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Psychological Therapies Therapy There are over 250 identifiable types of psychotherapy, though the most influential are: Psychoanalysis Therapies Humanistic Therapies Behavior Therapies Cognitive Therapies Medical Therapies Any therapist who uses a combination of therapies is said to be using an “eclectic” approach to therapy Psychoanalysis Why does the patient have a disorder? Psychoanalysis assumes that many problems are fueled by the childhood repression of impulses and conflicts. Disorders are based on fixations and defense mechanisms used to cope with unresolved life issues. You’re depressed because your relationships never work out. What’s the real reason it never works out? Lets look at the people you date…too much like Mom or Dad? Your addiction to drugs is based on the need to keep your memories of traumatic events hidden. Your insomnia is due to recurring nightmares that are symbolic of stressful life events. Your split personality is a reaction formation to being bullied. What strategies do these therapists use to help their patients? It is the job of a psychoanalyst to bring the repressed feelings into conscious awareness and gain insight as to the real source of a patient’s problem in order to resolve the conflict and bring to closure its accompanying behaviors. Free Association A method of exploring the unconscious, in which a person relaxes and says whatever comes to mind, no matter how trivial or embarrassing. Free Association Patients will instinctively avoid painful discussions and show signs of stress when they free associate. This is called resistance. The therapist will hone in on these areas of resistance and try to reveal the true problem of the patient. How to reveal the latent content? Hypnosis Inkblots TAT Tests Dream Analysis Transference Sometimes while revealing their secrets, patients may begin to experience strong feelings towards their therapists. Transferring emotions from one experience to the therapist is called transference. It’s then easier to deal with emotions if they aren’t as personalized anymore. Humanistic Therapies Why does the patient have a disorder? Disorders arise when people feel like they’ve underachieved, when they perceive themselves as less than ideal, or when they haven’t reached their fullest potential. (SelfActualization) IE. My depression is caused by the fact that I didn’t get a promotion, therefore I must be a very bad employee. (Safety, Esteem) IE. The secondary personality of Charlie arises when Steve feels bullied. Steve is too weak to deal with it, but Charlie can. (Safety) IE. Timmy broke up with me because I’m fat. I’ll stop eating so I can be thin. (Love and Belongingness) What strategies do these therapists use to help their patients? A therapist needs to recognize where the barriers to reaching self-actualization are (is it a safety issue? an esteem issue?), and help the client improve in this area in order to reach their potential. The symptoms of the disorder should fade as a person improves. Free Will Patients need to be reminded that they are capable of controlling their own destiny I don’t have to be a bad employee. I can either do better at this job, or get a new job that maximizes my skills. I don’t have to lose weight. I can date who I want to, be friends with who I want to, with someone who appreciates me. Client-Centered Therapy There are four parts to this interaction between therapist and patient. It involves setting achievable goals for the patient so that they can overcome their problems. Genuineness is authenticity. Aware of one’s own true inner thoughts and feelings. Being able to share and be honest with each other. Unconditional Positive Regard is finding value in yourself and finding a level of mutual respect during sessions. Empathetic Understanding is the sharing and understanding of feelings and sensitivity. Active Listening Active-listening involves a therapists technique of listening intently, echoing, restarting and seeking clarification, and acknowledgement of a clients expressed verbal and non-verbal emotions “I understand that…..” “So, what you’re saying is…” “Ok, let’s talk about this a bit more…” “How did that make you feel…” OK, maybe I did do everything I could to get the promotion and I’m just underappreciated. Maybe I did everything I could in that relationship, and it wasn’t my fault that it ended. Cognitive Therapies Why does the patient have a disorder? Cognitive therapy assumes that faulty thought processes and beliefs create problem behaviors and emotions. When people hold beliefs that are irrational, that are overly demanding, or that fail to match reality, their emotions and behaviors may become disturbed. What strategies do these therapists use to help their patients? Cognitive therapy involves learning skills that allow you to see the connection between thoughts and upsetting feelings, to appraise the accuracy of these thoughts that are creating upsetting feelings, and if they are inaccurate, to make them more accurate. A therapist wants to change the thought processes of patients from negative to positive to alleviate disorder symptoms. Rational-Emotive Behavior