CHAPTER 22 Psychological Treatment Zhang Lei SIR RUN RUN SHAW HOSPITAL Good afternoon, everyone! Let’s begin from questions: what is psychological treatments? Which psychotherapy is the most effective? How psychotherapy help the patients? To answer these questions, we must learn this chapter. Could you understand me?

Questions: What is psychotherapy? What are its goals? How do people change in therapy? What happens during psychotherapy? How would a psychotherapist work? … …

Defining Psychotherapy Talking cure Using communication to promote change To increase well-being, to access latent potentials Relationship: therapist＆patient

Classification of psychological treatments Technique Psychodynamic Cognitive behavioral other: systems theory Number of patients Individual therapy Couple therapy Family therapy Small and large group therapy End: there are more similarity than difference

Psychological treatments considered in this chapter CBT Individual dynamic psychotherapies Counseling Crisis intervention Supportive psychotherapy Historical treatments Meditation and traditional healing Small-group psychotherapy Large-group psychotherapy Psychotherapy with couples Family therapy Psychotherapy for children and older people

How psychological treatments developed Hypnosis and free association: 1895,1923 Classical dynamic psychotherapy: 1889 The neo-Freudians: 1930s Object relation theory Attachment theory Brief psychodynamic therapy Behaviour therapy: 1920s Cognitive therapy Cognitive-behaviour therapy The use of psychological healing is as old as the practice of medicine. However, in the history of psychiatry ,psychological treatment can be said to start in the nineteenth century with developments in hypnosis.

Common factors in psychological treatment Therapeutic relationship Listening Release of emotion Restoration of morale Providing information Providing a rationale Advice and guidance Suggestion

Psychodynamic therapy First: driven by inner force, the sources of illness help recognize free-association, analysis of dreams

Cognitive behaviour therapy General features: The patient is an active partner ABC approach Ways of thinking Investigation Homework Structured Monitoring progress Treatment manuals

Cognitive behaviour therapy Assessment for Cognitive behaviour therapy Describe each problem of behaviour, thoughts and emotions Where it occurs Common prior events The patient’s response to the events What follows the problem Factors making the problem better or worse Maintaining factors

Cognitive behaviour therapy Behavioural techniques: 16 types relaxation training, exposure, desensitization, flooding, exposure in everyday practice, exposure with response prevention, social skill training…… Cognitive techniques Distration, neutralizing, challenging beliefs

CBT for different mental disorders Anxiety disorders Panic disorder Post-traumatic stress disorder (PTSD) Depressive disorders Hypochondriasis Personality disorder

Treatment in groups Small group psychotherapy Therapeutic groups Large-group therapy

Psychotherapy with couples and families Couple therapy Psychodynamic Systems approaches Cognitive behvioural Behavioural-systems Family therapy Psychodynamic family therapy Structural family therapy Systemic family therapy Eclectic family therapy

Psychotherapy for children Play therapy

Crisis intervention Problems leading to crisis Indications: Loss Role changes Relationship problems Conflict problems Indications: well-motivated people with stable personalities who are facing major but transitory difficulties.

Crisis intervention: methods Stage Ⅰ: reduce arousal; focus on current problems; encourage self-help StageⅡ: assess problems; consider solutions; test solutions StageⅢ: consider future coping methods

Other psychological treatments Hypnosis Autogenic training Abreaction Meditation

Ethical problems in psychological treatment Autonomy Confidentiality Exploitation

Thank you for your attention!