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Transcript
Module 24
Therapies
HISTORICAL BACKGROUND
• Definition of psychotherapy
– Three basic characteristics
1.verbal interaction between therapist and client
2.development of a supportive relationship in which
a client can bring up and discuss traumatic or
bothersome experiences that may have led to
current problems
3.analysis of the client’s experiences and/or
suggested ways for the client to deal with or
overcome his or her problems
HISTORICAL BACKGROUND (CONT’D)
• Early treatments
– 1400 to 1700, people who today would be diagnosed
as schizophrenics were considered insane and called
lunatics
– Late 1800s, Dr. Benjamin Rush (considered the father
of American psychiatry), developed the “tranquilizing
chair”
– Believed that mental disorders were caused by too
much blood to the brain
HISTORICAL BACKGROUND (CONT’D)
HISTORICAL BACKGROUND (CONT’D)
• Reform movement
– Moral therapy, popular in the early 1800s
• patients could be helped to function better by
providing humane treatment in a relaxed and
decent environment; late 1800s, it was abandoned
• 1930s, Sigmund Freud developed psychoanalysis
• early 1950s, wretched conditions and inhumane
treatment of patients persisted
• mid 1950s, two dramatic changes happened:
discovery of antipsychotic drugs and development
of community mental health centers
HISTORICAL BACKGROUND (CONT’D)
• Phenothiazines and deinstitutionalization
– Phenothiazines
• discovered in the early 1950s, block or reduce the
effects of the neurotransmitter dopamine and
reduce schizophrenic symptoms, such as
delusions and hallucinations
• chlorpromazine (Thorazine)
– Deinstitutionalization
• refers to the release of mental patients from mental
hospitals and their return to the community to
develop more independent and fulfilling lives
HISTORICAL BACKGROUND (CONT’D)
• Community mental health centers
– Offer low-cost or free mental health care to members
of the surrounding community, especially the
underprivileged
– Provide briefer forms of therapy that are needed in
emergencies and focus on the early detection and
prevention of psychological problems
QUESTIONS ABOUT PSYCHOTHERAPY
• Are there different kinds of therapists?
– Psychiatrists
• go to medical school, receive M.D. degree, and then
take a psychiatric residency; additional training in
pharmacology, neurology, psychopathology, and
psychotherapeutic techniques
– Clinical psychologists
• go to graduate school in clinical psychology and earn a
doctorate degree (Ph.D., Psy.D., or Ed.D.)
– Counseling psychologists
• go to graduate school in psychology or education and
earn a doctorate degree (Ph.D., Psy.D., or Ed.D)
QUESTIONS ABOUT PSYCHOTHERAPY
(CONT’D)
• Are there different approaches?
– Insight therapy
• therapist and client talk about the client’s
symptoms and problems with the goal of reaching
or identifying the cause of the problem
– Cognitive-behavior therapy
• involves the application of principles of learning
• therapist focuses on the client’s problem, identifies
specific thoughts and behaviors that need to be
changed, and provides techniques based on
learning principles to make desired changes
QUESTIONS ABOUT PSYCHOTHERAPY
(CONT’D)
• Are there different approaches?
– Eclectic approach
• involves combining and using techniques and
ideas from many different therapeutic approaches
– Medical therapy
• involves the use of various psychoactive drugs to
treat mental disorders by changing biological
factors, such as the levels of neurotransmitters
INSIGHT THERAPIES
• Psychoanalysis
– Focuses on the idea that each of us has an
unconscious part that contains ideas, memories,
desires, or thoughts that have been hidden or
repressed because they’re psychologically dangerous
or threatening to our self-concept
• Unconscious conflicts
– Chief reason for the development of psychological
problems (paranoia) and physical symptoms (loss of
feeling in a hand)
INSIGHT THERAPIES (CONT’D)
• Psychoanalysis
– Three techniques
• free association, dream interpretation, and analysis
of slips of the tongue
– Transfer
• patient reacts to the therapist as a substitute
parent, lover, sibling, or friend and projects strong
emotions onto the therapist
INSIGHT THERAPIES (CONT’D)
INSIGHT THERAPIES (CONT’D)
• Techniques to reveal the unconscious
– Neuroses
• maladaptive thoughts and actions that arise from
some unconscious thought or conflict and indicate
feelings of anxiety
– Free association
• technique that encourages clients to talk about any
thoughts or images that enter their heads
• assumption is that this kind of free-flowing,
uncensored talking will provide clues to
unconscious material
INSIGHT THERAPIES (CONT’D)
• Techniques to reveal the unconscious
– Dream interpretation
• psychoanalytic technique based on the assumption
that dreams contain underlying, hidden meanings
and symbols that provide clues to unconscious
thoughts and desires
INSIGHT THERAPIES (CONT’D)
• Problems during therapy
– Transference
• client expresses strong emotions toward the therapist
as a substitute for someone important in the client’s life,
such as mother or father
– Resistance
• client reluctant to work through or deal with feelings or
to recognize unconscious conflicts and repressed
thoughts
– Short-term dynamic psychotherapy
• emphasizes a limited time for treatment (20-30
sessions) and focuses on limited goals
INSIGHT THERAPIES (CONT’D)
• Problems during therapy
– Short-term dynamic psychotherapy
• therapists take more active and directive role
– identify and discuss client’s problems
– resolve issues of transference
– interpret client’s behaviors
– offer opportunity for the client to foster changes
in behavior and thinking
– results in more active coping and important
image of oneself
INSIGHT THERAPIES (CONT’D)
• Client-centered therapy
– Also called person-centered therapy; assumes that each
person has an actualizing tendency to develop one’s full
potential
• Therapist’s traits
– Empathy
• ability to understand what the client says, feels
– Positive regard
• ability to communicate caring, respect, and regard
– Genuineness
• ability to be real and nondefensive in interactions
INSIGHT THERAPIES (CONT’D)
INSIGHT THERAPIES (CONT’D)
• Cognitive therapy
– Developed by Aaron Beck
– Assumes that we have automatic negative thoughts
that we typically say to ourselves without much notice
– Repeating these automatic negative thoughts causes
distortion in how we perceive and interpret our world
and influences how we behave and feel
BEHAVIOR THERAPY
• Definition
– Also called behavior modification
• uses the principles of classical and operant conditioning
to change disruptive behaviors and improve human
functioning
• focuses on changing particular behaviors rather than
the underlying mental events or possible unconscious
factors
– Systematic desensitization
• technique of behavior therapy in which the client is
gradually exposed to the feared object while
simultaneously practicing relaxation
BEHAVIOR THERAPY (CONT’D)
• Cognitive-behavior therapy
– Combines the cognitive therapy technique of
changing negative, unhealthy, or distorted thought
patterns with behavior therapy
– Technique of changing maladaptive or disruptive
behaviors by learning and practicing new skills to
improve functioning