Psychological Therapies

1. Psychological Therapies Therapy

2. There are over 250 identifiable types of psychotherapy, though the most influential are: • Psychoanalysis Therapies • Humanistic Therapies • Behavior Therapies • Cognitive Therapies • Group and Family Therapies • Any therapist who uses a combination of therapies is said to be using an “eclectic” approach to therapy

3. Psychoanalysis

4. Psychoanalysis assumes that many psychological problems are fueled by the childhood repression of impulses and conflicts. These unresolved issues impact our future behaviors and social relationships.

5. It is the job of a psychoanalyst to bring the repressed feelings into conscious awareness and gain insight as to the real source of a patient’s problem in order to resolve the conflict and bring to closure its accompanying behaviors.

6. Free Association • A method of exploring the unconscious, in which a person relaxes and says whatever comes to mind, no matter how trivial or embarrassing

8. Free Association • During free association, though, patients almost instinctively begin to edit themselves, feeling that some information is too trivial, irrelevant, or shameful. These blocks in the flow of free association are called resistance.

9. Resistance • Resistance hints at anxiety and the repression of sensitive material. Interpretation then involves the recognition by both the therapist and the patient that there are repressed issues to deal with….and then the process of actually dealing with those issues begins

10. Transference • Sometimes while revealing their secrets, patients may begin to experience strong feelings towards their therapists. Transferring emotions from one experience to the therapist is called transference. It’s then easier to deal with emotions if they aren’t as personalized anymore.

11. Humanistic Therapies

12. Disorders arise when people feel like they’ve underachieved, when they perceive themselves as less than ideal, or when they haven’t reached their fullest potential. (Self-Actualization)

14. IE. My depression is caused by the fact that I didn’t get a promotion, therefore I must be a very bad employee. (Safety, Esteem) • IE. The secondary personality of Charlie arises when Steve feels bullied. Steve is too weak to deal with it, but Charlie can. (Safety) • IE. Timmy broke up with me because I’m fat. I’ll stop eating so I can be thin. (Love and Belongingness)

15. A therapist needs to recognize where the barriers to reaching self-actualization are (is it a safety issue? an esteem issue?), and help the client improve in this area in order to reach their potential. The symptoms of the disorder should fade as a person improves.

16. Free Will Patients need to be reminded that they are capable of controlling their own destiny • I don’t have to be a bad employee. I can get a new job that maximizes my skills, or learn new skills to help me achieve my current career goals. • I don’t have to lose weight. I can date who I want to, be friends with who I want to, with someone who appreciates me.

17. Client-Centered Therapy There are four parts to this approach, with the ultimate goal of allowing a client to become more self-assured and on a path towards self-actualization.

18. Genuineness • Authenticity. Aware of one’s own true inner thoughts and feelings. Be able to share, honestly. No fakeness, defensiveness, or role playing. This is true for the client and the therapist.

19. Maybe I didn’t get the promotion because I was late too often, or didn’t take the job seriously. • You know, I have put on a few pounds since I stopped working out.

20. Unconditional Positive Regard • A genuine caring for people based on their innate value as individuals. Clients are cherished and respected without judgment. Avoiding evaluative statements of good and bad. • If the therapist finds value in you, you will as well.

21. Empathetic Understanding Sensitive understanding and sharing of another person’s inner experiences. Open-ended questions to explore feelings and express emotions.

22. Active Listening Active-listening involves a therapists technique of listening intently, echoing, restarting and seeking clarification, and acknowledgement of a clients expressed verbal and non-verbal emotions

23. “I understand that…..” • “So, what you’re saying is…” • “Ok, let’s talk about this a bit more…” • “How did that make you feel…” • OK, maybe I did do everything I could to get the promotion and I’m just underappreciated. • Maybe I did everything I could in that relationship, and it wasn’t my fault that it ended.

24. Cognitive Therapies

25. Cognitive therapy assumes that faulty thought processes and beliefs create problem behaviors and emotions. When people hold beliefs that are irrational, that are overly demanding, or that fail to match reality, their emotions and behaviors may become disturbed.

26. Cognitive therapy involves learning skills that allow you to see the connection between thoughts and upsetting feelings, to appraise the accuracy of these thoughts that are creating upsetting feelings, and if they are inaccurate, to make them more accurate. A therapist wants to change the thought processes of patients from negative to positive to alleviate disorder symptoms.

