Transcript Therapy Approaches

Therapy Approaches
• Biological Treatment
• Surgery & Electroshock
• Psychotherapy
• The Power of Forgiveness
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Biological Treatments
Drugs
• 1-Antipshchotic Drugs
• 2-Antidepressant Drugs
• 3-Tranquilizers
• 4-Lithium Carbonate
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1-Antipsychotic Drugs
or Neuroleptics
Good for treating psychosis and schizophrenia
Examople: Thorazine
Reduce receptivity to dopamine or increase
serotonin
Reduce positive symptoms of schizophrenia
Do not relieve other negative symptoms
Can have dangerous side effect: tardive
dyskinesia & neurolyptic malignant syndrome
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Antipsychotic Drugs
and Schizophrenia
• Good for reducing:
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• Offers little relief
from:
• Jumbled thoughts
Agitation
• Difficulty
Delusions
concentrating
Hallucinations
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Inability
to
interact
Can shorten
with others
schizophrenic episodes
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2-Antidepressant Drugs
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Treat depression, anxiety, phobias, OCD
Example: Prozac, Zoloft, and Paxil
Non addictive but can cause side effects
1-Monoamine oxidase inhibitors (elevate levels of
ser. & nor. by blocking inhibitors)
• 2-Tricyclic antidepressants (boost nor. & ser. by
preventing their reabsorption)
• 3-Selective serotonin reuptake inhibitors
(work on serotonin)
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3-Tranquilizers
• Prescribed for depressed mood, panic, and
anxiety
• Example: Valium
• Increase activity of neurotransmitter GABA
• If overused can result in tolerance and
withdrawal
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4-Lithium Carbonate
• Prescribed for bipolar disorder
• Can be dangerous if not given in the right
doze
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Cautions about Drugs
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Placebo effect
Relapse and drop out rates
Dosage problems
Long-term risks
Overprescription
Sometimes they have to be with therapy
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The Placebo Effect
Kirsch and Sapirstein (1998)
• 7315 participants
• 41% of those receiving antidepressants
experienced reduced symptoms.
• 31% of those given placebos also received
reduced symptoms.
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Surgery & Electroshock
• Psychosurgery
• Shock Therapy
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Psychotherapy
• Psychodynamic
• Behavioral
• Cognitive
• Humanistic/Existential
• Therapy in Social Context
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Psychodynamic Therapy
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Probes the past
Doesn’t tackle the immediate problem
The goal is insight
Takes a long time
Explores the unconscious
Methods: free association, interpretation
of dreams, & transference
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• Interpretation
The analyst noting supposed dream meanings,
resistances, and other significant behaviors
in order to promote insight.
• Resistance
In psychoanalysis, the blocking from
consciousness of anxiety-laden material.
• Transference
The patient’s transfer to the analyst of
emotions linked with other relationships
(such as love or hatred for a parent)
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Behavioral Techniques
Learning
Conditioning
Association between
Environmental Stimuli + Response
Classical Conditioning
Association
Stimulus-Response
Operant Conditioning
Reinforcement/
Punishment
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Behavioral Techniques
• There are no mental processes (will,
mind)
• Derived from classical and operant
conditioning
• The focus is on changing the behavior
• Works on the immediate problem
• Focuses on the present
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Classical Conditioning
• Ivan Pavlov
• Conditioning
Learning that involves associations between
environmental stimuli and the organism’s
responses
• Stimulus-response Learning
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Classical Conditioning in
Real Life
• Learning to like
• Learning to fear
• Accounting for Taste
• Reacting to Medical Treatment
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Operant Conditioning
• The behavior is more likely or less likely to
occur based on its consequences.
• B. F. Skinner modified Pavlov’s concept.
• Skinner used reinforcement and punishment
to enhance learning.
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Skinner’s Box
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Behavioral Techniques
• Systematic Desensitization/Counter
Conditioning
• Aversive Conditioning
• Exposure Treatment (Flooding)
• Behavioral Records & Contracts
• Skills Training
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Systematic Desensitization
• Fear of Flying
– Read about safety
– Look at pictures of airplanes
– Visit an airport
– Take a short flight
– Take a long flight
• Fear is extinguished
• Counterconditioning
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Cognitive Therapy
• Albert Ellis
(Rational Emotive Behavior Therapy)
• Aaron Beck
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Cognitive Distortions
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Labeling
Mind Reading
Exaggeration
Unrealistic Expectations
Belief in Entitlement
Belief in Absolute Fairness
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Fighting Dysfunctional Thought
• Hot Thoughts
• He is always mean to
me.
• I did a lousy job.
• I deserve better.
• It’s not fair.
• That jerk!
• They’re driving me
crazy.
