,” you might begin by reinforcing the child for saying anything that starts with a b sound.

5. Stimulus control. Responses tend to come under the control of the situation in which they occur. If you set your clock 10 minutes fast, it may be easier to leave the house on time in the morning. Your departure is under the stimulus control of the clock, even though you know it is fast.

6. Time out. A time-out procedure usually involves removing the individual from a situation in which reinforcement occurs. Time out is a variation of response cost: It pre- vents reward from following an undesirable response. For example, children who fight with each other can be sent to separate rooms and allowed out only when they are able to behave more calmly.

• Figure 15.3 (top) Dr. Larry Hodges (in the head-mounted display) and Dr. Page Anderson show how a virtual reality system is used to expose people to feared stimuli. (bottom) A computer image from a virtual Iraq or Afghanistan. Veterans suf- fering from post-traumatic stress disorder (PTSD) can re-experience their traumas. For example, someone whose Humvee was destroyed by an improvised explosive device can relive that moment complete with sights, sounds, vibrations, and even smells. Successive exposures result in a reduction of PTSD symptoms (Gerardi et al., 2008).

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Token economy A therapeutic program in which desirable behaviors are reinforced with tokens that can be exchanged for goods, services, activities, and privileges.

For a more thorough review of operant learning, return to Chapter 6, pages 212–229.

BRIDGES

As simple as these principles may seem, they have been used very effectively to overcome difficulties in work, home, school, and industrial settings. Let’s see how.

Nonreinforcement and Extinction An extremely overweight mental patient had a persistent and dis- turbing habit: She stole food from other patients. No one could persuade her to stop stealing or to diet. For the sake of her health, a behavior therapist assigned her a special table in the ward dining room. If she approached any other table, she was immediately removed from the dining room. Any attempt to steal from others caused the patient to miss her own meal (Ayllon, 1963). Because her attempts to steal food went unrewarded, they rapidly disappeared.

What operant principles did the therapist in this example use? The therapist used nonreward to produce extinction. The most frequently occurring human behaviors lead to some form of reward. An unde- sirable response can be eliminated by identifying and removing the rewards that maintain it. But people don’t always do things for food, money, or other obvious rewards. Most of the rewards maintaining human behavior are subtler. Attention, approval, and concern are common yet powerful reinforcers for humans (• Figure 15.4).

Nonreward and extinction can eliminate many problem behav- iors, especially in schools, hospitals, and institutions. Often, diffi-

culties center on a limited number of particularly disturbing responses. Time out is a good way to remove such responses, usu- ally by refusing to pay attention to a person who is misbehaving. For example, 14-year-old Terrel periodically appeared in the nude in the activity room of a training center for disturbed adolescents. This behavior always generated a great deal of attention from staff and other patients. As an experiment, the next time he appeared nude, counselors and other staff members greeted him normally and then ignored him. Attention from other patients rapidly sub- sided. Sheepishly, he returned to his room and dressed.

Reinforcement and Token Economies A distressing problem therapists sometimes face is how to break through to severely disturbed patients who won’t talk. Conven- tional psychotherapy offers little hope of improvement for such patients.

What can be done for them? One widely used approach is based on tokens (symbolic rewards that can be exchanged for real rewards). Tokens may be printed slips of paper, check marks, points, or gold stars. Whatever form they take, tokens serve as rewards because they may be exchanged for candy, food, cigarettes, recreation, or privileges, such as private time with a therapist, out- ings, or watching television. Tokens are used in mental hospitals, halfway houses, schools for the intellectually disabled, programs for delinquents, and ordinary classrooms. They usually produce improvements in behavior (Dickerson, Tenhula, & Green-Paden, 2005; Matson & Boisjoli, 2009).

Tokens provide an effective way to change behavior because they are secondary reinforcers. See Chapter 6, pages 218–220.

BRIDGES

By using tokens, a therapist can immediately reward positive responses. For maximum impact, therapists select specific target behaviors (actions or other behav- iors the therapist seeks to modify). Target behaviors are then reinforced with tokens. For example, a mute mental patient might first be given a token each time he or she says a word. Next, tokens may be given for speaking a complete sentence. Later, the patient could gradually be required to speak more often, then to answer questions, and eventually to carry on a short conversation in order to receive tokens. In this way, deeply withdrawn patients have been returned to the world of normal communication.

The full-scale use of tokens in an institutional set- ting produces a token economy. In a token economy,

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• Figure 15.4 This graph shows extinction of self-destructive behavior in two autistic boys. Before extinction began, the boys received attention and concern from adults for injuring them- selves. During extinction, the adults were taught to ignore the boys’ self-damaging behavior. As you can see, the number of times that the boys tried to injure themselves declined rapidly. (Adapted from Lovaas & Simmons, 1969.)

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Chapter 15526

patients are rewarded with tokens for a wide range of socially desirable or productive activities (Spiegler & Guevremont, 2010). They must pay tokens for privileges and when they engage in problem behaviors (• Figure 15.5). For example, tokens are given to patients who dress themselves, take required medication, arrive for meals on time, and so on. Constructive activities, such as gardening, cooking, or cleaning, may also earn tokens. Patients must exchange tokens for meals and private rooms, movies, passes, off-ward activities, and other privi- leges. They are charged tokens for disrobing in public, talking to themselves, fighting, crying, and similar target behaviors (Morisse et al., 1996; Spiegler & Guevremont, 2010).

Token economies can radically change a patient’s overall adjustment and morale. Patients are given an incentive to change, and they are held responsible for their actions. The use of tokens may seem manip- ulative, but it actually empowers patients. Many “hopelessly” intellectually disabled, mentally ill, and delinquent people have been returned to productive lives by means of token economies (Field et al., 2004).

