Psychotherapy (Chapter 19)

Second Lecture Outline:

Drug therapiesBehavior therapy

Cognitive-behavioral approaches

Psychotropic drug therapies

• Antipsychotic drugs: Phenothiazines– Cloropromazine: Block’s dopamine reuptake

• Antidepressant drugs: MAO Inhibitors and tricylics (e.g., Prozac)– increase serotonin & norepinephrine in synapse

• Barbituates and Benzodiazepines– valium, librium: relax muscles and tranquilize– barbituates: CNS depressant, addictive, lethal

• Concerns: Side effects, toxicity, latency

Behavior therapy

• Treatment of symptoms, objective behaviors, scientific methods – single subject designs

• Counterconditioning: stimulus response is replaced by alternative response– Aversion therapy: e.g., anta-abuse – Systematic desensitization: Relaxation paired with

gradually more threatening images and experiences, e.g., dog phobia, sex therapy

Behavior therapy (continued)

• Extinction procedures– Flooding: Exposure to threatening stimuli, e.g., fear of

flying– Implosion therapy: Imagine you are confronted with

very threatening stimuli

• Operant conditioning– token economy: earned tokens based on a system of

rewards and punishers– behavioral contract: e.g., gain weight to earn privilege

Modeling

• People can learn adaptive behaviors by having them modeled

• Age, credentials, similarity of the model is important

• Example: Social skills training videotapes function by having appropriate behavior demonstrated

• Example: Parent training with “bug in the ear”

Behavior Therapy

Begin with comprehensive assessment, using BASIC ID diagnosis

Behavior - Overt behaviors and habitsAffect - Emotions, moods, strong feelingsSensation - The five senses, unpleasant sensations, aches,

pains, dizzinessImagery - how does client view self, dreams and memoriesCognition - Insights, philosophies, ideas judgments

Interpersonal relationships - interactions with other people Drugs / biology - Drugs, prescription, non-prescription,

health and nutrition, concerns about health

Cognitive-Behavioral Approaches

• Clients change their behavior by changing their cognitions

• Goal: change how people think about things

• Rational-emotive behavior therapy– Cognition precedes emotion and irrational

thoughts therefore cause emotional distress– “I need to be a perfect student”– Therapist needs to challenge irrational cognitions

Cognitive-Behavior (video 101)

• Cognitive Therapy of Beck– Maladaptive schemas need to be changed because

they interfere wth your life

• Stress Inoculation Training– Stress management., adaptive cognitions, how did I

do?

• Social Problem Solving – Identify problem, choose alternatives, choose,

implement, evaluate outcome