Methods of Methods of TherapyTherapy

Abnormal PsychologyAbnormal Psychology

Ms. RebeccaMs. Rebecca

Do Now:Do Now:

What is one reason why you think What is one reason why you think someone would go to therapy?someone would go to therapy?

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TherapyTherapy

Methods of treating psychological Methods of treating psychological problems and disorders.problems and disorders.

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2 categories of therapy:2 categories of therapy:

1. 1. Psychological MethodsPsychological Methods 2. 2. Biological MethodsBiological Methods

Goals of Goals of psychological psychological methods methods (psychotherapy)(psychotherapy)

Fix the many thoughts, feelings, Fix the many thoughts, feelings, and/or behaviors that cause and/or behaviors that cause problems in peoples’ lives by talking problems in peoples’ lives by talking with a professional.with a professional.

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Goals of Goals of biological biological therapytherapy

Fix psychological problems by taking Fix psychological problems by taking medicine or changing the physical medicine or changing the physical nervous system or brain in some way nervous system or brain in some way (drugs, medical (drugs, medical procedures/surgery).procedures/surgery).

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PsychotherapyPsychotherapy

Goal: provide hope, new perspective Goal: provide hope, new perspective and trust for fixing problems. Help and trust for fixing problems. Help self-esteem.self-esteem.

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Most common methods of Most common methods of psychotherapypsychotherapy

PsychoanalysisPsychoanalysis Humanistic TherapyHumanistic Therapy Cognitive TherapyCognitive Therapy Behavior TherapyBehavior Therapy

Check out table on page 437!Check out table on page 437!

PsychoanalysisPsychoanalysis

GoalsGoals: Replace avoidance of things : Replace avoidance of things you don’t like with coping with them. you don’t like with coping with them. Reduce inappropriate anxiety and Reduce inappropriate anxiety and guilty feelings.guilty feelings.

Key TechniquesKey Techniques: Free association; : Free association; dream analysis; dream analysis; transferencetransference (transferring emotions about one (transferring emotions about one person to your therapist)person to your therapist)

Humanistic TherapyHumanistic Therapy

Goals:Goals: Remove obstacles to Remove obstacles to self-self-actualization.actualization. (Figure out your (Figure out your goals in life and be able to reach goals in life and be able to reach them)them)

Key Techniques:Key Techniques: active listening; active listening; unconditional positive regardunconditional positive regard

Cognitive TherapyCognitive Therapy

Goals: Goals: Replace self-defeating attitudes Replace self-defeating attitudes and beliefs with more rational, self-and beliefs with more rational, self-enhancing attitudes and beliefs.enhancing attitudes and beliefs.

Key Techniques: Key Techniques: teach and encourage teach and encourage clients to challenge irrational beliefs and clients to challenge irrational beliefs and replace them with rational beliefs and replace them with rational beliefs and attitudes.attitudes.

Behavior TherapyBehavior Therapy

Goals: Goals: Replace maladaptive, self-Replace maladaptive, self-defeating behavior with good, self-defeating behavior with good, self-enhancing behavior.enhancing behavior.

Key Techniques:Key Techniques: modeling, modeling, aversive conditioningaversive conditioning, , operant operant conditioningconditioning (train new behavior). (train new behavior).

Types of PsychologistsTypes of Psychologists

Counseling PsychologistCounseling Psychologist Clinical PsychologistClinical Psychologist PsychiatristPsychiatrist Psychiatric Social WorkerPsychiatric Social Worker Psychiatric NursePsychiatric Nurse

Other people who can Other people who can help:help:

Teachers, guidance counselors, Teachers, guidance counselors, ministers or religious leaders, family ministers or religious leaders, family doctors….doctors….

Often, these are the people who are Often, these are the people who are turned to first.turned to first.

Types of TherapyTypes of Therapy

Individual Individual vs. vs. Group TherapyGroup Therapy

Advantages of Advantages of Individual Individual TherapyTherapy

People get more personal attention.People get more personal attention. People who feel more comfortable People who feel more comfortable

talking about their problems alone talking about their problems alone are more likely to be open with a are more likely to be open with a therapist one-on-one.therapist one-on-one.

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Advantages of Advantages of Group Group therapytherapy

People can realize that they aren’t alone People can realize that they aren’t alone in having their problems.in having their problems.

People can learn how to deal with their People can learn how to deal with their problems by listening to how other problems by listening to how other people who had the same problems dealt people who had the same problems dealt with them.with them.

People can practice social skills in a People can practice social skills in a supportive environment.supportive environment.

People see that therapy CAN work when People see that therapy CAN work when they see other members of the group they see other members of the group recoveringrecovering..

