Treatment and therapy (Chap 17) First Lecture Outline : History of psychotherapy Psychotherapy approaches Foundations of counselling Video 101: Psychodynnamics

Last Monday’s midterm Results will be posted next Monday Many did well!! Keep it up!! Multiple choice (out of 40) were done well –Average around 27 to 30/40 Score is out of 35 for both quizzes

History Mental illness = demonic possession –Exorcism, flogging, torture, bleeding, enemas –Braveheart: “purification of spirit” Middle ages: Asylum –St. Mary of Bethlehem: Bedlem, uproar, confusion –“over-crowded prison for social outcasts” 1800s: Mesmer, Charcot, Breuer, Freud –origins of hypnosis and cathartic methods

Other interventions from the 1900’s Psychosurgery 1930s to 1950s: Prefrontal lobotomy –left patients vegetative, replaced by very specific microsurgery for lesions

Electroconvulsive therapy (ECT) in 1940s: 150 volts run through the head for 1-2 seconds –leads to memory loss, broken bones, still used as “last resort” for depression –Today the patient is usually placed under general anesthesia, paralysed with drugs, monitored and assisted with breathing. Antipsychotic medications in the 1950s

What is a clinical interview? Psychotherapy involves talking to people Structured and unstructured interviews Model of psychotherapy directs attention of interview –Psychodynamic: Focus on early experiences –Behavioral: Focus on symptoms, ABC’s –Cognitive: Questions about specific thought patterns –Humanistic: Unconditional positive regard

Interviewing in an assessment Focus depends on what you are assessing, diagnosis Background includes medical, school/work, family, hobbies, description of symptoms, and “other sources of information” Tests then augment interview –Intelligence, neuropsychological, memory tests –Personality and behavioral measures –Psychophysiological and computer tasks

Who can conduct “therapy” Anyone can offer themselves to the public as a “therapist” or “counsellor” These are not protected titles or services: watch out! Only a psychologist can say they offer “Psychological intervention” or “Psychological assessment” Title and services of a “psychologist” governed by provincial statute

Psychodynamic therapy approaches Patients improve once they become conscious of ego-threatening material Free association: Client says whatever comes to mind; Dream analyysis Resistance is an impediment to progress Transference of feelings from significant others to therapist; Countertransference Website listing psychotherapy approaches for personality disorder

Evolution of psychoanalysis Originally it could take years at 3-5 sessions per week Unstructured and relaxed approach necessitated comfortable seating, surroundings Change to become more task-oriented and time limited “Contracting” with clients for a specific number of sessions to reach a goal