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Psychology 132 Natalie B. Phelps M.S. Ed. NCC Chapter 17. Key Points. Theme: Psychotherapies are based on a common core of therapeutic principles. Medical therapies treat the physical causes of psychological disorders. In many cases, these approaches are complementary.
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Key Points Theme: Psychotherapies are based on a common core of therapeutic principles. Medical therapies treat the physical causes of psychological disorders. In many cases, these approaches are complementary. • How do psychotherapies differ? How did psychotherapy originate? • Is Freudian psychoanalysis still used? • What are the major humanistic therapies? • What is behavior therapy? • How is behavior therapy used to treat phobias, fears, and anxieties? • What role does reinforcement play in behavior therapy? • Can therapy change thoughts and emotions? • Can psychotherapy be done with groups of people? • What do various therapies have in common? • How do psychiatrists treat psychological disorders? • How are behavioral principles applied to everyday problems? • How could a person find professional help?
Psychotherapy-Overview • Does it work? • 9 out of 10 think so! • Session length -8 sessions
Psychotherapy/Therapy • Psychotherapy • Any psychological technique used to facilitate positive changes in a person's personality, behavior, or adjustment. • Therapists have many approaches to choose from: • Psychoanalysis • Desensitization • Gestalt Therapy • Client-centered Therapy • Cognitive Therapy • Behavior Therapy • AND MAY MORE!
Different Types Of Therapies • Individual therapy: A therapy involving only one client and one therapist. • Group therapy: A therapy session in which several clients participate at the same time. • Insight therapy: Any psychotherapy whose goal is to lead clients to a deeper understanding of their thoughts, emotions, and behavior. • Action therapy: Any therapy designed to bring about direct changes in troublesome thoughts, habits, feelings, or behavior, without seeking insight into their origins or meanings. • Directive therapy: Any approach in which the therapist provides strong guidance. • Nondirective therapy: A style of therapy in which clients assume responsibility for solving their own problems; the therapist assists, but does not guide or give advice. • Time-limited therapy: Any therapy begun with the expectation that it will last only a limited number of sessions. • Supportive therapy: An approach in which the therapist's goal is to offer support, rather than to promote personal change. A person trying to get through an emotional crisis or one who wants to solve day-to-day problems may benefit from supportive therapy. • Positive therapy: Techniques designed to enhance personal strengths, rather than "fix" weaknesses.
Elements of Positive Mental Health Ta b l e 1 7 . 1, p. 571 • Personal autonomy and independence • A sense of identity • Feelings of personal worth • Skilled interpersonal communication • Sensitivity, nurturance, and trust • Genuine and honest with self and others • Self-control and personal responsibility • Committed and loving personal relationships • Capacity to forgive others and oneself • Personal values and a purpose in life • Self-awareness and motivation for personal growth • Adaptive coping strategies for managing stresses and crises • Fulfillment and satisfaction in work • Good habits of physical health Adapted from Bergin, 1991.
“Early” Treatments For Mental Problems • Demonology • In medieval Europe, the study of demons and the treatment of persons "possessed" by demons. • Demonology • Exorcism • “demonic possession" • Ergot Poisoning (Witch trails?) • rye (grain) fields were often infested with ergot fungus and now we know, is a natural source of LSD.
Freud’s Theories • Hysteria • People suffering from hysteria have physical symptoms (such as paralysis or numbness) for which no physical causes can be found. Today we call it somatoform disorders, (as discussed in Chapter 16.) Slowly, Freud became convinced that hysteria was related to deeply hidden unconscious conflicts. • Based on this insight, Freud developed a therapy called psychoanalysis.
FreudContinued… • The psychoanalyst tends to take a position of authority, stating what dreams, thoughts, or memories "mean.“ • Dreams (share/talk)
FreudContinued… • PsychoanalysisA Freudian therapy that emphasizes the use of free association, dream interpretation, resistances, and transference to uncover unconscious conflicts. • Free associationIn psychoanalysis, the technique of having a client say anything that comes to mind, regardless of how embarrassing or unimportant it may seem. • latent dream contentThe hidden or symbolic meaning of a dream, as revealed by dream interpretation and analysis. • Manifest dream content The surface, "visible" content of a dream; dream images as they are remembered by the dreamer. • Dream symbolsImages in dreams whose personal or emotional meanings differ from their literal meanings. • ResistanceA blockage in the flow of free association; topics the client resists thinking or talking about.
Psychoanalysis Today • What is the status of psychoanalysis today? • Traditional psychoanalysis called for three to five therapy sessions a week, often for many years. • Today, most patients are only seen once or twice per week, but treatment may still go on for years (Friedman et al., 1998). • Because of the huge amounts of time and money this requires, psychoanalysts have become relatively rare. • Nevertheless, psychoanalysis made a major contribution to modern therapies by highlighting the importance of unconscious conflicts (Rangell, 2002).
Humanistic Therapies Client-Centered Therapy • Psychologist Carl Rogers (1902–1987) found it more beneficial to explore consciousthoughts and feelings. • Rogers believed that what is right or valuable for the therapist may be wrong for the client. (Rogers preferred the term client to patientbecause "patient" implies a person is "sick" and needs to be "cured.") • The client determines what will be discussed during each session. Thus, client-centered therapy (also called person-centered therapy) is nondirective and based on insights from conscious thoughts and feelings (Schneider, 2002).
