Therapy zPsychotherapy yan emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties yEclectic Approach xan approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy

Therapy- Psychoanalysis zPsychoanalysis yFreud ypatient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight yuse has rapidly decreased in recent years zResistance yblocking from consciousness of anxiety- laden material

Therapy- Psychoanalysis zInterpretation ythe analyst’s noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight zTransference ythe patient’s transfer to the analyst of emotions linked with other relationships xe.g. love or hatred for a parent

Therapy- Psychoanalysis zMalan: I get the feeling that you are the sort of person who needs to keep active. If you don’t keep active, something goes wrong. Is that true? zVader: Yes. zMalan: I get a second feeling about you and that is that you must, underneath all this, have an awful lot of very strong and upsetting feelings. Somehow, they’re all there, but you aren’t really quite in touch with them. Isn’t that right? I feel you’ve been like that as long as you can remember. zVader: For quite a few years, whenever I really sat down and thought about I got depressed, so I tried not to think about it. zMalan: You see, you’ve established a pattern, haven’t you? You’re even like that here with me, because in spite of the fact you are in some trouble, and you feel the bottom is falling out of your world, the way you’re telling me this as if there wasn’t anything wrong.

Humanistic Therapy zClient-Centered Therapy yAlso called humanistic therapy - Carl Rogers ya genuine, accepting, empathic environment to facilitate clients’ growth yActive Listening xempathic listening in which the listener echoes, restates, and clarifies

Humanistic Therapy zRogers: Feeling that now, hm? That you’re just no good to yourself, no good to anybody. Never will be any good to anybody. Just that you’re completely worthless, huh? – Those really are lousy feelings. Just feel you’re no good at all, hm? zJon Smith: Yeah. (muttering in low, discouraged voice) That’s what this guy I went to [the store] with just the other day told me. zRogers: This guy you went to [the store] with really told you that you were no good? Is that what you are saying? Did I get that right? zJon Smith: M-hm. zRogers: I guess the meaning of that - if I get it right - is that here’s somebody that meant something to you and what does he think of you? Why, he’s told you that he thinks you’re no good at all. And that just really knocks the props out from under you. (Jon weeps quietly.) It just brings the tears. (Silence 20 seconds) zJon Smith : (rather defiantly) I don’t care though. zRogers: You tell yourself you don’t care at all, but somehow I guess some part of you cares because some part of you weeps over it.

Biomedical Therapies zPsychopharmacology ystudy of the effects of drugs on mind and behavior xLithium chemical that provides an effective drug therapy for the mood swings of bipolar (manic-depressive) disorders

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 zPsychosurgery ysurgery that removes or destroys brain tissue in an effort to change behavior ylobotomy xnow-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients

Biomedical Therapies zElectroconvulsive Therapy

Behavior Therapy zBehavior Therapy ytherapy that applies learning principles to the elimination of unwanted behaviors yCounter-conditioning xprocedure that conditions new responses to stimuli that trigger unwanted behaviors xbased on classical conditioning

Behavior Therapy – Counter Conditioning zSystematic Desensitization yassociates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli ycommonly used to treat phobias

Behavior Therapy – Counter Conditioning zAversive Conditioning ytype of counter conditioning that associates an unpleasant state with an unwanted behavior yFood poisoning leads to not wanting that food anymore. Examples? UCS (drug) UCR (nausea) UCS (drug) UCR (nausea) CS (alcohol) CS (alcohol) CR (nausea)

Behavior Therapy – Counter Conditioning zToken Economy yan operant conditioning procedure that rewards desired behavior ypatient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats

Cognitive Therapy zCognitive Therapy yteaches people new, more adaptive ways of thinking and acting ybased on the assumption that thoughts intervene between events and our emotional reactions

Cognitive Therapy zThe Cognitive Revolution Can you title this chart?

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 therapy for depression Waiting list patients Cognitive training patients Cognitive training patients much less depressed Pre-therapy test Post-therapy test Depression scores

Cognitive Therapy zCreating Optimism yTemporary, not permanent. yCircumstantial, not personal. yLocalized, not pervasive.

Cognitive Therapy zCognitive-Behavioral Therapy ya popular integrated therapy that combines cognitive therapy (changing self- defeating thinking) with behavior therapy (changing behavior)

Group Therapies zFamily Therapy ytreats the family as a system yviews an individual’s unwanted behaviors as influenced by or directed at other family members yattempts to guide family members toward positive relationships and improved communication

Who Does Therapy? zTo whom do people turn for psychological difficulties?

zClinical psychologists yMost are psychologists with a Ph.D. and expertise in research, assessment, and therapy, supplemented by a supervised internship. yAbout half work in agencies and institutions, half in private practice. Who Does Therapy?

zClinical or Psychiatric social worker yA two-year Master of Social Work graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy xIt is mostly to people with everyday personal and family problems.

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 yPhysicians who specialize in the treatment of psychological disorders. yNot all psychiatrists have had extensive training in psychotherapy, but as M.D.s they can prescribe medications. yThey tend to see those with the most serious problems. yMany have a private practice.

Does Therapy Work? zMeta-analysis yprocedure for statistically combining the results of many different research studies