Overviw of Psychotherapy

8/3/2019 Overviw of Psychotherapy

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OVERVIEW OF PSYCHOTHERAPY

Presented by:

Sanjenbam Sarojini Devi.

Msc.Nsg (Psychiatric )

LGBRIMH


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Introductiony

Psychotherapy is an intentional interpersonalrelationship used by trained psychotherapists to aid aclient or patient in problems of living.

y It aims to increase the individual's sense of their ownwell-being.


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Definition

Psychotherapy is define as the treatment, by psychological means, of problems of emotionalnature, in which a trained person deliberately establisha professional relationship with the objects

y Removing, modifying or retarding existingsymptoms.

y Mediating disturbed patterns of behaviors.

y Promoting positive personality growth anddevelopment.


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Contd

y The psychiatrist Jerome Frank defined psychotherapyas the relief of distress or disability in one person byanother, using an approach based on a particulartheory or paradigm, and a requirement that the agent

performing the therapy has had some form of trainingin delivering this. It is these latter two points whichdistinguish psychotherapy from other forms ofcounseling or care giving.


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Various types ofpsychotherapy:

Supportive

psychotherapyReductive

psychotherapy

Reconstructivepsychotherapy.


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Supportive psychotherapy

Environmental manipulationReassurance to the persons

Emotional catharsis DesenthesizationSuggestive guidanceInterpersonal group therapy

Guidance Supportive adjacent


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Aims

y Correction of the situational problem

y Symptom rectification

y Restoring and strengthening defenses

y Prevention of emotional breakdown

y Teaching new coping skill


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Reconstructive psychotherapy

y Deliberate effort at readjustment

y Goal modification

y Living up to existing creative potentialities with or

without insight in conscious conflict.


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Types ofreconstructive

psychotherapy

y BehaviourTherapy.

y Cognitive therapy.


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Behaviour therapy

y Behaviour therapy is define as any of large number of

specific technique that psychological (especially

learning) principle to constructively change the humanmaladaptive behaviour.

y behavior therapy is define as anything a person doeswhich is observable


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Principle

y classical conditioning

y

operant conditioning andymodeling directly affected the development of

behaviour therapeutic approaches.


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Classical conditioningy The process of learning by Pavlov (1927)

y Experiment with dogs, to learned more about digestiveprocess.

y Two reflexive process

Unconditional response

Conditional response


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Operant Conditioningy It focus on behavioral responses that are elicited by

specific objects or events.

y Introduced by Skinner (1953)

y Positive reinforcement

Desirable behaviour is reinforced by reward

y Negative reinforcementOn performance of the desirable behaviour ,

punishment can be avoided.


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Techniques ofbehaviour therapy

y Systematic desensitization.y Assertive training.y Modeling procedure.

y Contingency management.y Response elimination and existing procedure

a. Negative practice.b. Stimulus satiation.

y Anxiety induction therapies.

y Response prevention/flooding.y Aversion therapy.y Social skill training.y Biofeedback.


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Systematic desensitizationy Joseph wolpe; (1958) is aimed specifically at the

alleviation of maladaptive anxiety.

y individuals learns to experience anxiety in presence of

certain stimuli through process of the classical

conditioning


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Use ofsystematic desensitizationy Phobia

y Speech disorder

y Social dysfunction

y OCD


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Ste

psy Training in relaxation

y Construction of hierarchies of anxiety

y Desensitization procedure


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Assertive Training

y Involves interpersonal behaviour the honest and relativelystraightforward

y Assertive behaviour is socially appropriate

y Standing up for one's rights no matter what thecircumstance.

y Correcting the situation when one's rights are beingviolated.

y Seeking respect and understanding for one's feelings abouta particular situation or circumstance


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Component ofassertive training

y Saying no (without feeling guilt)

y Making request

y Expressing feeling( positive & negative)

y Initiating and carrying on conversation.


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Goalsy To increased the patients ability to engage in assertive

behaviour.

yTo enhance the ability to expressed the negative andpositive feelings

y To encourage the patient to express straight forwardexpression i.e. enhance the strength of the relationship

and confidence.y Make the feeling explicit ( verbalizing emotion)

y


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Social skill training

y Specific response capabilities necessary for effectivesocial performance and is socially sanctioned.

y

According to Liberman, De Risi and Mueser(1989);all behaviour that helps us to communicate ouremotions needs accurately and allow us to achieve ourinterpersonal goals.


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Components ofsocial skill training

y Nonverbal skill

y Paralinguistic element

yVerbal content

y Interactive balance(Refers to the skills necessary formaintaining a satisfactory give and take during aconversation)


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Techniques

y Shaping

y Modeling

y Role playy Reinforcement home work assignment etc.

y Instruction

y Prompts

y Over learning

y Generalization


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Used ofsocial skill training

y Establish a rational for learning skills

a. The clinician can elicit the rational from group

member.b. The clinician himself/herself can provide reasons forthe importance of skill.

y Discussing the component steps of the skills.

y Modeling the skill in the role play.y Engaging a client in a role play.

y Providing positive feedback


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Contd..

ySpecific feedback about the participants performancesis necessary if behaviours changes are to take place.

y Providing corrective feedback

y The aim of corrective feedback is to identify the most

critical aspects of role play interaction that need to bechange in order to role play interaction that need to bechange in order to enhance overall performance.

y Engaging the client in a second role of same situation.

y Providing additional feedback.


