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Therapy

Therapy. Psychology 1107. Introduction. Remember Trephining? Bloodletting? Beatings? Changed with Pinel In general there are two approaches Psychological biomedical. Eclectic Approach. Today most people take bits and pieces form each

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Therapy

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  1. Therapy Psychology 1107

  2. Introduction • Remember Trephining? Bloodletting? Beatings? • Changed with Pinel • In general there are two approaches • Psychological • biomedical

  3. Eclectic Approach • Today most people take bits and pieces form each • There are, literally, hundreds of types of ‘talking therapies’

  4. A wee bit of history • Psychoanalysts got it all going • Disorders come from childhood experience and unresolved conflicts • Repression etc. • Bring repressed feelings to conscious awareness • Get rid of energy directed at id-superego conflict

  5. Lie back and tell me whatever comes to mind…. • Free association • Pauses • Slips • Show resistance • Analyst interprets for you, provides insight • transferrence

  6. The key • The key to the whole idea is repressed memories • Hmmmmm • Impossible to disprove analyst’s interpretations • And at 100 bucks an hour, three times a week….

  7. The Humanistic approach • When we talked about personality we talked about how humanistic psychologists are interested in ‘self-actualization’ • Humanistic therapy focuses on this • Care about the present and the future • Care about the conscious

  8. La la la la la la live for todaaay • Take responsibility • Growth and fulfillment, not curing some disease • Clients, not patients • Help them reach their potential

  9. Mr. Rogers Neighbourhood • Carl Rogers • Person’s interpretations not therapist’s • No judgement • Non directive • Genuineness • Openness • Acceptance • empathy

  10. It all sounds so nice… • Therapist must show unconditional positive regard • Echoing and restating • Basically a mirror the client can use

  11. Gestalt Therapy • Fritz Perls • Kind of humanistic and unconscious • Make client self aware by breaking down defenses • Still emphasizes the here and now, not the past • Still about responsibility

  12. Behaviour therapies • Instead of urges, actualization and all of that, what about the BEHAVIOUR? • Use of learning theory • Basically classical and operant conditioning approaches applied

  13. Classical conditioning • Systematic desensitization • Use of counter conditioning • Wolpe’s ideas, based on Cover-Jones • Anxiety hierarchy • Progressive relaxation • Pairing the two • Flooding • Aversive counter conditioning

  14. Operant approaches • Modify behaviour with reward • Token economies • What about when they leave? • Ethics?

  15. Cognitive Therapy • Thinking affects feeling • Feeling affects thinking • Well stop blaming yourself, it is not your fault • Basically learn new thinking patterns

  16. Rational Emotive • Ellis • Confront illogical thinking • Blunt • Sort of the anti Rogers • Beck’s approach for depression is a bit different • Not as blunt

  17. It is not all about you • Teach clients how non depressed people think • Can ‘vaccinate’ at risk people • Cognitive and behavioural approaches often combined into Cognitive Behaviour Therapy

  18. Family/Group Therapy • Hell of a lot cheaper… • Support groups • Family therapists treat the whole family • There are many talking therapies, many approaches, but one question lingers…..

  19. DOES IT WORK? • Ask the clients, they like it • Ask the therapists…. • Oh how about SCIENCE? • Eyesenk estimated that 67 percent recover on their own! • Not many studies then, many today

  20. Meta analysis • More improvement than chance for those in therapy • Very general • What type is the best? • Phobias best • Schizophrenia, personality disorders, not so much….

  21. Seems the therapy type is not as important as the therapist • Hope • Perspective • Empathy • ‘pseudotherapists’ can be as good for small problems • Cultural differences between therapists and clients

  22. Biomedical • Drugs! • Sounds good, but we still have to worry about the outcomes • Schizophrenia, very effective • Dopamine hypothesis, pretty much confirmed

  23. Antidepressants • Increase NE and 5Ht • SSRI and TCA • Some block breakdown • MAOI • Side effects • Li

  24. ECT • Now for sever depression that does not respond to drugs • Rare • Does work though • Why? • dunno

  25. Surgery • Even rarer • I’d rather have a bottle in front of me…. • Seizures • May come back now that we are learning more about the braim

  26. Prevention • Poverty • Stress • At risk people • Genetic markers

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