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Therapeutic Approaches

NCERT Class 12 · Psychology Based on NCERT Class 12 Psychology textbook · Free CBSE study kit

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Chapter Notes

Overview
This chapter introduces the nature, process, and types of psychotherapy used to treat psychological disorders. It explains that psychotherapy is a voluntary, confidential relationship between a trained therapist and a client aimed at reducing distress and fostering adaptive behaviour. The chapter covers major therapeutic systems—psychodynamic, behaviour, cognitive, humanistic-existential—along with alternative therapies like yoga and meditation, and the rehabilitation of the mentally ill. The one big idea is that all psychotherapies share a healing therapeutic relationship, but differ in their view of the cause of distress, methods of treatment, and the role of the therapist.
Key Concepts (24)
Psychotherapy
A voluntary relationship between a client and a trained therapist aimed at helping the client solve psychological problems, change maladaptive behaviours, decrease personal distress, and adapt better to the environment.
e.g. A student feeling anxious before exams visits a school counsellor weekly to talk about fears and learn relaxation techniques.
Therapeutic relationship/alliance
The special, confidential, interpersonal, and dynamic relationship between the therapist and client that is central to psychological therapy and the vehicle for change.
e.g. A client trusts the therapist enough to share deeply personal experiences because the therapist is accepting, empathic, genuine, and warm.
Unconditional positive regard
The therapist's non-judgmental, accepting attitude towards the client, showing the same positive feelings even if the client is rude or confides 'wrong' things.
e.g. A therapist does not scold a client who admits to cheating on a test; instead, the therapist continues to show warmth and acceptance.
Empathy
Understanding things from the other person's perspective, i.e., putting oneself in the other person's shoes; feeling like the other person, unlike sympathy or intellectual understanding.
e.g. When a friend fails an exam, instead of saying 'I feel sorry for you' (sympathy), you imagine how disappointed and stressed they must feel.
Psychodynamic therapy
A therapy that views intrapsychic conflicts (unfulfilled childhood desires and unresolved fears) as the source of psychological problems, using free association and dream interpretation to gain emotional insight.
e.g. A client who fears authority figures is helped to see that this stems from unresolved childhood conflicts with a strict father.
Behaviour therapy
A therapy that locates the cause of psychological distress in faulty learning, conditioning, and thought patterns, and uses techniques like systematic desensitisation, token economy, and aversive conditioning to change behaviour.
e.g. A person with a phobia of dogs is gradually exposed to pictures of dogs while in a relaxed state (systematic desensitisation).
Cognitive therapy
A therapy that locates the cause of psychological distress in irrational thoughts and beliefs, using techniques like ABC analysis and cognitive restructuring to change faulty thinking.
e.g. A student who thinks 'I must get 100% or I am a failure' is helped to see this irrational belief and replace it with 'I will do my best.'
Humanistic-existential therapy
A therapy that views psychological distress as arising from feelings of loneliness, alienation, and inability to find meaning; it provides a warm, accepting, non-judgmental environment to facilitate personal growth and self-actualisation.
e.g. A client feeling 'empty' and 'lost' is given a safe space to explore their feelings and discover their own values and purpose.
Self-actualisation
An innate or inborn force that moves a person to become more complex, balanced, and integrated; achieving wholeness without being fragmented.
e.g. A person who pursues a career in art despite family pressure to become a doctor is following their innate drive for self-fulfilment.
Systematic desensitisation
A behaviour therapy technique introduced by Wolpe for treating phobias, where the client is gradually exposed to anxiety-provoking stimuli while maintaining relaxation, based on the principle of reciprocal inhibition.
e.g. For a fear of heights, the client first imagines standing on a low stool while relaxed, then a ladder, then a tall building, step by step.
Reciprocal inhibition
The principle that the presence of two mutually opposing forces at the same time inhibits the weaker force; used in systematic desensitisation where relaxation overcomes anxiety.
e.g. You cannot feel relaxed and terrified at the same moment; relaxation 'wins' over mild anxiety.
Token economy
A behaviour modification technique where tokens are given as rewards for wanted behaviours, which can later be exchanged for a reward such as an outing or a treat.
e.g. In a classroom, a student earns a star for completing homework; after collecting 10 stars, they get extra playtime.
Aversive conditioning
A technique where an undesired response is repeatedly associated with an aversive consequence to eliminate the behaviour.
e.g. An alcoholic is given a mild electric shock while smelling alcohol, so the smell becomes associated with pain and the person gives up alcohol.
Rational Emotive Therapy (RET)
