1. 1 PSYCHOLOGY (8th Edition, in Modules) David Myers PowerPoint Slides Jessica Mulder Worth Publishers, © 2007

2. 2 The Psychological Therapies Module 52

3. 3 Therapy The Psychological Therapies  Psychoanalysis  Humanistic Therapies  Behavior Therapies  Cognitive Therapies  Group and Family Therapies

4. 4 History of Insane Treatment Maltreatment of the insane throughout the ages was based on irrational views. Many patients were subjected to strange, debilitating and downright dangerous treatments. The Granger Collection

5. 5 History of Insane Treatment Pinel in France and Dix in America founded humane movements to care for the mentally sick. http://wwwihm.nlm.nih.gov Philippe Pinel (1745-1826) Dorthea Dix (1745-1826) Culver Pictures

6. 6 Therapies Psychotherapy involves an emotionally charged, confiding interaction between a trained therapist and a mental patient. Biomedical therapy uses drugs or other procedures that act on the patient’s nervous system curing him of psychological disorders. An eclectic approach uses various forms of healing techniques depending on the client’s unique problems.

7. 7 Psychological Therapies We will look at four major forms of psychotherapy based on different theories on human nature: 1.Psychoanalytical theory 2. Humanistic theory 3.Behavioral theory 4.Cognitive theory

8. 8 Psychoanalysis The first formal psychotherapy to emerge was psychoanalysis developed by Sigmund Freud. Sigmund Freud's famous couch Edmund Engleman

9. 9 Psychoanalysis: Aims Since psychological problems originate from repressed impulses and conflicts in childhood, the aim of psychoanalysis is to bring repressed feelings into conscious awareness where the patient can deal with them. When energy devoted to id-ego-superego conflict is released, the patient’s anxiety lessens.

10. 10 Psychoanalysis: Methods Dissatisfied with hypnosis, Freud developed the method of free association to unravel the unconscious mind and its conflicts. The patient lies on a couch and speaks whatever comes to his mind. http://www.english.upenn.edu

11. 11 Psychoanalysis: Methods During free association, the patient edits his thoughts to resist his feelings and to express his emotions. Such resistance becomes important in the analysis of conflict-driven anxiety. Eventually the patient opens up and reveals his innermost private thoughts to the therapist, developing positive or negative feelings (transference) towards him.

12. 12 Psychoanalysis: Criticisms 1.Psychoanalysis is hard to refute because it cannot be proven or disproven. 2.Psychoanalysis takes a long time and is very expensive.

13. 13 Humanistic Therapies Humanistic therapists aims to boost self- fulfillment by helping people grow in self- awareness and self-acceptance.

14. 14 Person-Centered Therapy Developed by Carl Rogers, person-centered therapy is a form of humanistic therapy. The therapist listens to the needs of the patient in an accepting and non-judgmental way, addressing his problems in a productive way and building his or her self-esteem.

15. 15 Humanistic Therapy The therapist engages in active listening and echoes, restates, and clarifies patient’s thinking, acknowledging expressed feelings. Michael Rougier/ Life Magazine © Time Warner, Inc.

16. 16 Behavior Therapy Therapy that applies learning principles to the elimination of unwanted behaviors. To treat phobias or sexual disorders behavior therapists do not delve deeply below the surface looking for inner causes.

17. 17 Classical Conditioning Techniques Counterconditioning: a procedure that conditions new responses to stimuli that trigger unwanted behaviors. It is based on classical conditioning and includes exposure therapy and aversive conditioning.

18. 18 Exposure Therapy Exposes patients to things they fear and avoid. Through repeated exposures anxiety lessens because they habituate to the things feared. The Far Side © 1986 FARWORKS. Reprinted with Permission. All Rights Reserved.

19. 19 Exposure Therapy Exposure therapy involves exposing people to (fear of driving) objects in real or virtual environments. N. Rown/ The Image Works Both Photos: Bob Mahoney/ The Image Works

20. 20 Systematic Desensitization A type of exposure therapy that associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli commonly used to treat phobias.

21. 21 Aversive Conditioning A type of counterconditioning that associates an unpleasant state with an unwanted behavior. With this technique, temporary conditioned aversion to alcohol has been reported.

22. 22 Operant Conditioning Operant conditioning procedures enable therapists to use behavior modification in which desired behavior is rewarded and undesired behaviors are not or are punished. A number of withdrawn, uncommunicative 3-year-old autistic children have been successfully trained by giving and withdrawing reinforcements for desired and undesired behaviors.

23. 23 Token Economy In institutional settings therapists may create a token economy, where a patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats.

24. 24 Cognitive Therapy Teaches people adaptive ways of thinking and acting based on the assumption that thoughts intervene between events and our emotional reactions.

25. 25 Cognitive Therapy for Depression Aaron Beck (1979) suggests that depressed patients believe that they can never be happy (thinking) and thus associate minor failings (e.g. failing a test [event]) in life as major causes for their depression. Beck believes that cognitions such as “can never be happy,” need to change in order for depressed patients to recover. This change is brought into patients by gentle questioning.

