Therapeutic Approaches
Therapeutic Approaches
This domain tests the major models of psychological treatment, their techniques and their assumptions. Expect matching of approach to method, the therapeutic relationship, and ethical limits of intervention.
Core rules
- Psychodynamic therapy explores unconscious conflict through free association, dream analysis, transference and resistance.
- Behaviour therapy applies learning principles: systematic desensitisation, aversive conditioning, token economy, modelling and exposure.
- Cognitive therapy targets distorted beliefs; CBT combines cognitive restructuring with behavioural tasks; Ellis's REBT challenges irrational beliefs.
- Humanistic-existential therapy emphasises growth, self-acceptance and authentic choice; Rogers's client-centred therapy uses unconditional positive regard, empathy and congruence.
- Biomedical therapy uses drugs (antipsychotics, antidepressants, mood stabilisers, anxiolytics), ECT in selected cases, and rarely psychosurgery.
- All approaches require consent, confidentiality within limits, competence and attention to cultural context.
Worked example
A client has a disabling lift phobia. Systematic desensitisation begins with relaxation training, then a graded hierarchy from imagining entering a lobby to riding one floor, with exposure only at tolerable steps. Reasoning: relaxation competes with anxiety (reciprocal inhibition), and gradual success reduces avoidance. Flooding would start with intense exposure and is not the same procedure. If the client also believes 'I will certainly die in a lift,' cognitive restructuring would target that prediction alongside exposure.
Traps that cost marks
- Treating CBT as only behavioural or only cognitive.
- Confusing client-centred therapy with giving advice.
- Claiming drugs cure disorders rather than relieve symptoms.
- Ignoring confidentiality exceptions such as risk of harm.