A cognitive therapy by Albert Ellis that uses ABC analysis (Antecedent-Belief-Consequence) to identify and refute irrational beliefs characterised by 'musts' and 'shoulds'.
e.g. A client who believes 'Everyone must love me all the time' is gently questioned to see how unrealistic this belief is.
Cognitive restructuring
The process in cognitive therapy (Aaron Beck) of altering dysfunctional cognitive structures and negative automatic thoughts to reduce anxiety and depression.
e.g. A depressed client who thinks 'I am stupid' is guided to question this thought and replace it with 'I made a mistake, but I can learn.'
Cognitive Behaviour Therapy (CBT)
A short, efficacious therapy combining cognitive therapy with behavioural techniques, adopting a bio-psychosocial approach to treat disorders like anxiety, depression, and panic attacks.
e.g. A person with panic attacks learns relaxation (biological), challenges catastrophic thoughts (psychological), and practices going to crowded places (social).
Client-centred therapy
A humanistic therapy by Carl Rogers that provides a warm, empathic, and unconditionally accepting relationship where the client can reconnect with disintegrated feelings and achieve personal growth.
e.g. A therapist reflects a client's statement 'I feel so alone' by saying 'It sounds like you are feeling very isolated right now.'
Gestalt therapy
A therapy by Fritz Perls that aims to increase self-awareness and self-acceptance by encouraging the client to recognise blocked bodily processes and emotions, often through acting out fantasies.
e.g. A client who feels anger but suppresses it is asked to 'act out' the anger by hitting a pillow while describing the feeling.
Logotherapy
An existential therapy by Victor Frankl that focuses on helping patients find meaning and responsibility in their life, even in life-threatening circumstances, through the process of meaning making.
e.g. A terminally ill patient is helped to find meaning in the time they have left, such as by writing letters to loved ones.
Catharsis
The process of emotional unburdening that occurs when a client talks about their problems in therapy, which has healing properties.
e.g. A client cries while describing a painful breakup and feels a sense of relief afterwards.
Rehabilitation
The process of helping patients with severe mental disorders (e.g., schizophrenia) become self-sufficient and productive through occupational therapy, social skills training, and vocational therapy.
e.g. A patient recovering from schizophrenia is taught to make paper bags (occupational therapy) and practice conversations (social skills training).
Alternative therapies
Treatment possibilities other than conventional drug treatment or psychotherapy, such as yoga, meditation, acupuncture, and herbal remedies.
e.g. A person with stress-related insomnia practices yoga and meditation daily instead of taking sleeping pills.
Mindfulness-based meditation (Vipasana)
A meditation practice where the person passively observes bodily sensations and thoughts without holding onto any fixed object or thought.
e.g. While sitting quietly, you notice your breath, then a sound, then an itch, and simply observe each without reacting.
Clinical formulation
The process of formulating the client's problem in the therapeutic model being used, which helps in understanding the problem, identifying target areas, and choosing treatment techniques.
e.g. For a client unable to hold a job due to fear of superiors, the behaviour therapy formulation states 'lack of assertiveness skills and anxiety.'
How It Works
Steps in the Formulation of a Client's Problem (Clinical Formulation)
  1. Step 1: Understand the problem — the therapist grasps the full implications of the client's distress.
  2. Step 2: Identify the areas to be targeted for treatment — the theoretical formulation pinpoints specific problem areas (e.g., lack of assertiveness, anxiety).
  3. Step 3: Choose techniques for treatment — based on the therapeutic system and clinical formulation, the therapist selects specific techniques, timing, and outcome expectations.
  4. Step 4: Ongoing reformulation — as therapy progresses, new insights may require updating the initial formulation.
💡 Clinical formulation is an ongoing process; it is not advisable to start psychotherapy without one.
Behavioural Analysis in Behaviour Therapy
  1. Step 1: Interview the client to analyse behaviour patterns.
  2. Step 2: Identify malfunctioning behaviours (those causing distress).
  3. Step 3: Identify antecedent factors (causes that predispose the behaviour, e.g., anxiety).
  4. Step 4: Identify maintaining factors (factors that persist the faulty behaviour, e.g., relief from anxiety).
  5. Step 5: Choose a treatment package to extinguish faulty behaviours and substitute adaptive ones using antecedent and consequent operations.
💡 The past is relevant only to understand origins; therapy focuses on correcting faulty patterns in the present.
Systematic Desensitisation (Wolpe)
  1. Step 1: Interview the client to elicit fear-provoking situations.
  2. Step 2: Prepare a hierarchy of anxiety-provoking stimuli (least to most anxiety-provoking).
  3. Step 3: Relax the client using progressive muscular relaxation.
  4. Step 4: Ask the client to imagine the least anxiety-provoking situation while relaxed.
  5. Step 5: If tension is felt, stop imagining; over sessions, the client imagines more severe situations while maintaining relaxation.
