The treatment psychotherapy was fathered by Freud  who took Josef Breurs research with Anna O that proved that talking to clients helped relieve some  physical ailments.


How many types of treatments are there?

Procedures can be classified into three main categories; insight therapies, behavioural therapies, and biomedical therapies.


What are insight therapies?

This is the traditional Freudian “talk therapy”. This can be done on individual to individual or in groups.


What are behavioural therapies?

This is based  off of learning. The psychotherapist tries to directly alter behaviour (phobias, maladaptive behaviour) through classical, operant, or observational conditioning.


What are biomedical therapies?

These therapies attempt to work on the biological level. Drug therapy and electro shock  therapy are often in this category. There  are limitations on what kind  of psychological, usually only  a psychiatrist or a person with a medical degree, that can conduct these sorts of therapies.


Who can provide treatment for mental disorders?

There  are several ways  to get professional mental health. However the two primary careers are for psychologists and psychiatrists. Clinical social  workers, counsellors and marriage counsellors can also do some  treatment.


What are psychologists?

There  are two kinds  that can provide therapy; clinical psychologists (treatment of full-fledged disorders) and counselling psychologists (everyday adjustment problems). Both require a doctoral degree, which is a highly competitive degree to get accepted into. It is followed by a one year internship. Their  techniques are usually behavioural. However they also do psychological testing, psychotherapy and conducting of research.


What are psychiatrists?

This profession specializes in diagnosis and treatment of psychological disorders. The disorders they treat are often some  of the more  severe, such as schizophrenia. This profession requires an M.D degree, four years  of course  work  in medical school, and a four year  apprenticeship in a residency at a hospital. There  is an increase in drug  therapy in this profession. They use more  psychoanalysis then psychologists.


What other kinds of people can  provide professional treatment?

Clinical social workers: Masters degree. Work  with patients to ease way  back into community. Psychiatric nurses: hospital inpatient treatment. Bachelors or masters in their field.

Counsellors: Schools, colleges, youth centers, etc. Masters degree. Usually have  a specific kind of counselling (marital, etc).


What are insight therapies?

These therapies use verbal interaction to solve  the patients problems. There are several ways to go about doing this.


What is psychoanalysis?

This was developed by Freud. He believed that getting to the root problems hidden in the unconscious would alleviate psychological problems. These problems were  often caused  by our pleasure principle and the constant aggression between the Id, the superego and the ego. In order to hide  some  of our unconscious emotions we would use defence mechanisms.


What is the therapeutic procedure used in psychoanalysis.

Probing the unconscious is the technique that psychoanalysis uses. It relies  on two things; free association and dream analysis. Often, transference is encouraged during sessions.

Free association is allowing the client to talk with no censorship. This often leads  to the client pouring out very  deep  secrets, feelings or ideas.

Dream analysis is the training of clients to remember their dreams and recall them in sessions  so that the counsellor can weed  out hidden meanings or etc.

Transference is the process or behaviour that the client unconsciously starts treating his therapist as one of his relationship partners. So he or she might start treating the therapist like  an overprotecting mother or inadequate father.

These processes are often meet with resistance, especially to the interpretations the counsellor has.


What is the psychodynamic approach to therapy?

Psychodynamic therapy is a modern version of Freud’s original psychoanalytical therapy. This was necessary to do for changing times and changing clientele.  Such revisions where those that where made  by Carl Jung and Alfred.


What is client-centered therapy?

This came  from the human potential movement which was stimulated by Carl Rogers.  It focuses on providing emotional support. The theory behind this therapy is in contradiction to Freud’s; people are anxious because they have  an incongruence between their self-concept and reality and the fear of people telling you,  or recognizing that. This is ultimately rooted in peoples need  of acceptance from others. This is what client-centered therapy tries to stop and tries to, instead, foster personal acceptance and growth. An important factor of this therapy is therapeutic climate. Interpretation and advice on the part of the therapist is kept at a minimum.


What did Rogers mean by therapeutic climate?

Therapeutic climate is a climate of emotional security that is essential for the therapy to work. It was to be achieved in three ways;

Genuineness: Honest and spontaneous communication Unconditional positive regard: Acceptance of person. Empathy: Understand world from clients point of view.


