Therapy and Change

1. Therapy and Change Chapter 17

2. Therapy • Psychotherapy • an emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties • Eclectic Approach • an approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy

3. Psychoanalysis • Psychoanalysis • Freud believed the patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight • use has rapidly decreased in recent years • Resistance • blocking from consciousness of anxiety-laden material

4. Free Association • School of thought: Psychoanalysis (psychoanalysis is long term – it takes years) • During session the client says whatever comes to mind (no filter) • Goal – unconscious feels to become conscious • Resistance – “drawing a blank,” can’t think of what to say; analyst finds anxieties here

5. Dream Analysis • School of Thought: Psychoanalysis • Finding unconscious thoughts through dreams • Manifest content – what you remember about your dream • Latent content – hidden meaning of dream (symbolic) • www.dreammoods.com

6. Be careful of: • Transference – the client feeling toward a therapist in the way that he/she feels about an important figure in his/her life • Countertransference – the therapist feeling toward a client in the way that he/she feels about an important figure in his/her life

7. Client-Centered Therapy • School of Thought: Humanist (self-actualization) • Nondirective therapy – the client decides what should be discussed and what direction therapy should go through: - Active listening – restating what had been said - Unconditional Positive Regard – acceptance no matter what

8. Behavior Therapy • Behavior Therapy • therapy that applies learning principles to the elimination of unwanted behaviors • Counterconditioning • procedure that conditions new responses to stimuli that trigger unwanted behaviors • based on classical conditioning • includes systematic desensitization and aversive conditioning

9. Counterconditioning • Systematic desensitization – Step by step process to overcome fearEx. Fear of spiders 1. Look at picture of spider. 2. See spider on TV. 3. See spider (in a cage). 4. Touch spider while someone else holds it. 5. Hold spider. • Works well with OCD too • Aversive Conditioning • type of counterconditioning that associates an unpleasant state with an unwanted behavior • nausea ---> alcohol

10. Systematic Desensitization

11. Aversive Conditioning • type of counterconditioning that associates an unpleasant state with an unwanted behavior • nausea ---> alcohol

12. Token Economy • an operant conditioning procedure that rewards desired behavior • patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats (Autism/Asperger’s)

13. Cognitive Therapy • teaches people new, more adaptive ways of thinking and acting • based on the assumption that thoughts intervene between events and our emotional reactions

14. Rational – Emotive Therapy • Goal is to correct false and self-defeating beliefs • Techniques: role playing, humor, ABC method (Activating event, Belief, Consequent Emotion – goal is to change B)

15. Cognitive-Behavior Therapy • Changing behavior by changing the way the client looks at the current situation • Emphasis on setting goals and positive thoughts • Basically a combination of Behavior Therapy and Cognitive Therapy (most common form of therapy)

16. Family Therapy • Index person – the one who brings everyone to therapy • Designed to help increase communication amongst family members so that issues can be resolved in a fair way

17. Group Therapy • Group members work together with people who are struggling with the same issues • Advantage – group leaders can help more people • Disadvantage – less one on one time (if any) • Self-Help Groups – more specific type of group therapy with a professional therapist leading the group (Ex. AA)

18. Drug Therapy • School of Thought: Biological • Antipsychotics – medication to reduce hallucinations, delusions, etc (blocks dopamine) • Antidepressants – used to regulate neurotransmitters to decrease depression • Lithium – used to reduce symptoms of bipolar disorder • Antianxiety drugs – regulates neurotransmitters to reduce anxiety (many antidepressants are used for anxiety patients)

19. Electroconvulsive Therapy • School of Thought: Biological • Brief shocks into brain to treat manic episodes, severe depression, and some types of schizophrenia

20. Psychosurgery • School of Thought: Biological • Very rare (less than 200 done in 1997) • Patients who are very violent, have extreme depression or schizophrenia may receive a lobotomy (destroying frontal lobe) • This takes away the inability to plan, making the patient less threatening, but also less able to function

21. Therapists and Their Training • Clinical psychologists • Most are psychologists with a Ph.D. and expertise in research, assessment, and therapy, supplemented by a supervised internship • About half work in agencies and institutions, half in private practice

22. Therapists and Their Training • Clinical or Psychiatric Social Worker • A two-year Master of Social Work graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems • About half have earned the National Association of Social Workers’ designation of clinical social worker

23. Therapists and Their Training • Counselors • Marriage and family counselors specialize in problems arising from family relations • Pastoral counselors provide counseling to countless people • Abuse counselors work with substance abusers and with spouse and child abusers and their victims

24. Therapists and Their Training • Psychiatrists • Physicians who specialize in the treatment of psychological disorders • Not all psychiatrists have had extensive training in psychotherapy, but as M.D.s they can prescribe medications. Thus, they tend to see those with the most serious problems • Many have a private practice