Psychotherapy A planned emotionally charged, confiding interaction between a trained, socially sanctioned healer and a sufferer.

Therapy zPsychotherapy yTreatment of emotional and behavioral problems through psychological techniques, rather than biological approaches to treatment yInvolves conversations, verbal interactions b/w person with a disorder and someone who’s been trained to correct that disorder zEclectic Approach yan approach to psychotherapy that, depending on the client’s problems; uses blended technique, pulls from various forms of therapy

Therapy - Psychoanalysis zPsychoanalysis yFreud believed the patient’s free associations, defense mechanisms, resistances, dreams, and transferences (and the therapist’s interpretations of them) released previously repressed feelings often from childhood yHistorical reconstruction, allows patient to gain self-insight ysignificantly decreased use in recent years, takes time, very expensive zResistance yblocking flow of free associations to consciousness, often anxiety-laden material yAny unconscious behaviors by patient that hinder the progress of therapy (being late, missing sessions, anger at therapist.)

Therapy- Psychoanalysis zInterpretation yanalyst offers insights, alternative way of looking at dream meanings, resistances, other behaviors based on patient’s possible unconscious needs and desires in order to promote insight zTransference ybased on therapist’s neutral relationship with patient ypatient transfers to therapist the emotions, feelings, perceptions linked with other relationships xEx: love or hatred for a parent xsigns of transference include falling in love or being hostile to therapist xlacking confidence in one's own ability, worth, or fitness; timid; shy xhttps://

Humanistic Therapy zClient-Centered Therapy - Carl Rogers ytherapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients’ growth, unconditional positive regard, self actualization yfocuses on clients’ own point of view, not therapists’ interpretations, acts as psychological mirror, boosts self awareness, focused on present and future – NOT past zActive Listening yempathic listening in which the listener echoes, restates, and seeks clarification, acknowledges client’s feelings y understands emotion and content of clients’ statements

Behavior Therapy zBehavior Therapy yapplies learning principles to the elimination of unwanted, troubling behaviors yassumes both normal and abnormal behaviors are learned and can be replaced w/ constructive behaviors zCounterconditioning yprocedure that conditions new, more adaptive responses to stimulus that triggers unwanted behaviors ybased on Pavlov’s Classical Conditioning yincludes systematic desensitization (gradual), exposure therapy and aversive conditioning

Behavior Therapy zSystematic Desensitization ytype of exposure therapy; counterconditioning yassociates a pleasant, relaxed state with exposure to gradually increasing anxiety-triggering stimuli ycommonly used to treat phobias zAversive Conditioning ytype of counterconditioning that associates an unpleasant state or stimulus with an unwanted behavior; aversive response to a harmful stimuli yNausea drug in drinks ---> alcoholics yhttps://

Behavior Therapy zSystematic Desensitization

Behavior Therapy zAversion therapy for alcoholics UCS (drug) UCR (nausea) UCS (drug) UCR (nausea) CS (alcohol) CS (alcohol) CR (nausea)

Behavior Therapy zToken Economy yoperant conditioning procedure that rewards desired behavior, can also punish inappropriate behavior via “fines” ypatient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges/treats yOften used in institutional settings (schools, hospitals, prisons, with disturbed children, schizophrenics and AP Psych classrooms )

Behavior Therapy zToken Economy Criticisms yDependent on extrinsic rewards- what happens when the reinforces stop? ySubjective-Is it right for one human being to control another’s behavior, is behavior modification too authoritarian?

Cognitive Therapy zEmphasizes recognizing and changing negative thoughts and maladaptive beliefs (depression, anxiety). zTeaches new, more adaptive ways of thinking and acting (no more self-blame, criticism) zGoal – change, restructure client’s thinking process zPerson’s emotional reactions are produced not by the event (job loss) but by the person’s thoughts in response to the event

Cognitive Therapy zThe Cognitive Revolution

Cognitive Therapy zA cognitive perspective on psychological disorders Lost job Depression Internal beliefs: I’m worthless. It’s hopeless. Lost job Internal beliefs: My boss is a jerk. I deserve something better. No depression

