Chapter 12

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Treatment:Healing Actions,Healing Words


Assumptions of PsychotherapyThe therapist should be:• An expert vs. An equal

• Passive vs. Active

Psychotherapy should focus mostly on the:• Present vs. Past influences on

the present

• Conscious control vs. Unconscious forces

• Behaviors vs. Thoughts


How Psychoanalysis Works

Hidden conflicts / Repressed Impulses

Bring to Consciousness

Insight into

cause

Disorder Improve

s


Insight-Oriented Therapy

• Psychoanalysis– First use of a “talking cure”– Developed by Sigmund Freud– Identify unconscious motivationsTechniques– Free association– Dream analysis– Resistance– Transference



• Psychodynamic therapy– Similar to psychoanalytic therapy– Less frequent sessions– Less emphasis on sexual and aggressive drives Techniques

• Interpretation• Resistance• Transference



• Humanistic therapy– Carl Rogers– Client-centered therapy– Incongruence

• Real self• Ideal self


Client-Centered Therapy

Unrealistic conditions of

worth

Distortions of self concept

Client-Centered Therapy

Move toward self-acceptance



• Client-centered therapy techniques– Reflection– Empathy– Unconditional positive regard


Evaluating Insight-Oriented Therapies

• Difficult to evaluate• Who benefits from them?

– Healthy– Articulate


Behavior Therapy

A type of therapy based on learning principles that focuses on changing observable, measurable behaviors

• The ABCs– Antecedents– Behavior– Consequences


Behavior Therapy

• Techniques based on classical conditioning– Exposure

• Imaginable exposure• In vivo exposure• Virtual reality exposure

– Systematic desensitization• Progressive muscle relaxation


Cognitive Therapy

A type of therapy that focuses on thoughts rather than feelings or behaviors

• Cognitive distortions• Psychoeducation


Common Cognitive Distortions

• Dichotomous thinking• Mental filter• Mind reading• Catastrophic exaggeration• Control beliefs


Cognitive Therapy Techniques

• Beck’s cognitive therapy– Cognitive restructuring– Daily record of dysfunctional beliefs– Identify automatic thoughts– Identify rational responses


Biomedical Therapies


Psychopharmacology: Schizophrenia

• Antipsychotic medications– Target positive symptoms– Tardive dyskinesia

• Atypical antipsychotics– Newer– Target positive and negative symptoms


Antidepressants: Help or Hype?

• Tricyclic antidepressants (TCAs)• Monoamine oxidase inhibitors (MAOIs)

– Food interactions• Selective serotonin reuptake inhibitors (SSRIs)

– Prozac, Zoloft, Paxil

• Serotonin/norepinephrine reuptake inhibitors (SNRIs)– Serzone, Effexor

• St. John’s wort• Lithium


Psychopharmacology: Anxiety Disorders

• Benzodiazepines– Xanax, Valium– Often for short periods

• Antidepressants– TCAs– SSRIs– SNRIs


Electroconvulsive Therapy (ECT)

• Used when medication and therapy is ineffective

• Depression• Fell out of favor

– Abuse– Movie, One Flew Over the Cuckoo’s Nest

• Regaining popularity• Memory loss


Transcranial Magnetic Stimulation (TMS)

• New technique• 100- to 200- microsecond bursts of high-

intensity magnetism• May replace ECT


Modalities

• Individual therapy• Group therapy• Family therapy• Self-help therapies

– Support groups– Bibliotherapy

Chapter 12

Education

Transcript of Chapter 12