1. Psychotherapy Ch. 15 Music: “Therapy” India Arie “Mr. Therapy Man” Justin Nozuka

2. Today’s Agenda 1. Seeking Professional Help –When, where and how? –Which therapy works best? 2. Different Therapeutic Approaches: –i) Psychodynamic Therapy Clip illustration –ii) Behavioural Therapies Example of behavioural technique Movie: Virtual Reality Therapy (5 min.) –iii) Cognitive Therapy Clip illustration Distinction with CBT –iv) Client-Centred Therapy –v) Biomedical Treatments Movie: Deep Brain Stimulation (10 min.) 3. Basic Counseling Skills

3. 1.Seeking Professional Help: When, Where and How?  When:  1. You’re feeling significant levels of discomfort  2. Your functioning is impaired  3. Someone else tells you that you need help  4. Have have persistent suicidal thoughts  Where do you find help?  Ontario Psychological Association: (416) 961-0069  Your physician can refer you  Local Hospitals: North York General 416-756-6316 Humber River Regional 416-747-3833  Distress Centers: (416) 598-1211 or (416) 486-1456  Counseling and Development Center: 736-5297  York University Psychology Clinic: 650-8488  Free online mental health advice and information for young people:  www.yoomagazine.net  How to pay?  Distinction between psychologists, psychiatrists, social workers and other “therapists”

4. 1. Most people don’t get the help they need!

5. 1. Which therapy works best? Depends on the problem Depends on the technique Depends on the therapist But overall, studies show that different therapies have comparable results Common therapeutic ingredients: Alliance with the therapist * Emotional support and empathic understanding allowing emotional expression Rationale for one’s problems and provision of hope Gaining new insights and learning more adaptive ways to relate to others and the self

6. 2. Different Therapeutic Approaches All approaches differ on: –Assumptions regarding the origins of the problem –Therapist’s stance –Method of treatment –Goals of treatment 2. i) Psychodynamic Therapy: –Problem: resides in unconscious conflicts, repressed memories –Therapist: “blank-screen” –Method: free-association, dream analysis, transference analysis –Goal: make the unconscious conscious –Case illustration: http://www.youtube.com/watch?v=_KjmLN uyuuA&feature=related http://www.youtube.com/watch?v=_KjmLN uyuuA&feature=related

7. 2. Different Therapeutic Approaches 2. ii) Behaviour Therapy –Problem: resides in faulty learning –Therapist: examines current conditions that elicit the problem –Method: apply learning principles to get rid of symptoms training/ exposure/ counter-conditioning –Goal: alleviate symptoms/ modify behavior

8. 2. ii) Example of behavioural techniques a) Systematic Desensitization: –Effective with phobias –Use “counterconditioning” –Steps: Set-up a hierarchy of anxiety-triggering situations Learn relaxation response Imagine least anxiety-provoking situation while maintaining a relaxed state Imagine more difficult situations until most difficult is imagined while maintaining a relaxed state Practice with real-life situations b) “Virtual Reality Therapy” (movie 5 min.) Virtual reality moves into the clinician’s office Makes use of behavioural principle of “exposure” to treat phobias

9. 2. iii) Cognitive Therapy –Problem: is a function of the way you think –Therapist: more directive and challenging –Method: Challenge your automatic thoughts and underlying beliefs Use of homework exercises –Goal: Realistic thinking/ Better perspective –p. 672

10. 2. iii) Cognitive Therapy (cont’d) –Examples of cognitive techniques Clip: The case of Tim http://www.youtube.com/watch?v=LIzm4jiyvXI&feature=related –Cognitive-Behaviour Therapy (CBT): Combines elements of both cognitive and behavioural therapies Recommended for depression and anxiety http://www.youtube.com/watch?v=B5Z-dvL-qo8 –Mindfulness-based cognitive therapy: Learn to watch the contents of your consciousness and to label thoughts and feelings Prevents people from spiraling down and ruminating (getting “caught” in their dysfunctional thinking)

11. 2. iv) Client-Centered Therapy –Problem: incongruence with one’s true self –Therapist: Non-directive, genuine, empathic and unconditional –Method: therapeutic relationship allows fuller experiencing and greater acceptance of the self –Goal: self-actualization / greater congruence –Clip with Carl Rogers http://www.youtube.com/watch?v=HarEcd4bt- s&feature=relatedhttp://www.youtube.com/watch?v=HarEcd4bt- s&feature=related

12. 2. v) Biomedical Approach –Problem: Chemical imbalance/ Structural abnormalities in the brain –Therapist: Medical doctor (family or psychiatrist) will monitor symptoms and adjust medication/ monitor treatment –Method: psychopharmacological drugs Depression: Antidepressants, ECT Bipolar Disorders: Mood stabilizers Anxiety: Tranquilizers Schizophrenia: Anti-psychotics –Goal: reduce symptoms –Movie: “Deep Brain Stimulation” (10 min.) A new invasive brain surgery to alter patterns of thinking and emotions Impressive results with treatment resistant cases

13. 3. Basic Counseling Skills Or how to better help your family and friends: –Active listening: really listen Try to avoid giving advice or telling the person what to do –Avoid judgment Better not expressed –Clarify the problem –Empathize with the feelings –Maintain confidentiality!

14. 4. See you next week!