Psychotherapy Ch. 15 Music: “I Wanna be Sedated” Ramones “Just like a Pill” Pink

Today’s Agenda 1. Seeking Professional Help When, where and how? Which therapy works best? 2. Different Therapeutic Approaches: i) Psychodynamic Therapy ii) Behavioural Therapies Example of behavioural technique Movie: Virtual Reality Therapy (5 min.) iii) Cognitive Therapy Distinction with CBT iv) Client-Centered Therapy v) Biomedical Treatments Movie: Deep Brain Stimulation (10 min.) 3. Basic Counseling Skills

1.Seeking Professional Help: When, Where and How?  When:  1. You’re feeling significant levels of discomfort  2. Your functioning is impaired  3. Someone else tells you that you need help  4. Have persistent suicidal thoughts  Where do you find help?  Ontario Psychological Association: (416)  Your physician can refer you  Local Hospitals: North York General Humber River Regional  Distress Centers: (416) or (416)  Counseling and Development Center:  York University Psychology Clinic:  Free online mental health advice and information for young people:   Costs?

1. Most people don’t get the help they need!

1. Which Therapy Works Best? Depends on the problem Depends on the technique Depends on the therapist But overall, studies show that different therapies have comparable results Common therapeutic ingredients: Alliance with the therapist * Emotional support and empathic understanding: Allowing emotions to be expressed Rationale for one’s problems Gaining new insights and new coping tools

2. Different Therapeutic Approaches All approaches differ on: Assumptions regarding the origins of the problem Therapist’s stance Method of treatment Goals of treatment 2. i) Psychodynamic Therapy: Problem: resides in unconscious conflicts, repressed memories Therapist: “blank-screen” Method: free-association, dream analysis, transference analysis Goal: make the unconscious conscious Case illustration:

2. Different Therapeutic Approaches (cont’d) 2. ii) Behaviour Therapy Problem: resides in faulty learning Therapist: examines current conditions that elicit the problem Method: apply learning principles to get rid of symptoms training/ exposure/ counter-conditioning Goal: alleviate symptoms/ modify behavior

2. ii) Example of Behavioural Techniques a) Systematic Desensitization: Effective with phobias Use “counterconditioning” Steps: Set-up a hierarchy of anxiety-triggering situations Learn relaxation response Imagine least anxiety-provoking situation while maintaining a relaxed state Imagine more difficult situations until most difficult is imagined while maintaining a relaxed state Practice with real-life situations b) “Virtual Reality Therapy for PTSD” 5 min.

2. iii) Cognitive Therapy Problem: is a function of the way you think Therapist: more directive and challenging Method: Challenge your automatic thoughts and underlying beliefs Use of homework exercises Goal: Realistic thinking/ Better perspective p. 672

2. iii) Cognitive Therapy (cont’d) Examples of cognitive techniques Clip: Tim Cognitive-Behaviour Therapy (CBT): Combines elements of both cognitive and behavioural therapies Recommended for depression and anxiety Mindfulness-Based Cognitive Therapy: Learn to watch the contents of your consciousness and to bring attention back to the “here and now” Prevents people from spiraling down and ruminating (getting “caught” in their dysfunctional thinking)

2. iv) Client-Centered Therapy Problem: incongruence with one’s true self Therapist: Non-directive, genuine, empathic and unconditional Method: therapeutic relationship allows fuller experiencing and greater acceptance of the self Goal: self-actualization / greater congruence

2. v) Biomedical Approach Problem: Chemical imbalance/ Structural abnormalities in the brain Therapist: Medical doctor (family or psychiatrist) will monitor symptoms and adjust medication/ monitor treatment Method: psychopharmacological drugs Depression: Jogging, antidepressants, TMS, ECT, deep brain stimulation Bipolar Disorders: Mood stabilizers, neuroleptics Anxiety: Tranquilizers Schizophrenia: Anti-psychotics (neuroleptics) Goal: reduce symptoms Movie: “Deep Brain Stimulation” (10 min.)

3. Basic Counseling Skills Or how to better help your family and friends: Try to listen and avoid giving advice Don’t express judgment Try to clarify the problem Empathize with the feelings Maintain confidentiality!

4. See you next week!