1. THERAPY PSYCHOLOGY Ms. Currey Ms. LaBaw

2. Things you’ll know… 1.What are the 4 major approaches to psychological therapy? Briefly describe each. 2.What are the three major drug groups, and what disorders are each primarily used for? 3.Explain ECT and what disorder it is used for. 4.What is one psychosurgery that is now rarely used? 5.What is better, psychotherapy, drug therapy, or both? Why?

3. PSYCHOLOGICAL THERAPY 4 MAJOR APPROACHES: 4 MAJOR APPROACHES: 1. Psychoanalytic 1. Psychoanalytic 2. Humanistic 2. Humanistic 3. Behavioral 3. Behavioral 4. Cognitive 4. Cognitive *Eclectic Approach uses techniques from different combinations of the four approaches. *Eclectic Approach uses techniques from different combinations of the four approaches.

4. Psychoanalytic Approach Dig up the past to clarify the present Dig up the past to clarify the present Inspired by Freud Inspired by Freud Free association- say whatever comes to mind when thinking about a childhood event. Free association- say whatever comes to mind when thinking about a childhood event. Hesitation Hesitation Leave something out Leave something out Analyst’s job is to offer interpretation and insight Analyst’s job is to offer interpretation and insight Usually used dream analysis Usually used dream analysis

5. Problems Debate whether or not we repress important memories Debate whether or not we repress important memories Very expensive, so only the wealthy can afford treatment Very expensive, so only the wealthy can afford treatment Refuting gets you nowhere with the analyst. Refuting gets you nowhere with the analyst.

6. Psychoanalytic Approach cont. Psychodynamic Psychodynamic Try to foster insight to original problem from childhood, but focus on ‘the now’ Try to foster insight to original problem from childhood, but focus on ‘the now’ Fewer meeting times Fewer meeting times Interpersonal Interpersonal Life now and what’s going on now Life now and what’s going on now Proved effective against depression Proved effective against depression

7. Humanistic -Aim is to increase self-awareness and self-acceptance -Foster growth instead of relieving an illness (clients not patients) -Focus on the present & future -Emphasize conscious instead of unconscious -Thought that potential for self- fulfillment already exists

8. Humanistic cont. Client-Centered Therapy Client-Centered Therapy Developed by Carl Rogers Developed by Carl Rogers Uses non-directive methods Uses non-directive methods Active listening: Echo, Restate, Clarify Active listening: Echo, Restate, Clarify Supportive and empathetic environment Supportive and empathetic environment

9. Behavioral Approach To replace fearful thoughts and related behaviors with constructive thoughts and actions To replace fearful thoughts and related behaviors with constructive thoughts and actions Classical Conditioning Classical Conditioning 2 Types 2 Types Systematic Desensitization Systematic Desensitization Aversive Conditioning Aversive Conditioning Operant Conditioning Operant Conditioning

10. Classical Conditioning Counterconditioning- associate new responses to situations Counterconditioning- associate new responses to situations 1.) Systematic Desensitization Associate pleasant/relaxed state with gradually increasing stimuli that causes anxiety Associate pleasant/relaxed state with gradually increasing stimuli that causes anxiety Uses progressive relaxation and modeling Uses progressive relaxation and modeling **Technique commonly used for phobias.

11. Classical Conditioning cont. 2.) Aversive Conditioning Associates an unpleasant state with an unwanted behavior Associates an unpleasant state with an unwanted behavior Positive reaction now becomes a negative one Positive reaction now becomes a negative one Often combined with another form of treatment Often combined with another form of treatment=

12. Operant Conditioning Withhold rewards or punish for unwanted behaviors Withhold rewards or punish for unwanted behaviors Reward desired behaviors Reward desired behaviors Reinforce the small steps Reinforce the small steps Good for autism Good for autism 2 Problems: 2 Problems: If reward isn’t there??? If reward isn’t there??? Ethical??? Ethical???

