Therapy

1. Therapy

2. Psychodynamic Therapy

3. Psychodynamic Therapy • Used for unfocused anxiety/depression • Psychoanalysis- pioneered by Freud intensive technique for exploring the unconscious - Freud believed that anxiety disorders are inabilities to resolve inner conflicts (they become repressed) in the unconscious between the id and the superego

5. Psychodynamic Therapy • GOAL of Psychoanalysis: - make unconscious conflict  conscious - repressed material can then be dealt with - ego can be strengthened & defense mechanisms do not need to be used

6. Job of the Therapist • Main job: help a patient bring repressed thoughts into consciousness & gain insight into the relationship between current symptoms & the repressed conflict

7. Job of the Therapist • Therapy succeeds when patients are released from the repression established in early childhood - often through catharsis (AKA insight therapy) – expressing strong felt, but usually repressed emotions; a healing emotional release

8. Job of the Therapist • It is an attempt to reconstruct long-standing repressed memories & work through painful feelings to an effective resolution • This takes years, requires introspective patients who are highly motivated, verbally fluent & have $ to continue the therapy

9. Techniques Used • Free Association- say whatever comes to mind regardless of painful or irrelevant thoughts - therapist will note patterns that lie beneath the words (the surface) 2. Catharsis- see notes

10. Free Association • Start with a recent experience, memory, or dream and write every image or idea that enters your awareness • Don’t self-edit OR refrain from logic

11. Techniques Used 3. Dream Analysis- examines content of a person’s dreams to discover motivations, life experiences, desires - 2 kinds of content: a) manifest- people remember upon awakening b) latent- hidden, deeper content

12. Techniques Used 4. Analysis of Transference- transferring of feelings about a person in the past to the therapist due to unfinished business - positive- feeling of love/admiration - negative- feeling of anger/hostility - therapist provides a stage for re- enacting unresolved conflicts

13. Techniques Used 5. Analysis of Countertransference- - therapist begins to view client as someone in therapists life & projects feeling toward the client - can provide useful material to look at with client, but must be careful - become mirrors for one another

14. Techniques Used 6. Analysis of Resistance - individuals put up barriers to free association - resisting to “work” with the therapist - therapist’s job is to break down areas the client does not want to discuss

15. Techniques Used • Projective Techniques- help access unconscious, esp. in children - Rorschach, TAT, incomplete sentences, draw a picture

16. Behavioral Therapy

17. Behavioral Therapy • Abnormal behaviors are acquired through a learning process that follows basic principles of conditioning & learning • Therapy includes applying principles of conditioning & reinforcement to increase frequency of desired behaviors or decrease frequency of problem behaviors

18. Behavioral Therapy • Problems that generally use behavior modification/therapy: - fears/phobias, compulsions, depression, addictions, aggression, & delinquent behavior

19. Behavioral Therapy • When people can’t cope effectively, their maladaptive reactions can be overcome by therapy based on learning or relearning

20. Behavioral Therapy • 3 Types of Behavioral Therapy: • Counter-Conditioning- - a new response is conditioned to replace or “counter” a maladaptive response ex. Child afraid of the dark  have child listen to their favorite song while sitting in the dark

21. Behavioral Therapy - Techniques Used: a) systematic desensitization- client is taught to prevent the arousal of anxiety by confronting the feared stimulus & using relaxation techniques; used for social phobias (The King’s Speech);

22. Behavioral Therapy b) implosion- opposite; exposes a client to anxiety, provoking the stimuli (most frightening is the imagination) but in a safe setting; person cannot run away; “tough love” c) flooding- client is placed in or exposed to the phobic situation; used for agoraphobia

23. Behavioral Therapy *all 3 have in common  exposure through imagery, contact, or virtual reality; all are exposed to object feared

24. Behavioral Therapy d) aversion therapy- used for patients attracted to harmful stimuli (drug addictions, violent behavior); an attractive stimuli is paired with shock or drugs (noxious stimuli) to get the patient to pair the noxious stimuli with the harmful behavior

25. Behavioral Therapy 2. Contingency Management- Skinner; changing behavior by modifying consequences (operant cond.) - Techniques Used: a) token economy- positive reinforcement; desired behaviors are defined & token payoffs are given when behavior is performed (gold stars); can later be exchanged for rewards, etc.

