Transcript therapy
Different Styles Therapy Mental health therapies can be classified into two main categories Psychotherapy: trained therapist uses psychological techniques to assist someone seeking to overcome difficulties or achieve personal growth Biomedical: prescribed medication or medical procedure that acts directly on the patient’s nervous system ○ Many patients receive drug therapy in addition to psychotherapy Therapy Psychoanalysis Sigmund Freud’s therapeutic technique. Freud believed the patient’s free associations, resistance, dreams, and transference- and the therapist’s interpretations of them- released previously repressed feelings, allowing the patient to gain self-insight Therapy Aims of Psychoanalysis: sought to bring repressed feelings into patients’ conscious awareness ○ Presumes that healthier, less anxious living becomes possible when people release the energy they had previously devoted to id-ego-superego conflicts Therapy Methods: psychoanalysis emphasizes the power of childhood experiences, and aims to unearth the past ○ Freud first tried hypnosis but discarded it because it is unreliable Freud turned to free association: the client/patient says aloud whatever comes to his/her head - While this sounds easy it is actually very difficult not to omit information, change the subject quickly when uncomfortable, or when feeling shame Therapy ○ Resistance: the blocking from consciousness of anxiety-laden material The analyst will note your resistances and then interpret their meaning, providing insight ○ Another way to reach into the unconscious is dream analysis and interpreting the latent content of dreams ○ Transference: the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent) ○ This takes time and several years and can get quite expensive Therapy Psychodynamic therapy: therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight Therapy Differences between psychodynamics and psychoanalysis ○ Face to face ○ Lasts only a few weeks or months Malan: I get the feeling that you’re the sort of person who needs to keep active. If you don’t keep active, then something goes wrong. Is that true? Patient: Yes. Malan: I get a second feeling about you and that is that you must, underneath all this, have an awful lot of very strong and upsetting feelings. Somehow they’re there but you aren’t really quite in touch with them. Isn’t this right? I feel you’ve been like that as long as you can remember. Patient: For quite a few years, whenever I really sat down and thought about it I got depressed, so I tried not to think about it. Malan: You see, you’ve established a pattern, haven’t you? You’re even like that here with me, because in spite of the fact that you’re in some trouble and you feel that the bottom is falling out of your world, the way you’re telling me this is just as if there wasn’t anything wrong. Therapy Interpersonal psychotherapy: variation of psychodynamic therapy ○ Has been effective in treating depression ○ Goal is symptom relief in the here and now, not an overall personality change Therapy Humanistic Therapy Humanistic perspective emphasizes people’s inherent potential for self-fulfillment ○ Therapy aims to boost self-fulfillment by helping people grow in self-awareness and selfacceptance Therapy attempted to reduce the inner conflicts that are impeding natural development Insight therapies: a variety of therapies which aim to improve psychological functioning by increasing the client’s awareness of underlying motives and defenses ○ Both humanistic and psychoanalysis are considered insight therapies Therapy Humanistic therapy differs from psychoanalysis: ○ Focus on present and future more than the past ○ Focus on conscious rather than unconscious ○ Focus on taking immediate responsibility for one’s feelings and actions ○ Promoting growth instead of curing illness Call those in therapy clients and not patients Therapy Carl Rogers develop the technique called client- centered therapy ○ This is a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients’ growth (also call person centered therapy) ○ Client-centered therapy hinges on the therapist providing the client with unconditional positive regard Unconditional positive regard is blanket support and acceptance of a person regardless of what is said or behavior - Rogers believed this was essential ○ Client-centered therapy is non-directive Therapy ○ Active listening is essential to the humanistic view point Empathic listening in which the listener echoes, restates, and clarifies. A feature of Rogers’ clientcentered therapy Steps: - Paraphrase - Invite clarification - Reflect feelings ○ Rogers encouraged genuineness, acceptance, and empathy Therapy Group Therapy Group therapy can be just as effective for the individual and save time and money Also offers the unique benefit of social context ○ This allows people both to discover that others have problems similar to their own and to receive feedback as they try out new ways of behaving Therapy Family therapy ○ Therapy that treats the family as a system. Views an individual’s unwanted behavior as influenced by, or direct at, other family members Other types of groups ○ Closed group: only members of the group can attend or those with the same problem ○ Open group: anyone can come to the meeting Therapy Support groups and self-help groups Other examples of groups: ○ AA: Alcoholics Anonymous ○ GA: Gamblers Anonymous ○ Eating disorder groups Therapy Behavior Therapy Therapy that applies learning principles to the elimination of unwanted behaviors ○ Doubt the healing power of self-awareness ○ Behaviorist assume that problem behaviors are the problems and the application of learning principles can eliminate them Therapy Classical Conditioning Techniques ○ Since we learn many behaviors and emotions through classical conditioning, then we should be able to treat disorders with this technique as well Goal is to unlearn associations and relearn constructive behaviors and associations Counter conditioning: a behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; includes exposure therapies and aversive conditioning Therapy