27. Rational-Emotive Behavior Therapy

28. Identify the activating event, which is the stimulus for the feelings and behaviors.

29. Understand the belief system, which is the patient’s interpretation of the activating experience

30. Observe the emotional and behavioral consequences that the patient experiences as a result of their belief system

31. Dispute, or challenge, the erroneous belief with logic, with rational thought

32. Activating Event: Low Exam Grade • Irrational Beliefs: I’m so unintelligent. I’ll never graduate college • Emotional/Behavioral Consequences: I’m depressed. (this reinforces your feelings of being unintelligent as well, which makes you further depressed) • Dispute: It’s only one grade amongst many. I can do better on the next test and still pass.

33. Having made a mistake at work, a person may believe, "I'm useless and can't do anything right at work." Strongly believing this, in turn, tends to worsen his mood. The problem may be worsened further if the individual reacts by avoiding activities and then behaviorally confirming his negative belief to himself.

34. As a result, an adaptive response and further constructive consequence becomes unlikely, which reinforces the original belief of being "useless."

35. In therapy, the latter example could be identified as a self-fulfilling prophecy or "problem cycle," and the efforts of the therapist and client would be directed at working together to change it. This is done by addressing the way the client thinks and behaves in response to similar situations and by developing more flexible ways to think and respond, including reducing the avoidance of activities.

36. If, as a result, the client escapes the negative thought patterns and dysfunctional behaviors, the feelings of depression may, over time, be relieved. The client may then become more active, succeed and respond more adaptively more often, and further reduce or cope with his negative feelings.

37. Socratic Questioning • Get them to think more about what exactly they are asking or thinking about. Prove the concepts behind their argument. • Probing of assumptions makes them think about the presuppositions and unquestioned beliefs on which they are founding their argument. • When they give a rationale for their arguments, dig into that reasoning rather than assuming it is a given. • Most arguments are given from a particular position. So attack the position. Show that there are other, equally valid, viewpoints.

38. Behavior Therapies

39. Behaviorists believe that problem behaviors are learned behaviors. To treat disorders is toeliminate or unlearnthe problem behavior through various methods of counterconditioning

40. Classical Counter Conditioning • Systematic Desensitization • Implosive Therapy • Aversive Conditioning

41. Systematic Desensitization • Progressive Relaxation • Anxiety Hierarchy • Control Scene • Desensitization

42. Progressive Relaxation • A method of successfully relaxing one muscle group after another until a deep state of relaxation is achieved.

43. Anxiety Hierarchy A patient creates a list of anxiety provoking images associated with the feared situation, arranged in a hierarchy from least to most anxiety producing. • Control Scene • A soothing mental image to initiate muscle relaxation. If you begin to feel stressed, think of….walking on a beach, a sunny day, etc.

44. Lowest to Highest – Fear of Flying • Packing luggage • Realizing you have to make a flight • Making reservations • Driving to the airport • Checking in • Waiting for boarding • Boarding the plane • Waiting for departure • Taking off • Climbing to cruising altitude • In-flight service • Moving around the cabin • Turbulence • Descending • Landing

45. Systematic Desensitization • While deeply relaxed, the patient imagines the least threatening scene in the anxiety hierarchy. As long as they stay relaxed, they progress upwards. If they feel stressed, they find their control scene and start over. Gradually, a patient works from imagining the scenes to experiencing the events in real life.

46. Systematic Desensitization is also known as exposure therapy. A therapist is attempting to graduallysubstitute a positive response for a negative response to a harmless stimulus.

47. Implosive Therapy Floods patients with their worst fears first, in hopes that by confronting their worst fears, they’ll learn how to not back down

48. Aversive Conditioning In aversive conditioning, a therapist tries to replace a positive response to a harmful stimulus with a negative response.

49. IE. Dave enjoys sucking his thumb at night. This is a bad habit. A therapist would cover Dave’s thumb with hot pepper before bed time. Dave does not like the taste of hot peppers, and therefore he will stop sucking his thumb.

50. Operant Counter Conditioning • Use positive reinforcers to shape behavior that they want to continue • Withhold reinforcement, or punish, to stop undesirable behaviors