Therapy Psychology 1107

Introduction Remember Trephining? Bloodletting? Beatings? Changed with Pinel In general there are two approaches Psychological biomedical

Eclectic Approach Today most people take bits and pieces form each There are, literally, hundreds of types of ‘talking therapies’

A wee bit of history Psychoanalysts got it all going Disorders come from childhood experience and unresolved conflicts Repression etc. Bring repressed feelings to conscious awareness Get rid of energy directed at id- superego conflict

Lie back and tell me whatever comes to mind…. Free association Pauses Slips Show resistance Analyst interprets for you, provides insight transferrence

The key The key to the whole idea is repressed memories Hmmmmm Impossible to disprove analyst’s interpretations And at 100 bucks an hour, three times a week….

The Humanistic approach When we talked about personality we talked about how humanistic psychologists are interested in ‘self- actualization’ Humanistic therapy focuses on this Care about the present and the future Care about the conscious

La la la la la la live for todaaay Take responsibility Growth and fulfillment, not curing some disease Clients, not patients Help them reach their potential

Mr. Rogers Neighbourhood Carl Rogers Person’s interpretations not therapist’s No judgement Non directive Genuineness Openness Acceptance empathy

It all sounds so nice… Therapist must show unconditional positive regard Echoing and restating Basically a mirror the client can use

Gestalt Therapy Fritz Perls Kind of humanistic and unconscious Make client self aware by breaking down defenses Still emphasizes the here and now, not the past Still about responsibility

Behaviour therapies Instead of urges, actualization and all of that, what about the BEHAVIOUR? Use of learning theory Basically classical and operant conditioning approaches applied

Classical conditioning Systematic desensitization Use of counter conditioning Wolpe’s ideas, based on Cover-Jones Anxiety hierarchy Progressive relaxation Pairing the two Flooding Aversive counter conditioning

Operant approaches Modify behaviour with reward Token economies What about when they leave? Ethics?

Cognitive Therapy Thinking affects feeling Feeling affects thinking Well stop blaming yourself, it is not your fault Basically learn new thinking patterns

Rational Emotive Ellis Confront illogical thinking Blunt Sort of the anti Rogers Beck’s approach for depression is a bit different Not as blunt

It is not all about you Teach clients how non depressed people think Can ‘vaccinate’ at risk people Cognitive and behavioural approaches often combined into Cognitive Behaviour Therapy

Family/Group Therapy Hell of a lot cheaper… Support groups Family therapists treat the whole family There are many talking therapies, many approaches, but one question lingers…..

DOES IT WORK? Ask the clients, they like it Ask the therapists…. Oh how about SCIENCE? Eyesenk estimated that 67 percent recover on their own! Not many studies then, many today

Meta analysis More improvement than chance for those in therapy Very general What type is the best? Phobias best Schizophrenia, personality disorders, not so much….

Seems the therapy type is not as important as the therapist Hope Perspective Empathy ‘pseudotherapists’ can be as good for small problems Cultural differences between therapists and clients

Biomedical Drugs! Sounds good, but we still have to worry about the outcomes Schizophrenia, very effective Dopamine hypothesis, pretty much confirmed

Antidepressants Increase NE and 5Ht SSRI and TCA Some block breakdown MAOI Side effects Li

ECT Now for sever depression that does not respond to drugs Rare Does work though Why? dunno

Surgery Even rarer I’d rather have a bottle in front of me…. Seizures May come back now that we are learning more about the braim

Prevention Poverty Stress At risk people Genetic markers