By the time they are ready to leave, patients may be earning tokens on a weekly basis for maintaining sane, responsible, and productive behavior (Miltenberger, 2011). Typically, the most effective token economies are those that gradually switch from tokens to social rewards such as praise, recognition, and approval. Such rewards are what patients will receive when they return to family, friends, and community.

OXNARD DAY TREATMENT CENTER CREDIT INCENTIVE SYSTEM

EARN CREDITS BY SPEND CREDITS FOR MONITOR DAILY MENU PLANNING CHAIRMAN

PARTICIPATE

BUY FOOD AT STORE COOK FOR/PREPARE LUNCH WIPE OFF KITCHEN TABLE WASH DISHES DRY AND PUT AWAY DISHES MAKE COFFEE AND CLEAN URN CLEAN REFRIGERATOR ATTEND PLANNING CONFERENCE OT PREPARATION COMPLETE OT PROJECT RETURN OT PROJECT DUST AND POLISH TABLES PUT AWAY GROCERIES

CLEAN TABLE CLEAN 6 ASH TRAYS CLEAN SINK CARRY OUT CUPS & BOTTLES CLEAN CHAIRS CLEAN KITCHEN CUPBOARDS ASSIST STAFF ARRANGE MAGAZINES NEATLY BEING ON TIME

Multiple Choice Questions (Enter your answers on the enclosed answer sheet)

1. Considering the research findings described in the textbook, only one of the following is a true statement. Which one is true?

a. Repeating something over and over is usually the most effective way to learn it. b. Girls have a noticeable advantage over boys on verbal tasks. c. Students often study differently for different kinds of classroom assessments. d. For optimal performance, students should never feel the least bit anxious in the classroom.

2. Which one of the following is the best example of elaboration?

a. Logan copies a friend’s answers to last night’s homework assignment. b. Rosie repeats the spelling of each word several times the night before her spelling test. c. Melissa makes up stories to help her remember the various species she studies in biology. d. Sharon automatically knows how to study effectively for an upcoming history test.

3. Which one of the following is the best example of qualitative research?

a. comparing average achievement test scores for students at three different schools b. looking at school attendance records to identify potential school dropouts c. interviewing middle school students about cliques at their school d. finding out how long it takes 6-year-olds to assemble challenging picture puzzles

4. A study that tells us whether two variables are associated, but does not tell us if one variable causes or influences the other, is a(n):

a. experimental study with one or more control groups. b. experimental study without a control group. c. correlational study. d. descriptive study.

5. Experimental research requires which one of the following?

a. manipulating an aspect of the environment b. studying behavior in an actual classroom environment c. being able to predict two or more variables d. describing every variable in the study in considerable detail

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6. A research study finds that students who weigh more do better in school. Which one of the following is an appropriate deduction from this information?

a. On average, students who eat more do better in school. b. Parents should feed their children as much as possible. c. There is a correlation between weight and classroom performance. d. The school cafeteria should decrease the fat content of the food it serves.

7. Which one of the following conclusions can be drawn only from an experimental study?

a. Boys are more likely to show aggressive behavior than girls. b. Drugs administered during childbirth affect a child’s early development. c. Children grow taller as they get older. d. Children’s muscular coordination improves as they grow older.

8. Mr. Jacobs wants to find out whether a new program for teaching physical education promotes students’ physical development. He gives his students a number of tests before they begin the program (pretests) and the same tests again after they have been in the program for eight months (post tests). He finds that the students’ post test scores are higher than their pretest scores and so concludes that the program is effective. What is definitely wrong with Mr. Jacobs’ conclusion?

a. Tests are not a good measure of physical development. b. There are other possible explanations for his results. c. Eight months is too short a time for such a program to have a long-term effect. d. The post tests should always be different from the pretests.

9. Most developmental theorists agree that:

a. physical development occurs in a predictable sequence, but cognitive development does not. b. developmental milestones appear in a consistent sequence for most children. c. development occurs at a smooth, constant rate throughout childhood and early adolescence; it begins to slow down in the high school years. d. cognitive development occurs in a predictable sequence, but physical development does not.

10. Which one of the following statements reflects what developmentalists mean by the term maturation?

a. developmental changes that are controlled largely by heredity b. changes that reflect increasingly appropriate social behavior c. changes related specifically to children’s emotional development d. changes related specifically to children’s physical development

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11. A sensitive period in development can best be described as a(n):

a. approach to teaching or parenting that takes a child’s developmental level into account b. stage of development in which children display unpredictable (and often inappropriate) emotional responses c. period during children’s cognitive development in which they are highly distractible and are frequently off-task in the classroom d. age range during which environmental conditions are most likely to have an effect on a particular aspect of a child’s development

12. Which one of the following best describes our current knowledge about the brain and learning?

a. We know that the brain reaches adult levels of maturity at puberty, enabling young adolescents to think and learn as effectively as adults do. b. We know that “left-brained” individuals are, on average, more effective learners than “right-brained” individuals. c. We know that learning is often associated with the formation of new synapses or the strengthening of existing ones. d. We know that the cortexes of rapid learners are about 20% larger than the cortexes of slow learners.

13. As children grow older, many of their neurons begin to transmit messages more rapidly than they did in the early years of life thanks to:

a. myelination. b. increasing dominance of one brain hemisphere over the other. c. synaptogenesis. d. greater variety of neurotransmitters.

14. According to the textbook, which one of the following conclusions is most warranted from research on brain development?

a. Classroom experiences can affect students’ cognitive development throughout the elementary and secondary school years. b. It is essential that children begin studying basic mathematics and science before the age of seven. c. Children probably won’t master the skills essential to success in the adult world unless they begin developing those skills in the early elementary grades. d. The ability to think abstractly depends on the development of many synaptic connections during the first five years of life.

