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|Chapter||5. Therapeutic Approaches And Counselling|
|Category||NCERT Solutions for Class 12|
Class 12 Psychology Chapter 5 Solutions covers the question and answer of the whole chapter. These solutions will help you to understand the concept of Therapeutic Approaches And Counselling chapter. If you are preparing for your exams then you should not miss this guide. These solutions are based on the curriculum of CBSE and will help you to ace your exams with excellent grades.
NCERT Solutions for Class 12 Psychology Chapter 5
Therapeutic Approaches And Counselling Solutions
Questions & Answers
Q1) Describe the nature and scope of psychotherapy. Highlight the importance of therapeutic relationship in psychotherapy.
Answer) Psychotherapy is a voluntary relationship between the one seeking treatment or the client and the one who treats or the therapist.
The purpose of the relationship is to help the client to solve the psychological problems being faced by her or him. The relationship is conducive for building the trust of the client so that problems may be freely discussed. Psychotherapies aim at changing the maladaptive behaviours, decreasing the sense of personal distress, and helping the client to adapt better to her/his environment. Inadequate marital, occupational and social adjustment also requires that major changes be made in an individual’s personal environment.
All psychotherapies aim at a few or all of the following goals :
- Reinforcing client’s resolve for betterment.
- Lessening emotional pressure.
- Unfolding the potential for positive growth.
- Modifying habits.
- Changing thinking patterns.
- Increasing self-awareness.
- Improving interpersonal relations and communication.
- Facilitating decision-making.
- Becoming aware of one’s choices in life.
- Relating to one’s social environment in a more creative and self-aware manner.
Therapeutic Relationship: The special professional relationship between the client and the therapist is known as therapeutic relationship or alliance. There are two major components of this relationship:
- The Contractual Nature of the Relationship in which two willing individuals, the client and the therapist, enter into a partnership which aims at helping the client overcome his problems.
- Limited Duration of the Therapy: This alliance lasts until the client becomes able to deal with his problems and take control of his life.
Through therapeutic relationship the therapist wins the trust of the client. The quality of this relationship/alliance determines early healing in psychotherapy.
Q2) What are the different types of psychotherapy? On what basis are they classified?
Answer) Different types of psychotherapy are:
- Psychodynamic therapy
- Behaviour therapy
- Humanistic-existential therapy
- Biomedical therapy
Also, there are are many alternative therapies such as yoga, meditation, acupuncture, herbal remedies etc.
Basis of classification of psychotherapy:
- On the cause which has led to the problem: Psychodynamic therapy is of the view that intrapsychic conflicts, i.e. the conflicts that are present within the psyche of the person, are the source of psychological problems.
- On how did the cause come into existence: The psychodynamic therapy, unfulfilled desires of childhood and unresolved childhood fears lead to intrapsychic conflicts.
- What is the chief method of treatment?: Psychodynamic therapy uses the methods of free association and reporting of dreams to elicit the thoughts and feelings of the client.
- What is the nature of the therapeutic relationship between the client and the therapist?: Psychodynamic therapy assumes that the therapist understands the client’s intrapsychic conflicts better than the client and hence it is the therapist who interprets the thoughts and feelings of the client to her/him so that s/he gains an understanding of the same.
- What is the chief benefit to the client?: Psychodynamic therapy values emotional insight as the important benefit that the client derives from the treatment. Emotional insight is present when the client understands her/his conflicts intellectually; is able to accept the same emotionally; and is able to change her/his emotions towards the conflicts.
- On the duration of treatment: The duration of classical psycho- analysis may continue for several years. However, several recent versions of psychodynamic therapies are completed in 10–15 sessions.
Q3) A therapist asks the client to reveal all her/his thoughts including early childhood experiences. Describe the technique and type of therapy being used.
Answer) In this case psychodynamic therapy is used in the treatment of the client. Since the psychoanalytic approach views intrapsychic conflicts to be the cause of psychological disorder. The first step in the treatment is to elicit this intrapsychic conflict.
