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Transcript
Psychotherapy
A planned
emotionally charged,
confiding interaction
between a trained,
socially sanctioned
healer and a
sufferer.
Therapy
 Psychotherapy
Treatment of emotional and behavioral problems through
psychological techniques, rather than biological
approaches to treatment
Involves conversations, verbal interactions b/w person
with a disorder and someone who’s been trained to
correct that disorder
 Eclectic Approach
an approach to psychotherapy that, depending on the
client’s problems; uses blended technique, pulls from
various forms of therapy
Therapy - Psychoanalysis
 Psychoanalysis
Freud believed the patient’s free associations, defense
mechanisms, resistances, dreams, and transferences (and
the therapist’s interpretations of them) released previously
repressed feelings often from childhood
Historical reconstruction, allows patient to gain self-insight
significantly decreased use in recent years, takes time,
very expensive
 Resistance
blocking flow of free associations to consciousness, often
anxiety-laden material
Any unconscious behaviors by patient that hinder the
progress of therapy (being late, missing sessions, anger at
therapist.)
Therapy- Psychoanalysis
Interpretation
analyst offers insights, alternative way of looking at dream
meanings, resistances, other behaviors based on patient’s
possible unconscious needs and desires in order to
promote insight
Transference
based on therapist’s neutral relationship with patient
patient transfers to therapist the emotions, feelings,
perceptions linked with other relationships
Ex: love or hatred for a parent
signs of transference include falling in love or being hostile to
therapist
lacking confidence in one's own ability, worth, or fitness; timid;
shy
https://www.youtube.com/watch?v=uZq_U2hbnvs&feature=related
Humanistic Therapy
 Client-Centered Therapy - Carl Rogers
therapist uses techniques such as active listening within a
genuine, accepting, empathic environment to facilitate
clients’ growth, unconditional positive regard, self
actualization
focuses on clients’ own point of view, not therapists’
interpretations, acts as psychological mirror, boosts self
awareness, focused on present and future – NOT past
 Active Listening
empathic listening in which the listener echoes, restates,
and seeks clarification, acknowledges client’s feelings
 understands emotion and content of clients’ statements
Behavior Therapy
 Behavior Therapy
applies learning principles to the elimination of
unwanted, troubling behaviors
assumes both normal and abnormal behaviors are
learned and can be replaced w/ constructive behaviors
 Counterconditioning
procedure that conditions new, more adaptive
responses to stimulus that triggers unwanted behaviors
based on Pavlov’s Classical Conditioning
includes systematic desensitization (gradual), exposure
therapy and aversive conditioning
Behavior Therapy
Systematic Desensitization
type of exposure therapy; counterconditioning
associates a pleasant, relaxed state with exposure
to gradually increasing anxiety-triggering stimuli
commonly used to treat phobias
Aversive Conditioning
type of counterconditioning that associates an
unpleasant state or stimulus with an unwanted
behavior; aversive response to a harmful stimuli
Nausea drug in drinks ---> alcoholics
 https://www.youtube.com/watch?v=KZag1zlecGI
Behavior Therapy
Systematic Desensitization
Behavior Therapy
UCS
(drug)
Aversion
therapy
for
alcoholics
UCR
(nausea)
CS
(alcohol)
UCS
(drug)
UCR
(nausea)
CS
(alcohol)
CR
(nausea)
Behavior Therapy
Token Economy
operant conditioning procedure that rewards
desired behavior, can also punish
inappropriate behavior via “fines”
patient exchanges a token of some sort,
earned for exhibiting the desired behavior,
for various privileges/treats
Often used in institutional settings (schools,
hospitals, prisons, with disturbed children,
schizophrenics and AP Psych classrooms)
Behavior Therapy
Token Economy Criticisms
Dependent on extrinsic rewardswhat happens when the reinforces
stop?
Subjective-Is it right for one
human being to control another’s
behavior, is behavior modification
too authoritarian?
Cognitive Therapy
Emphasizes recognizing and changing negative
thoughts and maladaptive beliefs (depression,
anxiety).
Teaches new, more adaptive ways of thinking
and acting (no more self-blame, criticism)
Goal – change, restructure client’s thinking
process
Person’s emotional reactions are produced not
by the event (job loss) but by the person’s
thoughts in response to the event
Cognitive Therapy
The
Cognitive
Revolution
Cognitive Therapy
Lost job
Internal beliefs:
I’m worthless.
It’s hopeless.
Depression
Lost job
A cognitive
perspective
on
psychological
disorders
Internal beliefs:
My boss is a jerk.
I deserve something better.
No
depression
Cognitive Therapy
Cognitive-Behavioral Therapy (C.B.T.)
Aaron Beck identified patterns of thinking that correlated with symptoms
of depression. To understand depression and related illness, he
developed the Beck Depression Inventory, Beck Anxiety Inventory, and
the Scale for Suicide Ideation. Best known for cognitive approach to
treatment of disorders, especially depression, did much of the initial
research on the theory that distorted or inaccurate thoughts are
precursor in the development/continuation of depression.