15. Which one of the following reflects class inclusion as Piaget described it?

a. realizing that things that are cars can also be vehicles b. identifying a shape as a square one day but as a triangle the next c. understanding that some behaviors that are perfectly acceptable at home are unacceptable at school d. getting cows and horses confused

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16. Five-year-old Becky is playing with blocks, stacking them one on top of another until her towers eventually tumble and then stacking them again. Which one of the following best reflects Piaget’s view of how Becky is probably learning in this situation?

a. She is absorbing information about how the environment behaves (e.g., “objects fall”) without consciously thinking about it. b. Because she is probably still in the sensorimotor stage, she will remember what she learns about the blocks only while the blocks are still in front of her. c. She is actively thinking about and interpreting the results of her actions. d. Because she builds one tower after another, she is obviously reinforced by watching her towers tumble down.

17. Which one of the following most accurately describes the general concept of temperament?

a. an inherited predisposition to interact with one’s environment in certain ways b. the extent to which people like or dislike themselves c. the extent to which people use or don’t use their inherited intellectual potential d. the ways that individuals have learned to react to environmental stimuli as a result of their past experiences

18. Which one of the following fifth graders most clearly shows signs of healthy attachment to one or more parents or other primary caregivers?

a. Miranda seems withdrawn and frightened much of the time. b. Jeffrey is self-confident and often likes to work independently. c. Shelly has no friends and behaves aggressively toward the other girls in her class. d. Mike seems unusually preoccupied with an attractive young actress who stars in a popular television show.

19. Other things being equal, which student is most likely to have come from a home in which his or her parents exhibit an authoritative parenting style?

a. Frank is well-behaved and self-confident. b. Margaret is impulsive and disobedient. c. Patrick is selfish and unmotivated. d. Rhoda is anxious and unhappy.

20. If we extend research findings regarding effective parenting styles to the classroom, teachers would be well advised to:

a. reward good behavior and ignore inappropriate behavior. b. establish fair rules and high expectations, and provide loving support. c. insist on strict obedience, with immediate punishment for infractions. d. allow students to make their own decisions regarding how they should and should not

Unit 1 Examination

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behave in the classroom. 21. Three of the following suggestions are apt to be helpful when teachers work with students and their parents. With the textbook’s discussion of parenting styles in mind, choose the strategy that is apt to be counterproductive.

a. Keep in mind that many parents from Asian cultures effectively combine elements of authoritative and authoritarian parenting. b. Acknowledge that authoritarian methods may be quite appropriate if families live in dangerous neighborhoods. c. Point out that parents who use authoritarian methods may be causing some of their children’s behavior problems. d. Keep in mind that many children do well in school despite less-than-optimal parenting styles at home.

22. Which one of the following should you definitely do if you suspect that one of your students is the victim of abuse or neglect at home?

a. Temporarily lower your expectations for the student’s academic performance until conditions at home seem to improve. b. Spend some one-on-one time with the student in an effort to get him or her to confide in you. c. Keep a close eye on the student over the next few weeks, looking for additional evidence that either supports or disconfirms your suspicions. d. Immediately report your suspicions to a school administrator or social services.

23. Three of the following teachers are socializing their students in the way that schools typically do. Which teacher is not socializing students in a typical fashion?

a. Ms. Allen insists that her students complete their independent seatwork before they go to recess. b. Ms. Bernetti has her students go to lunch by rows, letting the quietest rows go first. c. Ms. Dobson suggests that Sean bang his fist against the wall a few times whenever he gets frustrated. d. Ms. Castanza does not permit her students to talk back to her in a disrespectful fashion.

24. Three of the following tend to be fairly stable personality traits that children have to varying degrees. Which one would psychologists not characterize as a relatively stable personality trait?

a. how dependable children are in doing their work carefully and following through on assigned tasks b. how outgoing and friendly children are with their peers c. how quickly children solve math problems d. how often children have negative emotions such as anger or depression

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25. Given what we know about the development of sense of self, three of the following are likely scenarios. Which scenario is not likely to occur?

a. Mike vacillates between thinking of himself as being very smart and as being extremely stupid. b. Aaron thinks that kids his age don’t like him, so he spends most of his spare time with his parents. c. Daniel knows he has many friends, but he wishes he were a better student. d. Rex knows he’s good in math and science but thinks of himself as a total klutz when it comes to sports.

Unit 2 Examination

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Multiple Choice Questions (Enter your answers on the enclosed answer sheet)

1. Which one of the following is the most accurate statement about group differences among students?

a. When we have knowledge about typical group differences, we have a very good idea of how individual students are likely to perform in the classroom. b. We can make fairly accurate predictions about individual students when we know their gender, but not when we know their ethnic background. c. We can make fairly accurate predictions about individual students when we know their ethnic background, but not when we know their gender. d. The average for two groups may be different, but variability within each group keeps us from predicting individual performance.

2. Ten-year-old Svana has recently immigrated from Iceland to the United States. If we say that Svana is undergoing acculturation, we mean that she is:

a. refusing to speak any English at school. b. afraid to engage in social activities with her American peers. c. adopting some American behaviors and attitudes. d. maintaining all of the customs of her homeland.

3. Three of the following are likely to give you reasonable clues about a student’s cultural background and/or ethnic group membership. Which one is probably least dependable as an indicator of a student’s cultural background and ethnicity?

a. the color of a student’s skin b. what language is most often spoken at home c. the ethnicity of the student’s parents d. the cultural and religious activities in which a student regularly participates

4. Which one of the following is the best example of playing the dozens?

a. Jameel says to Ronald, “Your momma’s so fat her picture takes two frames.” Ronald responds, “Yeah? Well, your momma’s so fat it took three cows to make her a pair of shoes.” b. Helena tells her friend Mary that Wendy has been saying unkind things behind Mary’s back. She then goes to Wendy and tells her that Mary has been saying unkind things behind her back. c. Tariq devoutly follows Muslim practices (e.g., praying five times a day, fasting during Ramadan) on weekends and school holidays, but he tries to behave as his American classmates do on days when he attends school. d. When Alegria finishes her own classwork, she goes to the assistance of classmates who appear to be struggling with theirs.

