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15. Therapies. Therapies. Psychotherapy. Specialized process where trained professional uses psychological methods Differing forms of psychotherapy have differing methods Psychoanalytic: focuses on gaining insight Humanistic: focuses on gaining insight

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psychotherapy

Therapies

Psychotherapy
  • Specialized process where trained professional uses psychological methods
  • Differing forms of psychotherapy have differing methods
    • Psychoanalytic: focuses on gaining insight
    • Humanistic: focuses on gaining insight
    • Social learning or behavior therapy: uses forms of teaching
psychotherapy1

Therapies

Psychotherapy
  • Relationship involves power of therapist, emotional patient divulging personal data
  • Ethical Standards
    • Goals of treatment understood/agreed to by client; in best interest of client and society
    • Careful consideration given to alternatives
    • Therapist treats only within limits of expertise
psychotherapy2

Therapies

Psychotherapy
  • Ethical Standards
    • Effectiveness of treatment must be evaluated
    • Rules and laws of confidentiality followed
    • No abuse of therapist-client relationship
    • Therapist must treat all humans with dignity; respecting all genders, races, sexual orientation, and other sociocultural factors
therapies1

Therapies

Therapies
  • Psychoanalysis – founded by Freud
    • Root of all problems is in unconscious conflicts
    • Imbalance in id, ego, and superego
    • Conscious insight can resolve conflicts
    • Special therapy techniques may be used
      • Free association
      • Dream interpretation
      • Interpretation of resistance (from vague forms to specific resistance)
therapies2

Therapies

Therapies
  • Psychoanalysis
    • Transference – therapist-client relationship takes form of client’s relationships with own parents and other authority figures
    • Catharsis – emotional experience or temporary relief from discomfort (some insight gained)
    • Interpersonal psychotherapy for depression
      • Emerged from psychoanalytic tradition
      • Identifies sources of depression and goals for therapy process; very successful outcomes
therapies3

Therapies

Therapies
  • Humanistic psychology – Carl Rogers
    • People not born with unconscious mind
    • Client-centered therapy or person-centered
      • Emphasis on client’s ability to help self – feels emotionally safe enough to explore own hidden emotions
      • Therapist creates unconditional atmosphere (warmth, genuine positive regard, empathy)
    • Reflection – therapist makes statements to clarify client’s feelings and emotions
therapies4

Therapies

Therapies
  • Gestalt therapy – founded by F. Perls
    • Humanistic psychotherapy approach
    • Meanings of sensations organized into whole perceptions
    • Goal: create therapeutic experience helping client achieve greater self-awareness
    • Emotional atmosphere: therapists often deal in confrontive, challenging manner necessary to loosen denied feelings
therapies5

Therapies

Therapies
  • Cognitive-Behavior Therapy (CBT)
    • Abnormal behavior learned from inappropriate experiences through
      • Classical conditioning
      • Operant conditioning
      • Modeling
    • Learning is central goal of therapy; therapist is teacher and client learns adaptive behaviors
    • Cognitions less important
therapies6

Therapies

Therapies
  • Cognitive-Behavior Therapy (CBT)
    • Fear reduction methods using
      • Graded exposure - series of increasingly fearful situations experienced for gradual mastery
      • Use of modern technology - computer-generated virtual reality
      • Treats obsessive-compulsive disorders when used with other methods
therapies7

Therapies

Therapies
  • Cognitive-Behavior Therapy (CBT)
    • Social skills training
      • Shaping and positive reinforcement used in role playing
      • Teach use of adaptive skills enough to handle real-life situations
      • Focus on social skill problem of unassertiveness
therapies8

Therapies

Therapies
  • Cognitive-Behavior Therapy (CBT)
    • Cognitive restructuring
      • Assumes faulty cognitions – maladaptive beliefs, expectations, and thinking
      • Effective for treating anxiety, depression
      • Cannot modify clients’ existing behaviors because of inaccurate ways of thinking about themselves
therapies9

Therapies

Therapies
  • Cognitive-Behavior Therapy (CBT)
    • Cognitive restructuring
      • Patterns of cognition contributing to emotional distress
  • Selective abstraction
  • Overgeneralization
  • Arbitrary interference
  • Magnification and minimization
  • Personalization
  • Absolutistic thinking
slide14

Untreated

Self-help booklet

CBT

35

30

25

20

15

10

5

0

Initial

3 wks

3 mos

6 mos

9 mos

Allocation

What works best?

group and family therapy

Therapies

Group and Family Therapy
  • Group therapy
    • Carried out with groups of 4 to 8 clients; sees experience more effective than individual therapy techniques
      • Receives encouragement from others
      • Sees problem experienced by others
      • Learn from others’ advice
      • Learn new ways to interact with others
      • Format of group therapy varies widely
group and family therapy1

Therapies

Group and Family Therapy
  • Family therapy
    • Group composed of family members
    • Therapist trained in psychoanalytic, humanistic, and behavioral approaches
    • Beliefs
      • Family issues at root of problem
      • Dynamics of family system need analysis – function of each need to be understood
group and family therapy2

Therapies

Group and Family Therapy
  • Family therapy
    • Therapists’ goals to resolve problems by improving functioning of family system
      • Give family members insights and correct family dysfunctions
      • Increase warmth and intimacy in family
      • Improve family member communication
      • Help members establish reasonable set of rules for family regulation
human diversity

Therapies

Human Diversity
  • Ethnic, gender, and sexual issues in mental health
    • U.S. has one of most advanced mental health system in world – does not cover all citizens
      • Hispanics - less outpatient care than whites
      • African Americans – more likely than whites to be committed to psychiatric hospitals (often involuntarily)
human diversity1

Therapies

Human Diversity
  • Ethnic, gender, and sexual issues
    • U.S. mental health system
      • Fewer women receive mental health services than men
      • Gender of therapist does not appear to influence outcomes
    • Feminist psychotherapy – radical approach
      • Women treated as second-class citizens and Barbie dolls
human diversity2

Therapies

Human Diversity
  • Goals of Feminist Psychotherapy
    • Advocates equal relationship in therapy
    • Encourage women to see how society limited them to dependent roles
    • Encourage women to become aware of their anger; find constructive ways of expressing
    • Have women define selves as independent
    • Women encouraged to consider own needs
    • Women should develop nontraditional skills
slide21

Therapies

  • Drug therapy
    • Widely used to treat abnormal behavior
    • Commonly used psychiatric drugs
    • Electroconvulsive therapy (ECT)
    • Transcranial stimulation
      • Magnetic field used on frontal cortex
  • Effexor
  • Paxil
  • Prozac
  • Zorloft
  • Xanax
  • Geodon
  • Haldol
  • Navane
  • Risperdal
  • Zyprexa
  • Depakote
  • Epilim
medical therapies

Therapies

Medical Therapies
  • Psychosurgery
    • Trephining
    • Prefrontal labotomy
    • Modernnames for labotomy surgeries conducted today
      • Capuslotomy
      • Cingulotomy
slide23

Trephining operations were apparently performed in the Middle Ages to treat abnormal behavior

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