What is the function of client-centered therapy?

The therapist is to act like  a mirror to the client; bouncing back  ideas,  thoughts, or feelings with heightened clarity. This is supposed to help  the client realize things and grow  further.


What is emotion-focused couples therapy?

Helping couples work  out what emotional needs  are not meet in their relationship.


What is emotion-focused therapy?

Based off of the work  of Carl Rogers,  emotion focused therapy on acknowledging and working with the underlying emotions of the client.


What are positive psychology inspired therapies?

These therapies have  grown from positive psychology (a psychology that looks  at all the positive aspects of humans). In this field are therapies like  well-being therapy and positive psychotherapy.


What is well-being therapy?

Created by Giovanni Fava it attempts to allow  the person self-acceptance, personal growth and etc. Great for treatment of anxiety and mood  disorders.


What is positive psychotherapy?

Created by Martin Seligman, it attempts to help  the client recognize their strengths, find meaning in their life, try to make  positive experiences and savour them as well  as forgive those who have wronged them. It has proven to be very  effective for depression.


What is group therapy?

This type of therapy came  out during World  War II and was based  off of insight therapies. The only difference is that instead of one client the therapist treats several at a time.


What is the function of the participants in group therapy?

The participants are screened so that there will  be congruency between the people. Most often you are not there for only  yourself but to act as a therapist to the others as well.  The therapists main responsibility lies in selecting the participants, making sure the participants are going in the right direction and protecting them from harm. The therapist and participants are mainly on equal  footing with the therapist remaining mostly in the background and being a model for behaviour.


What are the advantages of group therapy?

Group  therapy is often cheaper but it is also a good  way  to realize that you are not alone  in your problems and have  an opportunity to work  on your  social  skills.


Why is evaluating treatment important and difficult?

The fact of the matter is that some  patients have  spontaneous remission. So after therapy you cannot always conclude that the disorder has passed  because of the therapy. The difficulty in evaluating insight therapies in particular is the subjective nature of the therapy. Many  client evaluations are slanted towards attempting to make  the therapy sound  better then it might have been  just so they feel that the time and effort has paid  off.


What is the general belief about insight therapies with evaluation?

Even though it is difficult, there have  been  evaluations that look  at different aspects of insight therapies. Together they show  that insight therapy is superior to no treatment or placebo treatment and that the effects are fairly stable. They show  similar results to those of drug  therapies.


What are the common practices between different approaches to therapy?

There  are approximately five; 1) therapeutic alliance with the therapist, 2) emotional support and understanding from therapist, 3) beginning to hope  and have  positive expectations about ones life, 4) understanding what is causing anxiety and learning ways  to get rid of it, 5) expression of feelings and learning new things


What are behaviour therapies?

Behaviour therapies treat the symptoms as the problem and not an extension of deeper issues. They attempt to treat maladaptive behaviour with the principles of learning. This approach came from the work  of B.F. Skinner. It works  on two assumptions; 1) that behaviour is a product of learning and 2) what has been  learned can be unlearned.


What is systematic desensitization?

This was developed by Joseph Wolpe.  This is a therapy that attempts to get rid of phobias their client may  have  by counter conditioning (learning relaxation instead of anxiety towards stimuli). In other words, it attempts to lessen  the conditioned bond  between a conditioned stimulus and response. This works  great for phobic clients and other anxiety disorders


What is the process of systematic desensitization?

This therapy works  in three ways;

1) You identify and make  a list and/or rate stimuli that arouses anxiety. This is called an anxiety hierarchy.

2) Training of deep  muscle relaxation

3) Imagining each stimulus on the hierarchy, the client attempts to remain calm  while thinking of each by using  the deep  muscle relaxation techniques.

This is often followed by presentation of the real  stimulus in order to see if the patient has gotten rid of the conditioned links.


What is aversion therapy?