Unit 2 Examination

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5. A student says to you, “My momma, she be singin’ all da time.” This student appears to:

a. have a speech disorder that sometimes results from environmental toxins (e.g., lead-based paint). b. have had little exposure to language during a critical period in her language development. c. be using African American English, a dialect with some grammatical constructions different from those of Standard English. d. have grown up in Northern Ireland and so is using idioms typical of that country.

6. Three of the following alternatives describe reasons why, for cultural reasons, children may be relatively quiet in class. Which alternative is false?

a. In some cultures, children rarely hear spoken language until age 3 or 4. b. Children from some cultural backgrounds may have been taught that it’s rude to initiate a conversation with an adult. c. In some cultures, attentive listening is valued more highly than speaking. d. In some cultural groups, children are accustomed to learning more from quiet observation than from asking questions.

7. Psychologists believe that intelligence is culture-specific—that “intelligent” behavior in one culture is not necessarily intelligent behavior in a different culture. Three of the following are aspects of intelligence, regardless of the culture in which it is found. Which one is probably related to intelligence in some cultures but not in others?

a. learning how to perform a new task quickly b. doing well in academic classroom activities c. adapting readily to new situations d. applying prior knowledge to new situations

8. Robert is a 15-year-old boy who has attended U.S. schools since he began kindergarten at age 5. With this fact in mind, identify the task that is most likely to require Robert’s fluid intelligence rather than his crystallized intelligence.

a. applying algebra to a mathematical word problem b. solving a new kind of puzzle c. writing a persuasive essay on a current issue in the news d. finding Egypt on a map

9. Sam is a very talented dancer; he also shows considerable creativity in art class. He finds math and science classes very difficult, but he loves to read and tell stories to his many friends. Which view of intelligence is best reflected in Sam’s abilities?

a. Piaget’s theory of cognitive development b. Gardner’s multiple intelligences c. Sternberg’s triarchic theory d. distributed intelligence

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10. Which one of the following statements best reflects Sternberg’s triarchic theory of intelligence?

a. Intelligent behavior is a function of how well people draw on their prior experiences and cognitively process information in order to adapt to their particular environmental situation. b. Intelligent behavior evolves in three stages: preoperational thought, concrete thought and abstract thought. c. To be truly intelligent, one must show competence in critical thinking and appropriate classroom behavior, as well as in traditional academic tasks. d. Intelligence is due to heredity, environment, and a complex interaction between the two; ultimately, researchers will probably never be able to separate the relative effects of heredity and environment.

11. Which one of the following statements most accurately reflects the concept of distributed intelligence?

a. How intelligent students are is, to some extent, a function of class size; students achieve at lower levels when they are in larger classes. b. Students almost invariably perform at higher levels in some academic subject areas than they do in others. c. How intelligent children become is, to some extent, a function of the number of siblings they have; children from larger families tend to have slightly lower IQ scores. d. Students can behave more intelligently when they can use outside resources as well as their minds.

12. “A child’s ability to behave intelligently may vary considerably, depending on the particular context, skills, and cognitive processes required by a given task.” This statement is consistent with three of the following conceptualizations of intelligence. With which one is it least consistent?

a. Gardner’s theory of multiple intelligences b. Sternberg’s triarchic theory c. the concept of distributed intelligence d. Cattell’s concept of fluid intelligence

13. Three of the following are examples of learned behavior. Given the textbook’s definition of learning, which behavior probably does not reflect learning?

a. After many hours of heated debate, Brian begins to modify his religious beliefs. b. Cara suddenly recognizes how the division fact “24 ÷ 4 = 6” is related to the multiplication fact “6 × 4 = 24.” c. David has been running away from German shepherds ever since he was bitten by a German shepherd two years ago. d. Abigail cries when she feels sad.

Unit 2 Examination

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14. Which one of the following statements most accurately describes behaviorists’ view of how learning can best be studied?

a. To study learning scientifically, researchers must confine their investigations to animal research in a laboratory setting. b. The study of learning will be more objective and scientific if only observable events are considered. c. Asking people to describe what they’re thinking as they study is likely to yield the most accurate results. d. Psychologists can determine how learning occurs only if they can identify its physiological basis.

15. Which one of the following statements best characterizes cognitive psychology’s approach to learning?

a. Students are most likely to learn the things they think they will be reinforced for learning. b. Students learn through a series of either-or decisions similar to how computers operate. c. Students’ learning is a function of what they do, mentally, with the information they receive. d. Students’ learning is a function of how stimuli in the environment are organized and sequenced.

16. Which one of the following researchers is drawing an inference about cognitive processes from her observations of behavior?

a. Dr. Aragon finds that students who listen to an organized lecture remember more information than students who listen to an unorganized lecture; she concludes that organized material promotes better learning. b. Dr. Cooper discovers that students remember more when new concepts are illustrated by pictures as well as being verbally described; she concludes that visual imagery helps learning and memory. c. Dr. Burger finds that students who learn information word for word don’t remember it for very long; she concludes that requiring students to learn information verbatim isn’t an effective teaching strategy. d. Dr. Delgado finds that students who listen to foreign language tapes while sleeping don’t remember what they’ve heard; she concludes that being awake is necessary for learning to occur.

17. As human beings, we encounter a great many stimuli at any one time. Which one of the following most accurately reflects cognitive psychologists’ perspective about how we respond to all these stimuli?

a. We cannot remember everything, and we have little control over the things that we do remember. b. We must select the things we think are most important to learn and remember, and ignore the rest. c. We remember virtually everything we experience, but we have difficulty retrieving most of it. d. By learning to use effective long-term memory storage processes, we can eventually begin to remember almost everything we encounter.