Types of Types of Group TherapyGroup Therapy

Couples Therapy: Couples Therapy: for marriage issuesfor marriage issues Family Therapy: Family Therapy: for all members of a for all members of a

family who love someone with a problem.family who love someone with a problem. Self-help groups: Self-help groups: therapy for people all therapy for people all

facing the same problem.facing the same problem. Encounter groups: Encounter groups: strangers who do not strangers who do not

necessarily share common problems. necessarily share common problems. They may just want to grow emotionally They may just want to grow emotionally and become aware of their own feelings and become aware of their own feelings and the feelings of others.and the feelings of others.

Psychoanalytic ApproachPsychoanalytic Approach

Developed by Developed by Sigmund FreudSigmund Freud.. Unconscious thoughts and feelings Unconscious thoughts and feelings

are the root of peoples’ problems.are the root of peoples’ problems. Clients need to be helped to become Clients need to be helped to become

aware of these unconscious thoughts aware of these unconscious thoughts and feelings to resolve the problems and feelings to resolve the problems of their daily lives.of their daily lives.

How? How? Free association, dream Free association, dream analysis, transferenceanalysis, transference

Free AssociationFree Association

The The psychoanalystpsychoanalyst tells the client to tells the client to relax and sat whatever comes to mind. relax and sat whatever comes to mind. Analyst doesn’t say much. Analyst doesn’t say much.

The idea is that if the client can say what The idea is that if the client can say what is on their mind, eventually unconscious is on their mind, eventually unconscious thoughts and feelings will come to the thoughts and feelings will come to the surface.surface.

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How does it work?How does it work?

Based on what the client says, or doesn’t Based on what the client says, or doesn’t say, the analyst interprets meaning.say, the analyst interprets meaning.

Resistance: Resistance: When a client won’t talk When a client won’t talk about certain issues during free about certain issues during free association or makes jokes about certain association or makes jokes about certain issues it is thought that the reason is to issues it is thought that the reason is to repressrepress or or denydeny painful feelings. painful feelings.

TransferenceTransference Many clients start to see the Many clients start to see the

relationship with their analyst relationship with their analyst as being similar to a as being similar to a relationship they have in real relationship they have in real life. The client then begins to life. The client then begins to treat the analyst like they are treat the analyst like they are that person.that person.

Ex: Some people may see the Ex: Some people may see the

analyst as being like their fatheranalyst as being like their father

or mother, they may treat the or mother, they may treat the

analyst like they would their analyst like they would their

father or mother.father or mother.

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Is Is transference transference good?good?

Some psychologists like Some psychologists like transferencetransference because it helps because it helps clients to be comfortable expressing clients to be comfortable expressing emotions about how they feel about emotions about how they feel about a person. a person.

Does Does Psychoanalysis Psychoanalysis help?help?

YES! YES! In a study of dozens of patients, In a study of dozens of patients,

People who received People who received psychoanalysispsychoanalysis showed showed improvement happened 70-75% improvement happened 70-75% more times than those that did not more times than those that did not receive therapy.receive therapy.

When is When is PsychoanalysisPsychoanalysis especially helpful?especially helpful?

For people with For people with anxietyanxiety, , mile mile depressiondepression, and difficulty with , and difficulty with social relationships.social relationships.

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When is When is psychoanalysis psychoanalysis NOT very helpful?NOT very helpful?

For people with For people with MAJOR MAJOR DepressionDepression, , bipolar disorderbipolar disorder, or , or schizophreniaschizophrenia..

Other problems with Other problems with psychoanalysis: psychoanalysis: clients need to clients need to meet many times/week to be meet many times/week to be effective and this can be time effective and this can be time consuming AND expensive.consuming AND expensive.

Humanistic TherapyHumanistic Therapy

Goal:Goal: help help individualsindividuals reach their reach their full potential.full potential.

How: How: Become self-aware and Become self-aware and accept yourself for who you are and accept yourself for who you are and what you want to do.what you want to do.

Therapists assume that people Therapists assume that people want to become all that they can want to become all that they can be (be (Self Actualization)Self Actualization)..

What problems does What problems does Humanistic Therapy Humanistic Therapy try to try to

fix?fix? Helps people figure out what they Helps people figure out what they

can really do and helps them to can really do and helps them to reach their goals.reach their goals.

Most common type of Most common type of Humanistic TherapyHumanistic Therapy

Person Centered Person Centered Therapy: Therapy:

Idea: Problems happen Idea: Problems happen when people stop being when people stop being true to themselves and true to themselves and start acting how others start acting how others want/expect them to act.want/expect them to act.

Therapy: Therapy: is supposed to is supposed to help clients find their help clients find their true true selvesselves and realize their and realize their own own unique unique potential.potential.

How does How does Person Centered Person Centered TherapyTherapy work? work?

Clients are seen as Clients are seen as equalsequals in a working in a working relationship with their relationship with their therapist instead of therapist instead of being seen as inferiors being seen as inferiors who are sick.who are sick.

