1. Module 24
Therapies

2. HISTORICAL BACKGROUND
Definition of psychotherapy
Three basic characteristics
verbal interaction between therapist and client
development of a supportive relationship in which a client can bring up and discuss traumatic or bothersome experiences that may have led to current problems
analysis of the client’s experiences and/or suggested ways for the client to deal with or overcome his or her problems

3. HISTORICAL BACKGROUND (CONT’D)
Early treatments
1400 to 1700, people who today would be diagnosed as schizophrenics were considered insane and called lunatics
Late 1800s, Dr. Benjamin Rush (considered the father of American psychiatry), developed the “tranquilizing chair”
Believed that mental disorders were caused by too much blood to the brain

4. HISTORICAL BACKGROUND (CONT’D)

5. HISTORICAL BACKGROUND (CONT’D)
Reform movement
Moral therapy, popular in the early 1800s
patients could be helped to function better by providing humane treatment in a relaxed and decent environment; late 1800s, it was abandoned
1930s, Sigmund Freud developed psychoanalysis
early 1950s, wretched conditions and inhumane treatment of patients persisted
mid 1950s, two dramatic changes happened: discovery of antipsychotic drugs and development of community mental health centers

6. HISTORICAL BACKGROUND (CONT’D)
Phenothiazines and deinstitutionalization
Phenothiazines
discovered in the early 1950s, block or reduce the effects of the neurotransmitter dopamine and reduce schizophrenic symptoms, such as delusions and hallucinations
chlorpromazine (Thorazine)
Deinstitutionalization
refers to the release of mental patients from mental hospitals and their return to the community to develop more independent and fulfilling lives

7. HISTORICAL BACKGROUND (CONT’D)
Community mental health centers
Offer low-cost or free mental health care to members of the surrounding community, especially the underprivileged
Provide briefer forms of therapy that are needed in emergencies and focus on the early detection and prevention of psychological problems

8. QUESTIONS ABOUT PSYCHOTHERAPY
Are there different kinds of therapists?
Psychiatrists
go to medical school, receive M.D. degree, and then take a psychiatric residency; additional training in pharmacology, neurology, psychopathology, and psychotherapeutic techniques
Clinical psychologists
go to graduate school in clinical psychology and earn a doctorate degree (Ph.D., Psy.D., or Ed.D.)
Counseling psychologists
go to graduate school in psychology or education and earn a doctorate degree (Ph.D., Psy.D., or Ed.D)

9. QUESTIONS ABOUT PSYCHOTHERAPY (CONT’D)
Are there different approaches?
Insight therapy
therapist and client talk about the client’s symptoms and problems with the goal of reaching or identifying the cause of the problem
Cognitive-behavior therapy
involves the application of principles of learning
therapist focuses on the client’s problem, identifies specific thoughts and behaviors that need to be changed, and provides techniques based on learning principles to make desired changes

10. QUESTIONS ABOUT PSYCHOTHERAPY (CONT’D)
Are there different approaches?
Eclectic approach
involves combining and using techniques and ideas from many different therapeutic approaches
Medical therapy
involves the use of various psychoactive drugs to treat mental disorders by changing biological factors, such as the levels of neurotransmitters

11. INSIGHT THERAPIES Psychoanalysis
Focuses on the idea that each of us has an unconscious part that contains ideas, memories, desires, or thoughts that have been hidden or repressed because they’re psychologically dangerous or threatening to our self-concept
Unconscious conflicts
Chief reason for the development of psychological problems (paranoia) and physical symptoms (loss of feeling in a hand)

12. INSIGHT THERAPIES (CONT’D)
Psychoanalysis
Three techniques
free association, dream interpretation, and analysis of slips of the tongue
Transfer
patient reacts to the therapist as a substitute parent, lover, sibling, or friend and projects strong emotions onto the therapist

13. INSIGHT THERAPIES (CONT’D)

14. INSIGHT THERAPIES (CONT’D)
Techniques to reveal the unconscious
Neuroses
maladaptive thoughts and actions that arise from some unconscious thought or conflict and indicate feelings of anxiety
Free association
technique that encourages clients to talk about any thoughts or images that enter their heads
assumption is that this kind of free-flowing, uncensored talking will provide clues to unconscious material

15. INSIGHT THERAPIES (CONT’D)
Techniques to reveal the unconscious
Dream interpretation
psychoanalytic technique based on the assumption that dreams contain underlying, hidden meanings and symbols that provide clues to unconscious thoughts and desires

16. INSIGHT THERAPIES (CONT’D)
Problems during therapy
Transference
client expresses strong emotions toward the therapist as a substitute for someone important in the client’s life, such as mother or father
Resistance
client reluctant to work through or deal with feelings or to recognize unconscious conflicts and repressed thoughts
Short-term dynamic psychotherapy
emphasizes a limited time for treatment (20-30 sessions) and focuses on limited goals

17. INSIGHT THERAPIES (CONT’D)
Problems during therapy
Short-term dynamic psychotherapy
therapists take more active and directive role
identify and discuss client’s problems
resolve issues of transference
interpret client’s behaviors
offer opportunity for the client to foster changes in behavior and thinking
results in more active coping and important image of oneself

18. INSIGHT THERAPIES (CONT’D)
Client-centered therapy
Also called person-centered therapy; assumes that each person has an actualizing tendency to develop one’s full potential
Therapist’s traits
Empathy
ability to understand what the client says, feels
Positive regard
ability to communicate caring, respect, and regard
Genuineness
ability to be real and nondefensive in interactions

19. INSIGHT THERAPIES (CONT’D)

20. INSIGHT THERAPIES (CONT’D)
Cognitive therapy
Developed by Aaron Beck
Assumes that we have automatic negative thoughts that we typically say to ourselves without much notice
Repeating these automatic negative thoughts causes distortion in how we perceive and interpret our world and influences how we behave and feel

21. BEHAVIOR THERAPY Definition Also called behavior modification
uses the principles of classical and operant conditioning to change disruptive behaviors and improve human functioning
focuses on changing particular behaviors rather than the underlying mental events or possible unconscious factors
Systematic desensitization
technique of behavior therapy in which the client is gradually exposed to the feared object while simultaneously practicing relaxation

22. BEHAVIOR THERAPY (CONT’D)
Cognitive-behavior therapy
Combines the cognitive therapy technique of changing negative, unhealthy, or distorted thought patterns with behavior therapy
Technique of changing maladaptive or disruptive behaviors by learning and practicing new skills to improve functioning