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Different Styles
Therapy

Mental health therapies can be
classified into two main categories
 Psychotherapy: trained therapist uses
psychological techniques to assist someone
seeking to overcome difficulties or achieve
personal growth
 Biomedical: prescribed medication or
medical procedure that acts directly on the
patient’s nervous system
○ Many patients receive drug therapy in addition
to psychotherapy
Therapy
 Psychoanalysis
 Sigmund Freud’s therapeutic technique.
Freud believed the patient’s free
associations, resistance, dreams, and
transference- and the therapist’s
interpretations of them- released
previously repressed feelings, allowing
the patient to gain self-insight
Therapy
 Aims of
Psychoanalysis: sought
to bring repressed
feelings into patients’
conscious awareness
○ Presumes that
healthier, less
anxious living
becomes possible
when people release
the energy they had
previously devoted to
id-ego-superego
conflicts
Therapy
 Methods: psychoanalysis
emphasizes the power of
childhood experiences, and
aims to unearth the past
○ Freud first tried hypnosis but
discarded it because it is
unreliable
 Freud turned to free association:
the client/patient says aloud
whatever comes to his/her head
- While this sounds easy it is
actually very difficult not to
omit information, change the
subject quickly when
uncomfortable, or when feeling
shame
Therapy
○ Resistance: the blocking from consciousness
of anxiety-laden material
 The analyst will note your resistances and then
interpret their meaning, providing insight
○ Another way to reach into the unconscious is
dream analysis and interpreting the latent
content of dreams
○ Transference: the patient’s transfer to the
analyst of emotions linked with other
relationships (such as love or hatred for
a parent)
○ This takes time and several years and
can get quite expensive
Therapy

Psychodynamic therapy: therapy
deriving from the psychoanalytic
tradition that views individuals as
responding to unconscious forces and
childhood experiences, and that seeks
to enhance self-insight
Therapy
 Differences between psychodynamics and
psychoanalysis
○ Face to face
○ Lasts only a few weeks or months

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Malan: I get the feeling that you’re the sort of person who needs to
keep active. If you don’t keep active, then something goes wrong.
Is that true?
Patient: Yes.
Malan: I get a second feeling about you and that is that you must,
underneath all this, have an awful lot of very strong and upsetting
feelings. Somehow they’re there but you aren’t really quite in
touch with them. Isn’t this right? I feel you’ve been like that as
long as you can remember.
Patient: For quite a few years, whenever I really sat down and
thought about it I got depressed, so I tried not to think about it.
Malan: You see, you’ve established a pattern, haven’t you?
You’re even like that here with me, because in spite of the fact that
you’re in some trouble and you feel that the bottom is falling out of
your world, the way you’re telling me this is just as if there wasn’t
anything wrong.
Therapy
 Interpersonal psychotherapy: variation of
psychodynamic therapy
○ Has been effective in treating depression
○ Goal is symptom relief in the here and now,
not an overall personality change
Therapy

Humanistic Therapy
 Humanistic perspective emphasizes people’s
inherent potential for self-fulfillment
○ Therapy aims to boost self-fulfillment by helping
people grow in self-awareness and selfacceptance
 Therapy attempted to reduce the inner conflicts that are
impeding natural development
 Insight therapies: a variety of therapies which
aim to improve psychological functioning by
increasing the client’s awareness of underlying
motives and defenses
○ Both humanistic and psychoanalysis are
considered insight therapies
Therapy
 Humanistic therapy differs from
psychoanalysis:
○ Focus on present and future more than the
past
○ Focus on conscious rather than unconscious
○ Focus on taking immediate responsibility for
one’s feelings and actions
○ Promoting growth instead of curing illness
 Call those in therapy clients and not patients
Therapy
 Carl Rogers develop the technique called client-
centered therapy
○ This is a humanistic therapy, developed by Carl
Rogers, in which the therapist uses techniques
such as active listening within a genuine,
accepting, empathic environment to facilitate
clients’ growth (also call person centered therapy)
○ Client-centered therapy hinges on the therapist
providing the client with unconditional positive
regard
 Unconditional positive regard is blanket support and
acceptance of a person regardless of what is said or
behavior
- Rogers believed this was essential
○ Client-centered therapy is non-directive
Therapy
○ Active listening is essential to the humanistic
view point
 Empathic listening in which the listener echoes,
restates, and clarifies. A feature of Rogers’ clientcentered therapy
 Steps:
- Paraphrase
- Invite clarification
- Reflect feelings
○ Rogers encouraged genuineness,
acceptance, and empathy
Therapy

