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Unit 13 Therapy THERAPY (OBJ.1) Psychotherapy – emotional, interaction between a trained therapist and disorder patient Biomedical therapy – medications that act on NS Mental Illness – Philippe Pinel & Dorothea Dix Eclectic Approach (50%) - uses techniques from various forms of therapy Psychotherapy integration – all into one therapy Evidence-based practice – best research with clinical expertise and patients characteristics Psychoanalysis Humanistic Therapies Behavior Therapies Cognitive Therapies Group / Family Therapies Biomedical Therapies PSYCHOANALYSIS THERAPY FREUDIAN (OBJ. 1) Goal: gain insight into unconscious origins of their disorders Techniques: Interpretation of: Free association / Dreams Resistance – blocking of anxiety-laden material insight into your underlying wishes, feelings and conflicts analysis of dreams latent (hidden) content Transference – long-repressed feelings transferred to the therapist (Love – Anger) Criticisms: Interpretations cannot be proven or disproven Power in the hands of therapist Time consuming / Costly Repressed/Recovered/Implanted memory??? Psychodynamic Therapy: focused more on today than past HUMANISTIC THERAPY ROGERS (OBJ.2) Goal: focus on clients current conscious feelings and on their taking responsibility for their own growth (Insight Therapy) Techniques: client-centered therapy Client s conscious self-perceptions not therapist s Nondirective therapy Active listening: echoing, restating, and clarification express acceptance, empathy & genuineness No judging or interpreting Increase self-understanding and self-acceptance Unconditional positive regard – acceptance of others Reflective Listening w/ friends Paraphrase, Invite clarification, Reflect feelings BEHAVIOR THERAPY PAVLOV / WATSON / SKINNER (OBJ. 3) Goal: Apply learning principles (Classical & Operant Cond.) to eliminate unwanted behavior Techniques: Counterconditioning - conditions new responses to stimuli that trigger unwanted behaviors (stimulus / response) Exposure Therapy: expose people to things they fear/avoid Systematic desensitization: relaxed state is associated w/ gradually increasing anxiety-triggering stimuli flooding / imploding Virtual Reality / Exposure therapy: anxiety treatment that exposes people to simulations of their fears Aversive conditioning: unpleasant state is associated w/ an unwanted behavior Operant Conditioning: reinforcing desired behaviors, withholding it for undesired behaviors, behavior modification attention, food, token economy Criticisms: What happens when reinforcement stops? BEHAVIOR THERAPY PAVLOV / WATSON / SKINNER (OBJ. 3) Aversive conditioning: unpleasant state is associated w/ an unwanted behavior Operant Conditioning: reinforcing desired behaviors, withholding it for undesired behaviors, behavior modification attention, food, token economy Criticisms: What happens when reinforcement stops? BEHAVIOR THERAPY Systematic Desensitization FLOODING Goal: COGNITIVE THERAPY BECK – ELLIS (OBJ. 4) teach new, more constructive ways of thinking since thinking colors our feelings Mood / Anxiety Disorders Techniques: reverse clients negative beliefs, future self-blaming and over generalized explanations depressions vicious cycle suggestion = criticism, friendship = pity depressed people don t exhibit self-serving bias Cognitive (thinking) – Behavior (acting) therapy replace irrational (neg.) thinking w/ rational (pos.) thinking use positive reinforcement to change actions Rational-Emotive Therapy (RET) • Albert Ellis • ABC s (A=Activating event – B=Belief – C=Consequent emotion) THERAPY STATEMENTS / QUESTIONS A. B. C. D. E. F. G. Tell me about your earliest memories Psychoanalysis from childhood. Cognitive What were the consequences that happened after you punched your boss? Behavior Rank order the things that frighten you Humanistic from least to most so we can build a plan to overcome them. Have you been having recurring dreams? You have developed a very powerful mental set that you are a loser. If you can refrain from losing your temper, you ll get two red stars. How does that make you feel? GROUP THERAPIES (OBJ. 5) Goal: allows people to discover that others have problems similar to their own and to try out new ways of behaving Techniques: Sensitivity Training Groups (T Groups): relating to others more empathetically, sensitively and openly Active listening Encounter Groups: members confront emotion-laden experiences openly and honestly Communication Retreat self-help and support groups AA Alcoholics Anonymous Family therapy: Relationship healing, family members discover the role they play in the healthy family s system DOES THERAPY WORK? (OBJ.6-8) Meta-analysis – statistically combining the results of many different research studies (therapy effectiveness) Untreated often improve, treated more likely to improve Regression toward the mean – tendency for extreme or unusual scores to fall back (regress) toward their average. Placebo effect better than nothing Eye Movement and Desensitization (EMDR), not supported Light exposure, supported for (SAD) Evidence-based practice – clinical decision-making that integrates the best available research and practices Eclectic approach based on evidence clinical expertise and patient characteristics Psychotherapies offer new hope, fresh perspective and empathic relationship Meta –analysis, Regression toward the mean, Evidence-based practice Humanistic Actions BIOMEDICAL THERAPIES (OBJ.11-14) Psychopharmacology – study of the effects of drugs on mind and behavior placebo effect – double blind procedure Antipsychotic Drugs Schizophrenia: Positive symptoms (hallucinations / paranoia) blocking dopamine receptors (antagonist) fine line between symptom relief and unpleasant side effects (tardive dyskinesia), Parkinson like negative symptoms (apathy, withdrawal) not as treatable, some drug can reanimates patients BIOMEDICAL THERAPIES Antianxiety Drugs Anxiety disorders reduce tension and anxiety without sleepiness criticism – reduce symptoms wo/ resolving underlying problems Antidepressant Drugs SSRIs (selective-serotoninreuptake-inhibitors) Mood and Anxiety disorders: increases norepinephine and serotonin blocks reuptake Lithium: salt, stabilizes mood of bipolar patients BIOMEDICAL THERAPIES BIOMEDICAL THERAPIES (OBJ.12) Electroconvulsive Therapy (ECT) - brief electric current is sent through the brain, causes seizures/ convulsions balances neurotransmitters severely depressed patients Psychosurgery - surgery that removes brain tissue to change behavior Lobotomy - now-rare psychosurgical procedure to treat emotional/ violent patients - cutting nerves connecting frontal lobes w/ limbic system Repetitive transcranial magnetic stimulation (rTMS)