Clients are encouraged Clients are encouraged to to leadlead the therapy the therapy session and talk about session and talk about what is bothering them. what is bothering them. Non-directive Non-directive Therapy.Therapy.

Non-directive TherapyNon-directive Therapy

The therapist doesn’t lead.The therapist doesn’t lead. Therapist’s role is to act as a mirror, Therapist’s role is to act as a mirror,

reflecting back clients’ thoughts and reflecting back clients’ thoughts and feelings so clients can see feelings so clients can see themselves more clearly.themselves more clearly.

Techniques of Techniques of person-person-centered therapycentered therapy

Active ListeningActive Listening: The listener : The listener repeats, rephrases and asks for repeats, rephrases and asks for clarification of statements made by clarification of statements made by the speaker. the speaker.

Goal:Goal: Show the speaker that they Show the speaker that they are being heard and understood.are being heard and understood.

Techniques of Techniques of person-person-centered therapycentered therapy

Listener is Listener is non-judgmentalnon-judgmental and and supportive, regardless of what is supportive, regardless of what is being said.being said.

This is called: This is called: unconditional unconditional positive regard.positive regard.

This helps clients’ self esteem to rise This helps clients’ self esteem to rise and gives clients more confidence in and gives clients more confidence in the decisions they make.the decisions they make.

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Who uses Who uses person-centered person-centered therapytherapy??

Person-centered therapyPerson-centered therapy is used by is used by school counselors a lot to help students school counselors a lot to help students deal with deal with anxietyanxiety and to help them make and to help them make decisions.decisions.

Ex: what college to go to.Ex: what college to go to.

Who does Who does person-centered person-centered therapy therapy help?help?

In a study, about 75% more people were In a study, about 75% more people were helped after receiving helped after receiving person-centered person-centered therapy therapy than those who received no than those who received no therapy.therapy.

MOST MOST useful for educated, motivated useful for educated, motivated people.people.

Also helps people with Also helps people with anxiety, mild anxiety, mild depressiondepression or problems with social or problems with social relationships.relationships.

NOT HELPFUL for people with NOT HELPFUL for people with SERIOUS psychological problems.SERIOUS psychological problems.

Cognitive Therapy and Cognitive Therapy and Behavior TherapyBehavior Therapy

Goal: Goal: To help clients develop NEW To help clients develop NEW ways of thinking and behaving.ways of thinking and behaving.

Get rid of Get rid of self-defeating thoughtsself-defeating thoughts (I’m not good at ANYTHING) and (I’m not good at ANYTHING) and troubling behaviors (Smoking, lying troubling behaviors (Smoking, lying etc). etc).

Cognitive TherapyCognitive Therapy

Helps people to think about their Helps people to think about their problems in more productive ways. problems in more productive ways.

Two most common Two most common cognitive/behavioral cognitive/behavioral

therapy therapy methods:methods: 1. 1. Rational Emotive Behavior Rational Emotive Behavior

TherapyTherapy

2. 2. Beck’s Cognitive TherapyBeck’s Cognitive Therapy

Rational Emotive Behavior Rational Emotive Behavior TherapyTherapy

Based on the belief that people are Based on the belief that people are basically logical in their thoughts basically logical in their thoughts and actions and actions but but the assumptions the assumptions they base their thoughts or actions they base their thoughts or actions on are sometimes incorrect.on are sometimes incorrect.

Example of a Example of a false false assumptionassumption: “I MUST do : “I MUST do EVERYTHING perfectly”EVERYTHING perfectly”

No one is perfect. People who No one is perfect. People who believe that they have to do believe that they have to do everything perfect to be happy also everything perfect to be happy also believe that if they are unhappy it is believe that if they are unhappy it is because they did something wrong. because they did something wrong.

No matter how hard you try you will No matter how hard you try you will never be able to live up to an never be able to live up to an unrealistically high standard of unrealistically high standard of perfection.perfection.

ProblemProblem

People are often People are often unaware of their false unaware of their false assumptions.assumptions.

Therapy is supposed to Therapy is supposed to help people help people identifyidentify false assumptionsfalse assumptions and and then challenge them.then challenge them.

Therapy teaches clients Therapy teaches clients to think more to think more realistically.realistically.

Techniques of Techniques of Rational Rational Emotive Behavior Therapy:Emotive Behavior Therapy:

1. 1. role playingrole playing andand modeling modeling good, good, more realistic assumptions.more realistic assumptions.

2. Clients are given homework to do 2. Clients are given homework to do things like readings, and things like readings, and experiments to test assumptions. experiments to test assumptions. The more students do their The more students do their homework in the “real” world, the homework in the “real” world, the more likely they are to be successful more likely they are to be successful with their therapy.with their therapy.

