METHODS OF THERAPY Chapter 19

Section 1 What is therapy? Objective: Define psychotherapy, and list the advantages of each method of psychotherapy.

What is therapy? Therapy is a general term for the variety of approaches that mental health professionals use to treat psychological problems and disorders.

What is the purpose of therapy? Helping individuals by: Giving hope Gaining insight or perspectives on their problems Providing individual with a caring and trusting relationship

The 2 categories of therapy Psychologically based Psychotherapy involves interaction between trained professional and a person Biologically based Involves the use of drugs or other medical procedures to treat psychological disorders

Commonly used methods of Psychotherapy Goals Key Techniques Psychoanalysis To replace a avoidant behavior with coping behavior; to reduce inappropriate feelings of anxiety and guilt Free association; dream analysis; analysis of the transference relationship Humanistic therapy To remove obstacles in the path of self-actualization Active listening; unconditional positive regard

Methods of Psychotherapy Goals Key techniques Behavior therapy To replace maladaptive, self defeating behavior with adaptive self enhancing behavior Systematic desensitization; modeling; aversive conditioning; operant conditioning

Methods of Psychotherapy Model Goals Key Techniques Cognitive therapy To replace irrational, self-defeating attitudes and beliefs with rational, self-enhancing attitudes and beliefs Encouraging clients to challenge irrational beliefs and replace them with rational beliefs; teaching clients to evaluate their beliefs and attitudes rationally

TYPES OF PROFESSIONALS Counseling psychologist Master’s or Ph. D Doctor of Philosophy Educational institutions Clinical psychologist Ph. D in psychology Hospitals/ clinics Psychological problems Psychiatrist M.D. (special) psychiatry/ post grad abnormal behavior Prescribe meds Perform operations Psychiatric social worker Master’s social work Additional practice training 2 yrs grad psychology Counsels –everyday personal and family problems Psychiatric nurse Nursing license \advance training in psychology Dispenses meds. Contract person between counseling sessions

Selecting the right professional Cost of treatment? Field of study? What degrees? Licensed? Plan for treatment?

Individual –v- Group therapy Advantages of individual therapy More personal attention Feel uncomfortable talking in front of a group Will talk openly alone

Individual –v- Group therapy Advantages of group therapy Realizing you are not alone Benefit from insight gained by others struggle Can support each other Gives hope for recovery Shows therapy can work More affordable Therapist can work with several people at the same time

Type of group therapy Couples Family therapy Self-help groups Encounter groups

SECTION 2 The Psychoanalytic approach Objectives: Describe the major techniques of psychoanalysis.

Psychoanalysis = Freud Unconscious thoughts and feelings Reduces anxiety and guilt Allows insight Dream analysis Manifest content- actual dream Latent content- hidden meaning Free association Say what ever comes to mind (any topic) Resistance – unwilling to discuss issues

Transference Transferring feelings and expectations from one person to another Allows clients to express and analyze unconscious feelings Can expose unresolved problems Example Bad relationship with mother---start to treat therapist the same way-----bad relationship with boss

Evaluation of Psychoanalysis Useful therapy for Anxiety, mild depression and difficulty in handling social relationships Not useful therapy for Too seriously disturbed Major depression, bipolar disorder, schizophrenia Limited educational background Limited verbal skills TOO EXPENSIVE (meeting 4-5 X’s a week)

Section 3 The Humanistic Approach Objective: Identify the primary goals and methods of humanistic therapy.

Humanistic therapy Help individual reach their full potential Achieving self-awareness and self acceptance Basically good and strive for self- actualization Need to tap their inner resources

Carl Rogers Problem stop being yourself and act as others expect you to act Role of therapy Find their true self and realize their unique potential

Person-centered therapy or client-centered therapy client seen as an equal Encouraged to take the lead Called Nondirective therapy Therapist acts as a mirror Reflecting clients thoughts and feelings

Therapy technique Active listening Therapist repeats, rephrases, and asks for clarification of statements Clients is heard and understood Therapist must remain nonjudgmental , supportive, accepting regardless of what is said Client accepts themselves Self esteem rises Gain confidence to make their own choices Able to develope healthy relationships

Other applications Schools/ colleges Help students deal with anxiety and depression Use person centered approach to help students decide on a career and support their choices

Evaluation of humanistic therapy Most helpful with well educated motivated people Work best with people who are Mildly depressed Experiencing anxiety Problems with social relationships Ineffective major depression Bipolar disorder schizophrenia

Section 4 Cognitive therapy and Behavior therapy Objective Describe how cognitive and behavior therapists try to help people.