CBT exposes and confronts the client’s dysfunctional thoughts; a
popular, integrated therapy that combines cognitive therapy (changing
self-defeating thinking) with behavior therapy (changing behavior)
http://www.youtube.com/watch?v=3Y8VKs3__cA&feature=related
Cognitive Therapy
Rational Emotive Behavior Therapy- focuses
on uncovering irrational beliefs which may lead to
unhealthy negative emotions, replacing them with
more productive rational alternatives
Albert Ellis’ REB theory - it is generally irrational
and self-defeating to get all worked up about
someone else's behavior
RET is a direct, confrontational form of therapy that
challenges client’s irrational beliefs. Replace
irrational thoughts with those that are appropriate
and less distressing.
RET therapists – a warm client/therapist is not
necessary
Rational Emotive Behavior
Therapy
Proposed by Albert Ellis ABC Theory: Attempts to
restructure a person’s belief system into a more realistic,
rational, and logical set of views. Goal is D (Disputing)
the irrational thoughts and emotions.
Group Therapies
Family Therapy
treats the family as a system; often less
expensive and less time intensive than
individual therapy
views an individual’s unwanted behaviors as
influenced by or directed at other family
members; no one is an island
attempts to guide family members toward
positive relationships
improve communication
Who Practices Therapy?
To whom do
people turn
for help for
psychological
difficulties?
Who Practices Therapy?
Clinical Psychologists
Trained to diagnose, test and treat
individuals with psychological disorders
Most are psychologists with Ph.D. and
expertise in research, assessment, and
therapy, supplemented by supervised
internship
About half work in agencies and institutions,
half in private practice
Who Does Therapy?
Clinical or Psychiatric Social Worker
Two-year Master of Social Work graduate
program plus postgraduate supervision
prepares some social workers to offer
counseling and psychotherapy, mostly to
people with everyday personal and family
problems.
About half have earned the National
Association of Social Workers’ designation of
Clinical Social Worker.
Who Does Therapy?
Counselors
Marriage and family counselors
specialize in problems arising
from family relations.
Pastoral counselors provide
counseling to countless people.
Abuse counselors work with
substance abusers and with
spouse and child abusers and
their victims.
Who Does Therapy?
Psychiatrists
Medical doctors who specialize in the
treatment of psychological disorders
Not all psychiatrists have had extensive
training in psychotherapy, as MD’s they can
prescribe medications
Tend to see those with the most serious
problems
Many have a private practice
Biomedical Therapies
Psychopharmacotherapy
Treatment of the mental disorders with medication
Anti mania (Lithium Carbonate)
provides an effective drug therapy for the mood swings of
bipolar (manic-depressive) disorder, 80% effective, dosage
must be exact and constantly monitored
Anti psychotic (Clozapine, Thorazine, Haldol)
used in the treatment of schizophrenia for disorganized and
psychotic thinking. Used to help treat false perceptions (e.g.
hallucinations, paranoia or delusions.), 60-70% of patients
show improvement. Can cause tardive dyskinesia – tremors,
muscle movements.
Biomedical Therapies
The emptying of U.S. mental hospitals
State and county
mental hospital 700
residents, in 600
thousands
500
Introduction of antipsychotic drugs
Rapid decline
in the mental
hospital
population
400
300
200
100
0
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990
Year
Biomedical Therapies
Biomedical Therapies
 Electroconvulsive Therapy (ECT)
therapy for severely depressed patients in which a brief electric
current is sent through the brain of an anesthetized patient.
Routinely used in 1940’s - 50’s for schizophrenia and
sometimes mania. Not commonly used now, no one knows
why/how it worked, the seizure that resulted may temporarily
change the biochemical balance in the brain.
 Psychosurgery
surgery that removes or destroys brain tissue in an effort to
change behavior, only used for serious disorders
Lobotomy - frontal lobes surgically separated from brain
centers controlling emotion, now-rare psychosurgical
procedure once used to calm uncontrollably emotional or
violent patients (left impaired intellect, loss of motivation,
personality changes). Left patients permanently lethargic.
The Placebo Effect
 Any substance that is not known to have any pharmacological
effects (produces no meaningful changes in an organism, either
chemical, biological, etc.) that is made to look like an active ("real")
drug
 Sometimes the act of taking a pill produces an effect if the person
believes the pill is active
 https://www.youtube.com/watch?v=Zihdr36WVi4
Biomedical Therapies
Electroconvulsive Therapy
Biomedical Therapies ECT
https://www.youtube.com/watch?v=9L2B-aluCE
https://www.youtube.com/watch?v=44sU
rJytcLI – Patient after ECT
And we’re done
 http://www.youtube.com/watch?v=iQgMXOW0FLU&feat
ure=email