Client-Centered Therapy • Client-centered (or person-centered) therapyA nondirective therapy based on insights gained from conscious thoughts and feelings; emphasizes accepting one's true self. • Unconditional positive regardAn unqualified, unshakable acceptance of another person. • EmpathyA capacity for taking another's point of view; the ability to feel what another is feeling. • AuthenticityIn Carl Rogers's terms, the ability of a therapist to be genuine and honest about his or her own feelings. • Reflection In client-centered therapy, the process of rephrasing or repeating thoughts and feelings expressed by clients so they can become aware of what they are saying.
Humanistic TherapiesContinued… • Existential Therapy • Existential therapy An insight therapy that focuses on the elemental problems of existence, such as death, meaning, choice, and responsibility; emphasizes making courageous life choices. • Logotherapy A form of existential therapy that emphasizes the need to find and maintain meaning in one's life. • Frankl (1904–1997) based his approach on experiences he had as a prisoner in a Nazi concentration camp. In the camp, Frankl saw countless prisoners break down as they were stripped of all hope and human dignity (Frankl, 1955). Those who survived with their sanity did so because they managed to hang on to a sense of meaning (logos). Even in less dire circumstances, a sense of purpose in life adds greatly to psychological well-being (Lantz, 1998).
Humanistic TherapiesContinued… • Gestalt therapy • An approach that focuses on immediate experience and awareness to help clients rebuild thinking, feeling, and acting into connected wholes; emphasizes the integration of fragmented experiences. • Read p. 575-576
Behavior Therapy • Behavior therapy • Is the use of learning principles to make constructive changes in behavior. • Behavioral approaches include behavior modification, aversion therapy, desensitization, token economies, and other techniques (Forsyth & Savsevitz, 2002). • Aversion Therapy • Stopping smoking- to much smoking • Stopping drinking- add pain • Desensitization • Fear a flying
Behavior Therapy Continued… Relaxation Method • Discovering Psychology • “Feeling a little tense? Relax!” • p. 580-tape
Operant Therapies Skinner Box! • Token Economies • Positive Reinforcement • Etc.
Cognitive Therapy • Cognitive therapyA therapy directed at changing the maladaptive thoughts, beliefs, and feelings that underlie emotional and behavioral problems. • Selective perceptionPerceiving only certain stimuli among a larger array of possibilities. • OvergeneralizationBlowing a single event out of proportion by extending it to a large number of unrelated situations. • All-or-nothing thinkingClassifying objects or events as absolutely right or wrong, good or bad, acceptable or unacceptable, and so forth.
Rational-Emotive Behavior Therapy • Rational-emotive behavior therapy (REBT) • An approach that states that irrational beliefs cause many emotional problems and that such beliefs must be changed or abandoned. • Discovering Psychology • “Ten Irrational Beliefs– Which Do You Hold?” • p.585
Group Therapy • Group Therapy • Psychotherapy conducted in a group setting to make therapeutic use of group dynamics. • Family Therapy • Couple Therapy • Group Therapy • AA, OA, etc. groups • Large-group Awareness Training • Any of a number of programs (many of them commercialized) that claim to increase self-awareness and facilitate constructive personal change.
Therapy At A Distance • How valid are psychological services offered over the phone and on the Internet? • For better or worse, psychotherapy and counseling are rapidly becoming high-tech. Today, psychological services are available through radio, telephone, videoconferencing, e-mail, and Internet chat rooms (Maheu et al., 2004). • What are the advantages and disadvantages of getting help "online"? • What are the risks and possible benefits?
Basic Counseling Skills p. 591-592 • Active Listening (read) • Clarify the Problem (read) • Focus on Feelings (read) • Avoid Giving Advice(read) • Accept the Person's Frame of Reference (read) • Reflect Thoughts and Feelings (read) • Silence (read) • Questions (read) • Maintain Confidentiality (read)
Medical Therapies • Drug Therapies • Three major types of drugs are used. • Anxiolytics (such as Valium) produce relaxation or reduce anxiety. • Antidepressants are mood-elevating drugs that combat depression. • Antipsychotics (also called major tranquilizers) have tranquilizing effects and, in addition, reduce hallucinations and delusions. • (See Table 17.4, p. 592, for examples of each class of drugs.)
Medical TherapiesContinued… • Shock Therapy • Electroconvulsive Therapy (ECT) • A treatment for severe depression, consisting of an electric shock passed directly through the brain, which induces a convulsion.
Medical TherapiesContinued… • Psychosurgery • Any surgical alteration of the brain designed to bring about desirable behavioral or emotional changes. • The most extreme medical treatment is psychosurgery (any surgical alteration of the brain). • The best-known psychosurgery is the lobotomy. In the prefrontal lobotomy the frontal lobes were surgically disconnected from other brain areas. This procedure was supposed to calm persons who didn't respond to any other type of treatment. • Deep lesioning,in which small target areas are destroyed in the brain's interior.
Medical TherapiesContinued… • Hospitalization • Mental hospitalization for major mental disorders involves placing a person in a protected setting where medical therapy is provided. • Drug Rehab • ???
Medical TherapiesContinued… • Community mental health Programs • A facility offering a wide range of mental health services, such as prevention, counseling, consultation, and crisis intervention.