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Introduction to Psychotherapy

Introduction to Psychotherapy. Definitions and Examples. Today’s Lecture. Historical treatment of the mentally ill Psychotherapy definitions and examples Places of treatment Providers of treatment Recipients of treatment. Next Class: Does psychotherapy work?.

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Introduction to Psychotherapy

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  1. Introduction to Psychotherapy Definitions and Examples

  2. Today’s Lecture • Historical treatment of the mentally ill • Psychotherapy definitions and examples • Places of treatment • Providers of treatment • Recipients of treatment Next Class:Does psychotherapy work?

  3. Historical background: Beliefs and treatment of the mentally ill • Greek physician Hippocrates promoted humane treatment. Mentally ill patients were placed in pleasant surroundings and given soothing baths and massages. • Lack of balance between positive and negative energies • Disturbance in the balance of bodily fluids treatment

  4. Middle Ages through 18th century • Middle Ages to 17th century • Madness = in league with devil, possession by spirits • Diagnosis based on hearsay, unreliable “tests” • Treatment • Prayer, exorcism, magic incantation • Torture, starvation, and exile (sent to sea) • Treated like animals and sentenced to burn or hang • 18th century • mentally disordered people = degenerates • keep them away from society

  5. The 19th century: Attempts at reform • Philippe Pinel (1745-1826) • reform in Paris mental hospitals • removed restraints and treated mentally ill more humanely • some patients got better enough to leave hospital

  6. The 19th century: Attempts at reform • reform of U.S. system • moral-treatment movement • humane care • led to large, state-supported public asylums • But problems persisted • Overcrowding • Loss of public attention • Effective treatments not yet available Dorothea Dix (1802-1887)

  7. The 20th century • New Therapies introduced in 1930s • Insulin-coma therapy (ICT) • Electro-shock therapy (ECT) • Frontal lobotomy • Anti-psychotic drugs introduced in mid-1950s • Deinstitutionalization follows in early 1960s • get people out of asylums and back into community • general mood of optimism in country • Community mental health centers established in 1961 Video available

  8. Patients in Mental Hospitals. The number of patients cared for in the U.S. state and county mental hospitals has decreased dramatically since 1955.

  9. ECT Today Therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient Side effects of ECT include temporary short-term memory loss but it is painless and there is no risk for death or brain damage. 70% of depressed patients who did not respond to other treatment respond positively to ECT.

  10. What is psychotherapy? • Psychotherapy is a form of treatment for problems of an emotional nature in which a trained person deliberately establishes a professional relationship with a patient for the purpose of removing, modifying, or retarding existing symptoms, of mediating disturbed patterns of behavior, and of promoting positive personality growth and development (Wolberg, 1967). • Psychotherapy is a plannedactivity of the psychologist, the purpose of which is to accomplish changes in the individual that make his/her life adjustments potentially happier, more constructive, or both (Frank, 1982).

  11. 20th Century: Advances in psychotherapy • Psychoanalysis introduced by Freud in 1890s • Adler (1930s) and other neo-Freudians follow • Variety of new approaches introduced in 1950s • Behavioral (Wolpe, Watson, Skinner) • Rational Emotive Therapy (RET, Ellis) • Humanistic (Rogers) • Existential (May) • Gestault (Perls) • Cognitive therapy introduced in 1960s (Beck) • Group therapy also gains popularity in 1960s • Family Therapy comes in the 1970s

  12. Which of these is not psychotherapy? • A rabbi counseling a couple with marital difficulties • An abused child drawing pictures of his family for a psychologist • A woman presenting her testimony to her Alcoholic Anonymous group • A university Counseling Center psychologist with an M.A. helping a student choose a career • A man talking about his dreams and childhood experiences to a psychoanalyst in N.Y. • A police officer “talking down” a suicidal teenager from a tall building • A family having a loud argument in a therapist’s office

  13. Reasons for seeing a mental health professional(Murstein & Fontaine, 1993) Depression (21%)Relationship and couple problems (17%)Child rearing problems (19%)Difficulty in social and work relations (5%)Suicidal thoughts (5%)Alcohol/Drug dependence (3%)Obsessions (3%)Sexual dysfunctions (3%)Weight loss/Eating disorders (3%)Spousal/partner abuse (2%)Psychotic symptoms (2%)

  14. Modern Treatment Facilities • Hospitalization • Community Mental Health Centers • Advances in psychotropic medication • Deinstitutionalization • Consequences of deinstitutionalization • Out-patient mental health clinics • Nursing homes • Private offices

  15. Who do people turn to for help?

  16. Types of psychotherapists

  17. Professionals Who Provide Psychotherapy • Psychiatrists (M.D.) • Psychoanalysts • Psychologists • Clinical (M.A., Ph.D., Psy.D.) • Counseling (M.A., Ph.D.) • School (M.A., Ph.D.) • Social workers (MSW) • Psychiatric nurses (B.A., M

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