Cognitive Therapy zCognitive-Behavioral Therapy (C.B.T.) yAaron Beck identified patterns of thinking that correlated with symptoms of depression. To understand depression and related illness, he developed the Beck Depression Inventory, Beck Anxiety Inventory, and the Scale for Suicide Ideation. Best known for cognitive approach to treatment of disorders, especially depression, did much of the initial research on the theory that distorted or inaccurate thoughts are precursor in the development/continuation of depression. yCBT exposes and confronts the client’s dysfunctional thoughts; a popular, integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior) yhttp://

Cognitive Therapy zRational Emotive Behavior Therapy- focuses on uncovering irrational beliefs which may lead to unhealthy negative emotions, replacing them with more productive rational alternatives zAlbert Ellis’ REB theory - it is generally irrational and self-defeating to get all worked up about someone else's behavior zRET is a direct, confrontational form of therapy that challenges client’s irrational beliefs. Replace irrational thoughts with those that are appropriate and less distressing. zRET therapists – a warm client/therapist is not necessary

Rational Emotive Behavior Therapy Proposed by Albert Ellis ABC Theory: Attempts to restructure a person’s belief system into a more realistic, rational, and logical set of views. Goal is D (Disputing) the irrational thoughts and emotions.

Group Therapies zFamily Therapy ytreats the family as a system; often less expensive and less time intensive than individual therapy yviews an individual’s unwanted behaviors as influenced by or directed at other family members; no one is an island yattempts to guide family members toward positive relationships yimprove communication

Who Practices Therapy? zTo whom do people turn for help for psychological difficulties?

Who Practices Therapy? zClinical Psychologists yTrained to diagnose, test and treat individuals with psychological disorders yMost are psychologists with Ph.D. and expertise in research, assessment, and therapy, supplemented by supervised internship yAbout half work in agencies and institutions, half in private practice

Who Does Therapy? zClinical or Psychiatric Social Worker yTwo-year Master of Social Work graduate program plus postgraduate supervision prepares some social workers to offer counseling and psychotherapy, mostly to people with everyday personal and family problems. yAbout half have earned the National Association of Social Workers’ designation of Clinical Social Worker.

Who Does Therapy? zCounselors yMarriage and family counselors specialize in problems arising from family relations. yPastoral counselors provide counseling to countless people. yAbuse counselors work with substance abusers and with spouse and child abusers and their victims.

Who Does Therapy? zPsychiatrists yMedical doctors who specialize in the treatment of psychological disorders yNot all psychiatrists have had extensive training in psychotherapy, as MD’s they can prescribe medications yTend to see those with the most serious problems yMany have a private practice

Biomedical Therapies zPsychopharmacotherapy yTreatment of the mental disorders with medication zAnti mania (Lithium Carbonate) yprovides an effective drug therapy for the mood swings of bipolar (manic-depressive) disorder, 80% effective, dosage must be exact and constantly monitored zAnti psychotic (Clozapine, Thorazine, Haldol) yused in the treatment of schizophrenia for disorganized and psychotic thinking. Used to help treat false perceptions (e.g. hallucinations, paranoia or delusions.), 60-70% of patients show improvement. Can cause tardive dyskinesia – tremors, muscle movements.

Biomedical Therapies zThe emptying of U.S. mental hospitals Introduction of antipsychotic drugs Rapid decline in the mental hospital population Year State and county mental hospital residents, in thousands

Biomedical Therapies

zElectroconvulsive Therapy (ECT) ytherapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient. yRoutinely used in 1940’s - 50’s for schizophrenia and sometimes mania. Not commonly used now, no one knows why/how it worked, the seizure that resulted may temporarily change the biochemical balance in the brain. zPsychosurgery ysurgery that removes or destroys brain tissue in an effort to change behavior, only used for serious disorders yLobotomy - frontal lobes surgically separated from brain centers controlling emotion, now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients (left impaired intellect, loss of motivation, personality changes). Left patients permanently lethargic.

The Placebo Effect zAny substance that is not known to have any pharmacological effects (produces no meaningful changes in an organism, either chemical, biological, etc.) that is made to look like an active ("real") drug zSometimes the act of taking a pill produces an effect if the person believes the pill is active zhttps://

Biomedical Therapies zElectroconvulsive Therapy

Biomedical Therapies - ECT zhttps:// B-aluCEhttps:// B-aluCE zhttps:// rJytcLI – Patient after ECThttps:// rJytcLI – Patient after ECT

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