Unit 2 Examination

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18. When cognitive psychologists talk about the process of “putting” things in memory, they often use the term:

a. inference-drawing. b. retrieval. c. selectivity. d. storage.

19. Many cognitive psychologists believe that learning and understanding are often constructive in nature. Three of the following scenarios illustrate such construction. Which scenario does not necessarily involve construction in learning?

a. When George reads about the Vietnam War in his history book, he comes to the conclusion that the United States should never have gotten involved in Southeast Asia. b. Mr. McFarland asks his third graders to practice their multiplication tables every day. After a month of such practice, Misty can retrieve all the basic multiplication facts quickly and easily. c. Because the word photosynthesis begins with photo, Jeremy guesses that it must have something to do with taking photographs. d. Although no one has ever told her so, Peggy thinks that the night sky is a big black blanket covering the earth and that the blanket has tiny holes through which the stars shine.

20. Mr. Janus tells his class, “For tomorrow’s class, read pages 23 to 49 in your geography book.” Three of the following students are demonstrating the process of construction in their perceptions of what their teacher has said. Which student is not?

a. Christopher “hears” the teacher say “pages 33 to 39” because the student next to him is coughing loudly. b. Anthony thinks the teacher is saying “history book.” c. Bonita doesn’t hear what the teacher says because she’s thinking about something else. d. Dena understands the teacher even though the teacher speaks with a slight accent and mispronounces the word geography.

21. Michael has just written a short research paper that describes the events surrounding the first transatlantic telegraph cable. As he rereads his paper before giving it to his teacher, he doesn’t notice that he has misspelled Atlantic as “Altantic” on one occasion, even though he knows perfectly well how the word should be spelled. Michael’s proofreading error can best be explained by considering the role of __________ in the construction of meaning.

a. a script b. expectations c. assessment d. ambiguity

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22. Morris is trying to remember how to spell the word broccoli. He retrieves the first three letters (B R O) and the last three (O L I), then assumes that the “kuh” sound in the middle of the word must be a K. He writes “brokoli” on his paper. Morris’ process of remembering how to spell the word (in this case, incorrectly) illustrates which one of the following concepts?

a. verbal mediation b. a script c. construction in retrieval d. a retrieval cue

23. Which one of the following scenarios best reflects the basic idea of social constructivism?

a. Two students discuss possible interpretations of the proverb, “We only know the worth of water when the well is dry.” b. When a student borrows a classmate’s marker without asking and then forgets to put the cap back on, leaving it dried out and useless by the following morning, her teacher reminds her of one of the class rules: “Respect your classmates’ property.” c. Four students in a study group divide a reading assignment into four sections. Each student reads a section and then teaches the material to the other group members. d. A teacher assigns a laboratory activity using cumbersome equipment that students can operate successfully only by working in pairs.

24. Distributed cognition can best be described as a:

a. group of students thinking about a task or problem together. b. student trying to accomplish several different tasks simultaneously. c. group of students dividing up the various parts of a task that need to be done. d. student choosing one problem-solving strategy over other possible strategies.

25. Which one of the following examples best illustrates the concept of distributed cognition?

a. Rhonda watches her favorite situation comedy while simultaneously eating an apple and doing her homework. b. Edie, Linda, and DeWayne discuss various ways they might solve a physics problem. c. Mark, Jason, and Leanne each solve one-third of their homework problems and then share their results with the other two. d. Reginald thinks about the various plots he might use in the short story he is writing and then eventually chooses one of them.

Unit 3 Examination

132

PSY 430 Educational Psychology

Multiple Choice Questions (Enter your answers on the enclosed answer sheet)

1. Weston is working on a science project and wants to make his papier-mâché volcano “erupt.” He remembers that when his mother combined vinegar and baking soda while following a recipe, the batter foamed up as she added the vinegar. So he tries mixing vinegar and baking soda in his volcano and the mixture bubbles. Weston is showing ___________ transfer.

a. negative b. general c. specific d. intuitive

2. Mary is majoring in drama. Mary’s parents want her to study advanced mathematics as a way of strengthening her mind; with a stronger mind, they argue, she will be able to learn her lines more easily when she is rehearsing for a play. Based on their reasoning, which one of the following perspectives of transfer do Mary’s parents hold?

a. formal discipline b. specific transfer c. situated cognition d. information processing

3. Which one of the following recommendations is consistent with current beliefs about transfer?

a. “Study German so you’ll have an easier time learning Japanese next year.” b. “Studying calculus will help you think more abstractly about the various subjects you will study in college.” c. “Take computer programming to help you develop your analytical thinking skills.” d. “Use your knowledge of algebra to solve this chemistry equation.”

4. Considering the textbook’s views on general transfer, which one of the following is most likely to transfer across very different situations?

a. the ability to remember complex ideas b. the ability to take good notes on a lecture c. the ability to memorize a poem d. the ability to be creative

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5. Three of the following are accurate statements about factors that affect transfer. Which statement is inaccurate?

a. Students are more likely to transfer what they have learned when they see it as “belonging” to a particular academic subject area. b. Students are more likely to transfer what they have learned when they have studied it for a lengthy period of time. c. Students are more likely to transfer what they have learned when they have learned it in a meaningful, rather than rote, fashion. d. Students are more likely to transfer what they have learned when they have learned general principles rather than specific facts.

6. In which one of the following situations are we most likely to find transfer from one learning task to the other?

a. Brianne learns how to plant corn and then learns how to prune a hedge. b. Alice learns how to add two-digit numbers and then studies how to add three-digit numbers. c. Devlin learns how to play softball and then learns how to play a card game. d. Cathy learns early British history and then learns early Japanese history.

