Therapy Mental health therapies can be
classified into two main categoriesPsychotherapy: trained therapist uses
psychological techniques to assist someone seeking to overcome difficulties or achieve personal growth
Biomedical: prescribed medication or medical procedure that acts directly on the patient’s nervous system○ Many patients receive drug therapy in addition
to psychotherapy
Therapy
PsychoanalysisSigmund Freud’s therapeutic technique.
Freud believed the patient’s free associations, resistance, dreams, and transference- and the therapist’s interpretations of them- released previously repressed feelings, allowing the patient to gain self-insight
TherapyAims of Psychoanalysis:
sought to bring repressed feelings into patients’ conscious awareness○ Presumes that
healthier, less anxious living becomes possible when people release the energy they had previously devoted to id-ego-superego conflicts
TherapyMethods: psychoanalysis
emphasizes the power of childhood experiences, and aims to unearth the past○ Freud first tried hypnosis but
discarded it because it is unreliableFreud turned to free association:
the client/patient says aloud whatever comes to his/her head- While this sounds easy it is
actually very difficult not to omit information, change the subject quickly when uncomfortable, or when feeling shame
Therapy○ Resistance: the blocking from consciousness
of anxiety-laden materialThe analyst will note your resistances and then
interpret their meaning, providing insight
○ Another way to reach into the unconscious is dream analysis and interpreting the latent content of dreams
○ Transference: the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for
a parent)○ This takes time and several years and can get quite expensive
Therapy
Psychodynamic therapy: therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight
TherapyDifferences between psychodynamics and
psychoanalysis○ Face to face○ Lasts only a few weeks or months
Malan: I get the feeling that you’re the sort of person who needs to keep active. If you don’t keep active, then something goes wrong. Is that true?
Patient: Yes. Malan: I get a second feeling about you and that is that you must,
underneath all this, have an awful lot of very strong and upsetting feelings. Somehow they’re there but you aren’t really quite in touch with them. Isn’t this right? I feel you’ve been like that as long as you can remember.
Patient: For quite a few years, whenever I really sat down and thought about it I got depressed, so I tried not to think about it.
Malan: You see, you’ve established a pattern, haven’t you? You’re even like that here with me, because in spite of the fact that you’re in some trouble and you feel that the bottom is falling out of your world, the way you’re telling me this is just as if there wasn’t anything wrong.
TherapyInterpersonal psychotherapy: variation of
psychodynamic therapy○ Has been effective in treating depression○ Goal is symptom relief in the here and now,
not an overall personality change
Therapy Humanistic Therapy
Humanistic perspective emphasizes people’s inherent potential for self-fulfillment○ Therapy aims to boost self-fulfillment by helping
people grow in self-awareness and self-acceptanceTherapy attempted to reduce the inner conflicts that are
impeding natural developmentInsight therapies: a variety of therapies which
aim to improve psychological functioning by increasing the client’s awareness of underlying motives and defenses○ Both humanistic and psychoanalysis are
considered insight therapies
TherapyHumanistic therapy differs from
psychoanalysis:○ Focus on present and future more than the
past○ Focus on conscious rather than unconscious○ Focus on taking immediate responsibility for
one’s feelings and actions○ Promoting growth instead of curing illness
Call those in therapy clients and not patients
TherapyCarl Rogers develop the technique called client-
centered therapy○ This is a humanistic therapy, developed by Carl
Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients’ growth (also call person centered therapy)
○ Client-centered therapy hinges on the therapist providing the client with unconditional positive regardUnconditional positive regard is blanket support and
acceptance of a person regardless of what is said or behavior- Rogers believed this was essential
○ Client-centered therapy is non-directive
Therapy○ Active listening is essential to the humanistic
view pointEmpathic listening in which the listener echoes,
restates, and clarifies. A feature of Rogers’ client-centered therapy
Steps:- Paraphrase- Invite clarification- Reflect feelings
○ Rogers encouraged genuineness, acceptance, and empathy
Therapy
Group TherapyGroup therapy can be just as effective for
the individual and save time and moneyAlso offers the unique benefit of social
context○ This allows people both to discover that others
have problems similar to their own and to receive feedback as they try out new ways of behaving
TherapyFamily therapy
○ Therapy that treats the family as a system. Views an individual’s unwanted behavior as influenced by, or direct at, other family members
Other types of groups○ Closed group: only members of the group can
attend or those with the same problem○ Open group: anyone can come to the meeting
TherapySupport groups and self-help groupsOther examples of groups:
○ AA: Alcoholics Anonymous○ GA: Gamblers Anonymous○ Eating disorder groups
Therapy
Behavior TherapyTherapy that applies learning principles to
the elimination of unwanted behaviors○ Doubt the healing power of self-awareness○ Behaviorist assume that problem behaviors
are the problems and the application of learning principles can eliminate them
TherapyClassical Conditioning Techniques
○ Since we learn many behaviors and emotions through classical conditioning, then we should be able to treat disorders with this technique as wellGoal is to unlearn associations and relearn
constructive behaviors and associationsCounter conditioning: a behavior therapy procedure
that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; includes exposure therapies and aversive conditioning
TherapyExposure therapy: behavioral techniques,
such as systematic desensitization, that treat anxieties by exposing people to the things they fear and avoid○ Systematic desensitization: a type of exposure
therapy that associates a pleasant relaxed state with gradually increasing anxiety triggering stimuli. Commonly used to treat phobias
Therapy○ Virtual reality exposure therapy: an anxiety
treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders, or public speaking
○ In systematic desensitization, the goal is substituting a positive response for a negative response to a stimulus
TherapyAversive conditioning, however, is a type of
counter conditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol)○ Usually use with a combination of other
treatments
TherapyOperant Conditioning
○ Therapist apply the concepts of operant conditioning to the treatment of various behavioral issues in order to help the patient overcome their issuesOne concept that is used is called Token Economy
- An operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats
Therapy
Cognitive TherapyTherapy that teaches people new, more
adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions○ Self-blaming and overgeneralization
explanations for bad events are often integral part of the vicious cycle of depressionGoal is to change the way of thinking
Therapy
Lost your job
Internal Beliefs: I’m worthless. It’s hopeless
Depression
Lost Job
Internal beliefs: My boss is a jerk. I deserve something better.
