Chapter 13: Methods of Therapy

1. Chapter 13: Methods of Therapy

2. Learning Outcomes • Define psychotherapy and describe the history of treatment of psychological disorders • Describe traditional psychoanalysis and short-term psychodynamic therapies

3. Learning Outcomes • Define humanistic therapy and contrast its two main approaches • Define behavior therapy and identify various behavioral approaches to therapy

4. Learning Outcomes • Define cognitive therapy and describe Beck’s approach and REBT • Identify various types of group therapy and discuss their advantages and disadvantages

5. Learning Outcomes • Explain whether psychotherapy works and who benefits from it • Describe methods of biological therapy - their benefits and side effects

6. What is Psychotherapy?

7. Psychotherapy • Systematic interaction between client and therapist • Based on psychological principles • Influences clients’ thoughts, feelings, and behavior • Clients use it for psychological disorders, adjustment problems, and/or personal growth

8. History of Therapies • Asylums • Mental Hospitals • Community Mental Health Movement

9. The Unchaining of the Patients at La Salpêtrière

10. Truth or Fiction? • Residents of London used to visit the local insane asylum for a fun night out on the town.

11. Truth or Fiction? • Residents of London used to visit the local insane asylum for a fun night out on the town. • TRUE!

12. Psychodynamic Therapies

13. Traditional Psychoanalysis • Insight • Catharsis • Free Association • Resistance • Transference • Dream Analysis • Wish Fulfillment

14. Freud’s Consulting Room

15. Modern Psychodynamic Approaches • Briefer, less intense, usually directive • Ego analysis • More focus on ego, less on the id

16. Humanistic Therapies

17. Client-Centered Therapy • Carl Rogers • Provide insight into parts of us we have disowned so we may feel whole • Warm, therapeutic atmosphere • Unconditional positive regard • Empathy • Genuineness

18. Truth or Fiction? • Some psychotherapists let their clients take the lead in psychotherapy.

19. Truth or Fiction? • Some psychotherapists let their clients take the lead in psychotherapy. • TRUE!

20. Gestalt Therapy • Fritz Perls • Integrate conflicting parts of the personality • Directive, focused on the here and now

21. Behavior Therapy

22. Behavior Therapy • Apply principles of learning to directly promote desired behavioral changes • Conditioning and observational learning • Discontinue self-defeating behaviors

23. Truth or Fiction? • Some psychotherapists tell their clients exactly what to do.

24. Truth or Fiction? • Some psychotherapists tell their clients exactly what to do. • TRUE!

25. Fear-Reduction Methods • Systematic desensitization • Confront hierarchy of stimuli • Counterconditioning • Virtual Therapy • Modeling • Observational learning

26. A Program Containing Images of the World Trade Center Intended to Help People with PTSD

27. Truth or Fiction? • Lying in a reclining chair and fantasizing can be an effective way of confronting fears.

28. Truth or Fiction? • Lying in a reclining chair and fantasizing can be an effective way of confronting fears. • TRUE!

29. Eye-Movement Desensitization and Reprocessing • EMDR – used to treat stress disorders • Research does not explain why it works • Are the eye movements necessary? • May have to do with relationship with therapist and exposure to trauma while believing it can be managed

30. Aversive Conditioning • Pair an aversive stimuli with the unwanted impulse • Used to eliminate unwanted habits and antisocial behaviors

31. Truth or Fiction? • Smoking cigarettes can be an effective method for helping people stop smoking cigarettes.

32. Truth or Fiction? • Smoking cigarettes can be an effective method for helping people stop smoking cigarettes. • TRUE!

33. Aversive Conditioning

34. Operant Conditioning • Token economy • Successive approximation • Biofeedback training

35. Social Skills Training • Decrease social anxiety and build social skills through operant conditioning techniques • Self-monitoring, behavior rehearsal, and feedback

36. Cognitive Therapies

37. Cognitive Therapy • Changing beliefs, attitudes, and automatic types of thinking that create and compound problems • Awareness of current cognitions

38. Aaron Beck’s Cognitive Therapy • Client confronts feelings and beliefs that make no sense • Become aware of cognitive errors

39. Rational Emotive Behavior Therapy • Albert Ellis • Challenge irrational beliefs • Need for love and approval of others • Need to prove oneself to be thoroughly competent, adequate, achieving

40. Cognitive-Behavioral Therapy • Integration of behavioral and cognitive therapies

41. Group Therapies

42. Group Therapies • Advantages • Economical • More experiences for client to draw upon • Social support of the group • Affiliation with people with similar problems • Improvement provides hope for others • Practice social skills in safe environment • Disadvantages • Unable to express feelings to group

43. Group Therapies • Couple therapy • Improve communication and manage conflict • Cognitive behavioral approach • Family therapy • Systems approach • Self-help and support groups • Alcoholics Anonymous (AA)

44. Does Psychotherapy Work?

45. Truth or Fiction? • There is no scientific evidence that psychotherapy helps people with psychological disorders.

46. Truth or Fiction? • There is no scientific evidence that psychotherapy helps people with psychological disorders. • FICTION!

47. Effectiveness of Psychotherapy • Meta-analysis • People who obtain psychotherapy of client-centered therapies fare better than those who do not • Must consider type of therapy; type of problem; and type of patient

48. Effectiveness of Psychotherapy • Cognitive therapies • Best used for anxiety and depression • Also used with personality disorders

49. Evidence –Based Practices • Use of random controlled experiments (RCEs) • May favor cognitive-behavioral therapies • May not capture the complexity of clients in community settings

50. Examples of Evidence-Based Practices