💡 The principle of reciprocal inhibition operates here: relaxation overcomes anxiety because they are mutually opposing forces.
Rational Emotive Therapy (RET) - ABC Analysis
  1. Step 1: Identify the Antecedent event (A) that caused psychological distress.
  2. Step 2: Identify the irrational Belief (B) — thoughts with 'musts' and 'shoulds' that distort reality.
  3. Step 3: Note the Consequence (C) — negative emotions and behaviours resulting from the irrational belief.
  4. Step 4: The therapist refutes the irrational belief through gentle, non-directive questioning.
  5. Step 5: The client gradually replaces irrational beliefs with rational ones, reducing distress.
💡 Irrational beliefs are not supported by empirical evidence; they are characterised by 'musts' and 'shoulds'.
Aaron Beck's Cognitive Therapy
  1. Step 1: Childhood experiences develop core schemas (e.g., 'I am not wanted').
  2. Step 2: A critical incident in life triggers the core schema.
  3. Step 3: Negative automatic thoughts develop (e.g., 'nobody loves me', 'I am stupid').
  4. Step 4: These thoughts lead to cognitive distortions and dysfunctional cognitive structures.
  5. Step 5: The therapist uses gentle, non-threatening questioning to dispute the client's beliefs.
  6. Step 6: The client gains insight into dysfunctional schemas and achieves cognitive restructuring.
💡 Negative automatic thoughts are persistent, irrational, and distort reality in a negative manner.
Process of Client-centred Therapy (Carl Rogers)
  1. Step 1: The therapist provides a warm, empathic, and unconditionally accepting relationship.
  2. Step 2: The client feels secure enough to explore and express disintegrated feelings.
  3. Step 3: The therapist reflects the client's feelings in a non-judgmental manner by rephrasing statements.
  4. Step 4: The client becomes integrated, improves personal relationships, and achieves personal growth.
💡 The therapist is merely a facilitator; the client is responsible for the success of therapy.
Rehabilitation of the Mentally Ill
  1. Step 1: Provide occupational therapy — teach skills like candle making, paper bag making, weaving to form work discipline.
  2. Step 2: Provide social skills training — develop interpersonal skills through role play, imitation, and instruction.
  3. Step 3: Provide cognitive retraining — improve basic cognitive functions (attention, memory, executive functions).
  4. Step 4: Provide vocational training — help the patient gain skills for productive employment.
💡 Rehabilitation aims to empower the patient to become a productive member of society, not just reduce symptoms.
Exam Traps — Don't Make These Mistakes
⚠ Confusing empathy with sympathy
✗ Empathy means feeling sorry for someone or having compassion for their suffering.
→ Sympathy involves compassion and pity but does not involve feeling like the other person. Empathy means putting yourself in the other person's shoes and feeling what they feel.
✓ Empathy is understanding things from the other person's perspective, i.e., putting oneself in the other person's shoes and feeling like the other person.
⚠ Mixing up systematic desensitisation and aversive conditioning
✗ Systematic desensitisation pairs an undesired response with an aversive consequence to eliminate it.
→ Systematic desensitisation pairs relaxation with gradually increasing anxiety-provoking stimuli to reduce fear. Aversive conditioning pairs an undesired response with an aversive consequence (e.g., shock with alcohol).
✓ Systematic desensitisation uses relaxation to overcome anxiety through reciprocal inhibition; aversive conditioning uses an unpleasant stimulus to eliminate an undesired behaviour.
⚠ Thinking behaviour therapy ignores the past completely
✗ Behaviour therapy ignores the past and only focuses on the present.
→ Behaviour therapy does not ignore the past; it considers the past relevant to understand the origins of faulty behaviour and thought patterns. However, it does not activate or relive the past; it corrects faulty patterns in the present.
✓ Behaviour therapy views the past as relevant only to understand the origins of faulty behaviour; it focuses on correcting faulty patterns in the present.
⚠ Confusing unconditional positive regard with permissiveness
✗ Unconditional positive regard means the therapist agrees with everything the client says and allows any behaviour.
→ Unconditional positive regard means the therapist accepts the client without judgment and maintains warmth regardless of what the client reveals. It does not mean approving of harmful behaviour or being permissive.
✓ Unconditional positive regard is the therapist's total acceptance of the client as they are, without judgment, while maintaining a professional and healing relationship.
⚠ Thinking CBT is only cognitive or only behavioural
✗ Cognitive Behaviour Therapy is just about changing thoughts.
→ CBT combines cognitive therapy with behavioural techniques and adopts a bio-psychosocial approach, addressing biological (relaxation), psychological (cognitive restructuring), and social (environmental manipulation) aspects.
✓ CBT is a comprehensive therapy that combines cognitive therapy with behavioural techniques, addressing biological, psychological, and social realms.
⚠ Confusing the goal of psychodynamic therapy with behaviour therapy
✗ The chief benefit of psychodynamic therapy is changing faulty behaviour patterns.
