CHAPTER 22 Psychological Treatment

1. CHAPTER 22 Psychological Treatment Zhong-Lin Tan Ph.D. M.M. Hangzhou Mental Health Center Department of psychiatry, School of Medicine Hangzhou Normal University zlintan@yahoo.com.cn

2. Aim • Grasp classification of psychological treatments • Be familiar with different counseling approaches

3. Preface • Psychological treatment is not given in isolation, often combined with medication. Appropriate ways of doing this are considered in the chapters concerned with the relevant disorders. • This chapter contains advice on the general value of various treatments. • Although outline descriptions of technique are given in several places, supervised experience is essential before any of these treatments can be used with patients.

4. Counseling Crisis intervention Supportive psychotherapy CBT Individual dynamic psychotherapies Historical treatments Meditation and traditional healing Small-group psychotherapy Large-group psychotherapy Psychotherapy with couples Family therapy Psychotherapy for children and older people Psychological treatments considered in this chapter

5. How psychological treatments developed • Hypnosis and free association:1895,1923 • Classical dynamic psychotherapy • The neo-Freudians:1930s • Object relation theory • Attachment theory • Interpersonal therapy • Behaviour therapy:1920s • Cognitive therapy: • Cognitive-behaviour therapy

6. Classification of psychological treatments • Technique • Eclectic • Psychodynamic • Cognitive behavioral • other: systems theory • Number of patients • Individual therapy • Couple therapy • Family therapy • Small and large group therapy

7. Common factors in psychological treatment • Therapeutic relationship • Listening • Release of emotion • Restoration of morale • Providing information • Providing a rationale • Advice and guidance • Suggestion

8. Counselling and crisis intervention • Counselling • Counselling incorporates the non-specific factors shared by all kinds of psychotherapy • Crisis intervention • Helps patients cope with a crisis in their lives, and to learn effective ways of dealing with future difficulties.

9. Counselling 1 • Approaches to counselling • Problem-solving counselling • Interpersonal counselling • Loss, interpersonal disputes, role transitions, and interpersonal deficits. • Psychodynamic counselling

10. Counselling 2 • Counselling for specific purposes • Debriefing • Relationship problems • Late effects of trauma • Risks • Students • In primary care

11. Crisis intervention 1 • Problems leading to crisis • Loss problems • Role changes • Relationship problems • Conflict problems • Indications: • well-motivated people with stabel personalities who are facing major but transitory difficulties.

12. Crisis intervention 2: methods • Stage Ⅰ: • reduce arousal; • focus on current problems; • encourage self-help • StageⅡ: • assess problems; • consider solutions; • test solutions • StageⅢ: • consider future coping methods

13. Supportive psychotherapy • Table22.3

14. Interpersonal psychotherapy • Interpersonal problems under four headings • Bereavement and other loss • Role disputes • Role transitions • Interpersonal deficits such as loneliness

15. Cognitive behaviour therapy 1 • General features: 8 types • Assessment • Topics to be consided • Source of information for the assessment • The formulation

17. Cognitive behaviour therapy 2 • Behavioural techniques: 16 types ; relaxation training, exposure, desensitization, flooding, exposure in everyday practice, exposure with response prevention…… • Cognitive techniques

18. CBT for different mental disorders • Anxiety disorders • Panic disorder • Post-traumatic stress disorder (PTSD) • Depressive disorders • Hypochondriasis • Schizophrenis • Personality disorder • Dialectic behaviour therapy for borderline personality disorder

19. Individual dynamic psychotherapies • Brief insight-oriented psychotherapy • Cognitive-analytical therapy • Psychodynamic interpersonal therapy • Long-term individual dynamic psychotherapy

20. Treatment in groups • Small group psychotherapy • Types of small group psychotherapy • Therapeutic groups • Large-group therapy

21. Treatment in groups

22. Psychotherapy with couples and families • Couple therapy • Psychodynamic • Systems approaches • Cognitive behvioural • Behavioural-systems • Family therapy • Psychodynamic family therapy • Structural family therapy • Systemic family therapy • Eclectic family therapy

23. Psychotherapy for children • Play therapy

24. Psychotherapy for older people

25. Other psychological treatments • Hypnosis • Autogenic training • Abreaction • Meditation

26. Ethical problems in psychological treatment • Autonomy • Confidentiality • Exploitation

28. Thank you for your attention!