Beck’s Cognitive TherapyBeck’s Cognitive Therapy

Beck’s Cognitive TherapyBeck’s Cognitive Therapy concentrates on restructuring concentrates on restructuring thought processes that may lead to thought processes that may lead to emotional problems like emotional problems like depression.depression.

Behavior TherapyBehavior Therapy

Goal:Goal: Help people to get rid of bad Help people to get rid of bad behaviors, like smoking or behaviors, like smoking or overeating AND/OR start doing good overeating AND/OR start doing good behavior, like eating right and behavior, like eating right and exercising. OR helping people to get exercising. OR helping people to get over a over a phobiaphobia..

Behavior TherapistsBehavior Therapists

Don’t care Don’t care whywhy someone does bad someone does bad behavior. They just want to help behavior. They just want to help that person to that person to CHANGE CHANGE bad bad behavior.behavior.

Behavioral TechniquesBehavioral Techniques

Counter ConditioningCounter Conditioning

Operant ConditioningOperant Conditioning

Counter-conditioning

Training people to NOT do an undesirable behavior

Replace bad behavior with better behavior.

Techniques of counter-conditioning

Systematic Desensitization Modeling Aversive conditioning

Systematic Desensitization

Client is trained to relax in an anxiety producing situation.

Ex: If someone has a fear of spiders they might be systematically desensitized to spiders by being told to relax over and over after they were told to think about spiders until they no longer had anxiety when they heard the word….

Modeling

Client observes and imitates someone else dealing with a feared object in a healthy way.

Aversive Conditioning Therapist replaces a positive response to

doing something unhealthy, with a negative response.

Example: Smoking is a bad habit but it brings pleasure to a smoker.

The therapist tries to make smoking NOT pleasurable but doing something like making a smoker smoke 2 or more cigarettes at once.

Doing this many times may make a person associate smoking with displeasure and it can help them to quit smoking.

Operant Conditioning

Based on the idea that behavior that is reinforced (rewarded) will be repeated and behavior that is NOT reinforced will not be repeated.

Example: Speak English Campaign

Each time you are heard speaking English in the halls you get “money”.

The idea is that the more your English speaking is reinforced with getting money, the more you will speak English.

This is operant conditioning!

Another idea of Operant Conditioning

Successive Approximations: start small. If you have a goal of working out more start by working out for 20 min a day. If you go to the gym and try to run for an hour it’ll be too difficult and you’re likely to feel like your goal is hopeless.

Another example

Someone who has social anxiety might condition themselves to be more comfortable talking to people by just saying “hi” to one person. Eventually they can work up to having conversations but “hi” is a small step that they can do to start.

Does behavior therapy work?

Behavior Therapy tends to be more effective than psychoanalysis or person-centered therapy for disorders like:

Phobias, Post Traumatic Stress Disorder, Compulsions, mild depression, social problems, and self-control problems (drinking, smoking, overeating).

Does behavior therapy work?

It can also help people care for those with schizophrenia and mental retardation but DOES NOT TREAT THESE DISORDERS!

Biological Therapy

Relies on medication, electric shock and psycho surgery to affect the brain in some way to help treat psychological disorders.

Medical Treatments Drug Therapy: Most widely used

biological treatment. 4 major types of medication:

1. anti-anxiety drugs 2. antidepressant drugs 3. lithium 4. anti-psychotic drugs

All of these drugs require a prescription.

Anti-anxiety drugs

Help people with panic attack or anxiety disorders.

Helps people with serious tension and stress in their lives.

Anti-anxiety drugs

How do they work? They lower heart rate and breathing.

Decrease feelings of nervousness and tension.

NOT a permanent cure for anxiety disorders

ALSO drugs become LESS effective the more they are taken. So people start to need higher and higher does.

Side effects: fatigue and dependence

Anti-depressant Drugs

To treat depression and sometimes eating disorders and panic disorders.

What do they do?: Basically, they help to increase

chemicals and hormones in the brain that are linked to happiness.

Lithium

Helps people with Manic Depression (They have extreme happiness and excitement one moment and extreme depression or sadness the next.

How does it work: Lithium seems to flatten out the cycles for a more constant state instead of the extreme highs and lows.

Anti-psychotic drugs

Reduce agitation, delusions and hallucinations (believing/seeing/hearing things that aren’t really there)

Who do anti-psychotic drugshelp? People with Schizophrenia

Electroconvulsive Therapy

Passes an electric shock through a patient’s head and produces convulsions.

It’s supposed to help people who do not respond to drug therapy.

It has helped many people.

Psychosurgery

Brain surgery to treat people with psychological disorders.

Example: Prefrontal Labotomy: is used to reduce agitation and violence in people with severe psychological disorders. VERY rare!

Let’s Review!

Dr. Phil Movie: Psychotherapy and answer questions.

Types of Therapy Worksheet: use your notes and your book page 437.

Cinderella Therapy Packet