Therapy

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Therapy
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Psychodynamic Therapy
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Psychodynamic Therapy

• Used for unfocused anxiety/depression
• Psychoanalysis- pioneered by Freud? intensive
  technique for exploring the unconscious
• - Freud believed that anxiety disorders are
  inabilities to resolve inner conflicts (they
  become repressed) in the unconscious between the
  id and the superego

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Psychodynamic Therapy

• GOAL of Psychoanalysis
• - make unconscious conflict ? conscious
• - repressed material can then be dealt with
• - ego can be strengthened defense mechanisms
  do not need to be used

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Job of the Therapist

• Main job help a patient bring repressed thoughts
  into consciousness gain insight into the
  relationship between current symptoms the
  repressed conflict

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Job of the Therapist

• Therapy succeeds when patients are released from
  the repression established in early childhood
• - often through catharsis (AKA insight therapy)
  expressing strong felt, but usually repressed
  emotions a healing emotional release

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Job of the Therapist

• It is an attempt to reconstruct long-standing
  repressed memories work through painful
  feelings to an effective resolution
• This takes years, requires introspective patients
  who are highly motivated, verbally fluent have
  to continue the therapy

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Techniques Used

• Free Association- say whatever comes to mind
  regardless of painful or irrelevant thoughts
• - therapist will note patterns that lie beneath
  the words (the surface)
• 2. Catharsis- see notes

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Free Association

• Start with a recent experience, memory, or dream
  and write every image or idea that enters your
  awareness
• Dont self-edit OR refrain from logic

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Techniques Used

• 3. Dream Analysis- examines content of a persons
  dreams to discover motivations, life experiences,
  desires
• - 2 kinds of content
• a) manifest- people remember upon awakening
• b) latent- hidden, deeper content

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Techniques Used

• 4. Analysis of Transference- transferring of
  feelings about a person in the past to the
  therapist due to unfinished business
• - positive- feeling of love/admiration
• - negative- feeling of anger/hostility
• - therapist provides a stage for re- enacting
  unresolved conflicts

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Techniques Used

• 5. Analysis of Countertransference-
• - therapist begins to view client as someone in
  therapists life projects feeling toward the
  client
• - can provide useful material to look at with
  client, but must be careful
• - become mirrors for one another

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Techniques Used

• 6. Analysis of Resistance
• - individuals put up barriers to free
  association
• - resisting to work with the therapist
• - therapists job is to break down areas the
  client does not want to discuss

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Techniques Used

• Projective Techniques- help access unconscious,
  esp. in children
• - Rorschach, TAT, incomplete sentences, draw a
  picture

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Behavioral Therapy
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Behavioral Therapy

• Abnormal behaviors are acquired through a
  learning process that follows basic principles of
  conditioning learning
• Therapy includes applying principles of
  conditioning reinforcement to increase
  frequency of desired behaviors or decrease
  frequency of problem behaviors

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Behavioral Therapy

• Problems that generally use behavior
  modification/therapy
• - fears/phobias, compulsions, depression,
  addictions, aggression, delinquent behavior

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Behavioral Therapy

• When people cant cope effectively, their
  maladaptive reactions can be overcome by therapy
  based on learning or relearning

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Behavioral Therapy

• 3 Types of Behavioral Therapy
• Counter-Conditioning-
• - a new response is conditioned to replace or
  counter a maladaptive response
• ex. Child afraid of the dark ? have child listen
  to their favorite song while sitting in the dark

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Behavioral Therapy

• - Techniques Used
• a) systematic desensitization- client is taught
  to prevent the arousal of anxiety by confronting
  the feared stimulus using relaxation
  techniques used for social phobias (The Kings
  Speech)

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Behavioral Therapy

• b) implosion- opposite exposes a client to
  anxiety, provoking the stimuli (most frightening
  is the imagination) but in a safe setting person
  cannot run away tough love
• c) flooding- client is placed in or exposed to
  the phobic situation used for agoraphobia

