Transcript Psychological Therapies

Psychological Therapies
Psychoanalysis
PsychoTherapies
Humanistic
Therapies
Behavioral
Therapies
Cognitive
Therapies
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Psychoanalysis
Many Y problems are due to repressed
childhood impulses & conflicts
Historical Reconstruction to Shed Light on the Present
Patient provides Free Association & Dreams
Analyst provides Interpretations:
• Aim to provide insight into
patient’s underlying conflicts
• Understanding of Transference
• Problem - Slow & Expensive $
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Humanistic Therapies
Emphasis on people’s inherent potential for
self-fulfillment
Humanists focus on:
• the present, not the past
• awareness of feelings, not childhood origins
of feelings
• conscious thoughts, not unconscious ones
• taking responsibility for feelings & actions,
not uncovering hidden(?) causes
• promoting growth, not curing illness
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Person-Centered Therapy
Focus is on client’s self-perceptions,
not interpretations of the therapist
Non-Directive Therapy
Listen, without judging, interpreting
or directing the client toward certain
insights
Carl Rogers
Active Listening - echoing, restating,
clarification and acknowledgment
of the client’s feelings.
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Gestalt Therapy
Fritz Perls
Combine unconscious feelings with
“getting in touch with oneself” and
taking responsibility for oneself.
Make client “whole” by
breaking through their
defenses & helping
them sense and express
their moment-to-moment
feelings.
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Behavior Therapies
Behaviors are the problems !
Q: Does knowing why you are afraid
of heights make you not
afraid of heights?
A: NO…So why bother with “WHY”?
Learning Principles
are
used to eliminate
unwanted
behaviors
(Feldman, 1999; Kohn
& Kohn, 1998; Richarson, 1999)
Treatment of Psychological
Disorders
• Psychotherapy
– the process in which a patient (often
referred to as a client) and a professional
attempt to remedy psychological difficulties
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Psychotherapy: Psychological
Approaches to Treatment
• Psychodynamic therapy
• based on the premise that the primary sources
of abnormal behavior are unresolved past
conflicts and the possibility that unacceptable
unconscious impulses will enter consciousness
• Psychoanalysis
• psychodynamic therapy that involves frequent
sessions and often lasts for many years
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Behavioral Approaches to
Treatment
• Behavioral treatment approaches
– build upon the basic processes of learning
embodied in classical and operant
conditioning
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Behavioral Approaches to
Treatment
• Classical conditioning approaches
– aversive conditioning
• create unpleasant reactions to stimuli that an
individual previously enjoyed
– systematic desensitization
• person is taught to relax and then is gradually
exposed to an anxiety-producing stimulus in
order to extinguish the response of anxiety
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Behavioral Approaches to
Treatment
• Observational learning
• learning by watching others’ behavior and the
consequences of that behavior
• Modeling
• systematically teach people new skills and
ways of handling their fears and anxieties
• Operant conditioning
• token system of rewarding desired behavior
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Classical Conditioning
Counter-Conditioning
Pairing the CS with a new, “fear-less” response
Systematic
Desensitization
Swap (+) for (-)
Aversive
Conditioning
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Swap (-) for (+)
Operant Conditioning
Behaviors are influenced by their consequences
Rewards used to modify behavior varies
(e.g., attention, praise or food)
Token Economy
Rewards = tokens to be
redeemed for desirable
items like candy, TV,
trips, etc.
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Cognitive Therapies
Thinking affects our feelings - change patterns
of thinking and you change feelings
(major depression & general anxiety)
Depressed
Happy
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Cognitive Approaches to
Therapy
• Cognitive-behavioral approach
– people’s faulty cognitions about
themselves and the world are changed to
more accurate ones
• Rational-emotive therapy
– attempts to restructure a person’s belief
system into a more realistic, rational, and
logical set of views
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Cognitive Approaches to
Therapy
• Cognitive therapy
– psychotherpay based on Beck’s goal to
change people’s illogical thoughts about
themselves and the world
– less confrontational and challenging than
rational-emotive therapy
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Rational-Emotive Therapy
Many problems arise from
irrational thinking
Show client the absurdity of their
ideas and they will realize that
their problems aren’t really
“problems”.