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Biofeedbacky Its provides an individual with immediate information

(visual and or auditory) about a physiological process

(e.g.. HR, PR, BP) and the use of operant conditioning(reinforcement/punishment) to modify thephysiological process.

y The objective is to teach the individual to control

otherwise involuntary/unhealthy physiologicalprocess.


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Modelingy Involves the learning of new adaptive through

observing others behaviour.

y This is to successfully treat specific phobia, link snake,height etc.

y Based on social learning theory by Albert Bandura


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Cognitive psychotherapyy Cognitive psychotherapy focuses on identifying and

changing negative thinking patterns. Often people

with clinical depression make negative assumptionsabout their world. These assumptions lead them tohave negative thoughts about themselves, theirsituation, and their future (cognitive triad). Thesenegative thoughts create depressive feelings.


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Contd..y It developed byAaron Beck, stresses the importance of

belief systems and thinking in determining behaviour

and feeling.y It focus of cognitive therapy is on understanding

distorted belief and using techniques to changemaladaptive thinking, while also incorporatingaffective and behavioral method.


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Genera assumption o cognitive

therapy

y

Perception and experiencing in general are active process.y The patients cognitions represent a synthesis of internal

and external stimuli.

y How persons appraise a situation is generally evident in

their cognitions.yAlteration in the content of their underlying cognitive

structures affective their affective state and behaviourpattern.

y Through psychological therapy, patients can becomeaware of their cognitive distortions.

y Correction of those faulty dysfunctional constructs canlead to clinical improvement.


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Assessment in cognitive therapyMode of assessment:

a. Behaviour interview.

b. Self monitoringc. Thought samplingd. Scales and questionnaires.

Stages in the behavioral interview:a. Brief description of problems.

b.Development .PrecipitantsCourse, onset, progressPredisposing factors.

c.Description of problem behavior

BehavioralCognitive

AffectivePhysiological


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Cntd..y Contexts and

y modulating variables

y Situationaly Behaviour

y Cognitive

yAffective

y Interpersonal

y Physiological


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Selfmonitoring

y Thoughts

y Emotions and

y Behavioursy patients keep records of events,

feeling and or thoughts

y common methods is the DysfunctionalThought

Record (DTR)


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oug samp ng:

y For obtaining the information

though sampling (Hurlbut, Leach &Saltman,1984).

y tone sound at a random interval at home

y then recording thoughts is one way to get a sample ofcognitive pattern

y

thoughts in a tape recorder or notebook

y sampling can be useful in getting data that is related tospecific situations, such as work and school


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Scale and questionnaires

y Self report questionnaires or rating scales

y to assess irrational beliefs,

y self statement or

y cognitive distortions.


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The therapeutic process

y The initial session deals with assessment of theproblem, development of a collaborative relationshipand case conceptualization.

yAs therapy progresses, a guided discovery approach isused to help clients learn about their inaccuratethinking.

y Method to identify automatic thoughts and theassignment of homework, which is done throughouttherapy.


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Contd..In addition to cognitive techniques may use behavioral techniques such as

Activity schedulingBehavioral rehearsalSocial skill training

Assertive training

Cognitive behavioral - identify

y maladaptive cognition

y appraisal

y beliefs and reactions with the aim of influencing destructive negativeemotions and

y problematic dysfunctional behaviors.

xpress ve erapy


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xpress ve erapy

y Form of therapy that utilizes artistic expression as its

core means of treating clients.y Expressive therapists use the different disciplines of

the creative arts as therapeutic interventions.

modalities

y It includes:

dance therapy

drama therapy

art therapymusic therapy

writing therapy


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Interpersonal psychotherapyy

It focuses on the interpersonal context and

y son building interpersonal skills

y based on the belief that interpersonal factors maycontribute heavily to psychological problems

y It aims to change a person's interpersonal behavior byfostering adaptation to current interpersonal roles andsituations.


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Narrative therapy

y

It gives attention to each person's "dominant story" bymeans of therapeutic conversations

y also may involve exploring unhelpful ideas and how

they came to prominence

y Possible social and cultural influences may beexplored if the client deems it helpful


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Integrative psychotherapyy

It attempt to combine ideas and strategies fromy More than one theoretical approach.

y Include mixing core beliefs and combining proventechniques

multimodal therapythe trans theoretical model

cyclical psychodynamics,

systematic treatment selection,

cognitive analytic therapyInternal Family Systems Model

multi theoretical psychotherapyand

conceptual interaction


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Hypnotherapy

y Hypnotherapyis therapy that is undertaken with asubject in hypnosis.

y Hypnotherapy is often applied in order to modify asubject's behavior

y emotional contenty and attitudes

y as well as a wide range of conditions includingdysfunctional habits

y anxiety

y stress-related illness

y pain management and

y

personal development.


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Reference:y Bhatia BD. Elements of psychology and mental

hygiene for nurses in India. 1st edition. Hyderabad:Orient Longman Private Limited; 1999.

y Clement I. Psychosocial foundation of nursing.

1stedition. Bangalore: Jaypee brother medicalpublishers (p) LTD; 2010.

y Psychotherapy from Wikipedia, the free encyclopediaURL:http://

http://www.lenus.ie/hse/bitstream/10147/121474/1/DropoutRelatedfactorsPSI.pdf

y Class notes


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THANK YOU

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