→ Psychodynamic therapy values emotional insight as the chief benefit, not behaviour change. Behaviour therapy values changing faulty behaviour and thought patterns as the chief benefit.
✓ The chief benefit of psychodynamic therapy is emotional insight (intellectual understanding plus emotional acceptance of conflicts), while behaviour therapy values changing faulty behaviour and thought patterns.
Compare & Contrast
View of the cause of psychological problems
Psychodynamic therapy
Behaviour therapy
Psychodynamic therapy believes intrapsychic conflicts (unfulfilled childhood desires) are the cause; behaviour therapy believes faulty learning, conditioning, and thought patterns are the cause.
Nature of the therapeutic relationship
Psychodynamic therapy
Humanistic-existential therapy
In psychodynamic therapy, the therapist interprets the client's thoughts and feelings (directive). In humanistic-existential therapy, the therapist is a facilitator who provides a warm, empathic, non-judgmental environment (non-directive).
Focus of therapy
Rational Emotive Therapy (RET)
Aaron Beck's Cognitive Therapy
RET focuses on refuting irrational beliefs characterised by 'musts' and 'shoulds' using ABC analysis; Beck's therapy focuses on identifying and restructuring negative automatic thoughts and core schemas developed from childhood.
Method of behaviour change
Systematic desensitisation
Aversive conditioning
Systematic desensitisation uses relaxation to overcome anxiety (reciprocal inhibition) by gradual exposure; aversive conditioning pairs an undesired response with an aversive consequence (e.g., electric shock) to eliminate the behaviour.
Exam Focus
Marks pattern: 2 MCQs (1 mark each), 1 Very Short Answer (2 marks), 1 Short Answer (3 marks), 1 Long Answer (5 marks). Total approximately 11 marks.
Most asked: Nature and process of psychotherapy · Therapeutic relationship (empathy, unconditional positive regard) · Types of therapies (psychodynamic, behaviour, cognitive, humanistic-existential) · Behaviour therapy techniques (systematic desensitisation, token economy, aversive conditioning) · Cognitive therapy (RET, Beck's therapy, CBT) · Client-centred therapy (Carl Rogers) · Factors contributing to healing in psychotherapy · Ethics in psychotherapy
Don't skip: Compare and contrast any two therapies (e.g., psychodynamic vs. behaviour) — 5 marks; Explain the techniques of behaviour therapy with examples — 5 marks; Describe the nature and process of psychotherapy and the importance of the therapeutic relationship — 5 marks; Explain cognitive therapy (RET or Beck) with an example — 3 or 5 marks
One-Line Revision (read aloud before the exam)
  1. Psychotherapy is a voluntary, confidential relationship between a trained therapist and a client aimed at reducing psychological distress and fostering adaptive behaviour.
  2. The therapeutic relationship (alliance) is central to all psychotherapies and is the vehicle for change.
  3. Empathy means putting yourself in the other person's shoes and feeling like them, unlike sympathy which is compassion without shared feeling.
  4. Unconditional positive regard is the therapist's non-judgmental, accepting attitude towards the client regardless of what they reveal.
  5. Psychodynamic therapy uses free association and dream interpretation to resolve intrapsychic conflicts and gain emotional insight.
  6. Behaviour therapy uses techniques like systematic desensitisation, token economy, and aversive conditioning to change faulty behaviour.
  7. Systematic desensitisation (Wolpe) treats phobias by pairing relaxation with gradually increasing anxiety-provoking stimuli (reciprocal inhibition).
  8. Cognitive therapy (RET by Ellis) uses ABC analysis to identify and refute irrational beliefs characterised by 'musts' and 'shoulds'.
  9. Aaron Beck's cognitive therapy focuses on restructuring negative automatic thoughts and core schemas developed from childhood.
  10. Cognitive Behaviour Therapy (CBT) combines cognitive and behavioural techniques and is a short, efficacious treatment for anxiety, depression, and panic attacks.
  11. Client-centred therapy (Rogers) provides a warm, empathic, unconditionally accepting relationship where the client achieves personal growth.
  12. Humanistic-existential therapies view psychological distress as arising from alienation and lack of meaning; they facilitate self-actualisation.
  13. Logotherapy (Frankl) helps patients find meaning and responsibility in their life, even in life-threatening circumstances.
  14. Catharsis is the emotional unburdening that occurs when a client talks about problems, and it has healing properties.
  15. Non-specific factors in healing include patient variables (motivation, expectation) and therapist variables (positive nature, good mental health).
  16. Ethics in psychotherapy include informed consent, confidentiality, respect for human rights, and professional competence.
  17. Alternative therapies include yoga, meditation, and acupuncture; yoga and meditation have gained popularity for treating psychological distress.
  18. Rehabilitation of the mentally ill includes occupational therapy, social skills training, cognitive retraining, and vocational training.
  19. Clinical formulation is the ongoing process of stating the client's problem in the therapeutic model to guide treatment.
  20. The principle of reciprocal inhibition states that two mutually opposing forces cannot coexist; relaxation can overcome anxiety.