13. Cognitive Approach Our thinking affects how we feel Our thinking affects how we feel Best used for depression Best used for depression Negative thoughts fuel these feelings Negative thoughts fuel these feelings Teach clients to think constructively rather than destructively Teach clients to think constructively rather than destructively Cognitive-Behavioral Therapy (CBT) Cognitive-Behavioral Therapy (CBT) Change self-defeating thoughts and inappropriate behaviors Change self-defeating thoughts and inappropriate behaviors Good for OCD Good for OCD

14. BIOMEDICAL THERAPIES Before 1950’s, not much was available for treating severe disorders Before 1950’s, not much was available for treating severe disorders Usually hospitalized Usually hospitalized Mechanical devices were used Mechanical devices were used Drug Therapy Drug Therapy Helped patients “breakthrough” to a more stable hold on reality Helped patients “breakthrough” to a more stable hold on reality Deinstitutionalization Deinstitutionalization

15. Drug Therapy 3 Major Types 3 Major Types 1. ) Antipsychotics Used mainly for Schizophrenia Used mainly for Schizophrenia Reduced level of delusions and hallucinations Reduced level of delusions and hallucinations Help focus attention on significant aspects of environment Help focus attention on significant aspects of environment Block Dopamine Block Dopamine Thorazine and Clozaril Thorazine and Clozaril SE= Dry mouth, blurred vision, constipation, tardive dyskinesia, damage to white blood cells SE= Dry mouth, blurred vision, constipation, tardive dyskinesia, damage to white blood cells **Not “feel-good” drugs**

16. Drug Therapy cont. 2.) Antianxiety Drugs Treat anxiety and panic disorder Treat anxiety and panic disorder Works by boosting GABA Works by boosting GABA Sedative and euphoric effect Sedative and euphoric effect Temporary relief—don’t solve the problem Temporary relief—don’t solve the problem Used best in combo with psychotherapy Used best in combo with psychotherapy Valium, Librium, Xanax Valium, Librium, Xanax Shouldn’t be taken with other CNS depressants Shouldn’t be taken with other CNS depressants

17. Drug Therapy cont. 3.) Antidepressants Treats major depression Treats major depression Classified by how they work (neurotransmitters) Classified by how they work (neurotransmitters) Most common are SSRIs (Selective Serotonin Reuptake Inhibitors) Most common are SSRIs (Selective Serotonin Reuptake Inhibitors) Boost serotonin in the brain Boost serotonin in the brain Taken by approx. 38 million people around the world Taken by approx. 38 million people around the world Must be taken for about 1 month before effects are felt (therapeutic lag) Must be taken for about 1 month before effects are felt (therapeutic lag) Bipolar Disorder responds well to lithium compounds – lack of understanding how it works, but it does. Bipolar Disorder responds well to lithium compounds – lack of understanding how it works, but it does.

18. Electroconvulsive Therapy (ECT) Began in Europe in early 1900’s. Began in Europe in early 1900’s. Insulin levels led to convulsions; decreased symptoms Insulin levels led to convulsions; decreased symptoms Late 1930’s started using electricity Late 1930’s started using electricity Effective in treating depression, but scary to watch Effective in treating depression, but scary to watch Modern day, muscle relaxants and sedatives are given Modern day, muscle relaxants and sedatives are given Used when drug therapy doesn’t work (major depression) Used when drug therapy doesn’t work (major depression) Sometimes used on suicidal patients Sometimes used on suicidal patients SE= memory loss SE= memory loss

19. Electroconvulsive Therapy (ECT) cont. No explanation as to the reasons it works No explanation as to the reasons it works Controversial treatment Controversial treatment New Techniques: New Techniques: Repetitive Transcranial Magnetic Stimulation (rTMS) Repetitive Transcranial Magnetic Stimulation (rTMS) Implants Implants Less traumatic Less traumatic

20. Psychosurgery Lobotomy Lobotomy Now very rare Now very rare Used to calm uncontrollably emotional or violent patients Used to calm uncontrollably emotional or violent patients Cuts nerves that connects the frontal lobe to deeper emotional centers Cuts nerves that connects the frontal lobe to deeper emotional centers

21. SOOOOO…..What’s the best? Combination of drug therapy and psychotherapy. Combination of drug therapy and psychotherapy.

22. Exit Slip 1.What are the 4 major approaches to psychological therapy? Briefly describe each. 2.What are the three major drug groups, and what disorders are each primarily used for? 3.Explain ECT and what disorder it is used for. 4.What is one psychosurgery that is now rarely used? 5.What is better, psychotherapy, drug therapy, or both? Why?