Chapter 15 If You Go for Help

1. Chapter 15If You Go for Help

2. Chapter Overview How Well Does Therapy Work? If You Go for Help • Other Approaches to Treatment • Family, Couples, and Relationship Therapy • Biomedical Therapies • Community-Based Services • Insight Therapies-The Talking Cure • Psychoanalysis • The Person-Centered Approach • A Variety of Approaches • Cognitive-Behavioral Therapies • Behavioral Therapies • Cognitive Therapies • Status of Psychotherapy Today

3. Chapter Summary Insight Therapies – The Talking Cure • Psychoanalysis • The Person-Centered Approach • A Variety of Approaches

4. Chapter Summarycont’d Cognitive-Behavioral Therapies • Behavioral Therapies • Cognitive Therapies • Status of Psychotherapy Today

5. Chapter Summarycont’d Other Approaches to Treatment • Family, Couples, and Relationship Therapy • Biomedical Therapies • Community-Based Services

6. Chapter Summarycont’d How Well Does Therapy Work?

7. Introduction • Psychotherapy is the helping process in which a trained, socially sanctioned therapist performs certain activities that facilitate a change in the client’s attitudes and behaviors. • A therapist is a person trained to help people with psychological problems. • One type of psychotherapy is insight therapy, therapy designed to bring change by increasing self understanding.

8. Insight Therapies--The Talking Cure Psychoanalysis A form of psychotherapy aimed at helping the person gain insight and mastery over unconscious conflicts. • Founded by Dr. Sigmund Freud. • Uses the processes of free association, resistance, transference, dream analysis, etc. • Greatly criticized in the past, but shorter versions today are gaining some recognition from the psychological community.

9. Insight Therapies--The Talking Cure cont’d The Person-Centered Approach Psychotherapy designed to change a client via the therapist’s genuineness, acceptance, and empathic understanding. • Developed by Dr. Carl Rogers. • Uses the processes of acceptance, and empathy. • As clients are understood and accepted by the therapist, they come to accept themselves more fully and listen more accurately to their inner experiences.

10. Insight Therapies--The Talking Cure cont’d A Variety of Approaches Other forms of insight therapy exist. They include: • Existential therapy: An approach that emphasizes the client’s capacity for growth through affirmation of his or her free choice and personal values. • Logotherapy: Therapy that stresses the importance of clarifying values that give personal meaning and purpose to life.

11. Insight Therapies--The Talking Cure cont’d A Variety of Approaches Other forms of insight therapy exist. They include: • Gestalt therapy: Therapy that makes use of the here-and-now, the client’s responsibility, and nonverbal behavior as a way of helping clients unify their feelings and actions. • Actualization therapy: Therapy that combines elements of other therapies as a way of maximizing the individual’s growth.

12. Cognitive-Behavioral Therapies Behavioral Therapy This therapy involves discovering the factors that trigger and reinforce problem behavior; specifying a target behavior to replace it; and then, by manipulating these factors, bringing about the desired change.

13. Cognitive-Behavioral Therapiescont’d Behavioral Therapy • These therapies are based on operant and classical conditioning. • One example is desensitization, a method for controlling anxiety by learning to associate an incompatible response, like relaxation, with a fear-provoking stimulus (i.e. phobia).

14. Cognitive-Behavioral Therapiescont’d Cognitive Therapies Therapies that focus on faulty cognitive processes as the crucial element in maladaptive behaviors. • The central assumption: emotional and behavioral problems result from an individual’s distorted thoughts and reactions to external events rather than from the events themselves. • These therapies are meant to help clients think more rationally about themselves and their problems. • Therapists do not probe for deep-seated causes.

15. Cognitive-Behavioral Therapiescont’d Status of Psychotherapy Today • Most practitioners today are eclectic—they use a variety of approaches. • They hope to find and match the best technique to each client, given the client’s uniqueness. • Therapy today is done in fewer sessions than in the past; this is most likely because of managed health care.

16. Other Approaches to Treatment Mutual-Help Groups (Self-Help Groups) Group members share a common issue and meet regularly to discuss their concerns without the guidance of a professional. • An example is Alcoholics Anonymous. • A major assumption is that no one can understand you as well as someone else who has the same problem. • Research supports that these nonprofessional groups are effective. From MentalHealth.org

17. Other Approaches to Treatmentcont’d Family, Couples, and Relationship Therapy Relationship therapists try to help small units of people be more aware of how they treat each other, how they may unwittingly hurt one another, and how they can nurture each other better. An example is family therapy. Family therapy involves the larger family unit, including children and adolescents, on the assumption that disturbance of one family member reflects problems in the overall family.

