Introduction to Psychotherapy

Presentation Transcript

Definitions and Examples

Today’s Lecture

Historical treatment of the mentally ill
Psychotherapy definitions and examples
Places of treatment
Providers of treatment
Recipients of treatment

Next Class:Does psychotherapy work?

Historical background: Beliefs and treatment of the mentally ill

Greek physician Hippocrates promoted humane treatment. Mentally ill patients were placed in pleasant surroundings and given soothing baths and massages.
Lack of balance between positive and negative energies
Disturbance in the balance of bodily fluids treatment

Middle Ages through 18th century

Middle Ages to 17th century

Madness = in league with devil, possession by spirits
Diagnosis based on hearsay, unreliable “tests”
Treatment

Prayer, exorcism, magic incantation
Torture, starvation, and exile (sent to sea)
Treated like animals and sentenced to burn or hang

18th century

mentally disordered people = degenerates
keep them away from society

The 19th century: Attempts at reform

Philippe Pinel (1745-1826)

reform in Paris mental hospitals
removed restraints and treated mentally ill more humanely
some patients got better enough to leave hospital

The 19th century: Attempts at reform

reform of U.S. system
moral-treatment movement
humane care
led to large, state-supported public asylums
But problems persisted

Overcrowding
Loss of public attention
Effective treatments not yet available

Dorothea Dix (1802-1887)

The 20th century

New Therapies introduced in 1930s

Insulin-coma therapy (ICT)
Electro-shock therapy (ECT)
Frontal lobotomy

Anti-psychotic drugs introduced in mid-1950s
Deinstitutionalization follows in early 1960s

get people out of asylums and back into community
general mood of optimism in country

Community mental health centers established in 1961

Video available

Patients in Mental Hospitals. The number of patients cared for in the U.S. state and county mental hospitals has decreased dramatically since 1955.

ECT Today

Therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient

Side effects of ECT include temporary short-term memory loss but it is painless and there is no risk for death or brain damage.

70% of depressed patients who did not respond to other treatment respond positively to ECT.

What is psychotherapy?

Psychotherapy is a form of treatment for problems of an emotional nature in which a trained person deliberately establishes a professional relationship with a patient for the purpose of removing, modifying, or retarding existing symptoms, of mediating disturbed patterns of behavior, and of promoting positive personality growth and development (Wolberg, 1967).
Psychotherapy is a plannedactivity of the psychologist, the purpose of which is to accomplish changes in the individual that make his/her life adjustments potentially happier, more constructive, or both (Frank, 1982).

20th Century: Advances in psychotherapy

Psychoanalysis introduced by Freud in 1890s
Adler (1930s) and other neo-Freudians follow
Variety of new approaches introduced in 1950s

Behavioral (Wolpe, Watson, Skinner)
Rational Emotive Therapy (RET, Ellis)
Humanistic (Rogers)
Existential (May)
Gestault (Perls)

Cognitive therapy introduced in 1960s (Beck)
Group therapy also gains popularity in 1960s
Family Therapy comes in the 1970s

Which of these is not psychotherapy?

A rabbi counseling a couple with marital difficulties
An abused child drawing pictures of his family for a psychologist
A woman presenting her testimony to her Alcoholic Anonymous group
A university Counseling Center psychologist with an M.A. helping a student choose a career
A man talking about his dreams and childhood experiences to a psychoanalyst in N.Y.
A police officer “talking down” a suicidal teenager from a tall building
A family having a loud argument in a therapist’s office

Reasons for seeing a mental health professional(Murstein & Fontaine, 1993)

Depression (21%)Relationship and couple problems (17%)Child rearing problems (19%)Difficulty in social and work relations (5%)Suicidal thoughts (5%)Alcohol/Drug dependence (3%)Obsessions (3%)Sexual dysfunctions (3%)Weight loss/Eating disorders (3%)Spousal/partner abuse (2%)Psychotic symptoms (2%)