MCQs — 10 Questions with Answers

Q1. Which therapeutic approach emphasizes that unconscious conflicts are the source of psychological problems?

  • A. Behaviour therapy
  • B. Psychodynamic therapy ✓
  • C. Cognitive-behaviour therapy
  • D. Humanistic therapy

Answer: B — Psychodynamic therapy, based on Freud's theories, focuses on intrapsychic conflicts and unconscious material as the root cause of psychological distress.

Q2. In Wolpe's systematic desensitisation, the anxiety hierarchy is paired with which technique?

  • A. Token rewards
  • B. Negative reinforcement
  • C. Progressive muscle relaxation ✓
  • D. Cognitive restructuring

Answer: C — Systematic desensitisation uses relaxation procedures (progressive muscle relaxation) to counter-condition the anxiety response to feared stimuli by pairing relaxation with graded exposure.

Q3. Rogers' concept of 'unconditional positive regard' in client-centred therapy means:

  • A. The therapist agrees with everything the client says
  • B. The therapist accepts the client without judgment, regardless of thoughts or actions ✓
  • C. The therapist provides rewards when the client behaves well
  • D. The therapist maintains emotional distance to remain objective

Answer: B — Unconditional positive regard means the therapist values and accepts the client fully without judgment, even if the client confides wrong thoughts or behaviours — it is not about agreeing or giving rewards.

Q4. Which of the following is NOT a component of the therapeutic relationship?

  • A. Contractual partnership between client and therapist
  • B. Limited duration until client gains control over life
  • C. Permanent lifelong friendship between therapist and client ✓
  • D. Strict confidentiality and trust

Answer: C — The therapeutic relationship is specifically NOT a permanent lasting friendship; it has limited duration and ends when the client becomes able to manage their problems independently.

Q5. In Beck's cognitive therapy for depression, the cognitive triad consists of negative views about:

  • A. Past, present, and future
  • B. Self, world, and future ✓
  • C. Thoughts, feelings, and behaviours
  • D. Family, peers, and society

Answer: B — Beck's cognitive triad identifies three core negative belief patterns in depression: negative view of self, negative view of the world, and negative view of the future.

