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CHAPTER 22 Psychological TreatmentZhong-Lin Tan Ph.D. M.M.Hangzhou Mental Health CenterDepartment of psychiatry, School of Medicine Hangzhou Normal [email protected]

*Good afternoon, everyone! Lets begin from questions: what is psychological treatments? Which psychotherapy is the best effective? How psychotherapy help the patients? To answer these questions, we must learn this chapter. Could you understand me?

*AimGrasp classification of psychological treatments

Be familiar with different counseling approaches

*PrefacePsychological treatment is not given in isolation, often combined with medication. Appropriate ways of doing this are considered in the chapters concerned with the relevant disorders.This chapter contains advice on the general value of various treatments. Although outline descriptions of technique are given in several places, supervised experience is essential before any of these treatments can be used with patients.

*Psychological treatments considered in this chapterCounselingCrisis interventionSupportive psychotherapyCBTIndividual dynamic psychotherapiesHistorical treatmentsMeditation and traditional healing

Small-group psychotherapyLarge-group psychotherapyPsychotherapy with couplesFamily therapyPsychotherapy for children and older people

*How psychological treatments developedHypnosis and free association:1895,1923Classical dynamic psychotherapyThe neo-Freudians:1930sObject relation theoryAttachment theoryInterpersonal therapyBehaviour therapy:1920sCognitive therapy:Cognitive-behaviour therapy

*The use of psychological healing is as old as the practice of medicine. However, in the history of psychiatry ,psychological treatment can be said to start in the nineteenth century with developments in hypnosis.

*Classification of psychological treatmentsTechniqueEclecticPsychodynamicCognitive behavioralother: systems theoryNumber of patients Individual therapyCouple therapyFamily therapySmall and large group therapy

*End: there are more similarity than difference

*Common factors in psychological treatmentTherapeutic relationshipListeningRelease of emotionRestoration of moraleProviding informationProviding a rationaleAdvice and guidanceSuggestion

*Counselling and crisis interventionCounsellingCounselling incorporates the non-specific factors shared by all kinds of psychotherapy

Crisis interventionHelps patients cope with a crisis in their lives, and to learn effective ways of dealing with future difficulties.

*Counselling 1Approaches to counsellingProblem-solving counsellingInterpersonal counsellingLoss, interpersonal disputes, role transitions, and interpersonal deficits.Psychodynamic counselling

*Counselling 2Counselling for specific purposesDebriefingRelationship problemsLate effects of traumaRisksStudentsIn primary care

*Crisis intervention 1Problems leading to crisisLoss problemsRole changesRelationship problemsConflict problemsIndications:well-motivated people with stabel personalities who are facing major but transitory difficulties.

*Crisis intervention 2: methodsStage : reduce arousal; focus on current problems; encourage self-helpStage: assess problems; consider solutions; test solutionsStage: consider future coping methods

*Supportive psychotherapyTable22.3

*Interpersonal psychotherapyInterpersonal problems under four headings

Bereavement and other lossRole disputes Role transitionsInterpersonal deficits such as loneliness

*Cognitive behaviour therapy 1General features: 8 types

AssessmentTopics to be considedSource of information for the assessmentThe formulation

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*Cognitive behaviour therapy 2Behavioural techniques: 16 types ; relaxation training, exposure, desensitization, flooding, exposure in everyday practice, exposure with response prevention

Cognitive techniques

*CBT for different mental disordersAnxiety disordersPanic disorderPost-traumatic stress disorder (PTSD)Depressive disordersHypochondriasisSchizophrenisPersonality disorderDialectic behaviour therapy for borderline personality disorder

*Individual dynamic psychotherapiesBrief insight-oriented psychotherapyCognitive-analytical therapyPsychodynamic interpersonal therapyLong-term individual dynamic psychotherapy

*Treatment in groupsSmall group psychotherapyTypes of small group psychotherapyTherapeutic groupsLarge-group therapy

*Treatment in groups

*Psychotherapy with couples and familiesCouple therapyPsychodynamicSystems approachesCognitive behviouralBehavioural-systemsFamily therapyPsychodynamic family therapyStructural family therapySystemic family therapyEclectic family therapy

*Psychotherapy for childrenPlay therapy

*Psychotherapy for older people

*Other psychological treatmentsHypnosisAutogenic trainingAbreactionMeditation

*Ethical problems in psychological treatmentAutonomyConfidentialityExploitation

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*Good afternoon, everyone! Lets begin from questions: what is psychological treatments? Which psychotherapy is the best effective? How psychotherapy help the patients? To answer these questions, we must learn this chapter. Could you understand me?*The use of psychological healing is as old as the practice of medicine. However, in the history of psychiatry ,psychological treatment can be said to start in the nineteenth century with developments in hypnosis.*End: there are more similarity than difference