7. A police officer visits Ms. Duhaime’s first-grade class one morning to talk about safety precautions at home and on the street. The students listen quietly and attentively while the officer speaks. At the end of the visit, the officer and teacher agree that the students’ good behavior warrants some kind of reinforcement. Given what we know about effective reinforcers at different grade levels, their best choice would be:

a. a letter home to parents describing the children’s good behavior. b. plastic toy police “badges” awarded by the officer. c. an official-looking “good behavior” certificate given at the school’s award ceremony the following week. d. twenty minutes of free time at the end of the day.

8. If you wanted to encourage kindergartners to delay gratification, you would be most likely to:

a. occasionally remind them that they will get a bigger reward by waiting a couple of hours. b. tell them that how well they behave at the end of the day is what really counts. c. talk about how their learning efforts today will pay off in the years to come. d. ask them to focus on how good it feels to do something nice for a classmate.

9. Alex loses his best friend, Tyler, after he tattles on Tyler at recess. Alex learns that tattling on friends is not a good idea. The loss of Tyler’s friendship is an example of:

a. removal punishment. b. negative reinforcement. c. presentation punishment. d. positive reinforcement.

Unit 3 Examination

134

PSY 430 Educational Psychology

10. Linda wears bell-bottom pants to school and her classmates tease her about them. As soon as she gets home, Linda throws the pants in the trash. Linda’s being teased is an example of:

a. negative reinforcement. b. reinforcement of an incompatible behavior. c. removal punishment. d. presentation punishment.

11. Only one of the following consequences has been shown to be an effective and appropriate punishment for most students. Which one is it?

a. suspension from school b. scolding c. embarrassment in front of classmates d. extra homework

12. When Rochelle has an on-the-road lesson as part of her driver education class, she fails to stop at a school crossing zone, as is required by law. Her instructor has her drive around the block several times and stop each time at the crossing zone. He also insists that, once she has stopped, she must wait at least eight seconds before proceeding. The instructor’s strategy illustrates the use of __________ as a way of changing her behavior.

a. response cost b. a logical consequence c. intermittent reinforcement d. positive-practice overcorrection

13. Considering what we know about the kinds of models people are likely to imitate, we can guess that the girls in our classes will be least likely to imitate:

a. Brianne, head majorette in the school band. b. Anita, a skillful auto mechanic. c. Darla, a graceful dancer. d. Claudia, the most popular girl in school.

14. From the perspective of social cognitive theory, why might inner-city African American students learn more from an African American model who grew up in a ghetto than from a model of a different race or background?

a. because the students will view the African American model’s behavior as being applicable to their own situation b. because the students are more likely to realize that the African American model has prestige c. because the African American model is more likely to behave in a gender-appropriate manner d. because the students are more likely to perceive the African American model as being competent

Unit 3 Examination

135

PSY 430 Educational Psychology

15. Social cognitive theorists propose that three of the following are essential for students to learn successfully from models. Which one is not essential?

a. attention to the model b. reinforcement for good performance c. motivation to perform the behavior d. memory of the observed behavior

16. Only one of the following definitely illustrates high self-efficacy. Which one is the best example of self-efficacy?

a. Carmen enjoys being with her friends. b. Bryn swims the fastest butterfly on the swim team. c. Amy recently got a score of 120 on an intelligence test. d. Danielle knows she is a good singer.

17. In what way does self-efficacy differ from the term self-concept?

a. Self-efficacy results primarily from vicarious reinforcement and punishment. b. Self-efficacy varies depending on the specific task to be performed. c. Self-efficacy refers only to behaviors that people learn through modeling. d. Self-efficacy appears only after people begin to regulate their own behavior.

18. Jim has a high sense of self-efficacy regarding his ability to work with wood. Based on this information, we would predict three of the following from social cognitive theory. Which one of the following would we not necessarily predict?

a. Jim will be a bit careless when he works with wood, so he will often make silly little mistakes. b. Jim will frequently choose activities that involve working with wood. c. Compared to Joe, who has low self-efficacy, Jim will do a better job at woodworking tasks. d. If Jim has difficulty at a task requiring his woodworking skills, he will tend to “try, try again” until he gets it right.

19. Identify the student who appears to have a mastery goal rather than a performance goal.

a. When Abby gets a new assignment, she likes to set it aside for a day or so before she actually begins to work on it. b. When given the choice between taking an easy class or a more challenging one, Dana chooses the challenging one. c. Bonnie is a perfectionist who gets upset when her test performance is anything but A+. d. Cora is easily distracted by the many stimuli competing for her attention in the classroom.

Unit 3 Examination

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PSY 430 Educational Psychology

20. Which one of the following students clearly has a mastery goal rather than a performance goal?

a. Alice stays away from science courses because she’s never done very well in science. b. Dinah doesn’t worry about making mistakes as long as she knows she’s making progress. c. Boris wants the recognition that being a star football player will bring him. d. Cal is relieved to learn he passed his English composition course.

21. Three of the following strategies should promote productive achievement goals. Which strategy is not recommended?

a. Encourage students to focus on long-term rather than short-term goals. b. Commend students for truly understanding material rather than just memorizing it. c. Encourage students to rely on one another for occasional academic assistance and support. d. Show students how the things they learn in class are relevant to their present and future needs.

22. Which one of the following students most clearly has a work-avoidance goal?

a. Loni is so active in student government that she often doesn’t have time to get her homework done. b. Chris asks for his teacher’s help on something he is perfectly capable of doing on his own. c. Frederick stayed up so late last night watching television that he can hardly stay awake in class. d. Nancy wonders why she has to work harder than her friends to get the same grades they do.

