Therapy

o      Who does it?

o      Why go to them?

o      What do they do

n       Approaches

n       Techniques

o      Does it work?

Evaluating Psychotherapies

§         To whom do people turn for help for psychological difficulties?

Therapists and their Training

§         Clinical psychologists

§        Most are psychologists with a Ph.D. and expertise in research, assessment, and therapy, supplemented by a supervised internship

§        About half work in agencies and institutions, half in private practice

Therapists and their Training

§         Psychiatrists

§        Physicians who specialize in the treatment of psychological disorders

§        Not all psychiatrists have had extensive training in psychotherapy, but as M.D.s they can prescribe medications. Thus, they tend to see those with the most serious problems

§        Many have a private practice

Therapists and their Training

§         Clinical or Psychiatric Social Worker

§        A two-year Master of Social Work graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems

§        About half have earned the National Association of Social Workers’ designation of clinical social worker

Therapists and their Training

§         Counselors

§        Marriage and family counselors specialize in problems arising from family relations

§        Pastoral counselors provide counseling to countless people

§        Abuse counselors work with substance abusers and with spouse and child abusers and their victims

Why go to a therapist and not just a friend?

o      Objectivity

o      Experience

n       How many of you have dealt with a suicidal individual?

o      Evidence based approaches

n       Reading the research

o      Creative methodologies  

o      Privacy and Comfort

 

General Approaches to Therapy

History of Treatment

Historical methods (still used in limited cases)

§         Electroconvulsive Therapy (ECT)

§         therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient

§         Psychosurgery

§         surgery that removes or destroys brain tissue in an effort to change behavior

§         lobotomy

§          now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients 

Therapy- Psychoanalysis

§         Psychoanalysis

§         Freud believed the patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight

§         use has rapidly decreased in recent years

§         Resistance

§         blocking from consciousness of anxiety-laden material

Therapy- Psychoanalysis

§         Interpretation

§         the analyst’s noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight

Humanistic Therapy

§         Client-Centered Therapy

§        humanistic therapy developed by Carl Rogers

§        therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients’ growth

Humanistic Therapy

§          Active Listening-empathic listening in which the listener echoes, restates, and clarifies

Behavior Therapy

§         Behavior Therapy

§         therapy that applies learning principles to the elimination of unwanted behaviors

§         Counterconditioning

§         procedure that conditions new responses to stimuli that trigger unwanted behaviors

§         based on classical conditioning

§         includes systematic desensitization and aversive conditioning

Behavior Therapy

§         Exposure Therapy

§         treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid

Behavior Therapy

§         Systematic Desensitization

§         type of counterconditioning

§         associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli

§         commonly used to treat phobias

Behavior Therapy

§         Systematic Desensitization

Behavior Therapy

§        Token Economy

§        an operant conditioning procedure that rewards desired behavior

§        patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats

Cognitive Therapy

§        Cognitive Therapy

§        teaches people new, more adaptive ways of thinking and acting

§        based on the assumption that thoughts intervene between events and our emotional reactions (mind over body?)

Cognitive Therapy

§         The Cognitive Revolution

Cognitive Therapy

§         A cognitive perspective on psychological disorders

Group and Family Therapies

§         Family Therapy

§        treats the family as a system

§        views an individual’s unwanted behaviors as influenced by or directed at other family members

§        attempts to guide family members toward positive relationships and improved communication

Drug Therapies

§         Psychopharmacology

§        study of the effects of drugs on mind and behavior

§         Lithium

§        chemical that provides an effective drug therapy for the mood swings of bipolar (manic-depressive) disorders

Drug Therapies

§         The emptying of U.S. mental hospitals

Depression: Excess serotonin is blocked by drug (e.g., prozac)

Drug Therapies

Most Psychologists

§         Eclectic Approach

§         an approach to psychotherapy that, depending on the client’s problems, uses  techniques from various forms of therapy