Therapeutic Approaches
This domain tests the main psychotherapy schools, the techniques each uses, and the ethics of helping. Expect questions that describe a client's problem and ask which approach fits.
Psychodynamic therapy
Freud's method seeks insight into unconscious conflict. Techniques are free association, dream analysis, and interpretation of resistance and transference. It is long-term and assumes symptoms have unconscious roots.
Behaviour therapy
Maladaptive behaviour is learned, so it can be unlearned through conditioning.
- Systematic desensitisation (Wolpe): build an anxiety hierarchy, train relaxation, then pair each step of gradual imaginal or real exposure with relaxation - counter-conditioning.
- Aversive conditioning: pair an unwanted behaviour with an unpleasant stimulus.
- Token economy: reinforce desired behaviour with tokens exchangeable for rewards.
- Modelling and biofeedback also belong here.
Cognitive and cognitive-behavioural
Ellis's rational emotive therapy targets irrational beliefs through the ABC sequence - activating event, belief, consequence. Beck's cognitive therapy restructures negative automatic thoughts in depression. CBT combines cognitive restructuring with behavioural tasks and is the most researched approach.
Humanistic, biomedical and alternative
Rogers's client-centred therapy offers unconditional positive regard, empathy and genuineness so the client can move towards a congruent self. Biomedical treatment uses drugs (antipsychotics, antidepressants, lithium, anxiolytics), electroconvulsive therapy for severe depression and, rarely, psychosurgery. Yoga and meditation serve as complementary approaches.
Ethics
Informed consent, confidentiality, therapist competence, and avoiding harm or exploitation.
Worked example
A student panics at the thought of speaking in class. Reasoning: the fear is learned and maintained by avoidance, so a behaviour therapist builds a hierarchy (watching a video → speaking to two friends → speaking to the class) and pairs each step with relaxation. The mechanism is counter-conditioning, not insight.
Traps
Systematic desensitisation is not mere extinction. RET changes beliefs, not just behaviour. ECT is not a first-line treatment for ordinary anxiety.