Transcript Psychotherapies

Psychotherapies
Treatment of mental illness by
psychological rather than medical means.
Types of Psychotherapies
Psychoanalytic
Humanistic
Behavioral
Cognitive
Types of Therapists
Psychiatrists
Medical doctor + PhD / prescribe medication
Clinical psychologists
PH.D.
Counseling psychologist
Graduate degree
Psychotherapy
Points to Consider
“Patient”: Biomedical / psychoanalytical
“Client”: Other therapists
Insight Therapy: Psychoanalytic and
Humanistic
 Stress importance of patient / client understanding
their problems
Psychoanalytic Therapy
Psychoanalysis: Freud
Psychodynamic: Uncovering the unconscious
Psychoanalysis
Review of Key Principles
Unconscious conflict manifests in outward
behavior, thoughts
Find underlying (unconscious) problem
Methods
 Hypnosis, free association, dream analysis
Dream Analysis: Manifest and Latent Content
 “only true solution”- symptom substitution
other therapies mask it- thus conflict expresses
itself in new form
Subjective: based on interpretation
Psychoanalysis
Therapy Principles
Resistance
Patient objections, natural as uncovering
disturbing conflicts (resistance as sign of nearing
the conflict)
Transference
Patients develop strong feelings for therapist
(love, parental feelings, or hatred / transferred
from feelings toward others to therapist)
Psychoanalysis
Points of interest
Patient attends treatment 4-5 x a week
Analysts looks for & records repetitions of behavior
(unconscious)
Therapist says little (then interprets at the end of
session)
Dream Analysis (often uses free association to
analyze parts of a dream)
Weaknesses
 Not sanctioned by state or federal government
 Expensive / not covered by insurance
 Only 20 psychoanalytic schools in U.S.
Humanistic Therapies
Review of Key Principles:
Maslow, Rogers
Focus on self-concept (understanding self)
Self-Actualization: help support, recognize
goals = self-fulfillment
Free will (as opposed to determinism)
Man’s nature as good
Carl Rogers (Humanistic)
Client-centered therapy (aka personcentered: (genuineness, acceptance, empathy)
Unconditional Positive Regard
Essential for healthy development
Non-directive
Don’t tell clients what to do, but encourage them
to choose course of action for themselves
Therapist says little…
Active listening: “So what I’m hearing you
say is….”
Gestalt (Humanistic)
Fritz Perls
“Whole is greater than sum of its parts”
Get in touch with “whole self”
Integrate thoughts, actions, feelings,
talents, goals, body into harmonious whole
Body as extension of self
Healing a fragmented patient
Behavioral Therapy
Review of Key Principles
Pavlov, Watson, Skinner
Classical / Operant
“All behavior is learned”
Behavioral Modification, (or changing
maladaptive actions)
Behavioral Therapy
Counterconditioning / Mary Cover Jones
Classical conditioning
Negative CR (Conditioned response) is
replaced by positive CR
Example: Joey cries hysterically every time
he goes to the dentist.
Candy / toy upon entering dentists = positive CR
Behavioral Therapy
Counterconditioning
Joseph Wolpe / Systematic Desensitization
 Replace anxiety with relaxation
 Step one: relaxation techniques (breathing / meditation)
 Step two: anxiety hierarchy: rank ordered list of fear
(least to most)
 Start with least- incremental move up the ladder- learning
to relax at each step
 Classical / counterconditioning: more x relaxation paired
with fear, stronger relaxation response becomes
 Feared stimulus is imagined
Implosive Therapy: Imagine biggest fear first
Behavioral Therapy
In vivo desensitization
Confronting actual fear (not just imagining it)
Flooding: experiencing one’s peak fear
Idea is to realize irrationality of fear (huge
anxiety factor)
Aversive conditioning
Pairing undesired behavior with unpleasant
stimulus (Baby Albert)
Instrumental Conditioning: Token economies
Modeling: observation and imitation (Role
play)
Cognitive Therapy
(aka cognitive-behavior therapy)
Most widely practiced therapy
Core assumption: Conscious thoughts are
most influential to our psychological wellbeing
Changing unhealthy thought patterns
Combative nature: challenge irrational
thinking (negative attributional styles)
Cognitive Therapy
Rational Emotive Behavior Therapy
(REBT or RET)
Albert Ellis
Expose and confront irrational thoughts
Example: social phobia
Question likelihood of occurrence, likely result
Cognitive Therapy
Aaron Beck: Cognitive Triad
Negative thoughts about self, environment
and future result in depression
Develop positive thoughts for each factor
Somatic Therapies
Soma = body (bodily changes)
Biomedical = organic causes of disorders
Neurotransmitters / hormones
Structural brain abnormalities
Genetic predispositions
Somatic Therapies
Drug Therapy (psychopharmacology)
Schizophrenia:
Antipsychotic drugs
 Thorazine: to control positive symptoms such as
hallucinations, voices, or paranoia
 Clozapine: counteracts negative symptoms (Catatonic)
Block receptor sites for dopamine
Tardive dyskinesia: trembling side-effect
Mood Disorders
Anti-Depressants
Unipolar: Prozac, Zoloft (Clinical depression)
Bipolar: Lithium (Manic phase: stabilizes Norepinephrine
production)
Somatic Therapy
Drug Therapy
Anxiety Disorders
Librium, Valium
Relaxers, slows Central Nervous System
An eclectic approach…
Therapists often use…
Multiple perspectives- based on condition /
needs of patient
IOW: “Different tools for different problems”
Somatic Therapy
Electroconvulsive therapy (ECT)
Bilateral = both hemispheres of brain
Unilateral = one hemisphere
Theory: changes brain’s blood flow pattern
Side effects
Memory loss, brief seizure, brief loss of
consciousness
Severe depression (last resort)
Somatic Therapy
Psychosurgery
Prefrontal lobotomy
Cutting main neurons to the frontal lobe
= mental vegetable
Therapy Sessions
Individual
Group therapy sessions
Advantages? Examples?
Family therapy
Marital therapy
Play therapy (for children)
Multisystemic therapy (coordinating
specific environments)