18. Other Approaches to Treatmentcont’d Biomedical Therapies Strategies that rely on direct physiological intervention to treat the symptoms of psychological disorders. • These treatments include drugs, electroconvulsive treatment, and psychosurgery.

19. Other Approaches to Treatmentcont’d Biomedical Therapies • Many disorders are related to imbalances in neurotransmitters–chemical substances involved in the transmission of neural impulses between neurons. • Antianxiety drugs are drugs used primarily for alleviating anxiety; these drugs include minor tranquilizers. • Antidepressants are used to treat depression or to elevate mood, usually by increasing the level of certain neurotransmitter such as norepinephrine and serotonin.

20. Other Approaches to Treatmentcont’d Biomedical Therapies • Lithium, which is a natural mineral salt used to treat bipolar disorder. • Antipsychotic drugs are medications to relieve the symptoms of psychoses such as extreme agitation, hallucinations, and delusions. • Each drug has its own advantages and disadvantages such as tardive dyskinesia caused by antipsychotic medication.

21. Other Approaches to Treatmentcont’d Biomedical Therapies Electroconvulsive Therapy (ECT)involves the administration of an electric current to the patient’s brain to produce a convulsion. • Commonly used to treat depression. • Generally requires multiple treatments. • Can cause memory loss.

22. Other Approaches to Treatmentcont’d Biomedical Therapies Psychosurgery is surgery designed to destroy or disconnect brain tissue in an attempt to regulate abnormal behavior. • An example is a frontal lobotomy which is surgery of the frontal lobes of the brain intended to alter the emotion-controlling center of the brain. • …a very controversial treatment, but still utilized today. • Some patients emerge from surgery in a vegetative state!

23. Other Approaches to Treatmentcont’d Community-Based Services Services located in the individual’s own community, such as a community mental health center. • Such services were promoted by the Community Mental Health Centers Act (1963). • Outpatient community services are heavily used today with the closing of so many psychiatric hospitals.

24. Other Approaches to Treatmentcont’d Community-Based Services • The system does not seem to work well; many people with mental disorders end up in jail, then the hospital, later the streets, only to be put in jail again. • This revolving door syndrome of moving from institution to institution is known as transinstitutionalization. • Other places in the community where mentally disordered individuals are found include halfway houses and crisis intervention centers.

25. How Well Does Therapy Work? Is therapy better than no therapy? • Research shows that after treatment, the average treated patient is better off than 80 percent of untreated patients. • This result is encouraging, especially as more and more people in need of therapy are finding ways to participate.

26. How Well Does Therapy Work? cont’d What elements make therapy effective? • A good match between client and therapist is important. For example, directive therapy (where the therapist plays an active or authoritative role) works best for low-resistance clients. • Longer treatments provide better results. • Assigning projects (“homework”) between sessions also improves effectiveness. • Monitoring the effectiveness of therapy with assessments also improves results.

27. How Well Does Therapy Work? cont’d Is one type of therapy more effective than another? There is little difference among types of psychotherapies. Therapist characteristics that enhance the effectiveness of therapy include: • flexibility • respectfulness • honesty • warmth • trustworthiness • emotional expressiveness

28. How Well Does Therapy Work? cont’d Is one type of therapy more effective than another? Clients who: • are articulate • are motivated • believe in psychological processes • match the therapist in terms of ethnicity, race, or gender …are more likely to do well in therapy!

29. How Well Does Therapy Work? cont’d Is one type of therapy better or worse for a particular disorder? Research indicates that: • Behavior therapy is most effective for phobias and other anxiety disorders. • Psychoactive medication is best for treating schizophrenia. • Cognitive-behavioral techniques are best for depression.

30. Getting Help When should you seek professional help? A general guide: when a problem interferes with your daily life, it is time to seek help. BUT you don’t need to wait until a problem arises; therapy is a good way to experience personal growth.

31. Getting Help cont’d Where do you find help? • Many private therapists (counselors, psychologists, social workers) may be available in your community. Be sure you know the qualifications of any therapist! • The local or state psychological association can provide the names of practitioners. • Many hospitals, schools, and work sites employ therapists.

32. Getting Help cont’d What should you look for in a therapist? • Professional training and certification • Someone you are comfortable with Discuss: • his/her theoretical orientation • fees/payment policies

33. Getting Help cont’d What can you expect from therapy? Common benefits of therapy include: • hope for the future • caring for others • better understanding of personal problems • better relationships with others • positive personality changes

34. Getting Help cont’d How long must therapy continue? • There are no hard and fast guidelines…. • Managed care has shortened the amount of time. Two key conditions must be met to terminate therapy: • Is the crisis or problem under control? • Can the client maintain the gains acquired in therapy on his or her own?