THERAPYChapter 16

I. THE PSYCHOLOGICAL THERAPIES Psychotherapy – Planned, emotionally

charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties.

I. PSYCHOLOGICAL THERAPIES

Psychoanalysis – Sigmund Freud’s therapeutic technique whose aims are to bring repressed feelings into conscious awareness and gain insight into the origins of disorder. (Sheldon)Free associationResistance – Blocking of anxiety provoking

feelings and experiences. Interpretation is based on suggestions of

underlying wishes, feelings or conflicts.Dream analysisTransference – Transfer of emotions linked with

other relationships to the therapist.Psychodynamic Theory – Understand

symptoms by exploring childhood experiences.

I. PSYCHOLOGICAL THERAPIES

Humanistic Therapy – Aim is to boost self-fulfillment by helping people grow in self awareness. Client Centered Therapy – Use techniques like

active listening in a genuine and accepting environment to encourage client growth.

Active listening – Involves echoing, restating and clarifying.

I. PSYCHOLOGICAL THERAPIES Behavior Therapy – Applies learning

principles to the elimination of unwanted behaviors.Classical Conditioning Ideas

Counter conditioning – pairs the trigger stimulus with a new response that is incomparable to the old stimulus.

Systematic desensitization – Association of a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. (Often used to treat phobias)

Aversive Conditioning – Association of an unpleasant state (ex. Nausea) with an unwanted behavior (ex. Drinking alcohol)

I. PSYCHOLOGICAL THERAPIES

Aversion therapy for alcoholism After repeatedly imbibing an alcoholic drink mixed with a drug that produces severe nausea, some people with a history of alcohol abuse develop at least a temporary conditioned aversion to alcohol.

I. PSYCHOLOGICAL THERAPIES

Behavior Therapy (continued)Operant Conditioning Ideas

Reward used varies Token Economy – Rewards desired behavior with

tokens that can be exchanged for privileges or treats (often used in institutional settings) Token economy and autism

I. PSYCHOLOGICAL THERAPIES

Cognitive Therapies – Assume that our thinking colors our feelings; that between the event and our response is our mind. Cognitive Therapy for Depression

Reverse clients negative belief about themselves, their situation and their future.

Cognitive Behavior Therapy – Aims to alter the way people act and think.

I. PSYCHOLOGICAL THERAPIES

Cognitive therapy for depression. After undergoing a program that trained them to think more like non-depressed people (by noticing and taking personal credit for good events and by not taking blame for or over-generalizing from bad events) patients’ depression dropped dramatically. (From Rabin & oth-ers, 1986.)

I. PSYCHOLOGICAL THERAPIES Group and Family Therapies

Show people they aren’t aloneSelf help and support groups (ex. AA and

Alanon)Family Therapy – treats the family as a

whole, a system that works together.

II. EVALUATING PSYCHOTHERAPIES Is it Effective?

Client perspective 75-80% are satisfied with results Caution:

People enter therapy in crisisThere is a need to believe it was worth the

effortGenerally like the therapist and therefore

speak kindly of him/herClinician perspective

Self-serving bias (Would you say no if someone asked you if you were successful?)

Often credit themselves, but could it possibly be something else?

II. EVALUATING PSYCHOTHERAPIES Treatment versus no treatment These two

normal distribution curves based on data from 475 studies show the improvement of untreated people and psychotherapy clients. The outcome for the average therapy client surpassed that for 80 per-cent of the untreated people. (Adapted from Smith & others, 1980.)

II. EVALUATING PSYCHOTHERAPIES Alternative Therapies

Therapeutic touch – Move hands a few inches from patient’s body, “pushing energy fields into balance” (Scientific verdict – NO)

Eye Movement Desensitization and Reprocessing (EMDR) While imagining a traumatic scene, therapist

triggers movement by waving a finger in front of the patients eyes (lowers anxiety)

Results attributed to reliving trauma in a safe place and power of positive belief

Light exposure therapy – Effective treatment for Seasonal Affective Disorder (SAD)

II. EVALUATING PSYCHOTHERAPIES

Commonalities among PsychotherapiesOffers expectation that things can/will get

betterOffer an alternative way to look at selfChance for new experiencesEmpathetic, trusting and caring relationship

III. BIOMEDICAL THERAPIES

Drug therapiesPsychopharmacology – Use of drugs to

treat mental disorders.Drug therapy is a contributing factor to the

decline of mental hospital residents. Electroconvulsive Therapy (shock

treatment) – Patients are given general anesthetic and muscle relaxants; reserved for severely depressed patients. (example)

III. BIOMEDICAL THERAPIES Psychosurgery – Surgery that removes

or destroys brain tissue. (Most dramatic and least used)Lobotomy – Cut the nerves that connect the

frontal lobes to the emotion controlling centers of the inner brain. (Calmed uncontrollably emotional and violent patients)

Treatment of last resort – Irreversible

PBS Documentary – Walter Freeman, American Lobotomist

IV. PREVENTING PSYCHOLOGICAL DISORDERS

Preventative Mental Health – Aim is to change oppressive, esteem destroying environments into more benevolent, nurturing environments that foster individual growth and confidence.

A healthy mind in a healthy body