Exposure therapy: behavioral techniques, such as systematic desensitization, that treat anxieties by exposing people to the things they fear and avoid ○ Systematic desensitization: a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety triggering stimuli. Commonly used to treat phobias Therapy ○ Virtual reality exposure therapy: an anxiety treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders, or public speaking ○ In systematic desensitization, the goal is substituting a positive response for a negative response to a stimulus Therapy Aversive conditioning, however, is a type of counter conditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol) ○ Usually use with a combination of other treatments Therapy Operant Conditioning ○ Therapist apply the concepts of operant conditioning to the treatment of various behavioral issues in order to help the patient overcome their issues One concept that is used is called Token Economy - An operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats Therapy Cognitive Therapy Therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions ○ Self-blaming and overgeneralization explanations for bad events are often integral part of the vicious cycle of depression Goal is to change the way of thinking Therapy Lost your job Internal Beliefs: I’m worthless. It’s hopeless Lost Job Internal beliefs: My boss is a jerk. I deserve something better. Depression No depression Therapy Cognitive Behavioral Therapy ○ A popular integrated therapy that combines cognitive therapy with behavior therapy Change thoughts & actions - For a person with OCD, instead of washing hands again, tell yourself that your it’s your brain’s abnormal activity and move on to an enjoyable activity to avoid the urge. Therapy Is Psychotherapy effective? Client’s perceptions: people often enter therapy in crisis Clients may need to believe the therapy was worth the effort Clients generally speak kindly of their therapist Therapy Commonalities Among Psychotherapies Hope for demoralized people A new perspective An empathic, trusting, caring relationship Therapy Different therapies ○ Energy therapies ○ Recovered-memory therapy ○ Rebirthing therapies ○ Facilitated communication ○ Crisis debriefing ○ Eye Movement Desensitization and Reprocessing ○ Light Exposure therapy Therapy Homework: Over the weekend you are to research any three therapy methods on the list on the previous slide. One of the three methods must be EMDR, but the other two are you choice. Here is what you need to include The process of therapy (what the client must due during therapy) Discuss the effectiveness of the therapy Criticisms of the therapy method You own thoughts on each of the three. ○ Should total three pages (one page per method) Therapy Biomedical Therapies Prescribed medications or medical procedures that act directly on the patient’s nervous system ○ Often used with serious disorders Therapy Drug therapies ○ Psychopharmacology: the study of the effects of drugs on mind and behavior ○ Most widely used biomedical treatment ○ Allowed people to leave hospital confinements and live a life for their own However, in many cases this means homelessness, not liberation Therapy ○ Antipsychotic Drugs Example: Chlorpromzine (sold as Thorazine) Drugs used to treat schizophrenia and other forms of severe thought disorder - Reduce positive symptoms of schizophrenia Similar to the molecules of the neurotransmitter of dopamine to block activity at those sites Long term-use of medication can also produce tardive dyskinesia: involuntary movements of the facials muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors Therapy ○ Schizophrenia pateitns exhibiting negative symptoms do not respond well to antipsychotics However, newer atypical antipsychotics, such as clozapine (known as Clozaril), target both dopamine and serotonin receptors ○ Newer antipsychotic medications have fewer side effects ○ Antipsychotic need to be combined with lifeskills and family support Therapy Antianxiety Drugs ○ Drugs used to control anxiety and aggression Xanax and Ativan Depress central nervous system New antianxiety drug D-cycloserine (an antibiotic) can help facilitate the extinction of fears - Experiments show that the drug enhances the benefit of exposure therapy and helps relieve the symptoms of PTSD and OCD Therapy Antidepressant Drugs ○ Drugs used to treat depression; also increasingly prescribed for anxiety. Different types work by altering the availability of various neurotransmitters Fluoxetine, known as Prozac, partially blocks the absorption and removal of serotonin - Prozac and Paxil are known as SSRI (selectiveserotonin-reuptake-inhibitors) - Side effects such as: dry mouth, weight gain, hypertension, or dizzy spells Therapy ○ For all medication therapy it is important that it is linked to other treatment methods such as counseling or psychotherapy ○ For depressed patients other things help such as: exercise, eating better, and family therapy Therapy Mood-Stabilizing Medications ○ The salt lithium can be effective for those with bipolar disorder ○ Depakote found effective to control manic episodes Therapy Electroconvulsive Therapy (ECT) ○ Although controversial, ECT is often an effective treatment for depression that does not respond to drug therapy ○ Therapist delivers 30 to 60 seconds of electrical current to the patient’s brain Some memory loss is associated with it, but no discernible brain damage ○ No one is really sure how ECT works Therapy Alternative neurostimulation therapies ○ Magnetic Stimulation Depressed moods seem to improve when repeated pulses surge through a magnetic coil held close to a person’s skull Repetitive transcranial magnetic stimulation (rTMS) - The application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity - No real side effects Therapy Psychosurgery ○ Surgery that removes or destroys brain tissue in an effort to change behavior ○ Lobotomy: a now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain Therapy Therapeutic Life Changes ○ Aerobic exercise ○ Adequate sleep ○ Light exposure ○ Social connection ○ Anti-rumination ○ Nutritional supplements