26. Behavioral Therapy 3. Social Learning Theory- clients observe models’ desirable behaviors being reinforced b/c people learn via observation - used to overcome phobias & to build social skills - based on Bandura’s research

27. Behavioral Therapy - Techniques Used: a) Participant Modeling- therapist demonstrates desired behavior & client is helped to imitate behavior with support & encouragement b) Behavioral Rehearsal- visual; how one should behave in a situation  helps strengthen social skills

28. Behavioral Therapy Most common problem: lack of assertiveness  often in children (have deficits in social skills that may lead to problems later)  pre-schools, elem. schools look to build skills in withdrawn, isolated children

29. Cognitive Therapy

30. Cognitive Therapy • Attempts to change the feelings & behaviors by changing the way a client thinks about or perceives significant life events

31. Cognitive Therapy • Abnormal behavior patterns start with problems in what people think & how they think (cognitive process) • Therapy will focus on changing how people think

32. Cognitive Therapy

33. Cognitive Therapy • 2 Types of Cognitive Therapy: 1. Cognitive Behavior Modification- • Combines thoughts w/ focus on reinforcement contingencies in modifying performance • Unacceptable behavior patterns are changed/modified by cognitive restructuring

34. Cognitive Therapy • Change the person’s negative self statement into constructive coping statements • Ex. I am boring, no one will invite me to another party. Change this thought to  next time I’ll tell a joke, be proactive, or more responsive to other’s stories

35. Cognitive Therapy • Step 1: figure out together the kind of thinking that is leading to dysfunctional behavior • Step 2: develop new self-statements that minimize negative thoughts that elicit anxiety or lower self-esteem

36. Cognitive Therapy • Step 3: set goals • Step 4: develop strategies for meeting them  develop self-efficacy • Step 5: evaluate feedback

37. Cognitive Therapy - Changing False Beliefs- cognitive therapy for depression (Aaron Beck) - depression arises when people are unaware of their negative automatic thoughts & faulty thinking

38. Cognitive Therapy - often emotional stress is caused by cognitive misunderstanding and failure to distinguish between reality & one’s expectations  MUST challenge patient’s basic assumptions

39. Cognitive Therapy 2. Rational Emotive Therapy (RET)- based on the transformation/changing of irrational beliefs that cause severe emotional reactions (ex. Anxiety) - Ellis

40. Cognitive Therapy - teach the client to recognize the “shoulds, oughts, haves, & musts” that control their actions & prevent them from choosing the life they want

41. Cognitive Therapy - through rational confrontation, client can dispute & examine alternative reasons for their thoughts/actions - this is followed up by replacing dogmatic thinking w/ rational, situationally appropriate ideas

42. Cognitive Therapy - it aims to increase individual’s self-worth by getting rid of faulty beliefs that block personal growth

43. Group Therapy

44. Group Therapy • Can sometimes be more effective • Less Expensive- small # of mental health personnel can help more people • Power of Groups- less threatening, provides opportunities to practice interpersonal skills and observe others

45. Group Therapy • Allows for corrective emotional experiences to take place in a “family-like” atmosphere • Helps people realize they are not alone • Provides social support outside of therapy

46. Group Therapy • Different Types: • Marital & Family- each member is treated as a member of a system of relationships - therapist helps to understand what the problems are in the family

47. Group Therapy - seeks to help communication, understand communication styles & how to express themselves - therapist acts as interpreter, clarifier, mediator, & referee when helping to resolve dysfunctional elements

48. Group Therapy 2. Community Support Groups - 10+ million Americans participate in self-help groups - pioneered by women’s groups & AA - 4 Main Groups:

49. Group Therapy a) Addictive behavior b) Physical/mental disorder c) Life transition or other crises d) Traumas experienced by friends or relatives w/ serious problems

50. Group Therapy • Many groups popping up on the Internet  providing social support, hope & control for problems; people dispense info about disorders & treatments