Psychoanalysis has invented free association and dream interpretation as two important methods for eliciting the intrapsychic conflicts. The free association method is the main method for understanding the client’s problems. Once a therapeutic relationship is established, and the client feels comfortable, the therapist makes her/him lie down on the couch, close her/his eyes and asks her/him to speak whatever comes to mind without censoring it in anyway. The client is encouraged to freely associate one thought with another, and this method is called the method of free association. The censoring superego and the watchful ego are kept in abeyance as the client speaks whatever comes to mind in an atmosphere that is relaxed and trusting.
As the therapist does not interrupt, the free flow of ideas, desires and conflicts of the unconscious, which had been suppressed by the ego, emerge into the conscious mind. This free uncensored verbal narrative of the client is a window into the client’s unconscious to which the therapist gains access. Along with this technique, the client is asked to write down her/his dreams upon waking up. Psychoanalysts look upon dreams as symbols of the unfulfilled desires present in the unconscious. The images of the dreams are symbols which signify intrapsychic forces. Dreams use symbols because they are indirect expressions and hence would not alert the ego. If the unfulfilled desires are expressed directly, the ever-vigilant ego would suppress them and that would lead to anxiety. These symbols are interpreted according to an accepted convention of translation as the indicators of unfulfilled desires and conflicts.
Q4) Discuss the various techniques used in behaviour therapy.
Answer) The techniques used in behaviour therapy are not based on any unified theory. These are developed on the basis of various principles particularly on classical conditioning, operant conditioning and modelling. The main objective of the techniques are to modify maladaptive behaviour. Negative reinforcement and aversive conditioning are the two major techniques of behaviour modification.
1. Reinforcement Techniques:
- (а) Negative Reinforcement: It refers to following an undesired response with an outcome that is painful or not liked. For example, a mother may cover her son’s thumb with a bitter NEEM paste so that he should not develop habit of thumb sucking. Due to the bitterness, the child tries to avoid or withdraw the bitterness of thumb and will leave the habit of thumb-sucking.
- It is establishing relationship between undesirable behaviour and aversive consequences.
- Aversive therapy is a therapeutic technique which uses an unpleasant stimulus to change a deviant behaviour.
- It works by pairing together the stimulus that normally invites the deviant behaviour (such as an alcoholic drink or sexual image) with an unpleasant (aversive) stimulus such as an electric shock or a nausea-inducing drug, with repeated presentations.
- The two stimuli become associated and the person develops an aversion toward the stimulus that formerly gave rise to the deviant behaviour.
- (b) Positive Reinforcement: If an adaptive behaviour occurs, positive reinforcement may be used by the therapist. For example, the child’s mother may prepare child’s favourite dish on the day when most of the time child was being observed not keeping his thumb in the mouth.
- A package or deal is being established between the therapist and the client.
- Persons with behavioural problems can be given a token as a reward every time a wanted behaviour occurs.
- The tokens are collected and exchanged with for a predetermined reward such as outing for the patient or a treat for the child.
- The technique is widely used in hospitals, schools and reformatory.
- (c) Differential Reinforcement: In differential reinforcement, both positive and negative reinforcements are used together. By using this method, unwanted behaviour can be reduced and wanted behaviour can be increased simultaneously.
- (d) Method of ignoring Unwanted Behaviour: In this method, the therapist positively reinforces the wanted behaviour and ignores the unwanted behaviour. For example, the parents are instructed to praise the child or give chocolate to him or to take him to cinema if the child does not suck the thumb, : but ignore the unwanted behaviour that is sucking the thumb. This method is less painful and equally effective for modifying the unwanted behaviour.
2. Systematic Desensitisation:
It is a technique introduced by Wolpe, for treating phobias or irrational fears. This technique is based on the principle of reciprocal inhibition. This principle states that the presence of two mutually opposing forces forces at the same time, inhibits the weaker force, e.g., distress, at the same time, relaxation, can not occur. The technique follows four steps:
- Initial interview.
- Training in relaxation exercises.
- Preparation of hierarchy of anxiety-provoking situation. This is a subjective process and changes from problem to problem.
- Desensitization: When the client becomes relaxed, he/she is exposed to least anxiety-provoking situation. Over sessions, the client is able to unique more severe fear-provoking situations while maintaining with relaxation. The client gets systematically desensitized to the fear.
3.Modelling: It is the procedure wherein the client learns to behave in a certain way by observing the behaviour of a role model or the therapist.
- It is role playing.
