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Chapter 15 Therapy
eclectic approach - โ๏ธ an approach to psychotherapy that, depending on the client's problems, uses techniques from various forms of therapy psychotherapy - โ๏ธ treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth psychologies major theories - โ๏ธ psychoanalytic, humanistic, behavioral and cognitive psychoanalysis - โ๏ธ +Sigmund Freud's therapeutic technique. Freud believed the patients free associations, resistances, dreams and transference's - and the therapists interpretations of them- released previously repressed feelings, allowing the patient to gain self-insight +first of the psychological therapies, terminology has crept into our modern vocab +few clinicians today practice therapy as Freud did, however some techniques and assumptions survive especially in the psycho-dynamic therapies What are the aims of psychoanalysis? - โ๏ธ Aims: believed that many psychological problems are fueled by childhoods residue of repressed conflicts and impulses, sought to bring theses repressed feelings into patients conscious awareness. Gaining insight into the origins of the disorder patients then work through the buried feelings and take responsibility for their own growth. Psychoanalytic theory presumes that healthier, less anxious living becomes possible when people release the energy they had to previously devoted to id-ego-super ego conflicts. What are the methods of psychoanalysis? - โ๏ธ Method: psychoanalysis is historical reconstruction. Emphasizes the formative power of childhood experiences, and thus aims to unearth the past in hope of unmasking the present. resistance - โ๏ธ in psychoanalysis, the blocking from consciousness of anxiety-laden material ( when your mind goes blank and find yourself unable to remember important materials - there block in the flow of your free association indicate resistance ) interpretation - โ๏ธ in psychoanalysis, the analysis's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight. transference - โ๏ธ in psychoanalysis, the patient's transfer to the analyst of emotions linked with other relationships. (such as love or hatred for a parent )
criticism with psychoanalysts - โ๏ธ that their interpretations can not be proven or dis proven. However, they insists that interpretations often are a great help to patients psycho-dynamic theory - โ๏ธ influenced by Freud, therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks in enhance self-insight The Psychological Therapies - โ๏ธ psychoanalysis, humanistic therapies, behavior therapies, cognitive therapies, and group & family therapies Evaluating Psychotherapies - โ๏ธ -is psychotherapy effective? -the relative effectiveness of different therapies -evaluating alternative therapies -commonalities among psychotherapies -culture an values in psychotherapy The Biomedical Therapies - โ๏ธ drug therapies, brain stimulation, psycho-surgery, therapeutic life-style change (T or F): "Psychoanalysis" is another word for "psychotherapy" - โ๏ธ False (T or F): Daily exposure to bright light successfully counteracts winter depression - โ๏ธ True (T or F): Most people who suffer psychological problems become worse without therapy - โ๏ธ False The use of drugs has liberated hundreds of thousands of people with severe psychological disorders from hospital confinement - โ๏ธ True Electroconvulsive therapy no longer used in the treatment of psychological disorders - โ๏ธ False Therapy - โ๏ธ refers to how mental disorders are treated with the help of the knowledge base of psychology issues in psychotherapy - โ๏ธ culture, gender, values, effective factors and types, and the evaluation of psychotherapy effectiveness old ways of getting rid of "the evil spirits" -
โ๏ธ the therapists suggests unconscious meanings and underlying wishes to help the client gain insight and release tension Interpretation in psychoanalysis: resistance, dreams and transference - โ๏ธ Resistance: the therapist notices times when the patient seems blocked in speaking about certain subjects Dreams: there may be themes or "latent content" behind the plot of a patient's dream Transference: the patient may have reactions toward the therapist that are actually based on feelings toward someone from the past criticism of psychoanalysis - โ๏ธ is hard to refute because it cannot be proven nor dis proven and takes a long time and is very expensive psycho dynamic therapy - โ๏ธ less intense version of psychoanalysis: -fewer sessions per week and fewer years -less theory about sex, id, and superego focus on the improved self-awareness and insight into unconscious thoughts and feelings which may be rooted in past relationships. Interpersonal Therapy - โ๏ธ Brief (12-16 sessions) variation of psycho dynamic therapy. The goal is less focused on insight and more on relational behavior change and symptom relief. The focus is less on the past and more on current feelings and relationships including interaction with the therapist Three Humanistic Therapies - โ๏ธ humanistic psychology, humanistic therapy, and "client- centered therapy". Humanistic Psychology - โ๏ธ emphasizes the human potential for growth, self-actualization, and personal fulfillment (Abraham Maslow and Carl Rogers) Humanistic therapy - โ๏ธ attempts to support personal growth by helping people gain self-awareness and self acceptance. Client-centered therapy - โ๏ธ is Carl Roger's name for his style of humanistic therapy Humanistic Psychotherapy goal - โ๏ธ promote growth Psychoanalytic Psychotherapy goal - โ๏ธ cure mental illness How to improve Humanistic Psychotherapy - โ๏ธ take responsibility for feelings and actions
