Psychotherapy

It is easier to build a child than repair an adult.

What is Psychotherapy?

…a formal process of interaction between two parties, each party usually consisting of one person but with the possibility that there may be two or more people in each party, for the purpose of amelioration of distress in one of the two parties relative to any or all of the following areas of disability or malfunction: cognitive fx’s (disorders of thinking), affective fx’s (suffering or emotional discomforts), or behavioral fx’s (inadequacy of beh), with the therapist having some theory of personality’s origins, development, maintenance and change along with some method of treatment logically related to the theory and professional and legal approval to act as a therapist.

R. Corsini

Estimate of Percent of Time Spent by “Counselors” and “Psychotherapists” in Professional ActivitiesProcess Counseling PsychotherapyListening 20 60Questioning 15 10Evaluating 5 5Interpreting 1 3Supporting 5 10Explaining 15 5Informing 20 3Advising 10 3Ordering 9 1

Therapies

Psychotherapy Procedures in which a trained person

establishes a relationship with an individual seeking help, in order to remove or modify existing symptoms, change disturbed patterns of thought and behavior, and promote personal growth.

Psychodynamic Therapies

Freud Disorders stem from hidden, inner conflict Free association – tell analyst whatever

comes to mind Sessions last 45 minutes Fixed schedule of fees & appts (if deviate

from, calls for investigation & analysis)

Four Phases of Psychoanalytic Treatment1. Opening Phase 1st contact History taking Everything person says & does

are all clues to unconscious processes

Lasts 3-6 months

2. Development of Transference Major portion of therapeutic

work Emotionally, analyst assumes

major significance in the life of the person

Transference helps person understand how one misperceives, misinterprets, and relates to the present in terms of the past

Four Phases of Psychoanalytic Treatment3. Working Through Analysis of transference Working through =

repetition, elaboration and amplification

4. Resolution of Transference

Termination phase of tx Date is set for ending tx Analyst aims to resolve

patient’s unconscious, neurotic attachment to him/her

Sudden aggravation of symptoms

Humanistic Therapies

Focus on helping “clients” (not patients) to become themselves

Person-Centered Therapy C. Rogers Full potential Clients can choose what to

talk about and provide their own insights

3 Impt Concepts:1. Congruence – corresponds

between thoughts & behaviors of therapist. Therapist does NOT put up a professional “front.”

2. Unconditional Positive Regard – accept client no matter what

3. Empathy – an attitude of profound interest in client’s world of meaning.

Gestalt Therapy

F. Perls Person must acknowledge all parts of

behavior, cognitions & emotions Techniques:

“What are you feeling now?” Discussing incongruencies

Two-chair technique (assume roles of others & themselves)

Behavior Therapies

Three Main Approaches1. Applied Behavior Analysis – direct extension of Skinner’s

work Fundamental assumption =

behavior is a fx of it’s consequences

Uses reinforcement, punishment, extinction & stimulus control

2. Neo-behaviorist Mediational Stimulus-Response Model –

Derived from Pavlov’s work Uses classical conditioning Tech’s = systematic

desensitization & flooding

3. Social-Cognitive Model – 3 processes = external stimulus,

external reinforcement; cognitive mediational processes

Person is agent of change Assumption = change person’s

interpretation of an experience; have therapeutic success

Common Characteristics of Behavior Therapies Commitment to scientific model View abnormal behavior as “problems of living;”

not illnesses Abnormal behavior is assumed to be acquired &

maintained the same as normal behavior Focus on present, not past Tx strategies are individually tailored Understanding the origins of a problem is NOT

essential to tx’ing the behavior

Cognitive Therapies

Rational-Emotive Behavior Therapy

Albert Ellis (1950s) People are born with potential

to be rational, as well as irrational

People can be self-preserving, as well as self-destructive

Irrational thinking & self-destruction tends to be exacerbated by culture & family (greatest in early years)

People perceive, think, emote & behave simultaneously

Tech’s = highly cognitive, homework-assigning, discipline oriented, role-play, assertion training, suggestion & support

Do not believe a warm relationship is necessary

Stress unconditional acceptance & close collaboration, but point out deficiencies in behavior

Real “cause” of upsets lies in people, NOT what happens to them

Two Types of REBT

1. General REBT Teach clients rational

and appropriate behaviors

2. Preferential REBT – Teaches how to

dispute irrational ideas & inappropriate behaviors & to become more creative, scientific thinkers

Ellis songs…

"Love Me, Love Me, Only Me!"(To the tune of "Yankee Doodle")

Love me, love me, only me or I'll die without you!Make your love a guarantee, so I can never doubt you!Love me, love me totally; really, really try, dear;But if you must rely on me, I'll hate you till I die, dear!Love me, love me all the time, thoroughly and wholly;Life turns into slushy slime 'less you love me solely!Love me with great tenderness, with no ifs or buts, dear:For if you love me somewhat less, I'll hate your goddamned guts, dear!

Songs…Glory, Glory Hallelujah!(Battle Hymn of the Republic)Mine eyes have seen the glory of relationships that glowAnd then falter by the wayside as love passions come and go!I’ve heard of great romances where there is no slightest lullBut I am skeptical!Glory, glory hallelujah!People love ya till they screw ya!If you’d cushion how they do ya,Then don’t expect they won’t!Glory, glory hallelujah!People cheer ya then pooh-pooh ya!If you’d soften how they screw ya,Then don’t expect they won’t!

A. Beck’s Cognitive-Behavior Therapy Believes how one thinks largely

determines how one feels & behaves Client’s maladaptive interpretations are

treated as testable hypotheses Processing of info is crucial In psychological dx’s a systematic bias is

introduced into processing info

Strategies

Collaborative Empiricism – views clients as a practical scientist who lives by interpreting stimuli, but has been temporarily thwarted by info-gathering, biased processes.

Guided Discovery – discovering what threads through a client’s misperceptions & linking them to past experiences.

Goal = shift the info-processing to a more “neutral” condition so that events will be evaluated in a balanced way.

Questionable Therapies…

Primal Therapy Arthur Janov "Primal Therapy is not just

making people scream. It was the title of a book. It was never 'Primal Scream Therapy'. Those who read the book knew that the scream is what some people do when they hurt. Others simply sob or cry. It was the hurt we were after, not mechanical exercises such as pounding walls and yelling, 'mama'."

Subliminal Tapes Thousands of videotapes and

audiotapes purported to contain repeated messages are being marketed with claims that they can help people make friends, reduce pain, conquer fears, relieve depression and do many other things.

Many researchers have found that subliminal tapes provide no benefit to the user.