Psychotherapies

1
Psychotherapies

• Treatment of mental illness by psychological
  rather than medical means.

2
Types of Psychotherapies

• Psychoanalytic
• Humanistic
• Behavioral
• Cognitive

3
Types of Therapists

• Psychiatrists
• Medical doctor PhD / prescribe medication
• Clinical psychologists
• PH.D.
• Counseling psychologist
• Graduate degree

4
Psychotherapy

• Points to Consider
• Patient Biomedical / psychoanalytical
• Client Other therapists
• Insight Therapy Psychoanalytic and Humanistic
• Stress importance of patient / client
  understanding their problems

5
Psychoanalytic Therapy

• Psychoanalysis Freud
• Psychodynamic Uncovering the unconscious

6
Psychoanalysis

• Review of Key Principles
• Unconscious conflict manifests in outward
  behavior, thoughts
• Find underlying (unconscious) problem
• Methods
• Hypnosis, free association, dream analysis
• Dream Analysis Manifest and Latent Content
• only true solution- symptom substitution
• other therapies mask it- thus conflict expresses
  itself in new form
• Subjective based on interpretation

7
Psychoanalysis

• Therapy Principles
• Resistance
• Patient objections, natural as uncovering
  disturbing conflicts (resistance as sign of
  nearing the conflict)
• Transference
• Patients develop strong feelings for therapist
  (love, parental feelings, or hatred / transferred
  from feelings toward others to therapist)

8
Psychoanalysis

• Points of interest
• Patient attends treatment 4-5 x a week
• Analysts looks for records repetitions of
  behavior (unconscious)
• Therapist says little (then interprets at the end
  of session)
• Dream Analysis (often uses free association to
  analyze parts of a dream)
• Weaknesses
• Not sanctioned by state or federal government
• Expensive / not covered by insurance
• Only 20 psychoanalytic schools in U.S.

9
Humanistic Therapies

• Review of Key Principles
• Maslow, Rogers
• Focus on self-concept (understanding self)
• Self-Actualization help support, recognize
  goals self-fulfillment
• Free will (as opposed to determinism)
• Mans nature as good

10
Carl Rogers (Humanistic)

• Client-centered therapy (aka person-centered
  (genuineness, acceptance, empathy)
• Unconditional Positive Regard
• Essential for healthy development
• Non-directive
• Dont tell clients what to do, but encourage them
  to choose course of action for themselves
• Therapist says little
• Active listening So what Im hearing you say
  is.

11
Gestalt (Humanistic)

• Fritz Perls
• Whole is greater than sum of its parts
• Get in touch with whole self
• Integrate thoughts, actions, feelings, talents,
  goals, body into harmonious whole
• Body as extension of self
• Healing a fragmented patient

12
Behavioral Therapy

• Review of Key Principles
• Pavlov, Watson, Skinner
• Classical / Operant
• All behavior is learned
• Behavioral Modification, (or changing maladaptive
  actions)

13
Behavioral Therapy

• Counterconditioning / Mary Cover Jones
• Classical conditioning
• Negative CR (Conditioned response) is replaced by
  positive CR
• Example Joey cries hysterically every time he
  goes to the dentist.
• Candy / toy upon entering dentists positive CR

14
Behavioral Therapy

• Counterconditioning
• Joseph Wolpe / Systematic Desensitization
• Replace anxiety with relaxation
• Step one relaxation techniques (breathing /
  meditation)
• Step two anxiety hierarchy rank ordered list of
  fear (least to most)
• Start with least- incremental move up the ladder-
  learning to relax at each step
• Classical / counterconditioning more x
  relaxation paired with fear, stronger relaxation
  response becomes
• Feared stimulus is imagined
• Implosive Therapy Imagine biggest fear first

15
Behavioral Therapy

• In vivo desensitization
• Confronting actual fear (not just imagining it)
• Flooding experiencing ones peak fear
• Idea is to realize irrationality of fear (huge
  anxiety factor)
• Aversive conditioning
• Pairing undesired behavior with unpleasant
  stimulus (Baby Albert)
• Instrumental Conditioning Token economies
• Modeling observation and imitation (Role play)

16
Cognitive Therapy(aka cognitive-behavior therapy)

• Most widely practiced therapy
• Core assumption Conscious thoughts are most
  influential to our psychological well-being
• Changing unhealthy thought patterns
• Combative nature challenge irrational thinking
  (negative attributional styles)

17
Cognitive Therapy

• Rational Emotive Behavior Therapy
• (REBT or RET)
• Albert Ellis
• Expose and confront irrational thoughts
• Example social phobia
• Question likelihood of occurrence, likely result

18
Cognitive Therapy

• Aaron Beck Cognitive Triad
• Negative thoughts about self, environment and
  future result in depression
• Develop positive thoughts for each factor

19
Somatic Therapies

• Soma body (bodily changes)
• Biomedical organic causes of disorders
• Neurotransmitters / hormones
• Structural brain abnormalities
• Genetic predispositions

20
Somatic Therapies

• Drug Therapy (psychopharmacology)
• Schizophrenia
• Antipsychotic drugs
• Thorazine to control positive symptoms such as
  hallucinations, voices, or paranoia
• Clozapine counteracts negative symptoms
  (Catatonic)
• Block receptor sites for dopamine
• Tardive dyskinesia trembling side-effect
• Mood Disorders
• Anti-Depressants
• Unipolar Prozac, Zoloft (Clinical depression)
• Bipolar Lithium (Manic phase stabilizes
  Norepinephrine production)

21
Somatic Therapy

• Drug Therapy
• Anxiety Disorders
• Librium, Valium
• Relaxers, slows Central Nervous System

22
An eclectic approach

• Therapists often use
• Multiple perspectives- based on condition / needs
  of patient
• IOW Different tools for different problems

23
Somatic Therapy

• Electroconvulsive therapy (ECT)
• Bilateral both hemispheres of brain
• Unilateral one hemisphere
• Theory changes brains blood flow pattern
• Side effects
• Memory loss, brief seizure, brief loss of
  consciousness
• Severe depression (last resort)

24
Somatic Therapy

• Psychosurgery
• Prefrontal lobotomy
• Cutting main neurons to the frontal lobe
• mental vegetable

25
Therapy Sessions

• Individual
• Group therapy sessions
• Advantages? Examples?
• Family therapy
• Marital therapy
• Play therapy (for children)
• Multisystemic therapy (coordinating specific
  environments)