METHODS OF THERAPY

Chapter 19

SECTION 1WHAT IS THERAPY?Objective: Define psychotherapy, and list the advantages of each method of psychotherapy.

WHAT IS THERAPY? Therapy is a general term for the variety

of approaches that mental health professionals use to treat psychological problems and disorders.

WHAT IS THE PURPOSE OF THERAPY?Helping individuals by:

Giving hope Gaining insight or perspectives on

their problems Providing individual with a caring and

trusting relationship

THE 2 CATEGORIES OF THERAPY Psychologically

basedPsychotherapy

involves interaction between trained professional and a person

Biologically based Involves the use

of drugs or other medical procedures to treat psychological disorders

COMMONLY USED METHODS OF PSYCHOTHERAPY

Method Goals Key Techniques

Psychoanalysis

To replace a avoidant behavior with coping behavior; to reduce inappropriate feelings of anxiety and guilt

Free association; dream analysis; analysis of the transference relationship

Humanistic therapy

To remove obstacles in the path of self-actualization

Active listening; unconditional positive regard

METHODS OF PSYCHOTHERAPYMethod

Goals Key techniques

Behavior therapy

To replace maladaptive, self defeating behavior with adaptive self enhancing behavior

Systematic desensitization; modeling; aversive conditioning; operant conditioning

METHODS OF PSYCHOTHERAPYModel Goals Key Techniques

Cognitive therapy

To replace irrational, self-defeating attitudes and beliefs with rational, self-enhancing attitudes and beliefs

Encouraging clients to challenge irrational beliefs and replace them with rational beliefs; teaching clients to evaluate their beliefs and attitudes rationally

TYPES OF PROFESSIONALS

Counseling psychologist

Master’s or Ph. DDoctor of Philosophy

Educational institutions

Clinical psychologist

Ph. D in psychology Hospitals/ clinicsPsychological problems

Psychiatrist M.D. (special) psychiatry/ post gradabnormal behavior

Prescribe medsPerform operations

Psychiatric social worker

Master’s social workAdditional practice training2 yrs grad psychology

Counsels –everyday personal and family problems

Psychiatric nurse Nursing license \advance training in psychology

Dispenses meds. Contract person between counseling sessions

SELECTING THE RIGHT PROFESSIONAL

Cost of treatment? Field of study? What degrees? Licensed? Plan for treatment?

INDIVIDUAL –V- GROUP THERAPY Advantages of individual therapy

More personal attentionFeel uncomfortable talking in front of a group

Will talk openly alone

INDIVIDUAL –V- GROUP THERAPY

Advantages of group therapyRealizing you are not aloneBenefit from insight gained

by others struggleCan support each otherGives hope for recoveryShows therapy can workMore affordable

Therapist can work with several people at the same time

TYPE OF GROUP THERAPY Couples Family therapy Self-help groups Encounter groups

SECTION 2THE PSYCHOANALYTIC APPROACH

Objectives:Describe the major techniques of psychoanalysis.

PSYCHOANALYSIS = FREUD Unconscious thoughts and feelings Reduces anxiety and guilt Allows insight

Dream analysisManifest content- actual dreamLatent content- hidden meaning

Free association Say what ever comes to mind

(any topic)Resistance – unwilling to discuss

issues

TRANSFERENCE Transferring feelings and expectations

from one person to another Allows clients to express and analyze

unconscious feelings Can expose unresolved problems Example

Bad relationship with mother---start to treat therapist the same way-----bad relationship with boss

EVALUATION OF PSYCHOANALYSIS Useful therapy for

Anxiety, mild depression and difficulty in handling social relationships

Not useful therapy forToo seriously disturbedMajor depression, bipolar disorder,

schizophrenia Limited educational backgroundLimited verbal skills

TOO EXPENSIVE (meeting 4-5 X’s a week)

SECTION 3THE

HUMANISTIC APPROACH

Objective:Identify the primary goals and methods of humanistic therapy.

HUMANISTIC THERAPY Help individual reach their full

potential Achieving self-awareness and

self acceptance Basically good and strive for self-

actualization Need to tap their inner resources

CARL ROGERS

Problemstop being yourself and act as others expect you to act

Role of therapyFind their true self and realize their unique potential

PERSON-CENTERED THERAPY

ORCLIENT-CENTERED

THERAPY

client seen as an equal Encouraged to take the lead Called Nondirective therapy

Therapist acts as a mirrorReflecting clients thoughts and feelings

THERAPY TECHNIQUE Active listening

Therapist repeats, rephrases, and asks for clarification of statements

Clients is heard and understoodTherapist must remain nonjudgmental ,

supportive, accepting regardless of what is said

Client accepts themselves Self esteem rises Gain confidence to make their own

choices Able to develope healthy relationships

OTHER APPLICATIONS Schools/ colleges Help students deal with anxiety

and depressionUse person centered approach to help students decide on a career and support their choices

EVALUATION OF HUMANISTIC THERAPY Most helpful with well educated

motivated people Work best with people who are

Mildly depressedExperiencing anxietyProblems with social relationships

Ineffectivemajor depressionBipolar disorder schizophrenia

SECTION 4COGNITIVE THERAPY ANDBEHAVIOR THERAPY

ObjectiveDescribe how cognitive and behavior therapists try to help people.