23. Three of the following statements accurately describe the diversity we are likely to see in students’ career goals. Which statement is not accurate?

a. Students’ career choices are to some extent dependent on the values they assign to various professions. b. Many young children reach relatively stable decisions about which career they want to pursue; adolescents change their minds fairly frequently. c. Despite more open-mindedness about career options in recent years, many students continue to aspire to careers that are stereotypically “for” their own gender. d. Many children and adolescents from low-income neighborhoods express interest in becoming well-educated professionals (e.g., doctors, lawyers, teachers).

Unit 3 Examination

137

PSY 430 Educational Psychology

24. Which one of the following is the best example of a student attributing success to internal factors?

a. Sue Ellen has just gotten a good grade on her geography test. She is proud that she did so well and glad that she studied hard. b. Polly’s teacher has just told her that she will be the group leader for her reading group next quarter. Polly is glad her teacher is in a good mood today. c. Renata has just gotten a good grade on her math test and she is glad that her mother got her a math tutor. d. Nita has just gotten an A on her final exam in world history and is feeling very grateful to the teacher for her good grade.

25. Which one of the following students is attributing success or failure on a geology test to an internal source and thinks the cause is unstable and controllable?

a. Duncan said he did well on the test because he studied hard. b. Joe said he studied hard, but he failed because he is just not good in geology. c. Jane said she failed the test because it was too difficult. d. Emily said she did well on her test because she is smart in science.

Unit 4 Examination

180

PSY 430 Educational Psychology

Multiple Choice Questions (Enter your answers on the enclosed answer sheet)

1. Mr. Phillips wants his students to develop the ability to separate and control variables in scientific experimentation. Which one of the following instructional methods is most likely to help his students achieve this goal?

a. individualized assignments using computer spreadsheets b. unstructured discovery-learning activities c. small-group reciprocal-teaching activities d. scaffolded inquiry-learning activities

2. Which one of the following conditions is recommended for effective learning in a discovery- learning activity?

a. having a lesson that has been broken down into small, discrete pieces b. having freedom to explore one’s environment without any structure or restraint c. having some prior knowledge about the material being explored d. having an advance organizer for the lesson

3. Which one of the following is the best example of an authentic in-class activity?

a. discussing reasons why World War I occurred b. putting definitions of new terms in your own words c. listing four different kinds of sedimentary rocks d. designing a bridge using principles of physics

4. Which one of the following uses of a computer in instruction is most similar to an authentic activity?

a. a computer-based instructional program that teaches the various parts of the human digestive system b. a computer-based instructional program that teaches the basics of first aid c. a computer simulation that allows students to conduct an experiment d. a computer game that promotes automaticity for basic math facts

5. The four teachers below are assigning homework to their students. Which teacher is giving an assignment that’s inconsistent with general recommendations regarding the appropriate use of homework?

a. Mr. Needham asks his first graders to bring something from home that begins with the letter B. b. Ms. Wong asks her sixth graders to make up sentences using each of their new spelling words. c. Ms. Powell asks her high school algebra students to read the next two chapters in their textbook and then do the problems at the end of each chapter. d. Mr. Rhodes asks his eighth graders to write the answers to a series of questions based on material they’ve been studying over the past week.

Unit 4 Examination

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PSY 430 Educational Psychology

6. Three of the following are purposes that asking questions in class can serve. Which one is not a typical use of asking questions?

a. to decrease the extent to which students need to cognitively process classroom material b. to encourage students to elaborate on classroom material c. to help students monitor their own comprehension of classroom material d. to determine whether students understand classroom material

7. Ms. Girardi, a sixth-grade teacher, is explaining an assignment. She notices two students passing notes to one another. While continuing to discuss the assignment, she moves toward the students and confiscates the written notes. Then she walks back to the front of the class, still continuing her explanation, and asks Mark, who is daydreaming, to answer a question. This scenario best illustrates which one of the following classroom management skills?

a. planning for transitions b. withitness c. negative reinforcement d. scaffolding

8. Many students in Ms. Janklow’s class seem to have little intrinsic motivation for learning math, science or social studies. Their minds are more apt to be on peer relationships (who the “popular kids” are, who bullies whom on the playground, etc.) than on their studies. Without knowing anything else about Ms. Janklow’s students, your best guess would be that they are:

a. kindergartners. b. seventh graders. c. fourth graders. d. second graders.

9. From the textbook’s perspective, which one of the following classroom management strategies is probably most important for students from diverse ethnic backgrounds?

a. setting limits b. planning effectively for transitions c. creating a supportive climate d. demonstrating withitness

10. Three of the following describe recommendations that the textbook offers for helping students with special needs. Which statement is inconsistent with the textbook’s recommendations?

a. Give students with physical disabilities any additional time they may need to complete assigned tasks. b. When students have significant general delays in cognitive development, give them explicit feedback about their behavior. c. When students have specific cognitive or academic difficulties, teach them strategies for organizing their time more effectively. d. When students have social or behavioral problems, vary the classroom routine considerably from one day to the next.

Unit 4 Examination

182

PSY 430 Educational Psychology

11. Which one of the following best illustrates collective self-efficacy of teachers?

a. A third-grade teacher and a fourth-grade teacher at North Elementary School have combined their two classes into a single, larger class. Sometimes they team-teach the entire group. At other times they divide the class into two smaller groups, one of which is ready for more advanced work than the other. b. The teachers at South Elementary School have coordinated what they do at each grade level so that at any particular grade, students master the knowledge and skills they will need in the following grade. c. The English teachers at East High School have agreed on how they will teach the required freshman English class. That way, students will have a similar classroom experience no matter which teacher they have for the course. d. The teachers at West Middle School confer weekly about students who they believe are at risk for academic failure, and they are confident that by working together, they can help these students be successful at school.

