psychological therapies

1. 13 psychological therapies

2. why study therapies for psychological disorders?There are almost as many therapy methods as there are disorders. Correctly matching the type of therapy to the disorder can mean the differ- ence between a cure or a crisis. It is important to know the choices available for treatment and how they relate to the different kinds of disorders so that an informed decision can be made and the best possible outcome can be achieved for mental health and wellness.

3. Learning Objective Menu • LO 13.1 Two ways modern ways to treat psychological disorders • LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • LO 13.3 Basic elements Humanistic therapies • LO 13.4 Behavior therapists’ use of classical and operant conditioning • LO 13.5 Goals of cognitive therapies • LO 13.6 Types of group therapy • LO 13.7 Effectiveness of psychotherapy • LO 13.8 Types of drugs used to treat psychological disorders • LO 13.9 Modern electroconvulsive therapy and psychosurgery • LO 13.10 How might computers be used in psychotherapy

4. Two Kinds of Therapy LO 13.1 Two modern ways to treat psychological disorders • Therapy • Treatment with goal of improved mood and functioning • Psychotherapy • Treats mental disorders

5. Two Kinds of Therapy LO 13.1 Two modern ways to treat psychological disorders • Psychotherapy • Talk with a psychological professional • Insight therapy • Gain insight about behavior, thoughts, and feelings • Action therapy • Change behavior directly

6. Two Kinds of Therapy LO 13.1 Two modern ways to treat psychological disorders • Biomedical therapy • Treatment with biological or medical methods to relieve symptoms • Includes drugs, surgical methods, electroconvulsive treatment • Medication alone not sufficient • Treats symptoms of disorder • Psychotherapy builds coping strategies, aids in adjustment

7. Treatment in the Past LO 13.1 Two modern ways to treat psychological disorders • Early efforts to treat mentally ill • 1500’s Bethlehem Hospital converted to asylum • Treatments included beatings bloodletting, ice baths

8. Treatment in the Past LO 13.1 Two modern ways to treat psychological disorders • Philippe Pinel’s Reforms • Unchained inmates • La Bicêtre Asylum, Paris 1793 • Treated mentally ill with kindness • Advocated “moral” therapy

9. In this famous painting by French artist Robert Fleury, French psychiatrist Dr. Philippe Pinel orders the chains removed from patients at a Paris asylum for insane women. Pinel was one of the first psychiatrists to recommend humane treatment of the mentally ill.

10. Freud’s Psychoanalysis LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • Insight therapy • Emphasizes revealing unconscious conflicts

11. Freud’s Psychoanalysis LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • Two techniques for accessing unconscious: • Dream interpretation • Manifest content • Actual dream and it’s events • Latent content • Symbolic or hidden meaning of dreams

12. Freud’s Psychoanalysis LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • Two techniques for accessing unconscious: • Free association • Patient free to say anything that came to mind • No fear of negative evaluation

13. Freud’s Psychoanalysis LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • Resistance • Patient reluctant to talk about certain topics • Changes subject or becomes silent

14. Freud’s Psychoanalysis LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • Transference • Therapist becomes a symbol of parental authority figure from the past • Countertransference • Therapist has transference reaction to the patient

15. Evaluation of Psychoanalysis andPsychodynamic Approaches LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • Criticisms • Lack of scientific methodology • Over-emphasis on sexual problems

16. Evaluation of Psychoanalysis andPsychodynamic Approaches LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • Modern Psychodynamic therapy • Client sits face-to-face with therapist • Therapist is more directive • Asks questions, suggests helpful behavior, and gives opinions • Therapy not useful for clients with psychoses

17. Interpersonal Psychotherapy LO 13.2 Elements of Freud’s psychoanalysis and psychoanalysis today • Developed to treat depression • Insight-oriented therapy • Focus on relationships • Psychodynamic origins • More eclectic • Combines elements of humanistic and cognitive behavioral therapies • Effectiveness supported by research

18. Psychotherapy often takes place one-on-one, with a client and therapist exploring various issues together to achieve deeper insights or to change undesirable behavior.

19. Roger’s Person-Centered Therapy LO 13.3 Basic elements of Humanistic therapies • Non-directive insight therapy • Based on the work of Carl Rogers • Client talks and the therapist listens

20. Roger’s Person-Centered Therapy LO 13.3 Basic elements of Humanistic therapies • Four Elements: • Reflection • Therapist restates client’s talk • No interpretation of statements • Unconditional positive regard • Accepting atmosphere created by therapist • Empathy • Therapist understands client feelings

21. Roger’s Person-Centered Therapy LO 13.3 Basic elements of Humanistic therapies • Four Elements: • Authenticity • Genuine, open, and honest response of therapist

22. A Rogerian person-centered therapist listens with calm acceptance to anything the client says. A sense of empathy with the client’s feelings is also important.

23. Gestalt Therapy LO 13.3 Basic elements of Humanistic therapies • Founded by Fritz Perls • People hide parts of self behind false “mask” • Mask is socially acceptable behavior • Inner self not matching mask causes conflict

24. Gestalt Therapy LO 13.3 Basic elements of Humanistic therapies • Therapist is confrontational and directive • Lead clients through exercises • Attention to body language • Focus on “denied parts” not hidden past of psychoanalysis

25. In Gestalt therapy, it is not unusual to find a client talking to an empty chair. The chair represents some person from the past with whom the client has unresolved issues, and this is the opportunity to deal with those issues.

