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METHODS OF THERAPY Chapter 19
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Section 1 What is therapy?
Objective: Define psychotherapy, and list the advantages of each method of psychotherapy.
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What is therapy? Therapy is a general term for the variety of approaches that mental health professionals use to treat psychological problems and disorders.
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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
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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
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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
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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
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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
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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
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Selecting the right professional
Cost of treatment? Field of study? What degrees? Licensed? Plan for treatment?
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Individual –v- Group therapy
Advantages of individual therapy More personal attention Feel uncomfortable talking in front of a group Will talk openly alone
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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
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Type of group therapy Couples Family therapy Self-help groups
Encounter groups
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SECTION 2 The Psychoanalytic approach
Objectives: Describe the major techniques of psychoanalysis.
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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
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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
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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)
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Section 3 The Humanistic Approach
Objective: Identify the primary goals and methods of humanistic therapy.
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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
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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
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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
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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
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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
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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
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Section 4 Cognitive therapy and Behavior therapy
Objective Describe how cognitive and behavior therapists try to help people.
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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
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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
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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
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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)
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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
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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.
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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
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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
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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
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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,
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Evaluation of Behavior Therapy
More effective overall Short term therapy of Phobias, post-traumatic stress disorder compulsions, depression social problems self-control issues
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Section 5 Biological Therapy
Objective Describe the three major biological treatments for psychological disorders
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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
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Drug Therapy Mostly used biological treatment
Four major types of medication used Anti-anxiety drugs Anti-depression drugs Lithium Anti-psychotic drugs
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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
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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
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Lithium Treats Bipolar disorder Flattens out the mania and depression
Don’t understand how it works Side effects Shakiness Memory impairment Excessive thirst
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Antipsychotic drugs Major tranquilizers
Reducing agitation and delusions Treats Schizophrenia Blocks level of dopamine Side effects Balance Coordination Tremors twitches
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Electroconvulsive therapy ECT
Not recommended much Electric current passes through the brain Used when drug therapy is not working Side effect Memory loss
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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
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