12. Three of the following strategies are recommended for conducting effective parent-teacher conferences. Which strategy is not necessarily recommended?

a. Minimize your use of educational jargon. b. Prepare ahead of time by reviewing what you know about the student. c. Emphasize that the student’s education is ultimately your responsibility rather than that of parents. d. Encourage parents to share their perspectives and ideas.

13. Which one of the following is a drawback of using essay questions on a paper-pencil assessment?

a. Lengthy essay questions can limit sampling of the content domain being assessed. b. Guessing is likely to inflate students’ scores considerably. c. Reliability tends to be lower than that for recognition tasks. d. The administration of essay questions is difficult to standardize.

14. From the textbook’s perspective, which one of the following is the primary advantage of allowing students to use reference materials during a paper-pencil assessment?

a. Students are more likely to learn material meaningfully if they know they are going to have an open-book test rather than a closed-book test. b. Such a procedure is less likely to lead to test anxiety than would otherwise be true. c. Students don’t have to study the material ahead of time; they can simply learn it during the assessment session. d. Such a procedure better assesses students’ ability to apply material that they don’t necessarily need to commit to memory.

Unit 4 Examination

183

PSY 430 Educational Psychology

15. When we give high school students instructions about a summative classroom assessment, we should:

a. assume that they have had experience with such standard item types as true-false and multiple-choice. b. always deduct points for any grammatical or spelling errors. c. give them considerable freedom about how to respond. d. communicate clear guidelines about how they should respond.

16. Three of the following are accurate statements about cheating in the classroom. Which one is not necessarily accurate?

a. Students are more likely to cheat if they think their teacher is a “softie” who grades leniently. b. Students are more likely to cheat if they have performance goals rather than mastery goals. c. Students are more likely to cheat if they think their teacher’s expectations for them are unreasonably high. d. Students are more likely to cheat if they think an assessment instrument doesn’t reflect classroom objectives.

17. Which one of the following illustrates the use of a rubric in a classroom assessment?

a. In a swimming test, students are asked to swim one lap each of the breaststroke, backstroke and crawl. b. A math assignment presents a complex problem with several parts and asks students to break it down into at least five simpler problems. c. Responses to a 10-point essay in a history class are given 5 points for describing historical events accurately, 4 points for explaining how the events are interrelated, and 1 point for using complete sentences throughout the essay. d. A science test has 30 multiple-choice questions, 10 alternative-response questions, 3 short-answer questions and one essay.

18. The four students below have just received feedback about their test performance. With the textbook’s discussion of assessment and feedback in mind, choose the student who is most likely to benefit from the feedback he or she has received.

a. Garry got his multiple-choice science test back with the errors circled in red and the comment, “You need to study harder for the next test” written at the top of the page. b. Kerrie received her math test with any incorrect answers corrected in red and with the comment, “You have learned how to ‘carry’ in addition but are having trouble with ‘borrowing’ in subtraction.” c. Jerry could not see his geography test after it was scored as his teacher plans to use the test again with next year’s class. However, he’s gotten the feedback, “You need to work more on the characteristics of the countries we’re studying.” d. Harry received his history essay test with the comment, “You have a thorough knowledge of history, but your discussion is vague and disorganized.”

Unit 4 Examination

184

PSY 430 Educational Psychology

19. The textbook author suggests that it is not a good idea to incorporate more than a few extra- credit points into students’ grades. Why?

a. Incorporating extra-credit work into classroom grades typically affects only the grades of high-achieving students, so it is not worth the time and trouble. b. The time spent on extra-credit assignments is better spent planning classroom activities. c. Scores on extra-credit projects frequently suffer from low reliability. d. Too many opportunities for extra-credit points allow students who have not met instructional objectives to get good grades.

20. Which one of the following statements best reflects the textbook’s recommendation with regard to assigning criterion-referenced or norm-referenced grades?

a. Assign criterion-referenced grades in the lower elementary grades and in all low-ability classes; assign norm-referenced grades in high-ability classes in the middle school and high school grades. b. Assign norm-referenced grades at all grade levels to the extent that such is possible. c. Assign criterion-referenced grades at all grade levels to the extent that such is possible. d. Assign criterion-referenced grades at the elementary level, but assign norm-referenced grades at the high school level.

21. Three of the following statements are accurate with regard to the advantages of portfolios. Which statement is false?

a. Portfolios are useful for fostering students’ self-evaluation skills. b. Portfolios provide a means through which instruction and assessment can be easily interrelated. c. As a means of summarizing students’ achievement, portfolios have greater practicality than final grades. d. Portfolios can reflect the complex nature of students’ achievement.

22. For which one of the following classes would it be most helpful to create an electronic portfolio rather than a paper portfolio?

a. a high school creative writing class b. a high school debating class c. a middle school geography class d. a middle school math class

Unit 4 Examination

185

PSY 430 Educational Psychology

23. Three of the teachers below are using strategies consistent with the textbook’s recommendations regarding the use of portfolios. Which one is not consistent?

a. Ms. Gaudet lists the criteria that she will use to evaluate students’ portfolios. b. Ms. James tells each of her students which specific artifacts they should include in their class portfolios. c. Ms. Salih asks students to include at least four writing samples written at various times during the school year in order to show how they have improved over time. d. Ms. Shaklee asks her students to include a brief statement about each of the entries they include in their portfolios.

24. How can teachers most accurately assess the content validity of a standardized achievement test?

a. Calculate the correlation between the scores of the norm group and the scores of the students in the classroom. b. Consult the test manual regarding content validity data for the norm group. c. Compare the school curriculum to a table of specifications for the test. d. Calculate the correlation between the students’ scores on the test and their scores on a similar achievement test.

25. Which one of the following questions is more likely to be found on a scholastic aptitude test than on an achievement test?

a. Of what two elements does water consist? b. What’s missing in this picture of a chair? c. How is the circumference of a circle calculated? d. What significant historical event happened at Waterloo, Belgium, in 1815?