26. Evaluation of Humanistic Therapy LO 13.3 Basic elements of Humanistic therapies • Little experimental research to support ideas • Theories built around case studies • Clients need to be intelligent, highly verbal • Not a good choice for seriously mentally ill

27. Behavioral Therapy and Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Action-based rather than insight-based therapy • Change behavior through learning new responses • Learning created problem • New learning corrects problem

28. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Through classical conditioning: • Old and undesirable automatic responses can be replaced by desirable ones • Techniques originally called Behavior Modification

29. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Applied behavior analysis • Newer term • Highlights need for a functional analysis of behavior • Analysis followed by conditioning

30. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Systematic desensitization • Used to treat phobias • Client is first taught deep muscle relaxation • Next creates a list of ordered fears • Hierarchy of fears • Pairs relaxation with fears • Computer generated simulations used

31. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Aversion therapy • Undesirable behavior is paired with aversive stimulus • Reduces frequency of behavior

32. This device allows the delivery of high levels of nicotine to the smoker in a process known as rapid smoking. Rapid smoking is an aversive technique for helping people to quit smoking and is based on the classical conditioning principle of counterconditioning.

33. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Flooding • Technique for treating phobias, stress disorders • Person is intensely exposed to fear-provoking situation • Prevented from making avoidance or escape response

34. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Techniques include reinforcement, extinction, shaping, and modeling • Change the frequency of voluntary behavior • Results quick and practical

35. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Modeling • Learning through observation, imitation of a model • Participant modeling • Model demonstrates the desired behavior in a step-by-step process • Client is encouraged to imitate

36. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Reinforcement • Strengthening of response by following it with: • A pleasurable consequence (positive reinforcement) • Removal of an unpleasant stimulus (negative reinforcement)

37. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Reinforcement • Token economy • Tokens to reinforce behavior • Can be accumulated and exchanged for desired items or privileges • Used effectively to modify behavior of disturbed institutionalized individuals

38. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Contingency contract • Formal, written agreement between the therapist and client • Goals for behavioral change, reinforcements, and penalties are clearly stated • Useful in treating problems such as drug addiction

39. Therapies Based on Classical Conditioning LO 13.4 Behavior therapists’ use of classical and operant conditioning • Extinction • Removal of a reinforcer • Reduces frequency of behavior • Time-out • Extinction process • Person is removed from situation reinforcing an undesirable behavior • Placed away from attention and reinforcement opportunities

40. This boy is sitting in the “time-out” corner at his school. By removing the attention that he found rewarding, the teacher is attempting to extinguish the behavior that earned the boy a time-out. Do you see anything in this time-out corner that might make it less effective?

41. Evaluation of Behavioral Therapies LO 13.4 Behavior therapists’ use of classical and operant conditioning • Effective in treating specific problems • Bedwetting, drug addictions, phobias • More serious psychological disorders do not respond as well to behavioral treatments • Overall behavior therapies are: • Relatively quick and efficient • Eliminate or greatly reduce symptoms

42. Cognitive Therapy LO 13.5 Goals of cognitive therapy • Focus on: • Helping clients recognize distortions in thinking • Replace distorted, unrealistic beliefs with realistic thoughts • Is critical thinking applied to one’s own beliefs

43. Cognitive Therapy LO 13.5 Goals of cognitive therapy • Beck • Identified five common distortions • Arbitrary inference • Jumping to conclusions • Drawing conclusions not based on evidence

44. Beck's Cognitive Therapy LO 13.5 Goals of cognitive therapy • Selective thinking • Focusing on one aspect of a situation • Ignoring all other relevant aspects • Overgeneralization • Drawing sweeping conclusions based on only one incident • Applying conclusions to events unrelated to original

45. Beck's Cognitive Therapy LO 13.5 Goals of cognitive therapy • Magnification and minimization • Negative event blown out of proportion to its importance (magnification) • Ignore relevant positive events (minimization) • Personalization • Taking responsibility for events unconnected to the person

46. Cognitive-Behavioral Therapy LO 13.5 Goals of cognitive therapy • Assumes disorders come from illogical, irrational cognitions • Is an action therapy • Learning to think more rationally and logically

47. Cognitive-Behavioral Therapy LO 13.5 Goals of cognitive therapy • Three goals: • Relieve the symptoms and solve the problems • Develop strategies for solving future problems • Help change irrational, distorted thinking

48. Rational-Emotive Behavior Therapy LO 13.5 Goals of cognitive therapy • A cognitive-behavioral therapy • Clients are directly challenged on irrational beliefs • Restructures thinking into rational belief statements • Therapists are directive • Provide homework assignments • Challenge “my way or nothing” statements

49. Success of CBT LO 13.5 Goals of cognitive therapy • CBT has seemed successful in treating • Depression, stress disorders, and anxiety • Criticized for focusing on symptoms, not causes of disordered behavior

50. Table 13.1 Characteristics of Psychotherapies