THERAPIESPertemuan 23

Matakuliah : L0014 / PSIKOLOGI UMUMTahun : 2007

Psychotherapy • Specialized process where trained professional

uses psychological methods• Differing forms of psychotherapy have

differing methods– Psychoanalytic: focuses on gaining insight– Humanistic: focuses on gaining insight– Social learning or behavior therapy: uses forms of

teaching

Therapies

Psychotherapy (2)• Relationship involves power of therapist,

emotional patient divulging personal data• Ethical Standards

– Goals of treatment understood/agreed to by client; in best interest of client and society

– Careful consideration given to alternatives– Therapist treats only within limits of expertise

Therapies

Psychotherapy (3)• Ethical Standards

– Effectiveness of treatment must be evaluated– Rules and laws of confidentiality followed– No abuse of therapist-client relationship– Therapist must treat all humans with dignity;

respecting all genders, races, sexual orientation, and other sociocultural factors

Therapies

Therapies (1) • Psychoanalysis – founded by Freud

– Root of all problems is in unconscious conflicts– Imbalance in id, ego, and superego– Conscious insight can resolve conflicts– Special therapy techniques may be used

• Free association• Dream interpretation• Interpretation of resistance (from vague forms to

specific resistance)

Therapies

Therapies (2) • Psychoanalysis

– Transference – therapist-client relationship takes form of client’s relationships with own parents and other authority figures

– Catharsis – emotional experience or temporary relief from discomfort (some insight gained)

– Interpersonal psychotherapy for depression• Emerged from psychoanalytic tradition• Identifies sources of depression and goals for therapy

process; very successful outcomes

Therapies

Therapies (3) • Humanistic psychology – Carl Rogers

– People not born with unconscious mind– Client-centered therapy or person-centered

• Emphasis on client’s ability to help self – feels emotionally safe enough to explore own hidden emotions

• Therapist creates unconditional atmosphere (warmth, genuine positive regard, empathy)

– Reflection – therapist makes statements to clarify client’s feelings and emotions

Therapies

Therapies (4)• Gestalt therapy – founded by F. Perls

– Humanistic psychotherapy approach– Meanings of sensations organized into whole

perceptions– Goal: create therapeutic experience helping client

achieve greater self-awareness– Emotional atmosphere: therapists often deal in

confrontive, challenging manner necessary to loosen denied feelings

Therapies

Therapies (5) • Cognitive-Behavior Therapy (CBT)

– Abnormal behavior learned from inappropriate experiences through

• Classical conditioning• Operant conditioning• Modeling

– Learning is central goal of therapy; therapist is teacher and client learns adaptive behaviors

– Cognitions less important

Therapies

• Cognitive-Behavior Therapy (CBT)

– Fear reduction methods using • Graded exposure - series of increasingly fearful situations

experienced for gradual mastery• Use of modern technology - computer-generated virtual reality

• Treats obsessive-compulsive disorders when used with other methods

– Social skills training• Shaping and positive reinforcement used in role playing• Teach use of adaptive skills enough to handle real-life situations• Focus on social skill problem of unassertiveness

Therapies

• Cognitive-Behavior Therapy (CBT)– Cognitive restructuring

• Assumes faulty cognitions – maladaptive beliefs, expectations, and thinking

• Effective for treating anxiety, depression• Cannot modify clients’ existing behaviors because of inaccurate ways of

thinking about themselves• Patterns of cognition contributing to emotional distress

Therapies

– Selective abstraction

– Overgeneralization– Arbitrary

interference

–Magnification and minimization

–Personalization–Absolutistic thinking

Group and Family Therapy (1)• Group therapy

– Carried out with groups of 4 to 8 clients; sees experience more effective than individual therapy techniques

• Receives encouragement from others• Sees problem experienced by others• Learn from others’ advice• Learn new ways to interact with others • Format of group therapy varies widely

Therapies

Group and Family Therapy (2)• Family therapy

– Group composed of family members– Therapist trained in psychoanalytic, humanistic, and

behavioral approaches– Beliefs

• Family issues at root of problem• Dynamics of family system need analysis – function of each

need to be understood– Therapists’ goals to resolve problems by improving

functioning of family system• Give family members insights and correct family dysfunctions• Increase warmth and intimacy in family• Improve family member communication• Help members establish reasonable set of rules for family

regulation

Therapies

Human Diversity• Ethnic, gender, and sexual issues in mental

health – U.S. has one of most advanced mental health system in

world – does not cover all citizens• Hispanics - less outpatient care than whites• African Americans – more likely than whites to be

committed to psychiatric hospitals (often involuntarily)– U.S. mental health system

• Fewer women receive mental health services than men• Gender of therapist does not appear to influence outcomes

– Feminist psychotherapy – radical approach• Women treated as second-class citizens and Barbie dolls

Therapies

Human Diversity• Goals of Feminist Psychotherapy

– Advocates equal relationship in therapy– Encourage women to see how society limited them

to dependent roles– Encourage women to become aware of their anger;

find constructive ways of expressing– Have women define selves as independent– Women encouraged to consider own needs– Women should develop nontraditional skills

Therapies

• Drug therapy – Widely used to treat abnormal behavior– Commonly used psychiatric drugs

– Electroconvulsive therapy (ECT)– Transcranial stimulation

• Magnetic field used on frontal cortex

Therapies

• Effexor• Paxil • Prozac

• Zorloft • Xanax• Geodon

• Haldol• Navane• Risperdal

• Zyprexa• Depakote• Epilim

Medical Therapies• Psychosurgery

– Trephining – Prefrontal labotomy– Modern names for labotomy surgeries

conducted today• Capuslotomy • Cingulotomy

Therapies

Trephining operations were

apparently performed in

the Middle Ages to treat

abnormal behavior