1. Psychotherapy (Chapter 19)
First Lecture Outline:
History of psychotherapy
Psychotherapy approaches
Foundations of counselling
Video 101: Psychodynnamics

2. Monday’s midterm Results will not be finalized until Monday
Many did well!! Keep it up!!
Multiple choice (out of 40) were done well
Average around 27 or 28/40
Score is out of 30 for both quizzes

3. History Mental illness = demonic possession Middle ages: Asylum
Exorcism, flogging, torture, bleeding, enemas
Braveheart: “purification of spirit”
Middle ages: Asylum
St. Mary of Bethlehem: Bedlem, uproar, confusion
“over-crowded prison for social outcasts”
1800s: Mesmer, Charcot, Breuer, Freud
origins of hypnosis and cathartic methods

6. Other interventions from the 1900’s
Psychosurgery 1930s to 1950s: Prefrontal lobotomy
left patients vegetative, replaced by very specific microsurgery for lesions

7. Electroconvulsive therapy (ECT) in 1940s:
150 volts run through the head for 1-2 seconds
leads to memory loss, broken bones, still used as “last resort” for depression
Today the patient is usually placed under general anesthesia, paralysed with drugs, monitored and assisted with breathing.
Antipsychotic medications in the 1950s

8. What is a clinical interview?
Psychotherapy involves talking to people
Structured and unstructured interviews
Model of psychotherapy directs attention of interview
Psychodynamic: Focus on early experiences
Behavioral: Focus on symptoms, ABC’s
Cognitive: Questions about specific thought patterns
Humanistic: Unconditional positive regard

9. Interviewing in an assessment
Focus depends on what you are assessing, diagnosis
Background includes medical, school/work, family, hobbies, description of symptoms, and “other sources of information”
Tests then augment interview
Intelligence, neuropsychological, memory tests
Personality and behavioral measures
Psychophysiological and computer tasks

10. Who can conduct “therapy”
Anyone can offer themselves to the public as a “therapist” or “counsellor”
These are not protected titles or services: watch out!
Only a psychologist can say they offer “Psychological intervention” or “Psychological assessment”
Title and services of a “psychologist” governed by provincial statute

12. Psychodynamic therapy approaches
Patients improve once they become conscious of ego-threatening material
Free association: Client says whatever comes to mind; Dream analyysis
Resistance is an impediment to progress
Transference of feelings from significant others to therapist; Countertransference
Website listing psychotherapy approaches for personality disorder

13. Evolution of psychoanalysis
Originally it could take years at 3-5 sessions per week
Unstructured and relaxed approach necessitated comfortable seating, surroundings
Change to become more task-oriented and time limited
“Contracting” with clients for a specific number of sessions to reach a goal