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Behavioral Therapy

• all 3 have in common ? exposure through
  imagery, contact, or virtual reality all are
  exposed to object feared

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Behavioral Therapy

• d) aversion therapy- used for patients attracted
  to harmful stimuli (drug addictions, violent
  behavior) an attractive stimuli is paired with
  shock or drugs (noxious stimuli) to get the
  patient to pair the noxious stimuli with the
  harmful behavior

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Behavioral Therapy

• 2. Contingency Management- Skinner changing
  behavior by modifying consequences (operant
  cond.)
• - Techniques Used
• a) token economy- positive reinforcement
  desired behaviors are defined token payoffs are
  given when behavior is performed (gold stars)
  can later be exchanged for rewards, etc.

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Behavioral Therapy

• 3. Social Learning Theory- clients observe
  models desirable behaviors being reinforced b/c
  people learn via observation
• - used to overcome phobias to build social
  skills
• - based on Banduras research

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Behavioral Therapy

• - Techniques Used
• a) Participant Modeling- therapist demonstrates
  desired behavior client is helped to imitate
  behavior with support encouragement
• b) Behavioral Rehearsal- visual how one should
  behave in a situation ? helps strengthen social
  skills

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Behavioral Therapy

• Most common problem lack of assertiveness
• ? often in children (have deficits in social
  skills that may lead to problems later)
• ? pre-schools, elem. schools look to build
  skills in withdrawn, isolated children

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Cognitive Therapy
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Cognitive Therapy

• Attempts to change the feelings behaviors by
  changing the way a client thinks about or
  perceives significant life events

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Cognitive Therapy

• Abnormal behavior patterns start with problems in
  what people think how they think (cognitive
  process)
• Therapy will focus on changing how people think

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Cognitive Therapy
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Cognitive Therapy

• 2 Types of Cognitive Therapy
• 1. Cognitive Behavior Modification-
• Combines thoughts w/ focus on reinforcement
  contingencies in modifying performance
• Unacceptable behavior patterns are
  changed/modified by cognitive restructuring

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Cognitive Therapy

• Change the persons negative self statement into
  constructive coping statements
• Ex. I am boring, no one will invite me to another
  party.
• Change this thought to ? next time Ill tell a
  joke, be proactive, or more responsive to others
  stories

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Cognitive Therapy

• Step 1 figure out together the kind of thinking
  that is leading to dysfunctional behavior
• Step 2 develop new self-statements that minimize
  negative thoughts that elicit anxiety or lower
  self-esteem

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Cognitive Therapy

• Step 3 set goals
• Step 4 develop strategies for meeting them ?
  develop self-efficacy
• Step 5 evaluate feedback

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Cognitive Therapy

• - Changing False Beliefs- cognitive therapy for
  depression (Aaron Beck)
• - depression arises when people are unaware of
  their negative automatic thoughts faulty
  thinking

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Cognitive Therapy

• - often emotional stress is caused by
  cognitive misunderstanding and failure to
  distinguish between reality ones expectations
  
• ? MUST challenge patients basic assumptions

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Cognitive Therapy

• 2. Rational Emotive Therapy (RET)- based on the
  transformation/changing of irrational beliefs
  that cause severe emotional reactions (ex.
  Anxiety)
• - Ellis

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Cognitive Therapy

• - teach the client to recognize the shoulds,
  oughts, haves, musts that control their
  actions prevent them from choosing the life
  they want

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Cognitive Therapy

• - through rational confrontation, client can
  dispute examine alternative reasons for their
  thoughts/actions
• - this is followed up by replacing dogmatic
  thinking w/ rational, situationally appropriate
  ideas

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Cognitive Therapy

• - it aims to increase individuals self-worth by
  getting rid of faulty beliefs that block personal
  growth

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Group Therapy
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Group Therapy

• Can sometimes be more effective
• Less Expensive- small of mental health
  personnel can help more people
• Power of Groups- less threatening, provides
  opportunities to practice interpersonal skills
  and observe others

