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Module 52 & 53
Therapies
Psychotherapy
Types of Therapy
1) Behavioral Therapy
2) Psychotherapeutic (Talk Therapy)
3) Biomedical Therapy
Eclectic Psychotherapy—drawing on
techniques from different forms of therapy,
depending on the client and the problem.
Pragmatic – use what evidence has shown to
work.
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This chart shows the
percentage of
psychologists (from
among 1,000
members
of the American
Psychological
Association’s
Division of
Psychotherapy) who
have various primary
psychotherapy
orientations.
Behavioral Therapies
“Behavior centered”
Classical Conditioning – e.g., Bell and Pad
Treatment
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Counter Conditioning
e.g., Exposure Therapy
Flooding (exposing person to high levels of feared or
avoided stimuli) often backfires
Systematic Desensitization
- learn inhibiting response (relaxation)
- progressively image feared situations
while relaxed.
- very effective treatment for
phobias.
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Aversion Conditioning e.g., antabuse
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Operant Conditioning (Behavioral
Modification)
Rewarding desired behaviors while ignoring or
punishing undesired behaviors.
- shaping (scaffolding)
- token Economies
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Talk Therapies
1) Psychoanalysis “insight oriented”
Catharsis
Transference
Resistance
Evaluation
- costly & time consuming
- based on a questionable theory
-patients need to be highly verbal,
- educated and intelligent
- limited application
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When would false memories be Created?
Hypnosis
Repetition
Authority
Explanation of current symptoms
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"Loftus (1997) reviewed 30 cases selected at
random from 670 claims submitted to the
Washington Victims Compensation Program.
Twenty-six had 'recovered' a memory of
abuse through therapy. All 30 were still in therapy after
three years, 18 for more than five years. After treatment
20 were suicidal compared with three before treatment
began, 11 were hospitalized (cf. two before treatment),
eight engaged in self-mutilation (cf. one before) and
marriage break-up occurred in almost all. It appears that
in these cases, recovery and abreaction had serious
adverse effects." -- Sydney Brandon, M.D., et al,
"Recovered memories of childhood sexual abuse:
implications for clinical practice,"
British
Journal
of
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Psychiatry, April 98, p.
Short Term Psychodynamic Therapies
- focus on the present
- very directive
e.g., Unresolved grief
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2) Humanist Therapies
“Client-centered Insight Therapy”
Non-directive
- Client figures out what is wrong,
Therapists Role -acts as a sounding board
- genuine
- unconditional positive regard (acceptance)
- empathetic
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Techniques
Active Listening and Reflecting back
- Therapist restates what the client says.
• Paraphrase
• invite clarification
• reflect feelings
Evaluation of Humanist Theories
- shorter term and less costly
- requires verbal ability
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3) Cognitive Learning Therapies
Rational-Emotive Behavioral Therapy (Albert Ellis)
Help Client identify and deal with irrational thoughts
(Stinking Thinking)
Musturbation e.g., I must get an A in this class.
Everyone must like me.
Catastrophising e.g., If I don’t get an A I will be a failure for life.
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ABC theory of Emotions
A - Activating event
B - Belief triggered when the event occurs
C - Emotional Consequences
-belief is the source of the problem.
Techniques
-examination of beliefs
- directive
- writing exercises
- self-talk
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Beck’s Cognitive Therapy (CT)\
-distorted thinking
- unrealistic beliefs
Challenge them empirically.
e.g., No one cares about me.
Challenge them to call friends and family
to see if that is true.
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Family Systems Therapy
Communication
Behavioral Contracts
Group Therapy
- therapist led
Self-Help Groups
- peer led
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Module 53
Evaluating Psychotherapies
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Does Therapy Work?
Spontaneous Remission - 65% (Eysenck)
Meta-Analysis
Average person in therapy shows better
improvement than 80% of persons with similar
problems who are not in therapy.
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Does one Therapy work better than another?
No. -- but some work better for some problems
Non-specific Factors
1) Hope
2) New perspective (support and explanation)
3) Empathic, trusting, caring relationship
4) Commitment to change
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Eclectism – pragmatic
- draws from all therapeutic techniques
- tailored to problem type
- tailored to client type
Evidence Based Practice.
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Alternative therapies
Eye Movement Desensitization and
Reprocessing (EMDR)
Does it work?
-Specific traumas (84% success)
Why ??
- perhaps just systematic desensitization.
- Placebo effect?
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