Insight therapies - landman

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Transcript Insight therapies - landman

chapter 13
Therapies
PowerPoint by Prentice Hall, Inc., modified by Stephen Landman, Ph.D.
chapter 13
Insight Therapies
Insight therapies
Provide people with better awareness and
understanding of their feelings,
motivations, and actions
• Psychoanalysis
• Client-Centered Therapy
• Gestalt Therapy
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Psychoanalysis
Hidden feelings and motives are made
conscious for better adaptation.
Freud’s method of
psychotherapy
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Psychoanalysis (continued)
Freudian therapist = “psychoanalyst”
Symptoms are caused by unconscious conflicts
Goal of Psychoanalysis = Insight, which causes symptoms
to disappear
Task of psychoanalyst is to make timely interpretations
Freud interpreted:
1. Free Association – (reason for use of the couch)
2. Dreams
3. Transference
Catharsis = “Emotional Insight” (also called “abreaction”)
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Client-Centered Therapy
(person-centered therapy)
Carl Rogers
Problems stem from conditional love from
parents
Calls for unconditional positive regard
• Conditional positive regard
– Love and acceptance comes from
conforming to what others want
• Unconditional positive regard
– True acceptance regardless of actions
Nondirective
“Reflection of Feeling”
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Gestalt Therapy
To help people be more genuine in day-today interactions
Focus on here-and-now, and whole person
Therapy is active, directive
Empty chair technique
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Behavior Therapies
Focus on behavior change, rather than
insight
Belief that all behavior is learned. Uses
principles of learning for treatment.
Maladaptive behaviors themselves are the
focus of the therapy; they are not
“symptoms” of an underlying problem.
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Behavior Therapy (continued)
Examples:
• Desensitization – uses classical conditioning of
Pavlov
• Token Economy – uses operant conditioning of
Skinner
• Aversive therapy – classical conditioning
(Antabuse for alcholism, slap a car to teach dog
not to chase cars)
• Behavioral marriage counseling
• Behavioral Contracting
• Modeling
Many other applications exist
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Cognitive Therapies
Changing clients’ perceptions of
themselves and the world
One method: Rational-emotive therapy
Albert Ellis, Ph.D.
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Irrational ideas, common in society, cause problems.
Client needs to understand how the ideas are irrational and what
self-talk is associated with them, and then needs to change to
using rational self-talk instead.
Ellis uses “counterpropaganda” to counter the irrational
propaganda the client has been affected by.
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Cognitive-Behavioral
Therapy widely used today
•Combines cognitive therapy and behavior therapy
methods – not one specific technique
•Supported by much research as being effective
for wide range of problems (eating disorders,
personality disorders, depression, pain disorders)
•Short term
•Structured and goal-directed
•An educational model - Client does homework
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Group Therapies
Many advantages to group approach
Increased feedback on how a person affects others
Modeling
Learning from others’ mistakes
Laboratory for trying new behaviors
Social support
Realizing that one is not alone
Social skills and communication practice
Opportunity to be helpful to others
Cost effective
Types
Family therapy
Couple therapy
Self-help groups (not technically a therapy group)
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Effectiveness of Psychotherapy
Success rate
Eysenck (1952): About two-thirds get better
with or without therapy. He was criticizing
psychodynamic therapy, claiming behavior
therapy to be superior.
Smith & Glass (1977) Meta-analysis of
psychotherapy outcome studies concludes
that therapy is better than no therapy.
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Which Therapy is Best?
Truax and Carkhuff (1967) found that
characteristics of therapist are crucial.
Effective therapists are characterized by
warmth, genuiness, and empathy.
Most therapists are “eclectic”, drawing
form various approaches, rather than
strictly following one method.
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Which Type of Therapy is Best?
No apparent difference in effectiveness
Possible explanations:
All offer an explanation for problems
All offer hope
All provide a therapeutic alliance with a
therapist
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Biological Treatments
Drug therapy
Major types
• Antipsychotic drugs
• Antidepressant drugs
• Lithium & Other Mood
Stabilizers
Electroconvulsive therapy
Transcranial magnetic
stimulation (new treatment for
depression)
Psychosurgery
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Institutionalization
In past, institutionalization was most
common approach
Antipsychotic drugs reduced this practice
Deinstitutionalization
This approach has own problems
Alternative forms of treatment
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Prevention
Forms of prevention
Primary prevention
• Efforts to reduce new cases of mental
disorders
Secondary prevention
• Identifying at-risk groups
Tertiary prevention
• Helping people adjust after hospital release
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Client Diversity and Treatment
Gender and treatment
Rates of treatment for females is higher
Form of treatment can be gender biased
Culture and treatment
What constitutes normal can be culturebound