• Cool Thoughts
• Maybe he had a bad
day.
• It’ll be better next time
• But people are people
• Life is not fair.
• It’s his problem!
• Just don’t accept the
ride.
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Dysfunctional Thought
Situation
Emotion Automatic Cognitive
Thought Distortion
Rate
1-100%
Fight with
spouse
Angry,
99%
Sad,
50%
-I’ll never
have a
normal
marriage
-I deserve
better
-He’s
stubborn
Rational Outcome
Response Rate
0-100%
Magnificat- -It’s not
ion
the end
of the
world
Entitlement -That’s
normal
-Maybe
Labeling
he had a
bad day
Angry,
50%
Sad,
10%
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Humanistic/Existential
Therapy
• Works on self-fulfillment and selfactualization
• Does not delve into the past
• Helps the client think about the present and
the future
• Helps people feel good about themselves
• Tackles conscious rather than unconscious
thoughts
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Carl Rogers
Client-Centered Therapy
Person-Centered Therapy
• The therapist uses techniques such as
active listening within a genuine,
accepting, empathetic environment to
facilitate clients’ growth.
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Carl Rogers
Client-Centered Therapy
• Offers unconditional positive regard
• No specific techniques
• Therapist should be warm, genuine and
empathetic
• Client adopts these views and becomes selfaccepting
• Promotes growth instead of curing illness.
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Effective Listening
Client’s
Remark
Closed
Response
Open Response
I can’t do it.
Don’t talk like
that.
It seems very
difficult to you.
I will never be
able to have a
good life.
We’ve discussed It may look very
that before. Stop discouraging
being negative. now.
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Active Listening
• Paraphrase.
Summarize the speakers words in your own
words.
• Invite Clarification.
Encourage the speaker to say more.
• Reflect Feelings.
Reflect what you’re sensing from the speakers
words and body language.
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Existential Therapy
• Helps client explore meaning of existence
• Helps client choose a destiny
• Helps client accept self-responsibility.
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Therapy in Social Context
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Family Therapy
Family Kaleidoscope
Family Systems
Group Therapy
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Communication Approach
Virginia Satir
• Offered description of conjoint family
therapy
• Emphasized growth enhancing techniques
to evoke feeling and clarify family
communications patterns
– (dance, massage, sensory awareness, group
encounter techniques)
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Contextual Family Therapy
Ivan Boszormenyi-Nagy
• Effective family therapy must attend to
family context especially to those dynamic
and ethical connections – past, present,
future – that bind families together
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The Structural Approach
Salvador Minuchin
• The individual’s symptoms are best understood as
rooted in the context of family transaction
patterns.
– The family’s hierarchical organization
– The wholeness of the family system
– The interdependent functioning of its subsystems
• Enmeshment
The family boundaries are too diffuse to allow for
individual autonomy
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Strategic Approach
Jay Haley
• The therapist devices a strategy for solving
the client’s present problems
• Goals are clearly set
• Therapy is carefully planned to achieve
these goals
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Object Relations
• Introjects – the psychological
representations of external objects
• The most powerful obstacle to change is
people’s attachment to their parental
introjects
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Family Systems Theory
Multigenrational
Murray Bowen
• Conceptualizes the family as an emotional
unit, a network of interlocking relationships,
best understood when analyzed within a
multi generational or historic framework
• Genograms
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When Therapy Helps
• When clients have enough sense of self
• When clients have enough distress to
motivate them to change
• When therapists are warm and empathetic
• When client and therapist establish a good
rapport
• Hostile, negative clients are less likely to
benefit
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When Therapy Harms
• Bias on the therapist’s part because of
gender, religion, or race
• Coercion by the therapist to accept his/her
advice
• Coercion by the therapist to have sexual
intimacy
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Alternatives to Psychotherapy
• Community Psychologists
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Half-way houses
Clubhouse model
Foster care
Family support groups
• Rehabilitation Psychologists
– Epilepsy, physical injury, arthiritis, chronic pain
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The Power of Forgiveness
• Giving up grudges can reduce chronic back pain
• Forgiveness limited the number of relapses among
women battling substance abuse problems.
• Using MRI scans to explore how just thinking
about empathy and reconciliation sparks activity
in the brains left middle gyrus, suggesting we all
have a mental forgiveness center set to be tapped.
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The Power of Forgiveness
• Cortisol’s depressive effect on the immune
system has been linked to serious disorders.
• Forgiveness stops the cortisol and
adrenaline from flowing.
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American Psychosomatic Society
A Study
• 36 male veterans who had coronary artery
disease and who were also burdened by
other war-related issues
• Those who received forgiveness training
showed greater blood flow to the heart.
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