Chapter 19

1. Chapter 19 Therapy

7. Goals of Psychotherapy • Giving individuals hope for recovery • Helping individuals gain new perspectiveson their problems • Providing an individual with a caring, trusting relationship • Help people realize they are responsible for their own problems • They are the only ones that can solve their problems

8. Who’s Who Among Mental Health Professionals? • Counseling psychologists (PhD, PsyD, MA) • Clinical psychologists (PhD or PsyD) • Psychiatrists (MD or DO) • Social workers (MA or MSW) • Psychiatric nurses (RN) • Marriage and family therapist (MA) • LPC (MA) • Teachers, guidance counselors, clergy, and family doctors

9. Gender Shift 28% of Psychologists in 1978 were female 52% of Psychologist’s today are female 75% of current undergraduate psychology majors are female 66% of current psychology graduate students are female -Gill, 2006; APA, 2005; Barber, 1999

10. Selecting the Right Professional for YOU • What is the professional’s field? • What degrees does the professional hold? • Is the professional licensed by the state? • What are the therapist’s plans with treatment, and how long will treatment take? • What is the estimated cost of treatment?

12. Psychoanalytic Therapy Freud and his famous couch

13. Psychoanalysis • Aimed at making patients aware of their unconscious motives so that they can gain control over their behavior • Try to reduce anxiety and guilt • Insight- self-awareness (YOU are the root of your problems) which leads to a solution • Long-term: Meet 4-5 times a week for 3-6 years • Useful for anxiety, mild depression, and difficulty in handling social relationships

14. Methods used in Psychoanalysis • Free association– a method used to examine the unconscious; the patient is instructed to say whatever comes into his/her mind – nothing is unimportant • Resistance– the reluctance of a patient either to reveal painful feelings or to examine long-standing behavior patterns • Dream analysis– technique used by psychoanalysts to interpret the content of patients’ dreams • Manifest content– actual content of dream • Latent content– hidden meaning

15. Transference – the process, experienced by the patient, of feeling toward a therapist the way he or she feels or felt toward some other important figure in his/her life

16. 4 Qualities Crucial to Determine if Psychoanalysis will be Successful • Motivation • Capacity for interpersonal relationships • Capacity for introspection and insight • Ego strength

17. http://www.youtube.com/watch?v=uZq_U2hbnvs

18. In your notebooks… What is “humanistic therapy”? What is meant by client-centered therapy?

20. Humanistic Approach • Most effective for people who experience anxiety, mild depression, and problems in social relationships • Person-centered therapy – help clients find their true selves and realize their unique potential • Therapist’s role is to act as a mirror, reflecting the client’s thoughts and feelings back so they can see themselves more clearly • Active listening – listener repeats, rephrases, and asks for clarification of the statements made by the speaker • Unconditional positive regard • Genuineness • Acceptance

21. Another forms… • Gestalt Therapy – importance of the whole; integrate all actions, feelings, and thoughts into a harmonious whole - Focus on the present • Existential therapies – focus on developing a sense of their life purpose

22. Imposter Effect • The Imposter Syndrome is a totally distorted self-view – one that limits people’s perceptions of who they are and what they are capable of. • 70% of the talented and successful people they interviewed experienced feeling like a fake or fraud, dismissing their successes as good luck, fate or someone’s mistakenly positive view of them.

23. In your notebooks… Write down any irrational thoughts you’ve had recently….

24. Identifying Distorted Thinking • Catastrophizing – expecting a disaster to occur • Mind reading – assuming that you know what someone else is thinking or feeling without the person expressing his or her thoughts • Being right - needed to prove that your opinions and decisions are always right even in the face of evidence to the contrary • Emotional reasoning – believing that what you feel must be true

25. Cognitive Therapy Nobody likes me  Even people who like me occasionally get mad at me I’m a moron  I’m smart, even if I do make mistakes now and then I’m worthless  I’m a good person My jokes are bad  It’s not my fault that the class has no sense of humor.

26. Cognitive Therapy Constant Repetition of Negative thoughts leads to abnormality

27. Cognitive Therapy • Help people learn to think about their problems in more productive ways • Meet once a week for 15-25 weeks • Effective for depression, anxiety, personality disorders, and schizophrenia if also receiving drug therapy

28. Beck’s Cognitive Therapy • Focused on illogical thought processes • Arbitrary inference – drawing conclusions when there is no evidence • Selective abstraction – focusing on ONE detail • Overgeneralization – failed ONE test = worthless • - triad: beliefs about self, world, and future Rational – emotive therapy (RET)– based on Ellis’s belief that people are basically logical in their thinking and actions but the assumptions upon which they base their thinking is sometimes flawed • identify/challenge assumptions • “I MUST DO EVERYTHING PERFECTLY.” • Role-playing and modeling • Homework assignments

29. Behavior Therapy • Aim is to teach people more desirable ways of behaving • Behaviorists believe that both desirable and undesirable behaviors are largely learned • Behavior modification – develop more adaptive behavior • Short-term therapy • Effective: phobias, PTSD, compulsions, substance abuse

30. Methods of Behavior Therapy • Counterconditioning – Mary Cover Jones • Systematic desensitization – Joseph Wolpe: anxiety hierarchy, in vivo desensitization, covert desensitization • Modeling • Aversive conditioning • Operant conditioning • Token economies • Successive approximations • Social skills training

31. Behavioral Therapy Systematic Desensitization

32. Behavioral Therapy Flooding

33. Behavioral Therapy Aversion Therapy + = + = Ipecac Alcohol Sobriety

34. In your notebooks… • What is the primary method used in psychoanalysis? • Who started person-centered therapy? • What is the focus of humanistic therapy? • What is the most effective method of therapy for those with depression? • If someone is experiencing hallucinations and delusions, what disorder may they be diagnosed with?

36. Somatic Therapy • Anti-anxiety drugs – prescribed to control symptoms of anxiety disorders and to reduce stress due to temporary life circumstances (Miltown, benzodiazepines: Xanax, Valium) • Anti-depressants – help people with major depression and sometimes to help with eating disorders and panic disorders (Prozac) • Anti-psychotic drugs – prescribed to control the disordered thoughts, delusions, and hallucinations of people with schizophrenia (Thorazine or Haldol) • Lithium – a chemical used to counteract mood swings of bipolar disorder; many side effects

37. Electroconvulsive therapy (ECT) – an electrical shock is sent through the brain to try to reduce symptoms of mental disturbance • Psychosurgery – medical operation that destroys part of the brain to make the patient calmer and freer of symptoms • Prefrontal lobotomy – a radical form of psychosurgery in which a section of the frontal lobe of the brain is destroyed • http://www.youtube.com/watch?v=DCUmINGae44

38. Review • What is the most used type of BEHAVIOR therapy? • What is a side effect of over-usage of antipsychotics? • The bell-pad technique is what type of therapy? • What is a major side effect of ECT? • Active listening & unconditional positive regard = person-centered therapy Number 38*