Therapy and Change

Psychological Therapies

PsychotherapyAn interaction between a trained therapist and someone suffering from psychological difficulties.

Eclectic ApproachThe most popular form of therapy- it is basically a

smorgasbord where the therapist combines techniques from

different schools of psychology.

PsychoanalysisPsychodynamic therapist try to understand a patients current symptoms by focusing on themes across important relationships, including childhood experiences and the therapist relationship.

PsychoanalysisFreud's therapy.•Freud used free association,

hypnosis and dream interpretation to gain insight into the client’s

unconscious.

Psychoanalytic Techniques

Free AssociationClient reports immediately without censoring any feelings or thoughts

InterpretationTherapist points out, explains, and teaches the meanings of whatever is revealed

Dream Analysis Therapist uses the “royal road to the unconscious” to bring unconscious material to light

Psychoanalytic Methods

Psychotherapists use their techniques to overcome resistance by the client.•The psychoanalyst wants you to become aware of the resistance and together interpret (ex. Latent content) it’s underlying meaning.

TransferenceIn psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships.

Active Listening: echoing,

restating, and seeking clarification of what the

person expresses.

Humanistic

Basic themes of Humanistic therapy:*The present and future more than the past.*Consciousness rather than unconscious thoughts.*Promoting growth instead of curing illness

Those in therapy become “clients” rather than patients.

Focuses of people’s potential for self-fulfillment (self-actualization).

Client (Person) Centered Therapy

Developed by Carl Rogers

Most widely used Humanistic technique is:

•Therapist should use genuineness, acceptance and empathy to show unconditional positive regard towards their clients. Ask me to click on an example.

Active ListeningCentral to Roger’s client-centered therapy

•Empathetic listening where the listener echoes, restates and clarifies. Paraphrase. Instead of

saying “I know how you feel” summarize the speakers words in your own words.Invite Clarification: “ What might be an example of that?” Reflect feelings: “it sounds frustrating”

Behavioral TherapiesTherapy that applies learning principles to the elimination of unwanted behaviors.

•HMMMM…………………The behaviors are the problems- so we must change the behaviors.

Classical Conditioning Techniques

Counter conditioning: A behavioral therapy that conditions new responses to stimuli that trigger unwanted behaviors.

Two Types: Exposure therapy and aversive conditioning

Exposure Therapy:Systematic Desensitization

A type of counter conditioning that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli.

How would I use systematic desensitization to reduce my fear of old women? The trick: proceed gradually!!

Exposure Therapy:Virtual Reality Exposure Therapy

Like you are an avatar

Aversive ConditioningA type of counter conditioning that associates an unpleasant state with an unwanted behavior.

Drinking whisky at a party, pairing that with throwing up. Just the smell will make

you sick.Does it work? Short term yes!

Aversive Conditioning

What are some ways you can change the behaviors of your friends with aversive conditioning?

Operant Conditioning: using positive and negative reinforcers for desired behavior.

Token Economy: an operant conditioning procedure that rewards a desired behavior.

CognitiveAaron Beck, changing castastrophizing beliefs about themselves, their situations and their futures. Gentle questioning seeks to reveal irrational thinking,, and then persuade people to remove the dark glasses through which they view life

We often think in words: therefore, getting people to change what they say to themselves is an effective way to change their thinking.

REBT Therapy

Albert Ellis and his REBT therapy:Rational Emotive Behavioral Therapy

Irrational Ideas

Group and Family Therapies

Group therapy saves money and great for family conflicts. It also allows people to realize there are other people out there with same problems.

Family Therapy: Assumes that no person is an island, that we live and grow in relation to others, especially our families.

Grandparent of support groups, Alcoholics Anonymous

Does therapy work?

The results of many such studies are then digested by a means of meta-analysis, a statistical procedure that combines the conclusions of a large number of different studies.

Bottom Line: meta-analysis gives us the bottom-line results of a lot of studies.

Alternative TherapiesEye movement Desensitization and

Reprocessing (EMDR):Therapy adored by thousands yet others say it is

a sham.

Alternative TherapiesLight Exposure Therapy: Have you ever

found yourself oversleeping, gaining weight and feeling lethargic during winter? You

might have SAD (Seasonal Affective Disorder)

How many therapists does it take to change a light bulb?

Just one, but the light bulb has to want to be changed.

Biological Approach or Biomedical TherapyPhysically changing the brain’s functioning by

altering its chemistry with drugs, or affecting its circuitry with electroconvulsive shock,

magnetic impulses, or psychosurgery.

Antipsychotic Drugs

Such as chlorpromazine (Thorazine) dampens responsiveness to irrelevant stimuli. It helps positive symptoms of schizophrenia.

The molecules are similar to dopamine to occupy its receptor sites and block its activity. Suggested that overabundance of dopamine contributes to schizophrenia.These medications are strong and can also produce tardive dyskesia (involuntary movements of the facial muscles)

Antianxiety Drugs

Like alcohol, antianxiety drugs, such as xanax or ativan depresses the central nervous system. However, does not help the CAUSE of the problem.

Antidepressant DrugsMood-Stabilizing Medications: The simple salt lithium can be an effective mood stabilizer for those suffering emotional highs and lows of bipolar disorder.

Electroconvulsive therapyShock treatment for severe depression.

Produces seizures. It is like restarting your computer, which solves many a problem even

if you don’t know why.

Alternative Nuerostimulation Therapies

Magnetic Stimulation: pulses surge through a magnetic coil called Repetitive transcranial magnetic stimulation or TMS

Psychosurgery: Surgery that removes or destroys brain tissue. Lobotomy: used to calm uncontrollably emotional or violent patients. The Dr. would shock the patient into a coma, hammer an ice pick through each eye socket into the brain, and then wiggle it to sever connections running up to the frontal lobes.

Ethics

Clients need enough information about the counseling process to be able to make informed choicesEducate clients about their rights and responsibilitiesConfidentiality is essential but not absolute

Exceptions:The client poses a danger to others or selfA client under the age of 16 is the victim of abuseThe client needs to be hospitalizedThe information is made an issue in a court action

The client requests a release of record

1st Interview

15%: Chief Complain and free speech30%: Pursue specific diagnoses; ask about suicide, history of violence, and substance abuse15%: Medical History, review of systems, family history25%: Personal and social history, evaluate character pathology10%: Mental Status Evaluation5%: Discuss diagnosis and treatment with patient; plan next meeting