- Vicarious learning (learning by observing others) is used and through a process of rewarding small changes in the behaviour, the client gradually learns to acquire the behaviour of the model.
Q5) Explain with the help of an example how cognitive distortions take place.
Answer) Aaron Beck devised cognitive therapy. It is also known as cognitive restructuring therapy.
Basic Assumption: Negative thinking, irrational beliefs and faulty generalization caused disorder. This therapy believes that repeated cognitive distortions play significant role in causing disorder. Cognitive distortion means way of thinking which are general in nature but which distorts the reality in a negative manner, e.g., persistent negative and irrational thoughts such as: “Nobody loves me”, “I am ugly”, “ I am stupid” etc.
Step I – Analysis of Core Schemata: Childhood experiences provided by the family and society develop core schemata or systems, which include beliefs and action patterns of the individual.
- A client, who was neglected by the parents as a child, develops the core schema of “I am not wanted.” This may be validated by the teachers in the school.
- Such negative automatic thoughts cause cognitive distortions.
- Cognitive distortions are ways of thinking which are general in nature but which distort the reality in a negative manner. Their patterns are called Dysfunctional cognitive structure.
- Repeated occurrence of these distorted thoughts leads to the development of feelings of anxiety and depression.
- The therapist uses questioning, which is gentle, non-threatening and non- judgmental, non probing but thought proviking questions.
- The questions make the client to think deeper into her/his assumptions about his life and problems.
- These questions make the client to think in a direction opposite to his negative thoughts and gains insight of his dysfunctional schemas and able to restructure his thoughts in positive direction.
- Beck’s cognitive approach does not attempt to disprove the ideas held by depressed persons, rather the therapist and client work together to identify the individual’s assumptions, beliefs and expectations and to formulate ways of testing them.
Aim of the Therapy:
- Cognitive restructuring by helping people to recognize and reject the false assumptions that are central to their difficulties.
Q6) Which therapy encourages the client to seek personal growth and actualise their potential? Write about the therapies which are based on this principle.
Answer) Humanistic-existential therapy encourages the client to seek personal growth and actualise their potential. It states that psychological distress arises from feelings of loneliness, alienation, and an inability to find meaning and genuine fulfilment in life.
The therapies which are based on this principle are:
- Existential therapy: There is a spiritual unconscious, which is the storehouse of love, aesthetic awareness, and values of life. Neurotic anxieties arise when the problems of life are attached to the physical, psychological or spiritual aspects of one’s existence. Frankl emphasised the role of spiritual anxieties in leading to meaninglessness and hence it may be called an existential anxiety, i.e. neurotic anxiety of spiritual origin.
- Client-centred therapy: Client-centred therapy was given by Carl Rogers. He combined scientific rigour with the individualised practice of client-centred psychotherapy. Rogers brought into psychotherapy the concept of self, with freedom and choice as the core of one’s being. The therapy provides a warm relationship in which the client can reconnect with her/his disintegrated feelings. The therapist shows empathy, i.e. understanding the client’s experience as if it were her/his own, is warm and has unconditional positive regard, i.e. total acceptance of the client as s/he is. Empathy sets up an emotional resonance between the therapist and the client.
- Gestalt therapy: The German word gestalt means ‘whole’. This therapy was given by Freiderick (Fritz) Perls together with his wife Laura Perls. The goal of gestalt therapy is to increase an individual’s self-awareness and self- acceptance. The client is taught to recognise the bodily processes and the emotions that are being blocked out from awareness. The therapist does this by encouraging the client to act out fantasies about feelings and conflicts. This therapy can also be used in group settings.
Q7) What are the factors that contribute to healing in psychotherapy? Enumerate some of the alternative therapies.
Answer) There are several factors which contribute to the healing process. Some of these factors are as follows:
- The techniques adopted by the therapist and the implementation of the same with the client.
- The quality of therapeutic alliance—the regular availability of the therapist, and the warmth and empathy provided by the therapist has its importance.
- The quality of emotional unburdening (catharsis) has significant impact on healing.
- Non-specific factors dre associated with psychotherapy. These are patient variable and therapist variable.
- Patient variable refers to attributed to the client, e.g., clients motivation for change and expectation of improvement due to the treatment etc. Therapist variable refers to his/her good mental health, absence of his/her unresolved emotional conflicts and expertise.
