Introduction to Psychotherapy

4. Introduction to Psychotherapy Sadia Zafar Dr. Bilal Durrani Naila Islaam

5. Historical background: Beliefs and treatment of the mentally ill • people with psychological disorders were subjected to such techniques as “skull-holes” and “placement in insane asylums.” • Only in recent historical times have people received decent, effect therapy for their psychological problems and disorders.

6. The Definition of Therapy: Psychotherapy is a word deriving from Ancient Greek,psyche(meaning "breath; spirit; soul") &therapia("healing; medical treatment"). • It is defined as the establishment of a helping relationship between a patient and a trained professional in which he or she attempts to treat and to remedy the client’s psychological difficulties.

8. The Definition of Therapy: • Psychotherapy involves the treatment of: disturbed thoughts; (2) disturbed emotions; (3) disturbed behaviors; (4) interpersonal and life situation difficulties; and (5) biomedical disturbances.

9. Professionals Who Provide Psychotherapy • Clinical Psychologists • Ph.D. in psychology, conducts testing, diagnosis, treatment, counseling & research • Psychiatrists • M.D., does a residency in psychiatry and can prescribe medications. • Psychiatric Nurses: • Trained nurses, usually with additional specialized training in psychiatric problems.

10. Reasons for seeing a mental health professional(Murstein & Fontaine, 1993) Major Depression (21%)Relationship and couple problems (17%)Child rearing problems (19%)Difficulty in social and work relations (5%)Suicidal thoughts (5%)Alcohol/Drug dependence (3%)Obsessions (3%)Sexual dysfunctions (3%)Weight loss/Eating disorders (3%)Spousal/partner abuse (2%)Psychotic symptoms (2%)

11. Types of Therapy • There are 4 main types of therapy: • Psychodynamic. • Humanistic. • Behavioral-Learning. • Cognitive. • Group therapy • Family & couple therapy

12. The Psychodynamic Approachto Therapy: • Psychodynamic Therapy: emphasizes the role of unconscious conflict. • Therapy Focus: bring the conflict to consciousness. • Source of the problem: childhood problems and unconscious conflicts. • Techniques of therapy: psychoanalysis, free association, and dream analysis. • Psychological component emphasized: suppressed emotions.

13. The Humanistic Approachto Therapy: • Empathy: • Looks at life from the client’s perspective. • Active involvement in the client’s world by imagining what it would be like to be the client. • Genuineness: • Shows honesty with client. • Requires therapists to let their inner feelings appear open and honest during therapy. • Unconditional positive regard: • Shows warmth and caring for the client. • Caring acceptance of the client’s individuality regardless of what the client says or does.

14. The Cognitive Approachto Therapy: • Cognitive Therapy: emphasizes the role of maladaptive and dysfunctional thinking. • Therapy Focus: restructure/change maladaptive and dysfunctional thinking. • Source of the problem: maladaptive thinking. • Techniques of therapy: client conducts self-statement modification; stress-inoculation. • Psychological component emphasized: thoughts.

15. The Cognitive Orientation to Therapy: • Three types of Cognitive Therapy: • Stress-Inoculation therapy. • Rational-Emotive Behavior Therapy. • Cognitive Therapy.

16. Cognitive Therapies:Rational-Emotive Behavior Therapy • In this, client learns to challenge and change dysfunctional-irrational thinking and, ultimately, behavior. • A. Ellis focuses on restructuring cognitions that are based on dysfunctional-irrational beliefs. • Challenge dysfunctional-irrational beliefs: “I must be perfect or no one will love me!” “I must be thoroughly competent, adequate, and successful in all possible respects if I am to be worthwhile.” “It is horrible when things do not turn out the way I want them to.”

17. Cognitive Behavior Therapy: Examples of thinking errors • Overgeneralization: • One person rejects your request for a date and you conclude that anyone you approach will also reject you. • Magnification/minimization: • You miss exercising for two days and you tell yourself, “I’ll never get in shape”. • Arbitrary Inference: • Your girlfriend is late picking you up and you suspect she wants to break up with you.

18. Psychological Therapies Cognitive Therapies Activating Event - Beliefs - Consequences

19. The Behavioral-Learning Approachto Therapy: • Behavioral-Learning Therapy: emphasizes the role of inappropriate learning. • Therapy Focus: identify and correct specific undesirable behaviors. • Source of the problem: inappropriate learning. • Techniques of therapy: systematic desensitization and behavior modification. • Psychological component emphasized: behaviors.

20. Behavioral (Learning) Approachesto Therapy: Classical Conditioning Therapies: 1. Systematic Desensitization: This approach uses progressive relaxation, the construction of an anxiety hierarchy, andcounter-conditioning. 2. Aversion Therapy: The goal of aversion therapy is to make a formerly pleasurable, but maladaptive, behavior become unpleasant.

21. Behavior (Learning) Therapies:Abnormal behaviors canbeunlearned. (1) Systematic Desensitization: A relaxation response is repeatedly paired with a stimulus that evokes anxiety in the hope that the anxiety will be alleviated. • Client relaxes while thinking aboutincreasingly more threatening images of phobic object. • Dog phobic remains relaxed while imagining a dog in the room, licking her hand, in her lap. (2) Aversion Therapy: Pair an unpleasant stimulus with an object that causes an inappropriate response. • Show a pedophile pictures of a child while delivering a shock.

22. Group Therapies: • Therapy in which people discuss problems with a group. • Psychotherapy with 4 - 8 clients. • Some advantages over individual therapy: • Experience interacting with other group members. • Discovering that others experience similar problems. • Receiving support and advice from other members.

24. How are therapy groups constructed? Groups may be, 1.Homogeneous Similar diagnosis 2.Heterogeneous a mix of individuals • The number of group members ranges from five to 12.

25. Family Therapy • In family therapy, the family system as a whole--not just one family member identified as having the “problem”--is treated. • Family therapy deals with problems involving family structure and family interaction patterns. • Many family therapists assume that family members fall into rigid roles, with one person acting as the scapegoat (i.e., as the “disturbed” family member).

26. Marital - Couples Therapy couples learn about compromises and expectations. • Compromises: Couples learn how about the give-and-take of intimate relationships. • Expectations: Couples learn that they sometimes have unconscious/conscious expectations about how they expect their partners to behave: • expect males to: car care, lawn care, etc. • expect females to: clean house, child care, etc.

27. Which of these is not psychotherapy? • To counsel a couple with marital difficulties . • A university Counseling Center psychologist with an M.A. helping a student choose a career • A police officer “talking down” a suicidal teenager from a tall building . • A family having a loud argument in a therapist’s office

28. Are Some Therapies Better Than Others? • All approaches are equally effective. • However for some disorders, certain types of therapy tend to be more successful. • Examples: behavioral therapy for phobias, person-centered therapy for raising self-esteem, and cognitive therapy for depression. • There is no universal “best” type of therapy.

29. Perspectives on PsychotherapyWhat is the Future of Psychotherapy? Eclectic: Borrowing ideas and techniques from different approaches

37. Thank you for being a good listener Questions and comments