Transcript Chapter 15 If You Go For Help

Chapter 15
If You Go for Help
Chapter Overview
How Well Does
Therapy Work?
If You Go for
Help
Other Approaches to
Treatment
• Family, Couples, and
Relationship Therapy
• Biomedical Therapies
• Community-Based Services
Insight Therapies-The
Talking Cure
• Psychoanalysis
• The Person-Centered
Approach
• A Variety of Approaches
Cognitive-Behavioral
Therapies
• Behavioral Therapies
• Cognitive Therapies
• Status of Psychotherapy Today
Chapter Summary
Insight Therapies – The Talking Cure
• Psychoanalysis
• The Person-Centered Approach
• A Variety of Approaches
Chapter Summary
cont’d
Cognitive-Behavioral Therapies
• Behavioral Therapies
• Cognitive Therapies
• Status of Psychotherapy Today
Chapter Summary
cont’d
Other Approaches to Treatment
• Family, Couples, and Relationship Therapy
• Biomedical Therapies
• Community-Based Services
1
Rank[d],D
HFDocs
Chapter Summary
cont’d
How Well Does Therapy Work?
Introduction
• Psychotherapy is the helping process in
which a trained, socially sanctioned therapist
performs certain activities that facilitate a
change in the client’s attitudes and
behaviors.
• A therapist is a person trained to help
people with psychological problems.
• One type of psychotherapy is insight
therapy, therapy designed to bring change
by increasing self understanding.
Insight Therapies-The Talking Cure
Psychoanalysis
A form of psychotherapy aimed at helping
the person gain insight and mastery over
unconscious conflicts.
• Founded by Dr. Sigmund Freud.
• Uses the processes of free association,
•
resistance, transference, dream analysis, etc.
Greatly criticized in the past, but shorter
versions today are gaining some recognition
from the psychological community.
Insight Therapies-The Talking Cure cont’d
The Person-Centered Approach
Psychotherapy designed to change a client via the
therapist’s genuineness, acceptance, and
empathic understanding.
• Developed by Dr. Carl Rogers.
• Uses the processes of acceptance, and empathy.
• As clients are understood and accepted by the
therapist, they come to accept themselves more
fully and listen more accurately to their inner
experiences.
Insight Therapies-The Talking Cure cont’d
A Variety of Approaches
Other forms of insight therapy exist. They include:
• Existential therapy: An approach that emphasizes the
client’s capacity for growth through affirmation of his or
her free choice and personal values.
• Logotherapy: Therapy that stresses the importance of
clarifying values that give personal meaning and purpose
to life.
Insight Therapies-The Talking Cure cont’d
A Variety of Approaches
Other forms of insight therapy exist. They include:
• Gestalt therapy: Therapy that makes use of the here-
and-now, the client’s responsibility, and nonverbal
behavior as a way of helping clients unify their feelings
and actions.
• Actualization therapy: Therapy that combines
elements of other therapies as a way of maximizing the
individual’s growth.
Cognitive-Behavioral Therapies
Behavioral Therapy
This therapy involves discovering the factors that
trigger and reinforce problem behavior; specifying
a target behavior to replace it; and then, by
manipulating these factors, bringing about the
desired change.
Cognitive-Behavioral Therapies
cont’d
•
•
Behavioral Therapy
These therapies are based on operant and
classical conditioning.
One example is desensitization, a method
for controlling anxiety by learning to
associate an incompatible response, like
relaxation, with a fear-provoking stimulus
(i.e. phobia).
Cognitive-Behavioral Therapies
cont’d
Cognitive Therapies
Therapies that focus on faulty cognitive processes
as the crucial element in maladaptive behaviors.
• The central assumption: emotional and
behavioral problems result from an individual’s
distorted thoughts and reactions to external
events rather than from the events themselves.
• These therapies are meant to help clients think
more rationally about themselves and their
problems.
• Therapists do not probe for deep-seated causes.
Cognitive-Behavioral Therapies
cont’d
•
•
•
Status of Psychotherapy Today
Most practitioners today are eclectic—
they use a variety of approaches.
They hope to find and match the best
technique to each client, given the client’s
uniqueness.
Therapy today is done in fewer sessions
than in the past; this is most likely
because of managed health care.
Other Approaches to Treatment
Mutual-Help Groups (Self-Help Groups)
Group members share a common issue and meet regularly
to discuss their concerns without the guidance of a
professional.
• An example is Alcoholics
Anonymous.
• A major assumption is that no one
can understand you as well as
someone else who has the same
problem.
• Research supports that these
nonprofessional groups are
effective.
From MentalHealth.org
Other Approaches to Treatment
cont’d
Family, Couples, and Relationship Therapy
Relationship therapists try to help small units of people
be more aware of how they treat each other, how they
may unwittingly hurt one another, and how they can
nurture each other better.
An example is family therapy.
Family therapy involves the
larger family unit, including
children and adolescents, on the
assumption that disturbance of one
family member reflects problems in
the overall family.
