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.