Q6. A therapist using token economy in a psychiatric ward gives tokens to patients when they complete assigned tasks. This token economy approach is based on principles of:

  • A. Psychodynamic theory and transference
  • B. Operant conditioning and positive reinforcement ✓
  • C. Cognitive restructuring and thought patterns
  • D. Empathy and unconditional positive regard

Answer: B — Token economy is a behaviour therapy technique based on operant conditioning, where desirable behaviours are reinforced with tokens that can be exchanged for rewards, strengthening those behaviours.

Q7. Which statement best describes the difference between empathy and sympathy in therapeutic relationships?

  • A. Empathy involves feeling pity; sympathy involves understanding perspective
  • B. Empathy means understanding and feeling like the client by taking their perspective; sympathy is compassion without shared feeling ✓
  • C. Both terms are identical and used interchangeably in therapy
  • D. Empathy is cold intellectual understanding; sympathy is emotional connection

Answer: B — Empathy uniquely involves understanding things from the client's perspective and feeling like they feel; sympathy is compassion and pity but without the shared emotional experience.

Q8. Assertion: Transference occurs when the client unconsciously projects feelings from past relationships onto the therapist. Reason: Psychodynamic therapy requires the therapist to maintain emotional distance to prevent transference. Choose the correct option:

  • A. Both assertion and reason are correct; reason explains assertion
  • B. Both assertion and reason are correct; reason does not explain assertion
  • C. Assertion is correct; reason is incorrect ✓
  • D. Both assertion and reason are incorrect

Answer: C — Transference is correctly described, but the therapist should NOT maintain distance; rather, transference is encouraged and analysed as it reveals unconscious conflicts, making the reason incorrect.

Q9. A client with irrational belief 'I must be perfect or I am worthless' is taught to dispute this belief and replace it with 'I can make mistakes and still have worth.' This technique is used in which therapeutic approach?

  • A. Systematic desensitisation
  • B. Rational Emotive Behaviour Therapy (REBT) or Cognitive-Behaviour Therapy ✓
  • C. Free association in psychodynamic therapy
  • D. Token economy in behaviour therapy

Answer: B — REBT (Ellis) and CBT involve identifying irrational beliefs, disputing them through logical argument, and replacing them with rational beliefs to reduce emotional distress.

Q10. Deinstitutionalisation in mental health rehabilitation refers to: (HOTS)

  • A. Increasing the number of large psychiatric hospitals
  • B. Moving patients from large hospitals to community mental health centres for normalised, humane care ✓
  • C. Providing only drug therapy without psychological support
  • D. Isolating mentally ill patients from society for their protection

Answer: B — Deinstitutionalisation is a rehabilitation approach that shifts care from large impersonal institutions to community-based centres, promoting social integration and dignity for mentally ill individuals.

Flashcards

What is psychotherapy?

A voluntary relationship between client and trained therapist to solve psychological problems through systematic application of therapeutic principles.

Define therapeutic alliance.

A trusting, confidential partnership between client and therapist with contractual nature and limited duration, lasting until the client regains control over life.

What is unconditional positive regard?

Rogers' concept where the therapist accepts and values the client without judgment, regardless of what the client says or has done.

Distinguish empathy from sympathy.

Empathy means understanding and feeling like the other person by taking their perspective; sympathy is compassion and pity without sharing the feeling.

What is systematic desensitisation (Wolpe)?

A behaviour therapy technique pairing anxiety-triggering stimuli with relaxation to reduce conditioned fear response through gradual exposure.

What is cognitive restructuring in CBT?

A technique where therapist helps client identify and replace irrational, distorted thoughts with rational, adaptive ones to reduce emotional distress.

What is transference in psychodynamic therapy?

Client unconsciously projects feelings, attitudes, and conflicts from past relationships (usually parents) onto the therapist.

What is a token economy in behaviour therapy?

A behaviour modification system where clients earn tokens for desirable behaviours, which can be exchanged for rewards or privileges.

What is the goal of deinstitutionalisation?

Moving mentally ill patients from large hospitals to community-based mental health centres to provide more humane, normalised care.

What are the four goals of psychotherapy mentioned in CBSE syllabus?

Reinforce resolve for betterment, lessen emotional pressure, modify habits, and change thinking patterns (plus increase self-awareness and improve relationships).

Important Board Questions

Define therapeutic relationship. State two key properties of a therapeutic alliance. (2 marks) [2 marks]

Therapeutic relationship = contractual partnership between client & trained therapist. Two properties: trust/confidentiality + limited duration until client gains control. Must define and list distinct properties.