Confrontational Style
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Humanistic Approaches to
Therapy
• Humanistic therapy
– the underlying assumption is that people
have control of their behavior, can make
choices about their lives, and are
essentially responsible for solving their
own problems
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Humanistic Approaches to
Therapy
• Client-centered therapy
• goal is to reach one’s potential for selfactualization
• Existential therapy
• addresses the meaning of life and human
freedom
• Gestalt therapy
• attempts to integrate a client’s thoughts,
feelings, and behavior into a whole
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Biomedical Therapies
Rapid decline in the “resident patient” population
due to advances in Psychopharmacology in ‘50s
Has the net result been
“Good” or “Bad”?
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Biomedical Therapy:
Biological Approaches to
Treatment
• Biomedical Therapy
– therapy that relies on drugs and other
medical procedures to improve
psychological functioning
• Drug Therapy
– control of psychological problems through
drugs
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Antipsychotic Drugs
Thorazine
Calms (+) symptom
Clozaril
May “awaken” (-) symptom
How?
By occupying Dopamine receptor sites at
neuron and blocking it’s activity
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Drug Therapy
• Antipsychotic drugs
– drugs that temporarily alleviate psychotic
symptoms such as agitation and
overactivity
• chlorpromazine
• clozapine
• haloperidol
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Antianxiety Drugs
Work by depressing CNS activity
Drugs like Valium & Librium
reduce tension and anxiety
without causing
excessive sleepiness.
Prince
Valium
Psychological
Dependence!
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Drug Therapy
• Lithium
– a form of simple mineral salts that has
been used very successfully in cases of
bipolar disorder
• Antianxiety drugs
– reduce the level of anxiety a person
experiences, essentially by reducing
excitability and in part by increasing
drowsiness
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Antidepressant Drugs
Increase availability of Norepinepherine or Seraton
Prozac blocks reuptake/removal
of seratonin from the synapse
$1 Billion in sales in ‘93
Prozac
Manic-Depressive Disorder
Lithium - simple salt
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Drug Therapy
• Antidepressant drugs
– medication that improves a depressed
patient’s mood and feeling of well-being
• Prozac (fluoxetine)
• Zoloft
• Paxil
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Therapies of Last Resort
Electroconvulsive Therapy & Psychosurgery
ECT - limited to severely depressed patients
How Does It Work? Good Question.
Lobotomy - cut nerves
connecting frontal lobes
with inner brain
(fad of ‘40s & ‘50s
...very nasty)
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Psychosurgery
• Psychosurgery
– brain surgery once used to alleviate
symptoms of mental disorder but rarely
used today
• Prefrontal lobotomy
– surgically destroying or removing parts of a
patient’s frontal lobes that were thought to
control emotionality
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Electroconvulsive Therapy
(ECT)
• Electroconvulsive therapy (ECT)
– a procedure in which an electric current of
70 to 150 volts is briefly administered to a
patient’s head, causing a loss of
consciousness and often seizures
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Evaluating
Psychotherapy:
Does Therapy
Work?
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Evaluating Psychotherapy:
Does Therapy Work?
• Spontaneous recovery
– recovery without treatment
• Eclectic approach to therapy
– an approach to therapy that uses
techniques taken from a variety of
treatment methods, rather than just one
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Group Therapy
• Group therapy
– therapy in which people discuss problems
with a group
• Family therapy
– an approach that focuses on the family as
a whole unit to which each member
contributes
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
Community Psychology:
Focus on Prevention
• Community psychology
– a movement aimed toward preventing or
minimizing psychological disorders in the
community
• Deinstitutionalization
– the transfer of former mental patients from
institutions into the community
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)
References
• Feldman, M. (1999). McGraw Hill Company.
Retrieved May 2002 from World Wide Web
at: http://www.mcgrawhill.com.
• Kohn, A. J. & Kohn, W. (1998). The
Integrator 2.0. CD-Rom. Brooks/Cole
Thomson Learning.
• Richardson, K. (1999). Retrieved May 2002
from the World Wide Web at:
http://www.monmouth.edu.
(Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)