Therapy Identify the activating event, which is the stimulus for the feelings and behaviors. Understand the belief system, which is the patient’s interpretation of the activating experience Observe the emotional and behavioral consequences that the patient experiences as a result of their belief system Dispute, or challenge, the erroneous belief with logic, with rational thought Behavior Therapies Why does the patient have a disorder? Behaviorists believe that problem behaviors are learned behaviors. To treat disorders is to eliminate or unlearn the problem behavior through various methods of counterconditioning What strategies do these therapists use to help their patients? Classical Counter Conditioning Systematic Desensitization Implosive Therapy Aversive Conditioning Systematic Desensitization is also known as exposure therapy. A therapist is attempting to gradually substitute a positive response for a negative response to a harmless stimulus. Four Steps of SD Progressive Relaxation A method of successfully relaxing one muscle group after another until a deep state of relaxation is achieved. Anxiety Hierarchy A patient creates a list of anxiety provoking images associated with the feared situation, arranged in a hierarchy from least to most anxiety producing. Control Scene - A soothing mental image to initiate muscle relaxation. If you begin to feel stressed, think of….walking on a beach, a sunny day, etc. Systematic Desensitization While deeply relaxed, the patient imagines the least threatening scene in the anxiety hierarchy. As long as they stay relaxed, they progress upwards. If they feel stressed, they find their control scene and start over. Gradually, a patient works from imagining the scenes to experiencing the events in real life. Lowest to Highest – Fear of Flying • • • • Packing luggage Realizing you have to make a flight Making reservations Driving to the airport Checking in Waiting for boarding Boarding the plane Waiting for departure Taking off Climbing to cruising altitude In-flight service Moving around the cabin Turbulence Descending Landing Implosive Therapy Floods patients with their worst fears first, in hopes that by confronting their worst fears, they’ll learn how to not back down Aversive Conditioning In aversive conditioning, a therapist tries to replace a positive response to a harmful stimulus with a negative response. IE. Dave enjoys sucking his thumb at night. This is a bad habit. A therapist would cover Dave’s thumb with hot pepper before bed time. Dave does not like the taste of hot peppers, and therefore he will stop sucking his thumb. Operant Counter Conditioning Token Economy A token economy is one in which a therapist rewards patients for displaying appropriate behaviors by giving them a token, such as a ticket or a plastic coin, that they can later exchange for prizes or gifts. Medical Model Why does the patient have a disorder? Patients have physical medical issues related to the brain, blood chemistry, hormonal and/or neurotransmitter imbalances, or traumatic injuries. What strategies do these therapists use to help their patients? Electroconvulsive Therapy Patient’s brains are given momentary shock treatments, generally for about 30 minutes. Only used in cases of deep depression, it may work by helping the release of norepinephrine in the brain, which is responsible for elevating arousal and mood. Psychosurgery Surgery that removes or destroys brain tissue in an effort to change behavior. Once popular, but no more, a lobotomy cuts the nerves that connect the frontal lobe to the emotioncontrolling centers in the inner-brain. Psychopharmacology The study of the effects of drugs on the mind and behavior Antipsychotic Drugs Drugs used for the purpose of calming psychotic patients (such as schizophrenia) characterized by defective or lost contact with reality (ie. hallucinations, paranoia, apathy, withdrawal) IE. Thorazine, Clozaril, Haldol Most antipsychotic drugs work by attaching themselves to receptor sites for dopamine, thus blocking their transmission from neuron to neuron, and helping to alleviate the hallucinations related to schizophrenia. Antianxiety Drugs Are used for the purpose of alleviating the symptoms stemming from frightening situations and fear-inducing stimuli IE. Xanax, Valium Antianxiety drugs work by depressing the central nervous system activity, generally by increasing the effectiveness of the calming neurotransmitter, GABA. Antidepressant Drugs The purpose is to lift people up from a state of depression IE. Prozac, Paxil, Zoloft Antidepressant drugs work by increasing the availability of norepinephrine and/or serotonin, which elevate arousal and mood Lithium is an antidepressant used mainly for manicdepressives (bipolar) Clips Cognitive Therapy – Modifying Negative Thoughts https://www.youtube.com/watch?v=a0YyC1iS8Rc&feature=related Behavioral Therapy - Systematic Desensitization https://www.youtube.com/watch?v=Nkd7zcvFQ5w https://www.youtube.com/watch?v=co7BWWoF-5I Psychodynamic Therapy – What to Expect https://www.youtube.com/watch?v=A_oGjPAPepk Humanistic Therapy – Carl Rogers/Client-Centered Therapy https://www.youtube.com/watch?v=ZBkUqcqRChg&feature=related