Therapy Approaches

1. Therapy Approaches • Biological Treatment • Surgery & Electroshock • Psychotherapy

2. Biological TreatmentsDrugs • 1-Antipshchotic Drugs • 2-Antidepressant Drugs • 3-Tranquilizers • 4-Lithium Carbonate

3. 1-Antipsychotic Drugsor Neuroleptics Good for treating psychosis and schizophrenia Example: Thorazine Reduce receptivity to dopamine or increase serotonin Reduce positive symptoms of schizophrenia Do not relieve other negative symptoms Can have dangerous side effect: tardive dyskinesia & neurolyptic malignant syndrome

4. Good for reducing: Agitation Delusions Hallucinations Can shorten schizophrenic episodes Offers little relief from: Jumbled thoughts Difficulty concentrating Inability to interact with others Antipsychotic Drugsand Schizophrenia

5. 2-Antidepressant Drugs • Treat depression, anxiety, phobias, OCD • Example: Prozac, Zoloft, and Paxil • Non addictive but can cause side effects • 1-Monoamine oxidase inhibitors (elevate levels of ser. & nor. by blocking inhibitors) • 2-Tricyclic antidepressants (boost nor. & ser. by preventing their reabsorption) • 3-Selective serotonin reuptake inhibitors (work on serotonin)

6. 3-Tranquilizers • Prescribed for depressed mood, panic, and anxiety • Example: Vlium • Increase activity of neurotransmitter GABA • If overused can result in tolerance and withdrawal

7. 4-Lithium Carbonate • Prescribed for bipolar disorder • Can be dangerous if not given in the right doze

8. The Placebo EffectKirsch and Sapirstein (1998) • 7315 participants • 41% of those receiving antidepressants experienced reduced symptoms. • 31% of those given placebos also received reduced symptoms.

9. Cautions about Drugs • Placebo effect • Relapse and drop out rates • Dosage problems • Long-term risks • Overprescription • Sometimes has to be with therapy

10. Surgery & Electroshock • Psychosurgery • Shock Therapy

11. Psychotherapy • Psychodynamic • Behavioral • Cognitive • Humanistic/Existential • Therapy in Social Context

12. Psychodynamic Therapy • Probes the past • Doesn’t tackle the immediate problem • The goal is insight • Takes a long time • Explores the unconscious • Methods: free association, interpretation of dreams, & transference

13. Interpretation The analyst noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight. • Resistance In psychoanalysis, the blocking from consciousness of anxiety-laden material. • Transference The patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)

14. Behavioral Techniques Learning Conditioning Association between Environmental Stimuli + Response Classical Conditioning Operant Conditioning Association Reinforcement/ Stimulus-Response Punishment

15. Behavioral Techniques • There are no mental processes (will, mind) • Derived from classical and operant conditioning • The focus is on changing the behavior • Works on the immediate problem • Focuses on the present

16. Classical Conditioning • Ivan Pavlov • Conditioning Learning that involves associations between environmental stimuli and the organism’s responses • Stimulus-response Learning

18. Classical Conditioning in Real Life • Learning to like • Learning to fear • Accounting for Taste • Reacting to Medical Treatment

19. Operant Conditioning • The behavior is more likely or less likely to occur based on its consequences. • B. F. Skinner modified Pavlov’s concept. • Skinner used reinforcement and punishment to enhance learning.

20. Skinner’s Box

21. Behavioral Techniques • Systematic Desensitization/Counter Conditioning • Aversive Conditioning • Exposure Treatment (Flooding) • Behavioral Records & Contracts • Skills Training

22. Systematic Desensitization • Fear of Flying • Read about safety • Look at pictures of airplanes • Visit an airport • Take a short flight • Take a long flight • Fear is extinguished • Counterconditioning

23. Cognitive Therapy • Albert Ellis • (Rational Emotive Behavior Therapy) • Aaron Beck

24. Cognitive Distortions • Labeling • Mind Reading • Exaggeration • Unrealistic Expectations • Belief in Entitlement • Belief in Absolute Fairness

25. Hot Thoughts He is always mean to me. I did a lousy job. I deserve better. It’s not fair. That jerk! They’re driving me crazy. Cool Thoughts Maybe he had a bad day. It’ll be better next time But people are people Life is not fair. It’s his problem! Just don’t accept the ride. Fighting Dysfunctional Thought

26. Dysfunctional Thought

27. Humanistic/ExistentialTherapy • Works on self-fulfillment and self-actualization • Does not delve into the past • Helps the client think about the present and the future • Helps people feel good about themselves • Tackles conscious rather than unconscious thoughts

28. Carl RogersClient-Centered TherapyPerson-Centered Therapy • The therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to facilitate clients’ growth.

29. Carl RogersClient-Centered Therapy • Offers unconditional positive regard • No specific techniques • Therapist should be warm, genuine and empathetic • Client adopts these views and becomes self-accepting • Promotes growth instead of curing illness.

30. Active Listening • Paraphrase. Summarize the speakers words in your own words. • Invite Clarification. Encourage the speaker to say more. • Reflect Feelings. Reflect what you’re sensing from the speakers words and body language.

31. Existential Therapy • Helps client explore meaning of existence • Helps client choose a destiny • Helps client accept self-responsibility.

32. Therapy in Social Context • Family Therapy • Family Kaleidoscope • Family Systems • Group Therapy

34. Communication ApproachVirginia Satir • Offered description of conjoint family therapy • Emphasized growth enhancing techniques to evoke feeling and clarify family communications patterns • (dance, massage, sensory awareness, group encounter techniques)

35. Contextual Family TherapyIvan Boszormenyi-Nagy • Effective family therapy must attend to family context especially to those dynamic and ethical connections – past, present, future – that bind families together

36. The Structural ApproachSalvador Minuchin • The individual’s symptoms are best understood as rooted in the context of family transaction patterns. • The family’s hierarchical organization • The wholeness of the family system • The interdependent functioning of its subsystems • Enmeshment The family boundaries are too diffuse to allow for individual autonomy

37. Strategic ApproachJay Haley • The therapist devices a strategy for solving the client’s present problems • Goals are clearly set • Therapy is carefully planned to achieve these goals

38. Object Relations • Introjects – the psychological representations of external objects • The most powerful obstacle to change is people’s attachment to their parental introjects

39. Family Systems TheoryMultigenrationalMurray Bowen • Conceptualizes the family as an emotional unit, a network of interlocking relationships, best understood when analyzed within a multi generational or historic framework • Genograms

40. When Therapy Helps • When clients have enough sense of self • When clients have enough distress to motivate them to change • When therapists are warm and empathetic • When client and therapist establish a good rapport • Hostile, negative clients are less likely to benefit

41. When Therapy Harms • Bias on the therapist’s part because of gender, religion, or race • Coercion by the therapist to accept his/her advice • Coercion by the therapist to have sexual intimacy

42. Alternatives to Psychotherapy • Community Psychologists • Half-way houses • Clubhouse model • Foster care • Family support groups • Rehabilitation Psychologists • Half-way houses • Clubhouse model • Foster care • Family support groups