1. Treatment: Day 2

2. Psychotherapy Three: Behavior Therapies Focus on Learning Unlike previous two psychotherapies, behavior therapies are not interested in the underlying cause of the problem or in achieving self-awareness. Behavior Therapies: assume the problems are the behaviors themselves –use well-established learning principles to eliminate the unwanted behavior. –usually used to treat anxiety disorders, drug addictions, bedwetting, sexual dysfunctions, and autism.

3. Behavioral cause of psychological disorders faulty conditioning therapeutic methods Counterconditioning (CC) (replace undesired behavior with something acceptable) Systematic desensitization (CC) Virtual Reality Exposure Therapy Virtual Reality Exposure Therapy (CC) Aversion therapy (CC) (pair undesired behavior with punishing / unpleasant behavior) Flooding (CC) (more immediate exposure) Token economies (OC) Modeling goal of therapyalleviate symptoms (change behavior) therapeutic approaches

4. Behavioral Therapy Techniques Counter-conditioning –Cause patient to associate something GOOD with whatever makes them anxious/fearful. –Used with petsUsed with pets –Often combined with desensitization Desensitization –Gradual exposure to feared objects or situationsGradual exposure –Uses relaxation techniques

5. Behavioral Therapy Techniques Virtual Reality Exposure Therapy –Form of desensitizationForm of desensitization Aversion Therapy –Combines unwanted behavior with negative stimulusCombines unwanted behavior with negative stimulus –Teaches patient to associate unwanted behavior (smoking, bedwetting, alcohol) with negative feeling

6. Cognitive-Behavior Therapy Combines the cognitive aspect (how to think differently) and the behavior aspect (learning/unlearning behaviors.) CBT Video – Panic/OCD Panic/OCD

7. The Most Dominant Form of Therapy is the Cognitive Approach

8. Most Common Illnesses Treated by Cognitive Psychotherapy 1. Depression 2. Eating Disorders 3. Chronic Pain 4. Marital Problems 5. Anxiety Disorders

9. Assumption and Goal of Cognitive Therapy Cognitive Therapy assumes that thoughts exist between events and responses. –Patient’s response depends on how they interpret the situation … you can teach people to interpret situations differently! –Schachter two-factor theory of emotion Goal of Cognitive therapy is to teach people new and more realistic, helpful, and adaptive patterns of thinking and acting. Learn how to see the glass half-full instead of half-empty (optimism instead of pessimism)!!

10. Two Major Therapies where Cognition Is A Strong Focus 1. Aaron Beck’s Cognitive Therapy 2. Albert Ellis’s Rational Emotive Behavior Therapy

11. Aaron Beck’s Views on Depression (NOT IN BOOK) Beck believed the key to understanding depression was in an individual’s thought patterns. Negative thought patterns and creation of negative schemas --> people misinterpret the world --> feel worthless and incompetent. Depressed people tend to view world with “dark sunglasses.”

12. Albert Ellis’s Rational Emotive Behavior Therapy (NOT IN BOOK) Albert Ellis also believed that people’s maladaptive thoughts led to maladaptive emotional responses (behaviors). Three irrational beliefs people hold that cause them to develop unhealthy ways of thinking/acting...

13. Irrational Belief #1 “I absolutely MUST, under practically all conditions and at all times, perform well (or outstandingly well) and win the approval (or complete love) of significant others. If I fail in these important—and sacred—respects, that is awful and I am a bad, incompetent, unworthy person, who will probably always fail and deserves to suffer.” Believing this leads to…anxiety, panic, depression, despair

14. Irrational Belief #2 "Other people with whom I relate or associate, absolutely MUST, under practically all conditions and at all times, treat me nicely, considerately and fairly. Otherwise, it is terrible and they are rotten, bad, unworthy people who will always treat me badly and do not deserve a good life and should be severely punished for acting so abominably to me." Believing this leads to…anger, rage, revenge, vindictiveness

15. Irrational Belief #3 “The conditions under which I live absolutely MUST, at practically all times, be favorable, safe, hassle-free, and quickly and easily enjoyable, and if they are not that way it's awful and horrible and I can't bear it. I can't ever enjoy myself at all. My life is impossible and hardly worth living." Believing this leads to…frustration, anger, self- pity

