Transcript Table 17-1 Psychoanalysis

Table 17-1 Psychoanalysis
Goal
Resolution of symptoms and major reworking
of personality structures related to
childhood conflicts
Patient selection
criteria
No psychotic potential
Able to use understanding
High ego strength
Able to experience and observe intense
emotional states
Psychiatric problem derived from childhood
conflicts
Table 17-1 Psychoanalysis
Techniques
Focus on fantasies and the transference
Free association
Couch
Interpretation of defenses and
transference
Frequent meetings
Neutrality of the analyst
Duration
3-6 years
Table 17-2 Psychoanalytic
Oriented Psychotherapy
Goal
Understanding conflict area and particular
defense mechanisms used
More “here and now” than psychoanalysis
Patient selection
criteria
Similar to psychoanalysis
Also includes personality disorders with
psychotic potential (Borderline, Narcissistic)
Some major depressions and schizophrenia may
be helped when combined with medication
during periods of remission for the treatment
of psychosocial features
Table 17-2 Psychoanalysis
Techniques
Face to face-sitting up
Free association
Interpretation and clarification
Some supportive techniques
Medication as adjunct
Duration
Months to years
Table 17-3
Brief Psychodynamic
Psychotherapy
Goal
Clarify and resolve focal area of conflict that
interferes with current functioning
Patient selection
criteria
High ego strength
High motivation
Can identify local issue
Can form strong interpersonal relationships,
including with therapist, in a brief time
Good response to trial interpretations
Table 17-3
Brief Psychodynamic
Psychotherapy
Techniques
Face to face
Interpretation of defenses and
transference
Setting of time limit at start of therapy
Focus on patient reactions to limited
duration of treatment
Duration
12-40 sessions; usually 20 sessions or
less
Table 17-4
Cognitive Psychotherapy
Goal
Identify and alter cognitive distortions
Patient selection
criteria
Unipolar, nonpsychotic depressed
outpatients
Contraindications include delusions,
hallucinations, severe depression,
severe cognitive impairment,
ongoing substance abuse, enmeshed
family system
Table 17-4
Cognitive Psychotherapy
Techniques
Behavioral assignments
Reading material
Taught to recognize negatively biased
automatic thoughts
Identify patients’ schemas, beliefs,
attitudes
Duration
Time limited: 15-25 sessions
Table 17-5
Supportive Psychotherapy
Goal
Maintain or reestablish best level of
functioning
Patient selection
criteria
Very healthy individuals exposed to
stressful life circumstances (e.g.,
Adjustment Disorder)
Individual with serious illness, ego
deficits, e.g., Schizophrenia, Major
Depression (psychotic)
Individuals with medical illness
Table 17-5
Supportive Psychotherapy
Techniques
Available, predictable therapist
No/limited interpretation of transference
Support intellectualization
Therapist acts as a guide/mentor
Medication frequently used
Supportive techniques: suggestion, reinforcement, advice,
teaching, reality testing, cognitive restructuring,
reassurance
Active stance
Discuss alternative behaviors, social/interpersonal skills
Duration
Brief (days-weeks) to very long term (years)
Table 17-6 Behavioral Therapy
(Behavioral Modification)
Goal
Eliminate involuntary disruptive behavior
patterns and substitute appropriate
behaviors
Patient selection
criteria
Habit modification
Targeted symptom
Phobias
Some psychophysiological responses:
headache, migraine, hypertension,
Raynaud’s phenomena
Sexual dysfunction
Table 17-6
Behavioral Therapy (Behavioral
Modification)
Techniques
Systemic desensitization
Implosion therapy and flooding
Aversive therapy
Biofeedback
Duration
Usually time limited