assistance needed with psychology

Methods of Therapy

Types of Psychotherapy

• Psychotherapy – psychologically based form of treatment used to help people better understand their emotional or behavioral problems and resolve them.

• Hundreds of types of psychotherapy

• Most widely used derive from psychodynamic, humanistic, behavioral, & cognitive models.

Psychoanalysis

The first formal psychotherapy to emerge was psychoanalysis, developed by Sigmund Freud.

Sigmund Freud's famous couch

Psychodynamic Therapy

• Evolved from psychoanalysis

• Psychological issues are rooted in unconscious psychological conflicts from childhood.

• Gaining insight to conflicts & working through them will help restore psychological health.

• GOAL: Making the unconscious conscious

• Techniques used to gain awareness of unconscious conflicts – free association, dream analysis, & interpretation.

Free Association

• Technique that encourages clients to talk about any thoughts or images that enter their heads

• Assumption is that this kind of free-flowing, uncensored talking will provide clues to unconscious material

PSYCHOANALYSIS

Techniques to reveal

the unconscious

• Dream interpretation

• psychoanalytic technique

based on the assumption that

dreams contain underlying,

hidden meanings and

symbols (latent content) that

provide clues to unconscious

thoughts and desires.

• Clients free associate about

the manifest content to

reveal unconscious.

Interpretation • Therapist’s attempt to explain connections between what the

client discloses during therapy & their unconscious conflicts – to help client gain insight.

• Insight – the realization or awareness of underlying unconscious wishes and conflicts.

• Resistance – blocking that occurs when therapy touches upon anxiety-evoking thoughts or feelings (avoidance of topic, sneeze attack, forget appointment, etc…)

• During free association, the patient edits his thoughts, resisting his or her feelings to express emotions. Such resistance becomes important in the analysis of conflict-driven anxiety.

Interpretation • Eventually the patient opens up and reveals his or her

innermost private thoughts, developing positive or negative feelings (transference) towards the therapist.

• Transference – patient’s transfer to the analyst of emotions linked with other relationships Ex. Love or hatred toward a parent.

• client expresses strong emotions toward the therapist as a substitute for someone important in the client’s life, such as mother or father

• By interpreting the transference relationship, the analyst raises the client’s awareness about how earlier conflicted relationships intrude upon the client’s present relationships.

Modern psychodynamic therapy

• Focus less on sexual issues & remote past & more on present relationships.

• Face to face instead of on a couch

• Meet 1-2 times per week instead of 3-5 times over several years.

• More direct approach to underlying defenses & transference issues

Humanistic Therapy

• Human beings have free will & can make conscious choices to enrich their lives.

• Emphasize client’s subjective conscious experiences

• Focus on how change must occur in the here & now.

• 2 major forms of humanistic therapy – Client-centered therapy by Carl Rogers, & Gestalt therapy by Fritz Perls.

Humanistic Therapy – Client-Centered Therapy AKA Person-Centered Therapy

• Focuses on exploration of the self - & acceptance of true self.

• Warm accepting environment

• Nondirective approach allowing client to lead direction of therapy

• Therapists role is to reflect back client’s feelings in a supportive manner to encourage self-exploration & acceptance.

• Children often valued when behaving in ways that please others & may lose a sense of self.

• Therapist’s traits

• Empathy—ability to understand what the client says, feels

• Positive regard —ability to communicate caring, respect, and regard

• Genuineness —ability to be real and nondefensive in interactions

Humanistic Therapy – Gestalt Therapy

• Helps integrate conflicting parts of personality into a whole

• Direct/confrontational approach

• Help clients get in touch with underlying feelings – challenge clients to express feelings in here & now.

• Empty chair technique

• Role-play different parts of own personality

Behavior Therapy AKA Behavior Modification

• Behavior Therapy – AKA Behavior Modification - uses the principles of classical and operant conditioning to change disruptive behaviors and improve human functioning

• focuses on changing particular behaviors rather than the underlying mental events or possible unconscious factors

Behavior Therapy

• Systematic desensitization - technique of behavior therapy in which the client is gradually exposed to the feared object while simultaneously practicing relaxation

• Gradual exposure/in vivo exposure – exposure in real life to treat phobias.

• Modeling – observing someone else’s behavior – ex. handling feared object, or learning new social skills.

• Virtual reality therapy

• Therapeutic apps – beating the blues, moodGYM, stress & anxiety companion.

Behavior Therapy

• Aversive conditioning – stimuli associated with undesirable behavior are paired with aversive stimuli to create a negative response to stimuli.

• Ex. alcohol – nausea

• Operant conditioning – reinforcement & punishment to reach goal behaviors

• Token economy

• Time out

Cognitive-Behavioral Therapy (CBT)

• Therapy that combines behavioral & cognitive treatment techniques – focusing on thoughts during exposure therapy.

• Technique of changing maladaptive or disruptive behaviors by learning and practicing new skills to improve functioning

COGNITIVE THERAPY

• Cognitive Therapy - Assumes that we have

automatic negative thoughts that we typically

say to ourselves without much notice

• Repeating these automatic negative thoughts

causes distortion in how we perceive and

interpret our world and influences how we

behave and feel

Cognitive Therapy – Rational Emotive Behavior Therapy ~ Albert Ellis

• Irrational or illogical thinking is the root to emotional problems

• Goal is to replace irrational beliefs with logical, self- enhancing believes.

• ABCD Model = Activating event – Beliefs – Consequences – Dispute

• Direct & confrontational

Cognitive Therapy ~ Aaron Beck

• Helps people identify & correct errors in thinking & replace them with rational alternatives

• Reality testing – test out negative beliefs to determine whether they are valid.

• Gentler collaborative approach to identify negative thinking patterns.

Eclectic Therapy

• Eclectic approach - involves combining

and using techniques and ideas from

many different therapeutic approaches

Therapy • Settings

• Group therapy

– Psychotherapy conducted in group setting in which clients receive

feedback from others in group, as well as from therapist

• Family therapy

– All family members are treated as the client and helped to change

destructive relationships and improve communication

• Couple therapy

– Couple is treated as client and helped to improve communication and

conflict resolution skills

Therapy

• Telemental health

• Providing psychological services remotely, via

telephone, e-mail, or video conferencing

• Cyber therapy is therapy delivered over the

internet

• Reduces cost and improves access, as well as

helps clients avoid some stigma

• But therapists may lack credentials or training,

and the communication medium may make it

harder to interpret body gestures or emotional

tone of voice

Therapy Works!

•A wealth of scientific findings supports the effectiveness of psychotherapy.

14.2 Biomedical Therapies Psychotropic drugs AKA psychiatric drugs AKA psychotherapeutic drugs

Antianxiety Drugs

• Minor tranquilizers help quell anxiety, induce calmness, & reduce muscle tension.

• Neurotransmitter, Gamma-aminobutyric acid (GABA) receptors are made more sensitive to enhance GABA’s calming effects.

Antidepressants • Increase levels of neurotransmitter norepinephrine & serotonin

in the brain.

• 3 types

• tricyclics – raise levels of norepinephrine & serotonin by interfering with reuptake process which chemical messengers are reabsorbed by transmitting cells. Norpramine, Tofranil

• Monoamine oxidase (MAO) inhibitors – inhibit action of enzyme monoamine oxidase which normally breaks down neurotransmitters in the synapse. Nardil, Parnate

• Selective serotonin reuptake inhibitors (SSRIs) – raise levels of serotonin by interfering with reuptake. Sertraline, Prozac

Antipsychotics

• Treat schizophrenia & other psychotic disorders.

• Block dopamine at receptor sites in the brain.

Therapeutic Techniques • Biomedical treatment

• Electroconvulsive therapy, or ECT

• involves placing electrodes on the skull and administering a mild electric current that passes through the brain and causes a seizure

• treatment consists of 10 to 12 sessions about three times per week

• used when antidepressant medication fails to decrease depression

• serious side effect of ECT is memory loss

MOOD DISORDERS (CONT’D)

• Biomedical treatment - New treatment

• Transcranial magnetic stimulation (TMS)

• noninvasive technique that activates neurons by sending

pulses of magnetic energy into the brain

• 40 min. daily for 4 weeks

• Side effects: headache, lightheadedness, & scalp

discomfort.

• Unlikely to cause seizures & does not require

anesthesia.

Mood Disorders Biomedical Treatment

• Deep brain stimulation

• surgical procedure that involves implanting electrodes

into the brain and placing a battery-powered stimulator

under the collarbone

• electrodes are wired to the stimulator to provide

electrical stimulation to the brain

• Shows greater improvement than patients who received

only meds.

• Batteries must be surgically replaced every few years.

• Risk of bleeding & infection

EMDR

• Does EMDR stop traumatic memories?

• EMDR – Eye Movement Desensitization &

Reprocessing

• Involves having the client talk about or imagine a

traumatic memory while visually focusing on and

following the back-and-forth movement of the

therapist’s hand

• Continues for several 90-minute sessions

• Evidence from both case studies and

experiments supports the effectiveness of this

treatment method