Psychotherapy:Psychotherapy:……it is a planned emotionally it is a planned emotionally charged confiding interaction charged confiding interaction

between a trained professional between a trained professional and a sufferer.and a sufferer.

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Major Theories used in Major Theories used in treatment:treatment:

• Psychoanalysis, Humanistic, Behavioral, Psychoanalysis, Humanistic, Behavioral, CognitiveCognitive

• BiomedicalBiomedical

• We will look at each in terms of aims, We will look at each in terms of aims, methods, and limitations/criticisms. methods, and limitations/criticisms.

Those who provide Those who provide treatment:treatment:• Psychologist- doctoral degree that includes Psychologist- doctoral degree that includes

training in diagnosis and treatment of training in diagnosis and treatment of disorders.disorders.

• Psychiatrist- M.D. who specializes in Psychiatrist- M.D. who specializes in treatments of psychological orders.treatments of psychological orders.

• Social Worker- part of a team in monitoring Social Worker- part of a team in monitoring treatments.treatments.

• Counselor- provides limited psychotherapy to Counselor- provides limited psychotherapy to those who do not have serious mental those who do not have serious mental problems.problems.

Ethics:Ethics:

• All information must be kept All information must be kept confidential.confidential.

• One exception- if the patient One exception- if the patient threatens to hurt someone else.threatens to hurt someone else.

Psychoanalytic Treatment Psychoanalytic Treatment Aims:Aims:• Problems stem from childhood anxiety.Problems stem from childhood anxiety.

• Insight therapy helps patients develop Insight therapy helps patients develop an understanding of inner conflicts.an understanding of inner conflicts.

• Freud founding father of Psychoanalysis.Freud founding father of Psychoanalysis.

• Psychodynamic therapists are the more Psychodynamic therapists are the more modern adaptation.modern adaptation.

Psychoanalytic Treatment Psychoanalytic Treatment Methods:Methods:

• Emphasizes the importance of the Emphasizes the importance of the unconscious mind and historical unconscious mind and historical reconstruction.reconstruction.– Free Association- verbalization of any Free Association- verbalization of any

thoughts or feelings that come to conscious thoughts or feelings that come to conscious mind.mind.

– Dream Analysis- a patient’s unfulfilled wishes Dream Analysis- a patient’s unfulfilled wishes and desires are part of latent dream content.and desires are part of latent dream content.

– Insight (interpretation) is offered.Insight (interpretation) is offered.– VideoVideo

Humanistic Therapy Aims:Humanistic Therapy Aims:

• Emphasize a persons inherent Emphasize a persons inherent potential for self-fulfillment.potential for self-fulfillment.

• Grow in self-awareness and self Grow in self-awareness and self acceptance.acceptance.

• Focus on conscious thoughts, Focus on conscious thoughts, responsibility, growth, the present, responsibility, growth, the present, and future. and future.

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Humanistic Therapy Humanistic Therapy Methods:Methods:• Client-centered therapy- focus on self perception Client-centered therapy- focus on self perception

rather than therapist interpretation.rather than therapist interpretation.– Client and Therapist are equal parts of the healing Client and Therapist are equal parts of the healing

process.process.– Emphasis is on active listening.Emphasis is on active listening.– Client-centered therapy must have 3 conditions for it to Client-centered therapy must have 3 conditions for it to

work:work:• GenuinenessGenuineness• Unconditional positive regardUnconditional positive regard• EmpathyEmpathy

• Group TherapyGroup Therapy• Family TherapyFamily Therapy

Behavior Therapy Aims:Behavior Therapy Aims:

• Emphasis on changing learned Emphasis on changing learned behaviors rather than understanding behaviors rather than understanding feelings.feelings.

• Evolved out of classical conditioning Evolved out of classical conditioning and operant conditioning. and operant conditioning.

• Common applications- Anxiety and Common applications- Anxiety and Phobic Disorders.Phobic Disorders.

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Behavior Therapy Methods:Behavior Therapy Methods:

• Counterconditioning-Counterconditioning-– Systematic Desensitization- gradual Systematic Desensitization- gradual

decrease in anxiety by creating new decrease in anxiety by creating new associations for the stimulus. (virtual associations for the stimulus. (virtual therapy)therapy)

– Aversion Therapy- creates an unpleasant Aversion Therapy- creates an unpleasant response to a previously enjoyable response to a previously enjoyable stimulus. (Antabuse)stimulus. (Antabuse)

• Operant Conditioning- behavior Operant Conditioning- behavior modification, token economy.modification, token economy.

Cognitive Therapy Aims:Cognitive Therapy Aims:

• Thinking controls our feelings.Thinking controls our feelings.

• Teach people new ways of thinking.Teach people new ways of thinking.

• Used widely for depression.Used widely for depression.

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Cognitive Therapy Methods:Cognitive Therapy Methods:

• Therapist help clients to reverse Therapist help clients to reverse negative beliefs. negative beliefs.

• Positive thinking exercises.Positive thinking exercises.

• Cognitive-Behavior Therapy-Cognitive-Behavior Therapy-– Integrates two styles.Integrates two styles.– Change the way we act and think.Change the way we act and think.

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The Biomedical TherapiesThe Biomedical TherapiesThese include physical, medicinal, and These include physical, medicinal, and

other forms of biological therapies.other forms of biological therapies.1. Drug Treatments2. Surgery3. Electric-shock therapy

Used if:1. The client is too agitated, disoriented, or unresponsive for psychotherapy.2. The disorder has a strong biological component.3. Dangerous to themselves or others.

Biomedical Therapy Aims:Biomedical Therapy Aims:

• Specific medical procedures and Specific medical procedures and medications that can help relieve medications that can help relieve symptoms of disorders.symptoms of disorders.

• Most often used in conjunction with Most often used in conjunction with talk therapy.talk therapy.

Biomedical Therapy Biomedical Therapy Methods:Methods:• Drug therapyDrug therapy

– Medications are divided into 4 categories:Medications are divided into 4 categories:• Anti-psychotics-similar to dopamineAnti-psychotics-similar to dopamine• Anti-depressants-increase norepinephrine and serotoninAnti-depressants-increase norepinephrine and serotonin• Anti-convulsantsAnti-convulsants• Anti-anxietyAnti-anxiety

– They reduce or increase activity at all They reduce or increase activity at all receptor sites for NT.receptor sites for NT.

– Video of how NT and drugs (Zoloft) work.Video of how NT and drugs (Zoloft) work.– Electroconvulsive- Shock therapy used to Electroconvulsive- Shock therapy used to

treat depression. rTMS modern approach.treat depression. rTMS modern approach.• Psychosurgery- least used. eg. LobotomyPsychosurgery- least used. eg. Lobotomy

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Evaluating PsychotherapiesWithin psychotherapies cognitive

therapies are most widely used, followed by psychoanalytic and family/group

therapies.

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The Relative Effectiveness of The Relative Effectiveness of Different TherapiesDifferent Therapies

Which psychotherapy would be most effective Which psychotherapy would be most effective for treating a particular problem?for treating a particular problem?

Disorder Therapy

Depression Behavior, Cognition, Interpersonal

Anxiety Cognition, Exposure, Stress Inoculation

Bulimia Cognitive-behavior

Phobia Behavior

Bed Wetting

Behavior Modification