How to improve Psychoanalytic Psychotherapy - โ๏ธ bring unconscious conflicts into conscious awareness Role of therapist in humanistic psychotherapy - โ๏ธ provide an environment in which growth can occur Role of therapist in psychoanalytic psychotherapy - โ๏ธ provide interpretations ( e.g of dreams, resistance and transference) Content of therapy for humanistic psychotherapy - โ๏ธ conscious feelings, actual self, and ideal self Content of therapy for psychoanalytic psychotherapy - โ๏ธ unconscious conflicts Time focus for Humanistic psychotherapy - โ๏ธ the present and future Time focus for psychoanalytic psychotherapy - โ๏ธ the past client centered therapists emphasize the importance of : - โ๏ธ enabling clients to feel unconditionally accepted Mackenzie's therapist believes that active listening is an extremely important component of therapy. He is probably a : - โ๏ธ Client-centered therapist Listen more actively in your own relationships, three ways: - โ๏ธ Summarize, paraphrase , invite clarification & reflect feelings humanistic therapies differ from psychoanalytic therapies in all of the following ways except: - โ๏ธ psychoanalytic therapists are more likely to encourage the client to take immediate responsibility for feelings Behavior therapy - โ๏ธ uses the principles of learning, especially classical and operant conditioning, to help reduce unwanted responses. These might include behaviors such as addiction or emotions such as panic How is sympton relief achieved by behavior therapy? - โ๏ธ is achieved by changing the rewards and punishments which are influencing problematic behaviors (operant conditioning) and by building new associations to disrupt unwanted panic and other automatic responses (classical conditioning) How to treat maladaptive behaviors (i.e phobias or sexual disorders) - โ๏ธ behavior therapists do not delve deeply below the surface looking for inner causes
application - โ๏ธ used with nonverbal children with autism. It rewards behaviors such as sitting with someone or making eye contact, and sometimes punishes self-harming behaviors Token economy - โ๏ธ uses coins and stars or other indirect rewards as "tokens" that can be collected and traded later for real rewards Critiques of Behavior Therapy - does it work? - โ๏ธ when it works, do the changes stick without insights and other changed to hold the new behavior in place? It does work often, but extinguished behaviors and reaction do spontaneously reappear transition is needed from artificial rewards to awareness of natural, environmental consequences. ` Critiques of behavior therapy - is it ethical? - โ๏ธ couldn't people choices and reactions be manipulated without their consent? How to minimize ethical problems with behavior therapy - โ๏ธ -acquire consent, at least of guardians -develop goals for treatment that are more human than the alternative. For example, shaping autistic behavior is seemingly better than institutionalization Cognitive therapies - โ๏ธ being depressed and/or anxious involves negative thoughts and interpretations. In the cognitive perspective, the cause of depression are not negative events, but by our thoughts about those events (irrational beliefs and cognitive distortions) Aaron Beck's treatment for Depression - โ๏ธ A.B helped people see how their depression worsened by errors in thinking such as interpreting current events as signs of the worst possible outcome Donald Meichenbaum - โ๏ธ trained people to restructure their thinking in stressful situations practicing healthier thinking before facing a stressor, disappointment or frustration Your therapist asks you to try to remember your dreams. He also encourages you to review incidents in early childhood. Your therapist is most likely practicing - โ๏ธ fruedian therapy Cognitive Behavioral Therapy (CBT) - โ๏ธ works to change both cognition's (the way they act) that are part of a mental health disorder Seeks to make people aware of irrational negative thinking and related behaviors, replace it with new ways of thinking, and to practice the new thinking and behaviors in everyday settings. Using CBT, people with OCD are led to -
โ๏ธ resist the urge to act on their compulsions as well as to learn to manage obsessional thinking Family Therapy - โ๏ธ having a session with the whole family, at home or in the office, allows the therapist to work on the family system. views an individual's unwanted behaviors as influenced by, or directed at, other family members Group Therapy - โ๏ธ assembles six to nine people with related needs into a group, facilitated by a therapist, to work on therapeutic goals together. Benefits include: -less cost per person -more interaction, feedback, and support -clients realize others share their problems and they are not alone Self Help Groups - โ๏ธ -self-help groups are led by group members instead of a therapist -they can be much larger than group therapy with less interaction -the focus is more on support rather than on working on goals during session Is psychotherapy effective - โ๏ธ there are different measure of the value and effectiveness of psychotherapy: -whether the client is satisfied -whether the client senses improvement -whether the therapist sees improvement -how friends and family feel about the patients improvement -whether there have been observable, measure change in initial symptoms Client's perceptions - โ๏ธ clients remain skeptical because even if clients improve, is the improvement really caused by therapy? could be: -people often enter therapy in crisis, but crisis may subside over the natural course of time (regression to the mean) -clients motivation to appear better to justify that therapy was worth the effort or to please the therapist -clients generally speak kindly of their therapists Clients Perceptions (two facts) - โ๏ธ clients hear little about their failure who may have experienced temporary relief and seek out new therapists for their problems clinicians are likely to testify to the efficacy of their therapy regardless of the treatment also because of regression toward the mean Regression toward the mean - โ๏ธ -the tendency for unusual events of emotions to regress (return) to their average state -extraordinary happenings (feeling low) tend to be followed by more ordinary ones ( a return to our more usual state)
โ๏ธ improves mood and control over depressing and anxious thoughts increasing levels of serotonin (sometimes nor-epinephrine) at synapses by inhibiting re uptake; possible neurogenesis side effects: dry mouth, reduced sexual desire and/or response mood stabilizers - โ๏ธ reduce the "highs" of mania as well as reduce the depressive "lows" under investigation on how they work side effects include: various; blood levels must be monitored inhibiting re uptake - โ๏ธ many medications increase synaptic neurotransmitter levels; they stop the sending neuron from taking back its chemical messages electroconvulsive therapy (ECT) - โ๏ธ ECT induces a mild seizure that disrupts severe depression for some people. this might allow neural re-wiring and might boost neurogenesis
