Chapter 19: Methods of Therapy

I. Two General Categories

A. Psychotherapy- Change thought processes, feelings or behaviors of a person. Verbal interaction btwn Professional and a client/patient.

B. Biological Methods- Relieve problems by affecting a persons nervous system in some way (READ: drugs).

x-Therapy- General term for the variety of approaches used to treat psychological problems.

II. Achieving the Goals of Psychotherapy

A. Giving people Hope.

B. Help them gain a new perspective (Away from negative).

C. Provide a caring, trusting, relationship.

D. Bring about changes in those seeking help.

III. Psychotherapy in Practice

A. Types of Mental Help Professionals1. Counseling Psychologists- Less serious problems. Often in

schools.

2. Clinical Psychologists- Help people adjust to life in general like anxiety, motivation, etc.

Often in hospitals, clinics, some have private practices.

3. Psychiatrists- Medical doctors ARE ONLY ONES WHO CAN PRESCRIBE MEDS!

4. Others..... Teachers, clergy, M.D., Guidance counselors.

Figure 19.2, page 438 in your book.

E. Psychotherapy websites

http://www.aboutpsychotherapy.com/

http://www.psychotherapy.net/

http://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml

https://www.youtube.com/watch?v=jfO5OmwoXVM&list=PLCA4C7B2F2B5283A5

B. Individual vs. Group Therapy1. Advantages of individual therapy

a. Greater personal attentionb. Uncomfortable talking personal issues in a group.

2. Advantages of group therapya. helps you understand you are not aloneb. Gain insight from others with similar problemsc. Gain support from others who have gone through

same.d. Practice new coping skills in safe environment.e. Gives people concrete examples therapy works.

C. Types of group therapy1. Couples Therapy- Improve relationships2. Family Therapy- many areas3. Self-Help groups- A.A., etc.4. Encounter groups (pg 440)

https://www.youtube.com/watch?v=aqImkDgDwHU

Common Therapy Myths

Psychotherapy: Six schools of thought.

1. Psychoanalysis

2. Psychodynamic (We will NOT cover this one)

3. Existential-Humanism

4. Cognitive

5. Behavioral

6. Biological

1. Psychoanalysis

Chapter 19.2: The Psychoanalytic Approach

x- Psychoanalysis- Analysis of the psyche (mind)

Sigmund Freud

*-Freud's ardent belief is that people's problems originate from early childhood experiences and inner conflicts.

*-This causes unconscious sexual and aggressive urges that make anxiety.

*-Guilt then occurs when these thoughts become conscious or you act on them.

*-For example: Anxiety and guilt may be caused by repressed rage against a parent.

*-A psychoanalyst tries to reduce anxiety and guilt by making these past experiences come to consciousness.

*-This creates insight or self-awareness. Then the client can begin to move forward.

THE GOAL:

CATHARSIS

HOW?

A. Free Association

This is the primary technique of the psychoanalyst.

x-free association- Say whatever comes to mind.

The patient is encouraged to say the very first thing that pops into their head regardless of how trivial, embarrassing or painful it may be.

x- resistance-Hesitance to discuss issues brought up during free association.

B. Transference

x-transference- when the patient/analyst relationship turns into a similar one with an important person in their life.

This exposes unsettled issues and allows patient to begin healing.

Patient will treat therapist as that person.Therapist will remain neutral.

An evaluation of psychoanalysis

Criticisms

A. Freud is too heavy on the sex and aggression thing.

B. He underestimates conscious ideas

C. He underestimates changes in behavior

D. It is NOT useful for handling major depression, bipolar disorder, schizophrenia

E. This stuff takes a LONG time.........................

Favorable Reviews

A. A 1977 meta-analysis showed 70-75% of those who had undergone psychoanalysis had an improved state of well-being.

B. It is useful in handling anxiety, mild depression, social relationships

4. Cognitive

19.4 Cognitive Therapy

The only way clients get better is to modify self-defeating thoughts and behavior patterns.(They don't care about the underlying causes......)

I. Cognitive Therapy

GOAL: To help people learn to think about their problems in a more productive way.

FOCUS: beliefs, attitudes, and thought processes.

***They believe faulty ways of thinking occur due to illogical thinking or faulty assumptions.***

Page 446; Figure 19.3

Cognitive psychologists try to change thinking and develop more logical, realistic ways of thinking.

A. Rational-Emotive Therapy (RET)

1. Developed by Albert Ellis

2. Basic belief is that people are logical in thoughts and actions, HOWEVER it's their assumptions on which they base those beliefs are wrong.

3. Emotional problems develop from this.

4. Example: perfection= happiness; therefore imperfection=unhappiness.

Will internalize this.It is just an unrealistic assumption.

5. People are unaware of these false assumptions.

6. RET goal is to make them aware of them and their influence.

7. In therapy, role-playing and modeling are key.

8. They will have homework.

THERE ARE TWO TYPES OF COGNITIVE THERAPY

B. Beck's Cognitive Therapy

1. Developed by Aaron Beck

2. The focus here is on illogical thought processes.

3. Depression is a main focus of this therapy.

4. Arbitrary inference-Drawing conclusions for which there is no evidence.

For example: Teacher sees you but does not smile.... soooooooo the teacher is going to fail you for the class.

5. Selective abstraction-Drawing conclusions about an event based on a single detail and misinterpreting or ingoring other details.

