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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