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Group Therapy

• Allows for corrective emotional experiences to
  take place in a family-like atmosphere
• Helps people realize they are not alone
• Provides social support outside of therapy

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Group Therapy

• Different Types
• Marital Family- each member is treated as a
  member of a system of relationships
• - therapist helps to understand what the
  problems are in the family

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Group Therapy

• - seeks to help communication, understand
  communication styles how to express themselves
• - therapist acts as interpreter, clarifier,
  mediator, referee when helping to resolve
  dysfunctional elements

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Group Therapy

• 2. Community Support Groups
• - 10 million Americans participate in self-help
  groups
• - pioneered by womens groups AA
• - 4 Main Groups

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Group Therapy

• a) Addictive behavior
• b) Physical/mental disorder
• c) Life transition or other crises
• d) Traumas experienced by friends or relatives
  w/ serious problems

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Group Therapy

• Many groups popping up on the Internet
• ? providing social support, hope control for
  problems people dispense info about disorders
  treatments

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Humanistic Bio-Medical Theory
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Humanistic Therapy

• Started in 1960s, goes along with theory that a
  human is a whole person who is constantly
  changing and growing
• - environment and heredity place some
  restrictions, but people are always free to
  choose what they will become

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Humanistic Therapy

• Therapists attempt to help clients define their
  own freedom, cultivate their individuality,
  discover ways to reach their fullest potential
  (self-actualization)

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Humanistic Therapy

• 1. Client-Centered Therapy (Carl Rogers)
• - major assumption people can self-actualize
  (realize their potential)
• - problems arise when there is conflict between
  positive self-image negative external
  criticisms ? anxiety

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Humanistic Therapy

• The counselor acts as a mirror
• Client is in the role of exploring thoughts,
  feelings, behaviors
• GOAL help people become more confident, fully
  functioning, able to counsel themselves

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Humanistic Therapy

• Techniques
• 1. Active listening (no advice, solutions,
  criticisms)
• - listen, reflect, rephrase
• 2. Respectful, unconditional positive regard,
  empathetic

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Biomedical Therapy

• Treat mental disorders as problems in the brain
• 3 Approaches
• 1. Psychosurgery- considered method of last
  resort not practiced anymore most famous is
  lobotomy
• - severed connections between prefrontal cortex
  rest of brain

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Biomedical Therapy

• 2. Electroconvulsive Therapy (ECT)- use of shock
  to treat psychiatric disorders such as
  schizophrenia, mania, depression
• - generally used to treat depression that has
  not worked with drugs
• - apply weak electrical current after patient
  has had a muscle relaxant

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Biomedical Therapy

• A last resort as well- been proved effective for
  severe depression, acute psychotic states mania
• Side effects memory loss, confusions (sometimes
  a little, sometimes permanent)

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Biomedical Therapy

• 3. Drug Therapy 3 types-
• A. Anti-Psychotic- dopamine blockers, mood
  stabilizers (Thorazine, Haldol, Clozapine)
• - try to reduce hallucinations, delusions,
  paranoia
• - too much dopamine hallucinations
• - too little dopamine flat emotional response

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Biomedical Therapy

• B. Anti-Depressants (SSRIs MAOs)
• - SSRIs- used for depression, anxiety (panic,
  OCD, eating disorder), some personality
  disorders
• - prozac, celexa, lexapro, paxil, zoloft

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Biomedical Therapy

• - MAOs- not used as much, can cause toxic
  reaction
• - enzyme breaks down norepinephrine
  serotonin

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Biomedical Therapy

• C. Anti-Anxiety- benzodiazepine (Valium, Xanax,
  Ativan, Klonopin)
• - need to be careful ? can form a dependence
  has a calming effect and can cause sedation
  affecting the CNS

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Biomedical Therapy

• 4. Lithium- takes time to work helps with manic
  highs lows of bipolar disorder
• - anticonvulsant- used for immediate treatment
  of manic episodes