Download Intro Psych March21

Treatment and therapy (Chap 17)
First Lecture Outline:
History of psychotherapy
Psychotherapy approaches
Foundations of counselling
Video 101: Psychodynnamics
Last Monday’s midterm
• Results will be posted Monday
• Many did well!! Keep it up!!
• Multiple choice (out of 40) were done well
– Average around 27 to 29/40
• Score is out of 30 for both quizzes
History
• Mental illness = demonic possession
– Exorcism, flogging, torture, bleeding, enemas
– Braveheart: “purification of spirit”
• Middle ages: Asylum
– St. Mary of Bethlehem: Bedlem, uproar,
confusion
– “over-crowded prison for social outcasts”
• 1800s: Mesmer, Charcot, Breuer, Freud
– origins of hypnosis and cathartic methods
Other interventions from the 1900’s
• Psychosurgery 1930s to 1950s: Prefrontal
lobotomy
– left patients vegetative, replaced by very
specific microsurgery for lesions
Electroconvulsive therapy (ECT)
in 1940s:
• 150 volts run through the head for 1-2
seconds
– leads to memory loss, broken bones, still used
as “last resort” for depression
– Today the patient is usually placed under
general anesthesia, paralysed with drugs,
monitored and assisted with breathing.
• Antipsychotic medications in the 1950s
What is a clinical interview?
• Psychotherapy involves talking to people
• Structured and unstructured interviews
• Model of psychotherapy directs attention of
interview
– Psychodynamic: Focus on early experiences
– Behavioral: Focus on symptoms, ABC’s
– Cognitive: Questions about specific thought
patterns
– Humanistic: Unconditional positive regard
Interviewing in an assessment
• Focus depends on what you are assessing,
diagnosis
• Background includes medical, school/work,
family, hobbies, description of symptoms,
and “other sources of information”
• Tests then augment interview
– Intelligence, neuropsychological, memory tests
– Personality and behavioral measures
– Psychophysiological and computer tasks
Who can conduct “therapy”
• Anyone can offer themselves to the public
as a “therapist” or “counsellor”
• These are not protected titles or services:
watch out!
• Only a psychologist can say they offer
“Psychological intervention” or
“Psychological assessment”
• Title and services of a “psychologist”
governed by provincial statute
Psychodynamic therapy
approaches
• Patients improve once they become
conscious of ego-threatening material
• Free association: Client says whatever
comes to mind; Dream analyysis
• Resistance is an impediment to progress
• Transference of feelings from significant
others to therapist; Countertransference
• Website listing psychotherapy approaches
for personality disorder
Evolution of psychoanalysis
• Originally it could take years at 3-5 sessions
per week
• Unstructured and relaxed approach
necessitated comfortable seating,
surroundings
• Change to become more task-oriented and
time limited
• “Contracting” with clients for a specific
number of sessions to reach a goal