Psychotherapy ­ treatment of psychological disorders through talking and other psychological methods

  • Types of therapy o Psychodynamic Psychotherapy
    • Psychoanalysis­ seeks to help clients gain insight by recognizing and understanding unconscious thoughts and emotions
    • Classical Psychoanalysis has 5 main techniques

Free association­ reporting whatever comes to mind without censoring

Dream analysis­ ego cannot defend well against urges of unconsciousness during sleep

  • Manifest content­ storyline of dream
  • Latent content­ “true” meaning or symbolic meaning of dream

Analyzing resistance­ patient avoids therapist’s attempts to bring threatening unconscious material into conscious awareness

Analyzing transference­ patient may displace unconscious feelings about significant person in his/her life onto therapist

Interpretation­ explanation of other 4 techniques

Psychodynamic Therapy­ modern form of psychoanalysis

 Less emphasis on unconscious/past­ focus on problems today/now

 More focused on behavior we have control over

 More directive­ therapist steps in

 Less time consuming­ patient phases out quicker

  • Humanistic Psychotherapy­ people with problems are blocked in some way from reaching their full potential
    • Goal­ maximize personal growth by adjusting client’s emotional reactions
    • Carl Rogers and Clien t­Centered Therapy

Client­ Centered Therapy­ allows the client to decide what to

talk about, without direction, judgment, or interpretation from therapist

  • 4 main aspects:
  • Empathy­ appreciate/understand how world looks from client’s point of view
  • Unconditional Positive Regard­ do not agree, but respect/accept individual as they are
  • Genuineness/Authenticity­ aware of/able to share one’s true inner thoughts/feelings in a safe environment

o Active listening­ listening with total attention

                o Reflection­ paraphrasing client’s statements and noting accompanying feelings

  • Gestalt Therapy­ active treatment designed to help clients get in touch with genuine feelings and disown foreign ones.

 Assumptions:

 People create their own versions of reality

 People’s natural psychological growth continues only as long as they perceive, remain aware of, and act on their true feelings

  • Behavior Therapy­ treatments that use classical conditioning principles to change behavior

 Techniques:

Systematic desensitization­ treatment for phobias in which clients visualize a graduated series of anxiety ­provoking stimuli while remaining relaxed

  • 3 step process
  • Client taught to maintain a deep state of relaxation o Ranked listing of ~ 10 anxiety ­arousing images

(Roach EX) o Relaxed client starts at bottom of ranked list and gradually works way up to top

  • Flooding­ opposite approach

Modeling­ demonstrating desirable behaviors as a way of teaching them to clients

Aversion Therapy­ uses classically conditioning to create a negative response to a particular stimuli (Antabuse EX)

  • Cognitive ­Behavior Therapy­ relies on learning principles to help change the way clients think, 2 main types:

Rational­ Emotive Behavior therapy­ designed to identify and change self­ defeating thoughts that lead to anxiety and other symptoms of disorder

  • Inner dialog/voice in head­ if all negative can lead to anxiety
  • Seeks to replace irrational/unrealistic beliefs with more reasonable beliefs ­Messy House EX

Beck’s Cognitive Therapy­ therapist helps clients to notice and change negative thoughts associated with anxiety and depression

  • Anxiety and depression are caused by:
  • Errors in logic­ everyone watching you o False beliefs­ “failure” is personal o Thoughts that minimize personal achievement
  • Group, Family, and Couples Therapy
  • Group therapy­ treatment of several unrelated clients under the guidance of a therapist at the same time

 Formed around particular problem or population

 Advantages over Individual therapy

  • Therapists can see how clients interact­ social skills, view of others
  • Clients realize others have the same problems­ they are not abnormal
  • Group members can boost self­ confidence and self acceptance of all the clients
  • Clients learn from one another­ share coping mechanisms
  • Group atmosphere may make people willing to share their feelings and show sensitivity to others­ model behavior
  • Clients can try out new skills in a supportive environment­ safe environment to try new behavior
  • Family therapy­ treatment of two or more individuals from the same family

 Goal­ create more harmonious family atmosphere, help individual problems, break up power alliances throughout families to create equal partners

  • Couples Therapy­ focuses on improving communication between partners

 Rules for Arguing Successfully

  • Always begin by saying something positive
  • Use specific behaviors rather than generalizations­ less likely to get defensive
  • Make connections between specific behaviors and your feelings about them
  • Admit your own role in the development of the problem
  • Be brief­ do not lecture or nag
  • Stay in the present or the future­ do not bring up the past
  • Talk about things you can observe­ don’t assume
  • Paraphrase what the other person says­ use reflection to check out your own perceptions

 Biological Treatments

  • Electroconvulsive Therapy­ brief electrical shock administered to the brain, usually to reduce depression that does not respond to drug treatments o Sounds bad but better than losing client to suicide o Improvement from Electric shock therapy
    • Use of anesthetics­ decrease muscle contraction
    • Shock lasts about ½ second
    • Delivered to one side of brain at a time
  • Psychosurgery­ surgical procedures that destroy tissue in small regions of the brain in an effort to treat psychological disorders o Very rare today
    • Destroys parts of frontal lobe that disrupts emotional reactions in disturbed people
      • Prefrontal­ 2 holes placed in forehead
      • Transorbital­ stylus in space between eye and socket
    • Psychoactive Drugs o Neuroleptics/Anti­Psychotics­ relieve symptoms of severe disorders such as schizophrenia and sometimes bipolar disorder by creating a calming effect

 Noncompliance­ do not take medications

 Tardive dyskinesia, slow thinking

  • Antidepressants­ most prescribed
    • Tricyclics­ act on multiple neurochemical pathways that effect NT

 Usually a net gain of NT but can increase reuptake, enable fewer NT to be broken down

  • Monoamine Oxidase Inhibitors/MAOI’s­ blocks enzyme that breaks down serotonin and other NT
  • Selective serotonin reuptake inhibitors/SSRIs­ affect only serotonin levels
  • Atypical antidepressants­ “catch all” category o Anti­anxiety drugs­ decrease activity of sympathetic NS High risk of addiction