For example: Looking in the mirror and seeing a small blemish instead of all the good qualities.

6. Overgeneralization- General conclusion from a single experience.

7. This approach trains clients to test the logic of their own thought process and develop better, more logical ways of thinking.

8. Often clients review and record their own thoughts in response to daily life.

C. Evaluation of Cognitive Therapy

A. Relative to psychotherapy, this is short-term.15-25 weeks.

B. This is really helpful for tx of depression (both mild and severe).

C. But with severe psychological disorders..... schizophrenia, bipolar... not so much.

They get some help if they are receiving drug therapy.

So where in the world did we leave off?

Psychoanalytical

Who: Freud

What??? Problems arise from unconcsious (where experiences are you don't remember). When you think have unacceptable sexual and aggressive urges you feel guilty. This you need help for. Work through the past.

Humanistic

Who: Rogers

What??? Develop self-awareness and self-acceptance. Person-centered therapy. Tap into your inner resources.

Cognitive

Who: Ellis Beck

What??? Develop new ways of thinking. You either have faulty assumptions or illogical thinking. Don't care about past memories/unconscious.

5. Behavioral

19.4 Behavior Therapy

GOAL: Get a better behavior!

Some seek to get rid of behaviors (for example- smoking)

Some seek to get better behaviors (for example- to help socially)

Basic Belief: All behaviors (good or bad) are learned and can be unlearned.

The reasons for your behavior are unimportant!

I. Counterconditioning

A. Unlearning undesirable behaviors.

1. Take the undesired stimulus with a desired behavior.

x- systematic desensitization- Can't be BOTH anxious and relaxed at same time.

e.g. phobias

x- modeling-observational learning.

x- aversive conditioning- Replace a positive response with a negative response.

e.g. smoking

II. Operant Conditioning

The basic idea: a behavior that is reinforced tends to be repeated; a behavior not reinforced tends to be extinguished.

Rewards for desired behaviors, withholding rewards for undesired behaviors.

x-token economy- Desired behaviors warrant some type of coin, can be used as currency to achieve real rewards.

e.g.- prison

x-successive approximations- series of behaviors which gradually lead to a desired change. (Reward yourself for these steps)

e.g.- study habits.

III. Evaluation of Behavior Therapy

A. This tends to be more effective than psychoanalytical or person-centered therapy.

B. Very effective for well-defined problems such as phobias, PTSD and compulsions.

C. Also good for depression, social problems, and control issues (i.e. drinking, smoking, etc.)

D. Can be useful managing schizophrenia and Mental Impairment.

E. Less effective on depression than cognitive therapy, and not good at treating schizophrenia.

6. Biological

19.5 Biological Therapy

So far.... therapy has been a verbal interaction between therapist and patient/client.

Biological therapy....

Medicine

Electric shock

surgery

SO WE ARE DEALING WITH PSYCHIATRISTS!

I. Drug Therapy

Most common.

A. Antianxiety drug (minor tranquilizers) (zoloft, paxil, prozac, lexapro)

- for anxiety or panic attacks.

- depress nervous system, slow heart rate, reduce nervousness and tension.

-A problem is you cannot use them for long, bc a tolerance builds up.

- side effects: dependency and fatigue.

B. Antidepressant drugs (elavil, wellbutrin)

- Increase the amount of the neurotransmitters noradrenaline and seratonin.

- This increases activity level and allows for better eating and sleeping.

- Must build up in body to help.

- A lot of debate if therapy or drugs treat depression better.

C. Lithium

-Lithium carbonate helps those with bipolar disorder. It flattens out cycles of mania and depression.

-side effects: shakiness, memory impairment, excessive thirst.

-Now a drug called depakote (1995) helps bipolar sufferers and epileptic patients as well. It is a mood stabilizer. (Mood Tracker- nxt pg)

-main side effect is liver damage which must be monitored very closely.

D. Antipsychotic Drugs (major tranquilizers) (seraquil, risperdal, abilify, buspar)

- schizophrenia patients.

- reduce agitation, delusions, hallucinations.

-block dopamine activity.

-side effects: problems in balance and coordination.... tremors and twitches.

https://www.depakote.com/Content/Pdf/Mood-Tracker.pdf

II. Electroconvulsive Therapy

A. electric shock therapy

- shoot electric current through the brain.

- It's a tad bit dangerous.

- Recommended only for those with severe depression who don't respond to medicines.

-Used to use it for schizophrenia and bipolar...now they don't even recommend that!!!

III. Psychosurgery

x-prefrontal lobotomy- Used to reduce agitation and violence in people with severe psych disorders.

What is it???

They cut nerve pathways in the brain between prefrontal lobes and the thalamus.

side effects: Well.............

distractability

reduced learning ability

overeating

apathy

seizures

death

You Tube

1. Getting help Psychotherapy: Crash Course Psychology #35

Time Topic1:30 Psychoanalysis

4:04 Humanistic

6:14 Behavioralist

8:20 Cognitive

2. Biomedical Treatments: Crash Course Psychology #36

Helpful sections of your notes

Page 3- Goals of Psychotherapy

Page 5- Individual vs. Group Therapy

Page 6- What Psychotherapy is.

Page 22- Cognitive Therapy R.E.T and

Page 23- Cognitive Therapy Beck's

Page 26- Brief Review of therapy we covered early in chapter.