Other Approaches to Treatment
cont’d
Biomedical Therapies
Strategies that rely on direct physiological
intervention to treat the symptoms of
psychological disorders.
• These treatments include drugs,
electroconvulsive treatment, and
psychosurgery.
Other Approaches to Treatment
cont’d
Biomedical Therapies
• Many disorders are related to imbalances in
neurotransmitters–chemical substances
involved in the transmission of neural impulses
between neurons.
• Antianxiety drugs are drugs used primarily for
alleviating anxiety; these drugs include minor
•
tranquilizers.
Antidepressants are used to treat depression or
to elevate mood, usually by increasing the level of
certain neurotransmitter such as norepinephrine
and serotonin.
Other Approaches to Treatment
cont’d
Biomedical Therapies
• Lithium, which is a natural mineral salt used to
treat bipolar disorder.
• Antipsychotic drugs are medications to relieve
the symptoms of psychoses such as extreme
agitation, hallucinations, and delusions.
• Each drug has its own advantages and
disadvantages such as tardive dyskinesia caused
by antipsychotic medication.
Other Approaches to Treatment
cont’d
Biomedical Therapies
Electroconvulsive Therapy (ECT) involves the
administration of an electric current to the
patient’s brain to produce a convulsion.
• Commonly used to treat depression.
• Generally requires multiple treatments.
• Can cause memory loss.
Other Approaches to Treatment
cont’d
Biomedical Therapies
Psychosurgery is surgery designed to destroy or
disconnect brain tissue in an attempt to regulate
abnormal behavior.
• An example is a frontal lobotomy which is
surgery of the frontal lobes of the brain intended
to alter the emotion-controlling center of the
brain.
• …a very controversial treatment, but still utilized
•
today.
Some patients emerge from surgery in a
vegetative state!
Other Approaches to Treatment
cont’d
Community-Based Services
Services located in the individual’s own community,
such as a community mental health center.
• Such services were promoted by the Community
Mental Health Centers Act (1963).
• Outpatient community services are heavily used
today with the closing of so many psychiatric
hospitals.
Other Approaches to Treatment
cont’d
Community-Based Services
• The system does not seem to work well; many
•
•
people with mental disorders end up in jail, then
the hospital, later the streets, only to be put in jail
again.
This revolving door syndrome of moving from
institution to institution is known as
transinstitutionalization.
Other places in the community where mentally
disordered individuals are found include halfway
houses and crisis intervention centers.
How Well Does Therapy Work?
Is therapy better than no therapy?
• Research shows that after treatment, the
average treated patient is better off than 80
percent of untreated patients.
• This result is encouraging, especially as more
and more people in need of therapy are finding
ways to participate.
How Well Does Therapy Work?
cont’d
What elements make therapy
effective?
• A good match between client and therapist is
•
•
•
important. For example, directive therapy (where
the therapist plays an active or authoritative role)
works best for low-resistance clients.
Longer treatments provide better results.
Assigning projects (“homework”) between
sessions also improves effectiveness.
Monitoring the effectiveness of therapy with
assessments also improves results.
How Well Does Therapy Work?
cont’d
Is one type of therapy more
effective than another?
There is little difference among types of
psychotherapies.
•
•
•
•
•
•
Therapist characteristics that enhance the
effectiveness of therapy include:
flexibility
respectfulness
honesty
warmth
trustworthiness
emotional expressiveness
How Well Does Therapy Work?
cont’d
Is one type of therapy more
effective than another?
Clients who:
• are articulate
• are motivated
• believe in psychological processes
• match the therapist in terms of ethnicity, race, or
gender
…are more likely to do well in therapy!
How Well Does Therapy Work?
cont’d
Is one type of therapy better or worse
for a particular disorder?
Research indicates that:
• Behavior therapy is most effective for
phobias and other anxiety disorders.
• Psychoactive medication is best for
treating schizophrenia.
• Cognitive-behavioral techniques are best
for depression.
Getting Help
When should you seek
professional help?
A general guide: when a problem interferes
with your daily life, it is time to seek help.
BUT
you don’t need to wait until a problem
arises; therapy is a good way to
experience personal growth.
Getting Help cont’d
Where do you find help?
• Many private therapists (counselors,
•
•
psychologists, social workers) may be
available in your community. Be sure you
know the qualifications of any therapist!
The local or state psychological
association can provide the names of
practitioners.
Many hospitals, schools, and work sites
employ therapists.
Getting Help cont’d
What should you look for in a
therapist?
• Professional training and certification
• Someone you are comfortable with
Discuss:
• his/her theoretical orientation
• fees/payment policies
Getting Help cont’d
What can you expect from
therapy?
Common benefits of therapy include:
• hope for the future
• caring for others
• better understanding of personal problems
• better relationships with others
• positive personality changes
Getting Help cont’d
How long must therapy continue?
• There are no hard and fast guidelines….
• Managed care has shortened the amount
of time.
Two key conditions must be met to
terminate therapy:
• Is the crisis or problem under control?
• Can the client maintain the gains acquired
in therapy on his or her own?