Psychotherapy/Psychotherapies. Overview What is psychotherapy? Who does psychotherapy? Approaches to...

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Transcript of Psychotherapy/Psychotherapies. Overview What is psychotherapy? Who does psychotherapy? Approaches to...

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Psychotherapy/Psychotherapies Slide 2 Overview What is psychotherapy? Who does psychotherapy? Approaches to psychotherapy. Classification of psychotherapies. Three examples of psychotherapy: psychoanalysis cognitive therapy interpersonal therapy. Slide 3 Psychotherapy Psychotherapyis a fiendish and expensive way of tampering with the lives of patients weak enough or foolish enough to seek outside help with personal problems for which, in fact, only will power is any solution. Quentin Crisp Slide 4 Definitions Somatic therapies Medicines Electroconvulsive Therapy Surgery Historical Insulin coma treatment Hydrotherapy Removal of teeth Hysterectomy Slide 5 Slide 6 Social Treatments Environmental therapy Work therapy Moral therapy Slide 7 Psychological treatments Talk-therapy Hypnosis Psychodrama Behavioral therapy Slide 8 Despite their diversityall psychotherapies attempt to relieve suffering and psychological disability by inducing changes in patients attitudes and behavior. Jerome Frank 1991 Slide 9 Psychotherapies Psychoanalysis (Freudian, Jungian) Cognitive Therapy Dialectical Behavioral Therapy Existential Psychotherapy Interpersonal Psychotherapy Gestalt Psychotherapy Motivational interviewing Slide 10 Who practices psychotherapy? Prescribing Psychiatrists Psychoanalysts Nurse Practitioners Psychologists (some) Non-Prescribing Psychoanalysts Clinical Psychologists Social Workers Counsellors (MA, Religious counsellors) Co-counsellors, peer therapy Slide 11 Modes of Psychotherapy Dyadic/Individual Adult Child Non-dyadic Couples therapy Family therapy Group therapy Slide 12 Classification Schemes Exploratory (insight oriented, expressive, uncovering) insight into unconscious psychic conflict Goal: structural change in personality Supportive (suppressive) support adaptive ego defenses Goal: strengthen adaptation Slide 13 Evocative Psychotherapies Seeks to improve total psychological functioning by providing a supportive, accepting therapeutic relationship in which unconscious experiences can emerge into awareness leading to change. Psychoanalysis Existential Psychotherapy Self-actualizing therapies (Rogers, Maslow) Slide 14 Directive Psychotherapies Symptom- or problem-focused. Cognitive Cognitive Therapy (Beck) Rational Emotive Therapy (Ellis) Social Learning Therapy (Bandura) Behavioral Reinforcement Counter-conditioning Abreactive Primal therapy EMDR Slide 15 Schools and Practitioners Eclecticism Cross-trained Self-selection General (e.g., psychoanalysis, client-centered therapy) vs. Condition-specific (e.g., Dialectical Behavioral Treatment for Borderline Personality Disorder, CBT for Panic Disorder) Slide 16 Slide 17 Slide 18 Psychoanalysis Freud Office-based psychiatry Drive theory Structural model of the mind (ego, id, superego) Derivations: Ego psychology, Object Relations Theory, Self Theory Unconscious Psychic determinism: past as prologue Slide 19 Psychoanalysis: Basic premise By making the implicit explicit, the uncontrollable becomes controllable. Slide 20 Psychoanalysis in practice Free association Transference Resistance Slide 21 Slide 22 Cognitive Therapy Aaron Beck Common sense psychology Psychological problems result from faulty learning, making incorrect inferences on the basis of inadequate or incorrect information, and not distinguishing between imagination and reality. Patients systematically misconstrue specific kinds of experiences Slide 23 Cognitive Distortions All-or-nothing thinking (black-white, polarized, dichotomous thinking) Catastrophizing (fortune telling) Emotional reasoning Mind reading Over-generalization Should and Must statements Etc. Slide 24 Slide 25 Cognitive Therapy techniques to modify intermediate and core beliefs: Socratic questioning Behavioral experiments Cognitive continuum Rational-emotional role playing Acting as if Using others as reference points Self-disclosure Slide 26 Interpersonal Psychotherapy Psychotherapy should focus on what happens between people, not on the brain, mind, unconscious, etc. Social attachments are protective against stress and depression. Depression is related to interpersonal relationships--as cause and consequence. Slide 27 Interpersonal functioning and Depression Grief Role Transition Interpersonal Disputes Interpersonal Deficits Slide 28 Interpersonal Therapy in Practice Focus on the here-and-now Personality restructuring is not attempted Assessment: inventory of relationships quality and pattern of interactions cognitions regarding self, others, roles associated emotions. Slide 29 Why Does Psychotherapy Work? Re-moralization Supportive, non-judgmental attitude of therapist Expression of emotions Unanalyzed positive transference Unanalyzed negative transference Identification with the therapist Strengthening ego functions Slide 30 Further Reading Freud and Beyond by Stephen Mitchell and Margaret Black Approaches to the Mind. Movement of the Psychiatric Schools from Sects toward Science by Leston Havens Persuasion and Healing by Jerome Frank