COGNITIVE AND BEHAVIOR THERAPY

Help clients develop new ways of thinking and behaving

Focus on their thought and actions

Eliminate troubling emotions or behaviors

Solve own problems

COGNITIVE THERAPY Thoughts that can lead to emotional and

behavioral problems Thinking- illogical or based on faulty

assumptions (person A—B swim team) PURPOSE OF COGNITIVE THERAPY

To help people develop more realistic and logical ways of thinking

Change thinking= solving their own emotional and behavioral problems

2 WIDELY USED COGNITIVE THERAPY METHODS

Rational- Emotive Behavioral TherapyBased on People being basically

logical in thinking and behaviorsProblems- based on faulty

assumptions Must do everything perfect

Unrealistic high standards Anxiety and severe depression

RATIONAL-EMOTIONAL BEHAVIOR THERAPY

challenges clients errors in their way of thinking

Meansrole play, modelinghomework-

Read relevant literature, listen to tapes, experiments to test their assumptions

( affects length of therapy)

BECK’S COGNITIVE THERAPY

Restructuring illogical thoughts processArbitrary inference-drawing

conclusions with no evidenceSelective abstraction- drawing conclusions with

Single detail Misinterpreting Ignoring other details

Overgeneralization- drawing conclusion from single experience

Gently guides clients in testing logic of their own thought processes and develop logical ways of thinking

MeansHave client observe and record their

response to events in daily life.Review responses to help see them as

illogical thought processes that are causing their emotional problems.

EVALUATION OF COGNITIVE THERAPY

Short term method (15-25 weeks) Has helped clients with

Anxiety‘DepressionPersonality disorders along with Meds

Provide coping skills Reduces risk of recurrence

BEHAVIOR THERAPY BEHAVIOR MODIFICATION Develop more adaptive behaviors Changing behaviors is most

importantOver eating stop smoking develop skills needed for healthy

relationshipsconfront phobias

2 CATEGORIES OF BEHAVIOR THERAPY

1. Counter-conditioning-Pairing the stimulus that triggers an unwanted behavior with a new more desirable behavior

1. Systematic desensitization 2. Aversive conditioning

BenefitLearn more desirable behaviorsBoost in self-esteemLess restrictive lives

OPERANT CONDITIONING BEHAVIORS REINFROCED TEND TO BE

REPEATED Token economy- reward + behavior Successive Approximations- reinforce

every step EFFECTIVE IN MORE SEVERE CASES.

SCHIZOPHRENIA CHILDHOOD AUTISM

USED INSTITUTIONAL SETTING: MENTAL HOSPITALS,

EVALUATION OF BEHAVIOR THERAPY

More effective overall Short term therapy of

Phobias, post-traumatic stress disorder compulsions,depression social problems self-control issues

SECTION 5BIOLOGICAL

THERAPYObjectiveDescribe the three major biological treatments for psychological disorders

BIOLOGICAL THERAPY Effects the Brain Relies on methods such as

medication electric shock and surgery

Medical in nature= administered or prescribed by a psychiatrists or other physicians

Paired up with other therapies

DRUG THERAPY Mostly used biological treatment Four major types of medication

usedAnti-anxiety drugsAnti-depression drugsLithiumAnti-psychotic drugs

ANTI-ANXIETY DRUGS Minor tranquilizers out patient treatment to help client with

anxiety panic attacksDistress Tension

Depresses the nervous system Long term use=less effectiveness Major side effects

fatigue dependence on drugs

ANTIDEPRESSANT DRUGS Treats major depression Increase the amount of one or both

neurotransmitters norepinephrine and serotonin

Must build up a certain level to work Major side effects

Escalated heart rateExcessive weight gain

LITHIUM Treats Bipolar disorder Flattens out the mania and depression Don’t understand how it works Side effects

ShakinessMemory impairmentExcessive thirst

ANTIPSYCHOTIC DRUGS Major tranquilizers Reducing agitation and delusions Treats Schizophrenia Blocks level of dopamine Side effects

Balance CoordinationTremors twitches

ELECTROCONVULSIVE THERAPYECT

Not recommended much Electric current passes through the brain Used when drug therapy is not working Side effect

Memory loss

PSYCHOSURGERY-BRAIN SURGERY Prefrontal lobotomy

Cutting nerve pathways in the brain between the prefrontal lobes and the thalamus

Reduce agitation and violence Side effects

DistractibilityReduced learning abilityOvereatingApathySocial withdrawalSeizuresReduces creativitydeath