Explain Wolpe's systematic desensitisation with reference to anxiety hierarchy and relaxation. Why is relaxation important in this technique? (5 marks) [5 marks]

Define systematic desensitisation as behaviour therapy. Explain: anxiety hierarchy (ranked fear list from mild to intense) + progressive muscle relaxation paired with graded exposure. Relaxation is important because it counter-conditions fear (relaxation incompatible with anxiety — reciprocal inhibition). Include one example (e.g., fear of heights).

Discuss Rogers' client-centred therapy with emphasis on unconditional positive regard, empathy, and genuineness. How do these three conditions facilitate therapeutic change? Provide a real-life Indian example of how a counsellor might apply these principles. (6 marks) [6 marks]

Define Rogers' humanistic approach based on congruence between self & ideal self. Explain: (1) unconditional positive regard = non-judgmental acceptance; (2) empathy = understanding client's perspective & feeling; (3) genuineness = therapist authenticity. Mechanism: these create safe space reducing incongruence & self-doubt. Example: Indian school counsellor helping student with family pressure or career confusion. Evaluation: humanistic vs cognitive/behavioural approaches.

Assertion-Reason Questions for Therapeutic Approaches

Q1. Assertion (A):

Psychotherapy is a voluntary relationship where the therapist systematically applies therapeutic principles learned through expert training and supervision.

Reason (R):

Untrained individuals may unintentionally cause harm because they lack knowledge of systematic therapeutic application.

Answer: A — Both A and R are true, and R is the correct explanation of A — Both the assertion and reason are true. The reason correctly explains why psychotherapy requires trained professionals—the systematic application of trained principles is essential, and untrained people risk causing harm. This directly supports the assertion that therapists must be systematically trained.

Q2. Assertion (A):

The therapeutic alliance involves a trusting and confiding relationship with specific time limits that end when the client gains control of their life.

Reason (R):

The alliance must be permanent and lasting because the client may experience crises later and need ongoing support.

Answer: C — A is true but R is false — The assertion is true according to the text; the alliance is indeed time-limited and ends when the client becomes able to manage their life. However, the reason is false—the text explicitly states the alliance is NOT permanent; it has limited duration. The reason contradicts the fundamental nature of therapeutic alliance.

Q3. Assertion (A):

Empathy in a therapeutic relationship requires the therapist to understand the client's experience from the client's perspective and feel alongside them.

Reason (R):

Empathy differs from sympathy because sympathy involves intellectual understanding alone without emotional resonance.

Answer: B — Both A and R are true, but R is NOT the correct explanation of A — The assertion is true—the text defines empathy as understanding from another's perspective with emotional resonance. The reason is also true—sympathy is distinguished from empathy by lacking emotional resonance. However, the reason does not explain WHY empathy requires perspective-taking and emotional resonance; it merely contrasts sympathy with empathy rather than explaining empathy's mechanism.

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Case-Based Questions (CBQ) for Therapeutic Approaches

Case Study:

Rajesh, a 28-year-old software engineer from Bangalore, experienced severe anxiety following a failed marriage proposal. He withdrew from friends, struggled to concentrate at work, and reported feeling worthless. A psychotherapist assigned to his case spent the first three sessions building rapport—listening without judgment, reflecting back Rajesh's feelings in his own words, and consistently showing warmth regardless of negative thoughts Rajesh shared about himself. By the fifth session, Rajesh began disclosing deep childhood fears of rejection and family expectations. The therapist never tried to 'fix' Rajesh immediately but instead created a safe space for exploration. After 16 weeks, Rajesh reported improved mood, renewed social connections, and a more realistic perspective on his situation.

Q1. Which core property of the therapeutic relationship did the therapist primarily establish during the initial sessions?

  • A. Contractual terms and session fees
  • B. A trusting and confiding relationship through acceptance and empathy ✓
  • C. Time-limited duration of therapy
  • D. Professional confidentiality agreements

Answer: B

Q2. The therapist's approach of listening without judgment and showing warmth regardless of Rajesh's negative self-talk demonstrates which specific therapeutic principle?

  • A. Unconditional positive regard ✓
  • B. Behavioral reinforcement techniques
  • C. Cognitive restructuring methods
  • D. Systematic desensitization

Answer: A

Q3. Why did Rajesh begin disclosing deeper, long-hidden fears only after several sessions rather than in the first session?