Cognitive and Behavior therapy Help clients develop new ways of thinking and behaving Focus on their thought and actions Eliminate troubling emotions or behaviors Solve own problems

Cognitive Therapy PURPOSE OF COGNITIVE THERAPY Thoughts that can lead to emotional and behavioral problems Thinking- illogical or based on faulty assumptions (person A—B swim team) PURPOSE OF COGNITIVE THERAPY To help people develop more realistic and logical ways of thinking Change thinking= solving their own emotional and behavioral problems

2 widely used cognitive therapy methods Rational- Emotive Behavioral Therapy Based on People being basically logical in thinking and behaviors Problems- based on faulty assumptions Must do everything perfect Unrealistic high standards Anxiety and severe depression

Rational-Emotional Behavior Therapy challenges clients errors in their way of thinking Means role play, modeling homework- Read relevant literature, listen to tapes, experiments to test their assumptions ( affects length of therapy)

Beck’s Cognitive Therapy Restructuring illogical thoughts process Arbitrary inference-drawing conclusions with no evidence Selective abstraction- drawing conclusions with Single detail Misinterpreting Ignoring other details Overgeneralization- drawing conclusion from single experience

Gently guides clients in testing logic of their own thought processes and develop logical ways of thinking Means Have client observe and record their response to events in daily life. Review responses to help see them as illogical thought processes that are causing their emotional problems.

Evaluation of Cognitive Therapy Short term method (15-25 weeks) Has helped clients with Anxiety‘ Depression Personality disorders along with Meds Provide coping skills Reduces risk of recurrence

Behavior Therapy Behavior modification Develop more adaptive behaviors Changing behaviors is most important Over eating stop smoking develop skills needed for healthy relationships confront phobias

2 categories of Behavior therapy Counter-conditioning-Pairing the stimulus that triggers an unwanted behavior with a new more desirable behavior Systematic desensitization Aversive conditioning Benefit Learn more desirable behaviors Boost in self-esteem Less restrictive lives

OPERANT CONDITIONING BEHAVIORS REINFROCED TEND TO BE REPEATED Token economy- reward + behavior Successive Approximations- reinforce every step EFFECTIVE IN MORE SEVERE CASES. SCHIZOPHRENIA CHILDHOOD AUTISM USED INSTITUTIONAL SETTING: MENTAL HOSPITALS,

Evaluation of Behavior Therapy More effective overall Short term therapy of Phobias, post-traumatic stress disorder compulsions, depression social problems self-control issues

Section 5 Biological Therapy Objective Describe the three major biological treatments for psychological disorders

Biological therapy Effects the Brain Relies on methods such as medication electric shock and surgery Medical in nature= administered or prescribed by a psychiatrists or other physicians Paired up with other therapies

Drug Therapy Mostly used biological treatment Four major types of medication used Anti-anxiety drugs Anti-depression drugs Lithium Anti-psychotic drugs

Anti-anxiety drugs Minor tranquilizers out patient treatment to help client with anxiety panic attacks Distress Tension Depresses the nervous system Long term use=less effectiveness Major side effects fatigue dependence on drugs

Antidepressant drugs Treats major depression Increase the amount of one or both neurotransmitters norepinephrine and serotonin Must build up a certain level to work Major side effects Escalated heart rate Excessive weight gain

Lithium Treats Bipolar disorder Flattens out the mania and depression Don’t understand how it works Side effects Shakiness Memory impairment Excessive thirst

Antipsychotic drugs Major tranquilizers Reducing agitation and delusions Treats Schizophrenia Blocks level of dopamine Side effects Balance Coordination Tremors twitches

Electroconvulsive therapy ECT Not recommended much Electric current passes through the brain Used when drug therapy is not working Side effect Memory loss

Psychosurgery-Brain surgery Prefrontal lobotomy Cutting nerve pathways in the brain between the prefrontal lobes and the thalamus Reduce agitation and violence Side effects Distractibility Reduced learning ability Overeating Apathy Social withdrawal Seizures Reduces creativity death