Group Therapy
 Group therapy can be just as effective for
the individual and save time and money
 Also offers the unique benefit of social
context
○ This allows people both to discover that others
have problems similar to their own and to
receive feedback as they try out new ways of
behaving
Therapy
 Family therapy
○ Therapy that treats the family as a system.
Views an individual’s unwanted behavior as
influenced by, or direct at, other family
members
 Other types of groups
○ Closed group: only members of the group can
attend or those with the same problem
○ Open group: anyone can come to the meeting
Therapy
 Support groups and self-help groups
 Other examples of groups:
○ AA: Alcoholics Anonymous
○ GA: Gamblers Anonymous
○ Eating disorder groups
Therapy

Behavior Therapy
 Therapy that applies learning principles to
the elimination of unwanted behaviors
○ Doubt the healing power of self-awareness
○ Behaviorist assume that problem behaviors
are the problems and the application of
learning principles can eliminate them
Therapy
 Classical Conditioning Techniques
○ Since we learn many behaviors and emotions
through classical conditioning, then we should
be able to treat disorders with this technique
as well
 Goal is to unlearn associations and relearn
constructive behaviors and associations
 Counter conditioning: a behavior therapy procedure
that uses classical conditioning to evoke new
responses to stimuli that are triggering unwanted
behaviors; includes exposure therapies and aversive
conditioning
Therapy
 Exposure therapy: behavioral techniques,
such as systematic desensitization, that
treat anxieties by exposing people to the
things they fear and avoid
○ Systematic desensitization: a type of exposure
therapy that associates a pleasant relaxed
state with gradually increasing anxiety
triggering stimuli. Commonly used to treat
phobias
Therapy
○ Virtual reality exposure therapy: an anxiety
treatment that progressively exposes people
to simulations of their greatest fears, such as
airplane flying, spiders, or public speaking
○ In systematic desensitization, the goal is
substituting a positive response for a negative
response to a stimulus
Therapy
 Aversive conditioning, however, is a type of
counter conditioning that associates an
unpleasant state (such as nausea) with an
unwanted behavior (such as drinking
alcohol)
○ Usually use with a combination of other
treatments
Therapy
 Operant Conditioning
○ Therapist apply the concepts of operant
conditioning to the treatment of various
behavioral issues in order to help the patient
overcome their issues
 One concept that is used is called Token Economy
- An operant conditioning procedure in which people
earn a token of some sort for exhibiting a desired
behavior and can later exchange the tokens for
various privileges or treats
Therapy

Cognitive Therapy
 Therapy that teaches people new, more
adaptive ways of thinking and acting; based
on the assumption that thoughts intervene
between events and our emotional reactions
○ Self-blaming and overgeneralization
explanations for bad events are often integral
part of the vicious cycle of depression
 Goal is to change the way of thinking
Therapy
Lost your job
Internal Beliefs: I’m
worthless. It’s
hopeless
Lost Job
Internal beliefs: My
boss is a jerk. I
deserve something
better.
Depression
No depression
Therapy
 Cognitive Behavioral Therapy
○ A popular integrated therapy that combines
cognitive therapy with behavior therapy
 Change thoughts & actions
- For a person with OCD, instead of washing hands
again, tell yourself that your it’s your brain’s
abnormal activity and move on to an enjoyable
activity to avoid the urge.
Therapy

Is Psychotherapy effective?
 Client’s perceptions: people often enter
therapy in crisis
 Clients may need to believe the therapy was
worth the effort
 Clients generally speak kindly of their
therapist
Therapy

Commonalities Among Psychotherapies
 Hope for demoralized people
 A new perspective
 An empathic, trusting, caring relationship
Therapy
 Different therapies
○ Energy therapies
○ Recovered-memory therapy
○ Rebirthing therapies
○ Facilitated communication
○ Crisis debriefing
○ Eye Movement Desensitization and
Reprocessing
○ Light Exposure therapy
Therapy