  • A. The therapist used direct questioning techniques to extract information
  • B. Rajesh needed time to develop sufficient trust in the therapeutic relationship ✓
  • C. The passage of time alone automatically resolves emotional barriers
  • D. Rajesh's family members encouraged him to open up more

Answer: B

Q4. According to the therapeutic principles discussed in the chapter, what aspect of Rajesh's improvement outcome can be attributed to the therapeutic alliance rather than other factors?

  • A. The creation of a safe, accepting space enabled Rajesh to process and explore his experiences ✓
  • B. Rajesh's employer automatically granted him a work transfer
  • C. Medication prescribed by a psychiatrist resolved his symptoms
  • D. The passage of 16 weeks inevitably heals all anxiety disorders

Answer: A

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Previous Year Questions (PYQ) for Therapeutic Approaches

Real CBSE board exam questions from past papers — free to attempt.

CBSE 2026 · Set Psychology · 1 mark

A therapist working with children with Attention-Deficit Hyperactivity Disorder (ADHD) gives them a star sticker each time they complete a task without distraction. After collecting five stars, they can exchange it with a small toy. What psychological technique is being used here?

  • Classical conditioning
  • Token economy
  • Systematic desensitization
  • Free association

CBSE 2026 · Set Psychology · 3 marks

Reena constantly thinks, "I must succeed at everything, or I am a failure," which causes her distress when she makes small mistakes. How can Rational Emotive Therapy (RET) help Reena overcome her psychological distress? Mention three steps involved in the Rational Emotive Therapy (RET).

CBSE 2026 · Set Psychology · 4 marks

Ritika has been feeling anxious, socially withdrawn and unable to manage her daily routine. She decides to see a psychotherapist. Over the course of several sessions, she begins to feel heard and supported. Based on this case, elaborate on the factors that contributed to Ritika's psychological healing through psychotherapy.

CBSE 2025 · Set 63_psychology · 1 mark

Ravi constantly believes he is a failure because he once performed poorly on a test. Which cognitive problem is he exhibiting according to the Cognitive Model?

  • Accurate self-assessment
  • Overgeneralisation
  • Rational thinking
  • Logical reasoning

CBSE 2025 · Set 63_psychology · 3 marks

Explain how the Age of Reason and Enlightenment influenced the treatment and perception of psychological disorders in the seventeenth and eighteenth centuries.

CBSE 2025 · Set 63_psychology · 3 marks

Ashok, who suffers from obsessive compulsive disorder (OCD), is considering alternative therapies to complement his current treatment. Recommend and justify which approach might be most beneficial for Ashok.

CBSE 2025 · Set 63_psychology · 6 marks

Discuss the role of core schemas, negative automatic thoughts, cognitive distortions and irrational beliefs in cognitive therapies.

CBSE 2023 · Set 63_Psychology · 1 mark

In the following question, a statement of Assertion (A) is followed by a statement of Reason (R). According to cognitive therapy, childhood experiences provided by the family and society develop core schemas in the child which include beliefs and action patterns in individual. In this therapy, irrational beliefs mediate between antecedent events and their consequences. Select the correct choice.

  • Both Assertion (A) and Reason (R) are true, and Reason (R) is correct explanation of Assertion (A).
  • Both Assertion (A) and Reason (R) are true, but Reason (R) is not the correct explanation of Assertion (A).
  • Assertion (A) is true, but Reason (R) is false.
  • Assertion (A) is false, but Reason (R) is true.

CBSE 2023 · Set 63_Psychology · 1 mark

Ritik is undergoing a therapy where he is being taught to recognise bodily processes and the emotions that are being blocked out from his awareness. Which therapy is being applied here?

  • Client-centred therapy
  • Logotherapy
  • Cognitive behaviour therapy
  • Gestalt therapy

CBSE 2023 · Set 63_Psychology · 1 mark

Why is behavioural analysis conducted to overcome stress?

  • (i), (iii) and (iv)
  • Only (iii)
  • (ii) and (iii)
  • (i) and (ii)

CBSE 2023 · Set 63_Psychology · 2 marks

Explain cognitive distortions. Give an example of cognitive distortion that a client might be experiencing.

CBSE 2023 · Set 63_Psychology · 4 marks

An eight-year-old child is showing aggressive and disruptive behaviour in the class. As a student of Psychology, what techniques would you suggest for behaviour modification to improve his behaviour?

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