Therapies

1. 15 Therapies

2. Therapies Psychotherapy • Specialized process where trained professional uses psychological methods • Differing forms of psychotherapy have differing methods • Psychoanalytic: focuses on gaining insight • Humanistic: focuses on gaining insight • Social learning or behavior therapy: uses forms of teaching

3. Therapies Psychotherapy • Relationship involves power of therapist, emotional patient divulging personal data • Ethical Standards • Goals of treatment understood/agreed to by client; in best interest of client and society • Careful consideration given to alternatives • Therapist treats only within limits of expertise

4. Therapies Psychotherapy • Ethical Standards • Effectiveness of treatment must be evaluated • Rules and laws of confidentiality followed • No abuse of therapist-client relationship • Therapist must treat all humans with dignity; respecting all genders, races, sexual orientation, and other sociocultural factors

5. Therapies Therapies • Psychoanalysis – founded by Freud • Root of all problems is in unconscious conflicts • Imbalance in id, ego, and superego • Conscious insight can resolve conflicts • Special therapy techniques may be used • Free association • Dream interpretation • Interpretation of resistance (from vague forms to specific resistance)

6. Therapies Therapies • Psychoanalysis • Transference – therapist-client relationship takes form of client’s relationships with own parents and other authority figures • Catharsis – emotional experience or temporary relief from discomfort (some insight gained) • Interpersonal psychotherapy for depression • Emerged from psychoanalytic tradition • Identifies sources of depression and goals for therapy process; very successful outcomes

7. Therapies Therapies • Humanistic psychology – Carl Rogers • People not born with unconscious mind • Client-centered therapy or person-centered • Emphasis on client’s ability to help self – feels emotionally safe enough to explore own hidden emotions • Therapist creates unconditional atmosphere (warmth, genuine positive regard, empathy) • Reflection – therapist makes statements to clarify client’s feelings and emotions

8. Therapies Therapies • Gestalt therapy – founded by F. Perls • Humanistic psychotherapy approach • Meanings of sensations organized into whole perceptions • Goal: create therapeutic experience helping client achieve greater self-awareness • Emotional atmosphere: therapists often deal in confrontive, challenging manner necessary to loosen denied feelings

9. Therapies Therapies • Cognitive-Behavior Therapy (CBT) • Abnormal behavior learned from inappropriate experiences through • Classical conditioning • Operant conditioning • Modeling • Learning is central goal of therapy; therapist is teacher and client learns adaptive behaviors • Cognitions less important

10. Therapies Therapies • Cognitive-Behavior Therapy (CBT) • Fear reduction methods using • Graded exposure - series of increasingly fearful situations experienced for gradual mastery • Use of modern technology - computer-generated virtual reality • Treats obsessive-compulsive disorders when used with other methods

11. Therapies Therapies • Cognitive-Behavior Therapy (CBT) • Social skills training • Shaping and positive reinforcement used in role playing • Teach use of adaptive skills enough to handle real-life situations • Focus on social skill problem of unassertiveness

12. Therapies Therapies • Cognitive-Behavior Therapy (CBT) • Cognitive restructuring • Assumes faulty cognitions – maladaptive beliefs, expectations, and thinking • Effective for treating anxiety, depression • Cannot modify clients’ existing behaviors because of inaccurate ways of thinking about themselves

13. Therapies Therapies • Cognitive-Behavior Therapy (CBT) • Cognitive restructuring • Patterns of cognition contributing to emotional distress • Selective abstraction • Overgeneralization • Arbitrary interference • Magnification and minimization • Personalization • Absolutistic thinking

14. Untreated Self-help booklet CBT 35 30 25 20 15 10 5 0 Initial 3 wks 3 mos 6 mos 9 mos Allocation What works best?

15. Therapies Group and Family Therapy • Group therapy • Carried out with groups of 4 to 8 clients; sees experience more effective than individual therapy techniques • Receives encouragement from others • Sees problem experienced by others • Learn from others’ advice • Learn new ways to interact with others • Format of group therapy varies widely

16. Therapies Group and Family Therapy • Family therapy • Group composed of family members • Therapist trained in psychoanalytic, humanistic, and behavioral approaches • Beliefs • Family issues at root of problem • Dynamics of family system need analysis – function of each need to be understood

17. Therapies Group and Family Therapy • Family therapy • Therapists’ goals to resolve problems by improving functioning of family system • Give family members insights and correct family dysfunctions • Increase warmth and intimacy in family • Improve family member communication • Help members establish reasonable set of rules for family regulation

18. Therapies Human Diversity • Ethnic, gender, and sexual issues in mental health • U.S. has one of most advanced mental health system in world – does not cover all citizens • Hispanics - less outpatient care than whites • African Americans – more likely than whites to be committed to psychiatric hospitals (often involuntarily)

19. Therapies Human Diversity • Ethnic, gender, and sexual issues • U.S. mental health system • Fewer women receive mental health services than men • Gender of therapist does not appear to influence outcomes • Feminist psychotherapy – radical approach • Women treated as second-class citizens and Barbie dolls

20. Therapies Human Diversity • Goals of Feminist Psychotherapy • Advocates equal relationship in therapy • Encourage women to see how society limited them to dependent roles • Encourage women to become aware of their anger; find constructive ways of expressing • Have women define selves as independent • Women encouraged to consider own needs • Women should develop nontraditional skills

21. Therapies • Drug therapy • Widely used to treat abnormal behavior • Commonly used psychiatric drugs • Electroconvulsive therapy (ECT) • Transcranial stimulation • Magnetic field used on frontal cortex • Effexor • Paxil • Prozac • Zorloft • Xanax • Geodon • Haldol • Navane • Risperdal • Zyprexa • Depakote • Epilim

22. Therapies Medical Therapies • Psychosurgery • Trephining • Prefrontal labotomy • Modernnames for labotomy surgeries conducted today • Capuslotomy • Cingulotomy

23. Trephining operations were apparently performed in the Middle Ages to treat abnormal behavior

24. Therapies 15 The End