No depression
TherapyCognitive Behavioral Therapy
○ A popular integrated therapy that combines cognitive therapy with behavior therapyChange thoughts & actions
- For a person with OCD, instead of washing hands again, tell yourself that your it’s your brain’s abnormal activity and move on to an enjoyable activity to avoid the urge.
Therapy
Is Psychotherapy effective?Client’s perceptions: people often enter
therapy in crisisClients may need to believe the therapy was
worth the effortClients generally speak kindly of their
therapist
Therapy
Commonalities Among PsychotherapiesHope for demoralized peopleA new perspectiveAn empathic, trusting, caring relationship
TherapyDifferent therapies
○ Energy therapies○ Recovered-memory therapy○ Rebirthing therapies○ Facilitated communication○ Crisis debriefing○ Eye Movement Desensitization and
Reprocessing○ Light Exposure therapy
Therapy Homework: Over the weekend you are to
research any three therapy methods on the list on the previous slide. One of the three methods must be EMDR, but the other two are you choice. Here is what you need to includeThe process of therapy (what the client must
due during therapy)Discuss the effectiveness of the therapyCriticisms of the therapy methodYou own thoughts on each of the three.
○ Should total three pages (one page per method)
Therapy
Biomedical TherapiesPrescribed medications or medical
procedures that act directly on the patient’s nervous system○ Often used with serious disorders
TherapyDrug therapies
○ Psychopharmacology: the study of the effects of drugs on mind and behavior
○ Most widely used biomedical treatment○ Allowed people to leave hospital confinements
and live a life for their ownHowever, in many cases this means homelessness,
not liberation
Therapy○ Antipsychotic Drugs
Example: Chlorpromzine (sold as Thorazine)Drugs used to treat schizophrenia and other forms of
severe thought disorder- Reduce positive symptoms of schizophrenia
Similar to the molecules of the neurotransmitter of dopamine to block activity at those sites
Long term-use of medication can also produce tardive dyskinesia: involuntary movements of the facials muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors
Therapy○ Schizophrenia pateitns exhibiting negative
symptoms do not respond well to antipsychoticsHowever, newer atypical antipsychotics, such as
clozapine (known as Clozaril), target both dopamine and serotonin receptors
○ Newer antipsychotic medications have fewer side effects
○ Antipsychotic need to be combined with life-skills and family support
TherapyAntianxiety Drugs
○ Drugs used to control anxiety and aggressionXanax and AtivanDepress central nervous systemNew antianxiety drug D-cycloserine (an antibiotic)
can help facilitate the extinction of fears- Experiments show that the drug enhances the
benefit of exposure therapy and helps relieve the symptoms of PTSD and OCD
TherapyAntidepressant Drugs
○ Drugs used to treat depression; also increasingly prescribed for anxiety. Different types work by altering the availability of various neurotransmittersFluoxetine, known as Prozac, partially blocks the
absorption and removal of serotonin- Prozac and Paxil are known as SSRI (selective-
serotonin-reuptake-inhibitors)- Side effects such as: dry mouth, weight gain,
hypertension, or dizzy spells
Therapy○ For all medication therapy it is important that it
is linked to other treatment methods such as counseling or psychotherapy
○ For depressed patients other things help such as: exercise, eating better, and family therapy
TherapyMood-Stabilizing Medications
○ The salt lithium can be effective for those with bipolar disorder
○ Depakote found effective to control manic episodes
TherapyElectroconvulsive Therapy (ECT)
○ Although controversial, ECT is often an effective treatment for depression that does not respond to drug therapy
○ Therapist delivers 30 to 60 seconds of electrical current to the patient’s brainSome memory loss is associated with it, but no
discernible brain damage
○ No one is really sure how ECT works
TherapyPsychosurgery
○ Surgery that removes or destroys brain tissue in an effort to change behavior
○ Lobotomy: a now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain