Psychology

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TherapiesII.pptx

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Therapy Types

Insight Therapies (Psychodynamics, Person-centered Therapy)

Behavioral Therapies

Cognitive Therapies

Biological Therapies

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Effectiveness of Psychotherapy

All therapies are “winners”.

Factors in Successful Psychotherapy

therapeutic alliance (monitored)

therapist expertise & personality

client active engagement

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Psychodynamic Perspective

Causes: fixation (early childhood), unresolved unconscious conflicts, breakdown of ego defense mechanisms

Treatment methods: psychoanalysis (free association, dream analysis)

Primary disorders treated: General feelings of unhappiness, unresolved problems from childhood.

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Psychodynamic Perspective

Presumed Problem: unconscious conflict from childhood experiences

Therapy aim: Reduce anxiety through self-insight.

Therapy Technique: interpret patient’s memories and feelings.

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Psychodynamics therapy techniques

Free association: helps patients discover unconscious thoughts and feelings that had been repressed or ignored.

Analysis of resistance: client is unwilling to discuss to discuss a particular topic—therapist have to interpret why it is occurring.

Dream analysis: dreams represent wish fulfillment, unconscious desires, and conflicts.

Analysis of transference: transfer of feelings from the past to someone in the present. (usually the therapist)

https:// www.youtube.com/watch?v=QV6DpJKW6a0

(dream analysis)

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Humanistic Therapy

Presumed Problems Barriers to self-understanding and self-acceptance.

Treatment Techniques: person-centered therapy (the therapist listen actively and reflect client’s feelings.

Goals of therapy: Enable growth via unconditional positive regard, geniuses, acceptance and empathy.

Primary disorders treated: general feelings of unhappiness, interpersonal problems

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Acceptance

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Client-Centered Therapy

Founded by carl rogers

Warm, supportive, encouraging environment

Therapist must genuinely like the client

Uses mirroring and reflective speech to promote self-actualization

Therapist must have empathy for client

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Suggestion: Ask students, “If you had a mental illness and were seeking therapy, which would you prefer, psychoanalysis or client-centered therapy, and why?”

Humanistic therapy

Only the client can judge if he or she is better

No way to independently verify success

https:// www.youtube.com/watch?v=0TmugJo-c9Y

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Limitations of insight therapies

A client must be motivated, intelligent, articulate, and rich

https:// www.youtube.com/watch?v=0TmugJo-c9Y

Not as effective as cognitive-behavioral therapy

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Behavioral perspective

Much more active and are related to the symptoms

Causes: abnormal behavior is learned by reinforcement, or classical conditioning, or observation and modeling

Treatment methods: behavior therapy (behavior modification, token economy, desensitization, therapy modeling, etc.)

Primary disorders treated: fears, phobias, panic disorder, ocd, unhealthy habits.

Goals of Therapy: reduce or eliminate maladaptive behaviors

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CBT- cognitive behavior therapy

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Therapy based on classical conditioning

Classical Conditioning Techniques Treating Phobias

(systematic desensitization)

Teach relaxation

Exposure: Create a hierarchy ranging from least to most feared stimulus

Work through a hierarchy while maintaining calm

Flooding

intense exposure without allowing avoidance

https:// www.youtube.com/watch?v=lMZ5o2uruXY

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It has helped a lot of people with anxiety or phobias. A lot of phobias because of classical conditioning. It was build by association by anxiety. Systematic. Help them to relax, you can’t be calm and anxious in the same time

First step:

Guided relaxation---lay down and relax, begin at feet (muscle relaxtion) clentch your toes and let go and as you let go think of beach

Tight you calf muscles, work your way up the body and relaxing. Process takes 10-15 minutes. Conditioning relaxtion with a trigger work.

Hierarchy of fears (public speech)

Watching someone else speak

Have others sing “happy birthday” to you

Be asked to give a toast to a small gathering of friends

Be asked to give a toast at a wedding

Flooding

intense exposure without allowing avoidance

https:// www.youtube.com/watch?v=lMZ5o2uruXY

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Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.

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It has helped a lot of people with anxiety or phobias. A lot of phobias because of classical conditioning. It was build by association by anxiety. Systematic. Help them to relax, you can’t be calm and anxious in the same time

First step:

Guided relaxation---lay down and relax, begin at feet (muscle relaxtion) clentch your toes and let go and as you let go think of beach

Tight you calf muscles, work your way up the body and relaxing. Process takes 10-15 minutes. Conditioning relaxation with a trigger work. Begin imaginary and then

Aversive Conditioning

Nauseating Drug

(Stimulus)

Nausea

(Response)

Alcohol

(Stimulus 2)

UCR

CR

CS

NS

UCS

No Response

Unlearned

Reflex

Repeatedly

Paired

Learned Association

Innate S-R Association

Neutral Stimulus

Unconditioned Stimulus

Unconditioned Response

Acquisition/Learning

Conditioned Stimulus

Conditioned Response

https:// www.youtube.com/watch?v=z0xgIE-SKpc (stimulus satiation)

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Note: This example is illustrative only. Contrary to the implication of this diagram, Antabuse does not cause nausea when taken by itself: It only causes nausea if alcohol is also consumed. Moreover, in practice, Antabuse is not used so much to create a lasting distaste for alcohol as to prevent sneaking beers when in detox.

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Therapies based on operant conditioning

Ignore the maladaptive behaviors

Rewarding positive behaviors

Token economies: using tokens that can be exchanged for other items or privileges as a reinforcers (juvenile)

Punishment (police) following some undesired behavior by an aversive stimulus.

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Give them the opportunities to gain tokens. Immediate reinforcement

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Cognitive therapy

Causes: abnormal behavior is caused by faulty, irrational, negative thinking.

Treatment methods: cognitive therapy is aimed at developing more positive and rational thinking patterns-structured analysis and specific guidance.

Primary disorders treated: depression, anxiety, panic disorder, general feelings of unhappiness.

Goals of therapy: Cognitive reconstructing, to train people to dispute negative thoughts and attributions.

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Elli’s Rational- emotive therapy

By pointing out alternative ways of viewing a situation, the person’s view of life, and ultimately their mood will improve.

**Research has shown that cognitive therapy can be as effective as medication in the long-term treatment of depression.

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Common irrational thoughts

I must be prefect

Everyone must love me

The past determines the future

It is catastrophic wen things don’t go as planned

I have no control over my happiness

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Common Cognitive Error/distortion

Selective abstraction: (Mental Filter) you pay undue attention to one negative detail instead of seeing the whole picture.

Example:  “Because I got one low rating on my evaluation (which also contained several high ratings), it means I’m doing a lousy job.”

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Biological Therapies

Causes: hereditary factors, malfunctioning of the NS or body’s biochemistry.

Treatment methods: Drug therapies, electroconvulsive therapy (ECT) and Psychosurgery

Primary disorders treated: Schizophrenia, depression, Bipolar disorder, anxiety disorders.

Goals of therapy: reduce/eliminate symptoms by altering body functioning

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Drug Therapy

Antianxiety Drugs ---Family of Tranquilizers

e.g. Valium, Xanax

short term effectiveness

prone to tolerance

Bipolar Disorder

Lithium-evens out mood swings.

majority improve substantially

toxicity reactions

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Antidepressant Drugs

Antidepressant Drugs

selective serotonin reuptake inhibitors (SSRIs)

majority improve moderately

risk of multiple significant side effects

Risks of Antidepressants for Children

FDA hearings on risk of suicide (2004)

“Black Box” warning

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Are Drugs Necessary in Treatment? This question presents an opportunity for students to reflect on the necessity/value of the various therapies described in this chapter.

Suggestion: Instructor might bring up the fact that there is a controversy about whether drugs that alter neurotransmitter levels are in fact effective. For example, research shows that while antidepressant drugs effectively increase targeted neurotransmitter levels within an hour or so of administration, reduction of depressive symptoms does not typically occur till more than a week has passed. Note that this particular evidence does concede the effectiveness of the drug, but undermines the explanation of why the drug works.

Drug Therapy

Antipsychotic Drugs

-Neuroleptics

e.g. Compazine (treats hallucinations and delusions)

--inhibits the NT (Dopamine)

atypical antipsychotic medications

Newer drugs- target both dopamine and serotonin

Improves positive and negative symptoms of schizophrenia

Clozapine

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Note: (As with antidepressants, see previous two slides) similar criticism of the dopamine connection to schizophrenia has been made in regard to antipsychotic drugs.

Biological Therapies

Electroconvulsive Therapy-used with informed consent (requires sedation and anesthesia)

small electric current produces a brief seizure

used to treat major depressive disorder which has not responded to other treatments

Unilateral ETC (admin to the RH)

Memory loss

Psychosurgery (discontinued)

prefrontal lobotomies

Results are unpredictable

Irreversible

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Biological Therapies

Modern treatment—Neurofeed back)

Non invasive therapy

No sedation required

No side effects (seizures or memory loss)

Highly effective in treating schizophrenia negative symptoms

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Chapter Review

Describe approaches to treating psychological disorders.

Define psychotherapy and characterize four types of psychotherapy.

Describe the biological therapies.

Explain the sociocultural approaches and issues in treatment.

Discuss therapy's larger implications for health and wellness and characterize the client's role in therapeutic success.

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Note: Instructors may use the learning objectives presented on this slide to review the chapter material.

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