26. 26 Cognitive Therapy for Depression Rabin et al., (1986) trained depressed patients to daily record positive events and relate how they contributed to these events. Compared to other depressed patients, trained patients showed lower depression scores.

27. 27 The A-B-C of Cognitive Therapy A (activating event) B (belief) C (consequence - emotional and behavioral) D (disputing intervention) E (effect - an effective philosophy is developed) F (new feeling)

28. 28 Stress Inoculation Training Meichenbaum (1977, 1985) trained people to restructure their thinking in stressful situations. “Relax, the exam may be hard, but it will be hard for everyone else too. I studied harder than most people. Besides, I don’t need a perfect score to get a good grade.”

29. 29 Cognitive-Behavior Therapy Cognitive therapists often combine the reversal of self-defeating thinking with efforts to modify behavior. Cognitive-behavior therapy aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy).

30. 30 Group Therapy Group therapy normally consists of 6-9 people and a 90-minute session which can help more people and cost less. Clients benefit from knowing others have similar problems. © Mary Kate Denny/ PhotoEdit, Inc.

31. 31 Family Therapy Family therapy treats the family as a system. Therapy guides family members toward positive relationships and improved communication.

32. 32 Psychoanalytic and Psychodynamic Theories of Psychotherapy Freud and many others

33. 33 Theory of Personality Development Psychodynamic theory relates personality to the interplay of conflicting forces within the individual (id, ego, superego). The individual may not be aware of some of the internal forces that are at work influencing thought and behavior. A strong ego and defenses are part of normal development. Pathology occurs when things go too far.

34. 34 Theory of Psychopathology Sometimes these unconscious conflicts are not kept in check. Freud believed that our inner conflicts reached a problematic level because of our early childhood experiences (e.g., the relationships we have with our parents) The thoughts and feelings that we repress influence our behavior although we cannot talk about them and may not even be aware of them.

35. 35 Theory of Psychotherapy Psychoanalysis brings these cancerous thoughts to consciousness to achieve catharsis and help the person overcome irrational and dysfunctional impulses. Analysts interpret content from these three techniques to understanding the patient’s unconscious conflicts: – Free Association : Saying whatever comes to mind without censorship, regardless of how embarrassing it is, will release unconscious material – Dream Analysis : Dreams express forbidden desires and unconscious feelings – Analysis of slips of the tongue : Saying something you did not mean to say at one level but may reveal your true unconscious thought Because he believed that the person needed to correct the maladaptive early childhood experience, Freud stated that it was important at some point during therapy for the patient to transfer strong emotions onto the therapist ( transference )

36. 36 Because he believed that these repressed thoughts, memories, and emotions were at the root of the person’s problems, treatment focused on bringing them into the consciousness makes perfect sense. Thus, he used his theory of personality development and his theory of abnormal development to provide the rationale for his theory and practice of psychotherapy. Figure 13.5 (Coon, 2002) Freud believed that psychoanalysis could bring parts of the unconscious into the conscious mind, where the client could deal with them.

37. 37 Refinements to Freudian Theories Many theorists who studied Freud have emphasized some parts of his theories more than others or have made significant changes to the theories. These changes, of course, necessitated a change in the emphasis of treatment. For example, because Alfred Adler postulated that it is not the childhood experiences that are crucial, rather our present interpretation of these events. Therefore, therapy should increase awareness with lifestyle analysis and interpreting basic mistakes such as overgeneralizations, minimization, distortions of life’s demands, and unrealistic goals.

38. 38 Humanistic Therapies Carl Rogers

39. 39 Rogerian or Person-Centered Theory Carl Rogers developed a theory of psychotherapy based on humanism. “Life, at its best, is a flowing, changing process in which nothing is fixed.” - Carl Rogers

40. 40 Theory of Personality The goal of development is self- actualization. –Self-actualization is an innate striving; everyone has it in themselves to want to grow personally and be content with who you are. Normal development is characterized by acceptance and enhancement of self.

41. 41 Theory of Psychopathology For Rogers, you start to be troubled psychologically when you deny rather than accept all parts of yourself. ( denial of self ) He says this can happen when you internalize conditions of worth that likely have their roots in your childhood. –You may have been a bright kid that always earned A’s in school. Your family came to expect that of you and gave you many compliments for it. You may then begin to feel that you MUST get good grades or you are somehow less of a person. You believe your worth is dependent upon your grades which then affects your behavior (i.e., perfectionism) and emotions (i.e., earning a B is devastating to you no matter the class average).

42. 42 Theory of Psychotherapy Practitioners of person-centered therapy believe people are capable of self-directed growth if involved in a therapeutic relationship. Through this relationship, the person finds freedom to relinquish their perceived conditions of worth and accept themselves To do this, the therapist must create a permissive, “growth promoting climate” involving: – Congruence - genuineness or realness – Unconditional positive regard - acceptance and caring, but not approval of all behavior – Accurate empathic understanding - an ability to deeply grasp the client’s subjective world