Homework: Over the weekend you are to
research any three therapy methods on the
list on the previous slide. One of the three
methods must be EMDR, but the other two
are you choice. Here is what you need to
include
 The process of therapy (what the client must
due during therapy)
 Discuss the effectiveness of the therapy
 Criticisms of the therapy method
 You own thoughts on each of the three.
○ Should total three pages (one page per method)
Therapy

Biomedical Therapies
 Prescribed medications or medical
procedures that act directly on the patient’s
nervous system
○ Often used with serious disorders
Therapy
 Drug therapies
○ Psychopharmacology: the study of the effects
of drugs on mind and behavior
○ Most widely used biomedical treatment
○ Allowed people to leave hospital confinements
and live a life for their own
 However, in many cases this means homelessness,
not liberation
Therapy
○ Antipsychotic Drugs
 Example: Chlorpromzine (sold as Thorazine)
 Drugs used to treat schizophrenia and other forms of
severe thought disorder
- Reduce positive symptoms of schizophrenia
 Similar to the molecules of the neurotransmitter of
dopamine to block activity at those sites
 Long term-use of medication can also produce
tardive dyskinesia: involuntary movements of the
facials muscles, tongue, and limbs; a possible
neurotoxic side effect of long-term use of
antipsychotic drugs that target certain dopamine
receptors
Therapy
○ Schizophrenia pateitns exhibiting negative
symptoms do not respond well to
antipsychotics
 However, newer atypical antipsychotics, such as
clozapine (known as Clozaril), target both dopamine
and serotonin receptors
○ Newer antipsychotic medications have fewer
side effects
○ Antipsychotic need to be combined with lifeskills and family support
Therapy
 Antianxiety Drugs
○ Drugs used to control anxiety and aggression
 Xanax and Ativan
 Depress central nervous system
 New antianxiety drug D-cycloserine (an antibiotic)
can help facilitate the extinction of fears
- Experiments show that the drug enhances the
benefit of exposure therapy and helps relieve the
symptoms of PTSD and OCD
Therapy
 Antidepressant Drugs
○ Drugs used to treat depression; also
increasingly prescribed for anxiety. Different
types work by altering the availability of
various neurotransmitters
 Fluoxetine, known as Prozac, partially blocks the
absorption and removal of serotonin
- Prozac and Paxil are known as SSRI (selectiveserotonin-reuptake-inhibitors)
- Side effects such as: dry mouth, weight gain,
hypertension, or dizzy spells
Therapy
○ For all medication therapy it is important that it
is linked to other treatment methods such as
counseling or psychotherapy
○ For depressed patients other things help such
as: exercise, eating better, and family therapy
Therapy
 Mood-Stabilizing Medications
○ The salt lithium can be effective for those with
bipolar disorder
○ Depakote found effective to control manic
episodes
Therapy
 Electroconvulsive Therapy (ECT)
○ Although controversial, ECT is often an
effective treatment for depression that does
not respond to drug therapy
○ Therapist delivers 30 to 60 seconds of
electrical current to the patient’s brain
 Some memory loss is associated with it, but no
discernible brain damage
○ No one is really sure how ECT works
Therapy
 Alternative neurostimulation therapies
○ Magnetic Stimulation
 Depressed moods seem to improve when repeated
pulses surge through a magnetic coil held close to a
person’s skull
 Repetitive transcranial magnetic stimulation (rTMS)
- The application of repeated pulses of magnetic
energy to the brain; used to stimulate or suppress
brain activity
- No real side effects
Therapy
 Psychosurgery
○ Surgery that removes or destroys brain tissue
in an effort to change behavior
○ Lobotomy: a now-rare psychosurgical
procedure once used to calm uncontrollably
emotional or violent patients. The procedure
cut the nerves connecting the frontal lobes to
the emotion-controlling centers of the inner
brain
Therapy
 Therapeutic Life Changes
○ Aerobic exercise
○ Adequate sleep
○ Light exposure
○ Social connection
○ Anti-rumination
○ Nutritional supplements