16. Albert Ellis’s Rational Emotive Behavior Therapy (NOT IN BOOK) Goal of therapy is to help people think rationally and see where their thoughts don’t make sense or aren’t realistic Rational Emotive Behavior Therapy: involves getting patients to recognize the irrationalities within their thought patterns and helping them create healthier forms of thinking and behaving. REBT film clip (start at 9:20). REBT film clip

17. Cognitive cause of psychological disorders maladaptive thoughts or schemas therapeutic methods Modeling Role playing Rational emotive therapy  A – Adversity (Actions)  B - Belief  C – Consequence goal of therapy change negative thinking therapeutic approaches

18. rational emotive therapy A – Adversity Break-up Fail a test B - Belief I can do better I’ll never find someone I should have studied harder I’m stupid C - Consequence Positive attitude Depressio n Positive attitude Depression

19. Exit Ticket Answer on a blank sheet of paper… 1.How is psychoanalysis different from behavioral and cognitive therapies? 2.Describe how exposure and desensitization work and what they can accomplish. 3.How is Rational Emotive Therapy different from Carl Rogers’ humanistic approach? 4.What types of disorders are most commonly treated with behavioral therapy?

20. Biological cause of psychological disorders Psychophysiological causes (ex: depletion of neurotransmitters) therapeutic methods Drugs Electroconvulsive Therapy (ECT) Psychosurgery goal of therapy Correct neurochemical imbalances therapeutic approaches

21. Types of drugs Used to treatExamples how do they work? side effects Anti- Psychotics (neuroleptics) schizophreni a Haldol Thorazine Clozapine Zyprexa Blocks the action of dopamine (dopamine antagonist) by targeting dopamine receptors. general lethargy, possible increase in negative symptoms, and sexual dysfunction Tardive Dyskinesia Tardive Dyskinesia can occur if D2 dopamine receptor blockers are used long-termoccur

22. 20/20 Special on Medicating Foster Children http://www.youtube.com/watch?v=8W8SHEe5y-o&feature=relmfu

23. Types of drugs Used to treatExamples how do they work? side effects Anti- Anxiety ( Anxiolytics) Anxiety & personality disorders XanaxXanax (addiction) Ativan,(addiction) &Valium (benzodiazepines) It boosts the effects of GABA, a natural chemical in your body that sends messages to your brain that tell it to "calm down.“ High risk of physical and psychological addiction

24. Types of drugs Used to treatExamples how do they work? side effects Anti- Depressant s Depression Tofranil Limbitrol Tricyclics (known as tricyclics because of the shape of their molecular structure) blocks the reuptake of both seratonin and norepinephrine – this causes arousal Many side effects, but most go away after the adaptation phase

25. Types of drugs Used to treatExampleshow do they work? Anti- Depressant s Depression Nardil Parnate MAOI Inhibitors (found to slow the body's production of the enzyme monoamine oxidase (MAO) Once the brain's three neurotransmitters, known as monoamines (serotonin, norepinephrine, and dopamine), have played their part in sending messages in the brain, they get burned up by a protein in the brain called monoamine oxidase, a liver and brain enzyme. If too many monoamines are absorbed, it leads to a chemical imbalance in the brain. Antidepressants known as monoamine oxidase inhibitors, or MAOI, work by blocking this cleanup activity.

26. Types of drugsUsed to treatExampleshow do they work? Anti- Depressant s Depressio n Prozac Celexa Zoloft (Zoloft for anxiety) Paxil (know these!) SSRI’s (selective serotonin reuptake inhibitors) prevent the reuptake of the neurotransmitter serotonin Many side effects, but most go away after adaptation phase

27. Types of drugsUsed to treatExampleshow do they work? Mood Stabilizers Bipolar Disorder Lithium ? The precise mechanism of action of Li+ as a mood- stabilizing agent is currently unknown

28. Types of drugsUsed to treatExampleshow do they work? stimulantsADHDRitalin Increases levels of norepinephrine and dopamine which arouse the central nervous system. It’s long-term effectiveness is questionable Ritalin as “competitive edge”