Module 52:The Psychological

Treatments

TherapyUnit 14

Mental Health Practitioners

• Psychiatrists: medical doctors (M.D.) who can prescribe medication and perform surgery.–They take a biological approach.

• Clinical psychologists: have a doctoral degree. Use different therapeutic approaches.–Cannot prescribe medication.

Mental Health Practitioners

• Counseling Psychologists: Has a doctoral degree in counseling. Tend to deal with less severe mental health problems. –Work in colleges or marital/family therapy practices.–Try not to assign blame but to listen and help clarify feelings of everyone involved.

Mental Health Practitioners

• Psychoanalysts: may or may not be psychiatrists, but follow the teaching of Freud and practice psychodynamic therapy.

• Clinical or psychiatric social workers: have masters degree in social work (M.S.W.).

• Many use eclectic approach which blends various approaches.

Psychological Treatments

• Psychotherapy: a planned emotionally charged, confidential interaction between a trained healer and a sufferer.

• Many types of therapies, but we will look at:–Psychoanalytic, humanistic, behavioral, and cognitive approaches, as well as groups.

Psychoanalysis

• Psychoanalysis was the first of the psychological therapies.

• Based on Freud’s belief that abnormal behavior was the result of unconscious conflicts from early childhood trauma experienced during the psychosexual stages of development.

Psychoanalysis

• It requires the patient to go back and discover the roots of the problems and bring the conflict to the conscious mind.

• Once the patient is aware of the problem, then they can change behavior to resolve the problem.

Psychoanalysis

• Psychoanalysis usually takes a few years and uses free association so patients say whatever comes to mind.

• The key is to not censor what they say so that their unconscious conflicts may come out.

• Dream analysis may be a part of therapy.

Psychoanalysis

• Hypnosis and Freudian slips (say one thing, but mean another) may reveal hidden conflicts.

• Resistance: blocking of anxiety provoking feelings and experiences.

• Patients avoid issues by talking about trivial issues or coming late to sessions.

• These are signs of important issues.

Psychoanalysis

• Transference: the patient’s transfer to the analyst of emotions linked with other relationships.

• Results in love or hatred for the analyst, which was meant for someone else.

• Revealing these transferred emotions allows people a chance to work through issues.

Psychoanalysis

• Catharsis: the release of emotional tension after a session and results in relief of anxiety.

• Feeling of relief because you came to a conclusion about your issues!

• Unfortunately, psychoanalysis requires too much time and cost too much for most people. ($100 per hour for years = Over $30,000!)

Psychodynamic & Interpersonal

• Psychodynamic therapy is shorter and less frequent than psychoanalysis.

• Therapist is more active and will point out conflicts more directly to work through feelings.

• Interpersonal therapy is even shorter and focuses on current relations to relieve symptoms.

Humanistic Therapy

• Humanistic therapists focus on:–The present and future.–Conscious thoughts.–Promoting growth.

• Problems arise because the clients inherent goodness and potential to grow emotionally have been stifled by external psychosocial constraints.

Humanistic Therapy

• Client-Centered Therapy: focuses on person’s conscious self-perceptions instead of therapist’s analysis.

• Goal is to provide an atmosphere of acceptance, empathy, and sharing that permits the client’s inner strength to come out so that personal growth can occur.

• Developed by Carl Rogers.

Humanistic Therapy

• Rogers developed active listening to use in his client-centered therapy.

• Active Listening: listening in which the listener echoes, restates, and clarifies the patient’s responses.

• Therapist is non-judgmental!• Goal is to develop a more positive

self-concept.

Behavior Therapy

• Behavior therapy: applies learning principles of elimination of unwanted behaviors.

• Skinner says that abnormal behavior is a result of faulty rewards and punishments.

• Behaviorists attempt to extinguish unwanted behavior and replace it with constructive behaviors.

Behavior Therapy

• Pavlov showed we learned behavior through classical conditioning, so abnormal behavior is a result of conditioning.

• Counterconditioning: conditions new responses to stimuli that trigger unwanted behaviors.

• Ex. Pairing a fear of small spaces with relaxation in a small space.

Counterconditioning Techniques

1. Exposure therapy: expose people to things they normally avoid. This allows them to get use to it and not fear it.Systematic Desensitization: a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli.Used to treat phobias.

Counterconditioning Techniques

2. Aversive Conditioning: associates an unpleasant state with an unwanted behavior.Ex. Pairing nausea and vomiting with alcohol.It conditions a person to avoid something they should avoid.

Operant Conditioning

• Rewards are used to target behaviors.

• Behavior modification: the client selects a goal and, with each step toward it, receives a small reward until the goal is finally achieved.

• Ex. Weight Watchers and other diet programs use this to keep clients motivated.

Operant Conditioning

• Token Economy: positive behaviors are rewarded with secondary reinforcers (tokens, points, etc.) which can eventually be exchanged for rewards, such as food.

• Ex. Jewel’s stamp saving programs for dishes, Titan bucks, etc.

• Parents use an allowance to reinforce household work habits.

Cognitive Therapy

• Cognitive therapists believe abnormal behavior is a result of faulty thought patterns.

• The person’s emotional reactions are produced not by the event, but by the person’s thoughts in response to the event.

• Goal is to teach people new, more constructive ways of thinking.

Cognitive Therapy

• Depressed people believe their failures are their fault and their successes are because of outside forces.

• Cognitive therapists seek to change this thinking into more positive thinking and thus change mood.

• Lydia: I’m going to fail this test!• Mr. Ng: You never do! You’ll do well.• Lydia: Ok. I feel better.

Group Therapy

• Group therapy allows a person to discover that they are not alone.

• Also allows feedback on trying new techniques of behaving.

• Ex. Alcoholics Anonymous• Family therapy treats the family as a

system.• Therapists help build better

communication amongst families.