This takes advantage of the physical nature of classical conditioning and attempts to pair  current behavioural problems or etc with physically unpleasant responses (drugs that make  you feel bad)  in order to strengthen the bond  between a behavioural problem and negative consequences. This works for drug  and alcohol abuse,  sexual deviance, gambling, stuttering, smoking and overeating.


What is social skills training?

Because  people are not born  great at socializing and have  to learn  to it may  cause  great anxiety to those who have  not properly learned to. Hence  this training works  on the principles of operant conditioning and observational learning in order to help  quell  some  of the anxieties people may  be feeling due to lack of social  skills.  It emphasizes modelling, behavioural reversal and shaping.

1) Modelling: observational learning. The patient is encouraged to watch socially skilled friends at “work”

2) Behavioural reversal: role  playing exercises where the patient is encouraged to try out techniques they’ve observed.

3)Shaping: are asked  to handle more  delicate and complicated real-life situations.


What are cognitive-behavioural treatments?

Uses verbal and behavioural modifications in order to change maladaptive patterns of thinking. This includes Albert Ellis’s rational emotive behaviour, Aaron  Beck’s cognitive therapy (both from insight therapies), Donald Meichenbaum and Michael Mahoney have  treatments that emerged from the behavioural tradition.


What is cognitive therapy?

This attempts to chance thinking patterns that underlie disorders. This was originally used more  for depression. It uses modelling, systematic monitoring of behaviour and behavioural rehearsal.


How was cognitive therapy used for depression?

The idea  was that depressed people where prone to certain negative types of feelings. There  are four specific types; 1) blame experiences on their own personal inadequacies, 2) focus selectively on negative events, 3)are  pessimistic about their future, 4) draw  bad conclusions about themselves from insignificant events.


What is self-instructional training?

Made by Meichenbaum. This is where patients are taught to use verbal statements in order to help cope with difficult situations.


What are biomedical therapies?

These are psychical therapies that attempt to reduce the symptoms of disorders so that people can go on with their lives.  Two most prominent types are drug  therapies and electroconvulsive therapy (shock  therapy).


What does drug therapy include?

There  are three areas  of drug  therapies; anti-anxiety drugs, antipsychotic, and antidepressant (most widely prescribed).

Anti-anxiety drugs: relieve tension, apprehension and nervousness.

Valium (diazepam) and  xanax (alprazolam).This is in the benzodiazepine family. Are often called tranquilizers. Immediate effects and relatively short- lived. Some have  withdrawal symptoms when  treatment stops.  Common side effects include drowsiness, light-headedness, dry  mouth and depression. Increase activity of GABA


Antipsychotic Drugs: reduce psychotic symptoms, including hyperactivity, mental confusion, hallucinations and delusions. Treatment of schizophrenia and severe mood  disorders. Decrease dopamine synapses. Common side effects include drowsiness, constipation and dry  mouth. Can produce symptoms of muscle tremors and impaired motor coordination. Can sometimes produce tardive dyskinesia, which is incurable. Take a while  to take effect

Atypical Antipsychotic Drugs; clozapine, olanzapine, quetiapine. Have less side-effects. Treatment of schizophrenia.

These drugs are often more effective for positive symptom schizophrenia (hallucinations) not negative (absence of effect). Positive symptoms are probably induced by too much dopamine so antipsychotic drugs act as dopamine antagonists to decrease the amount. Negative symptoms on the other hand are seen as happening due  to bran damage and  enlarged ventricles.


Antidepressant Drugs: take a time to exhibit effect. Tricyclis (block reuptake of Norepinephrine and  serotonin) ; fewer side-effects and  complications than MAO inhibitors (allows transmitter to work for longer periods of time).

Selective Serotonin Reuptake Inhibitors (SSRIs); sloes  the reuptake at serotonin synapses. Includes flexitime, paroxetine, sertraline. Less dangerous side- effects. Can treat OCD, panic  disorders, anxiety disorders. May increase suicide risk,  around 2-4% more  than placebos.


SNRIs: Inhibit reuptake of serotonin and Norepinephrine. Venlafazine and duloxetine. Stronger but  more  side-effects.


Mood Stabilizers: Controls mood  swings in bipolar people. Lithium; better for future episodes but can bring someone out of a current episode.