Alternative therapies are so called, because they are alternative treatment possibilities to the conventional drug treatment or psychotherapy. There are many alternative therapies such as yoga, meditation, herbal remedies and so on.
- Yoga is an ancient Indian technique detailed in the Ashtanga Yoga of Patanjali’s Yoga Sutra. Yoga, as it is commonly called today either refers to only the asanas or body positive component or to breathing practices or pranayama or to a combination of the two.
- Meditation refers to the practice of focusing attention on breath or an object or thought or a mantra.
- Vipasana Meditation, also known as mindfulness-based meditation, has ,no fixed object or thought to hold the attention. The person possibly observes the various bodily sensation and thoughts that are passing through his awareness.
- The rapid breathing techniques to induce hyperventilation as in Sudarshana Kriya Yoga (SKY) is found to be a beneficial, low-risk, low-cost, adjunct to the treatment of stress, anxiety, post-traumatic stress disorder (PTSD) depression, stress-related medical illness, substance abuse, and rehabilitations of criminal offenders.
- Kundalini Yoga taught in USA has found to be effective in treating mental disorders, obsessive-compulsive disorder. It combines pranayama or breathing with chanting of mantras.
Q8) What are the techniques used in the rehabilitation of the mentally ill?
Answer) Rehabilitation of the mentally ill is necessary to improve their quality of life once their active symptoms are reduced. In the case of milder disorders, such as generalized anxiety disorder, reduction of symptoms improves their quality of life and such patients need not to help rehabilitation.
However in severe mental disorders, such as schizophrenic disorders, reduction of symptoms does not mean that patient is cured. Such patients develop negative symptoms like apathy or lack of motivation and their cognitive social and occupational skills get impaired. So they need rehabilitation. Rehabilitation provides:
- Social Skill Training: It helps the patients to develop interpersonal skills through role play, imitation and instruction.
- Cognitive Retraining: It helps the patients to improve the basic cognitive functions of attention, memory and executive functions.
- Occupational Therapy: The patients are taught skills such as candle-making, paper bag making and weaving to develop work discipline.
- Vocational Training: When the patient becomes self-sufficient, vocational training is given wherein the patient is helped to gain skills necessary to undertake productive employment.
Q9) How would a social learning theorist account for a phobic fear of lizards/cockroaches? How would a psychoanalyst account for the same phobia?
Answer) Social learning theories work on the principle that our experience—be it positive or negative—such as phobia of lizards/cockroaches are the result of learning process which start early in life. Small children can play with snakes, they sire not aware of the danger involved. For them it is just another play object, as they grow up the fear of these things are instilled by their parents and society which is reinforced and accounts for reactions like phobia.
A psychoanalytical account for the same could involve attribution to some unconscious or/and repressed experiences. For example, suppose in your childhood you watched a group of rowdy boys brutally torturing a cockroach/snake, which eventually died, although you going about the incidence after some days, but it might remain in back of your mind forever, which might explain your phobia to cockroaches which might remind you of the incidence and disturbs you emotionally.
Q10) Should Electro-convulsive Therapy (ECT) be used in the treatment of mental disorders?
Answer) Yes, Electro-convulsive Therapy (ECT) can be used in the treatment of mental disorders.
Electro-convulsive Therapy (ECT) is another form of biomedical therapy. Mild electric shock is given via electrodes to the brain of the patient to induce convulsions. The shock is given by the psychiatrist only when it is necessary for the improvement of the patient. ECT is not a routine treatment and is given only when drugs are not effective in controlling the symptoms of the patient.
Q11) What kind of problems is cognitive behaviour therapy best suited for?
Answer) CBT is a short and effective treatment for a wide range of psychological disorders such as anxiety, depression, panic attacks and borderline personality, etc.
- It combines cognitive therapy and behavioural technique.
- According to CBT, the cause of client’s distress is biological, psychological and social relations in combination.
- CBT focuses on the biological aspects through relaxation procedures and the psychological ones through behaviour therapy. Social aspects are dealt with environmental manipulations.
- This multi-axial approach makes CBT a comprehensive technique, which is easy to use, applicable to a variety of disorders and has full potential to deal effectively with psychological disorders.
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