A P P S Y C H O L O G Y

TREATMENT AND THERAPIES

WHAT IS PSYCHOTHERAPY?

• Psychotherapy is an emotionally charged, confiding

interaction between a trained therapist and someone

who is dealing with psychological problems

APPROACHES TO THERAPY

Eclecticism approach

• An approach that

examines the client’s

problems and then

based on this analysis

develops and uses a

variety of techniques

and therapies to help

the client

• Includes examining a

variety of sources such as

interviewing patients,

family members, and

psychologists, and

looking over past

research reports in order

to develop a strong

conclusion and offer the

best help possible

Meta Analysis

PSYCHIATRIST VS. PSYCHOLOGIST

Clinical Psychologists

are therapists whose

education includes

doctoral or masters

training in clinical or

counseling psychology

Psychiatrists are medical

doctors who have

completed specific

training in a

psychological specialty.

They have medical

degrees that allow them

to prescribe medication

PSYCHOANALYSIS

PSYCHOTHERAPY

TYPES OF PSYCHOTHERAPY--PSYCHOANALYSIS

• Psychoanalysis was a method

developed by Sigmund Freud who

believed that psychological

problems were the result of

unresolved conflicts within the

unconscious

• Freud felt many of his patients

did not exhibit physical causes

for their psychological problems,

leading him to believe that the

conflicts originated in the

unconscious

PSYCHOANALYSIS METHODS: FREE ASSOCIATION

• Free association- the patient talks freely and

openly, discussing whatever comes to his or

her mind

• Freud would watch for patterns or phrases and

words that the patient would repeat in their

dialogue during free association.

PSYCHOANALYSIS METHODS: FREUDIAN SLIPS

• Freud referred to these statements as Freudian slips, • Occurred when the

patient “slipped” and made a statement that represented a thought from the unconscious that he or she did not consciously intend to say.

PSYCHOANALYSIS METHODS: RESISTANCE

• Resistance occurs when the patient unconsciously

blocks or refuses to discuss laden material or

sensitive

• Patients may not realize (unconsciously blocks) that he or she refuses to not discuss a certain topic.

• Even when asked about the topic the patient still seems to

avoid discussion, and then become defensive when asked

why he or she is not discussing the topic.

Therapist: “Tell me about your relationship with your dad.”

Patient: “I already did!” Therapist: “No, you have not yet discussed that.”

Patient: “I though I did, my brother is in the army.”

Therapist: “I am sorry, but talk to me about your dad”

PSYCHOANALYSIS METHODS: TRANSFERENCE

• Transference occurs when the patient transfers

emotions to the analyst or therapist, that were

meant to be directed towards another person- the

intended source of their conflict or problems

• When you keep on bringing up an issue with a friend, which

he or she does not want to talk about, eventually your

friend may become upset and possibly take out their

emotions on you even though you are not source of the problem

Patient: “YOU WERE NEVER THERE FOR ME- WHY DID YOU LEAVE ME”

Therapist: “I never left you, I am right here:”

Patient: “I can NEVER trust you”

Therapist: “Your mom is not here, I am”

PSYCHOANALYSIS THERAPY

• Psychoanalysis focuses on

childhood memories and conflicts;

involved long sessions- sometimes

years, and requires the patient to

participate on a daily basis

• Most people do not choose

psychoanalysis for therapy because

either they do not have time, or cannot afford all of the required

sessions.

• In addition, most people want a

solution to their problem quickly- not

in several years

PSYCHODYNAMIC THERAPY

• Psychodynamic therapy focuses on

current issues and

problems, and requires

fewer therapy sessions

• People are more

interested in discussing

and developing

resolution with current

problems- not spending

time discussing

childhood events

HUMANISTIC THERAPIES

PSYCHOTHERAPY

TYPES OF PSYCHOTHERAPY- HUMANISTIC THERAPY

• Humanistic therapy aims to promote self-fulfillment

(satisfaction with life) by increasing self-acceptance

(accepting who they are) and self-awareness

(being aware of their strengths and weaknesses)

through the development of free will, which

emphasizes the client making his or her own

decisions and finding solutions for his or her

problems

TYPES OF PSYCHOTHERAPY- HUMANISTIC THERAPY

• Humanistic therapists believed that psychological

problems are the result of inconsistencies, or

incongruence between a person’s self-concept-

thoughts of who they are, and how he or she may

actually behave.

• The aim is to make their thoughts consistent, or

congruent with their actions, while also improving

their self-confidence and self-esteem

HUMANISTIC: CLIENT-CENTERED THERAPY

• Client-centered therapy, or

person-centered therapy, was

developed by Carl Rogers

• Encouraged the therapist to use

active listening, showing

acceptance, and empathy with

the hope that the client will

develop for him or herself

answers to their own problems

HUMANISTIC: CLIENT-CENTERED THERAPY

• An example of client-centered therapy would be

how a friend discusses their conflict or problem

through dominating the conversation by answering

their own questions-

• “Should I leave him? You’re right,” (even though you did

not say anything) I will leave him:”

HUMANISTIC THERAPY: REFLECTION

• Reflection, also called active

listening, requires the therapist

to often repeat and clarify the

client’s thoughts to show the

client that he or she is paying

attention

• Reflection shows a patient that the

therapist is not only listening, but is

also concerned about his or her problems and helping him or her

resolve their issues

Patient: “My mother did not hold me enough.”

Therapist: “Tell me more about your mother not holding you.”

HUMANISTIC THERAPY: UNCONDITIONAL POSITIVE REGARD

• Unconditional positive regard is the therapist’s

acceptance and treating of the client as a valued

person- no matter what the client states

• A patient will be honest when he or she knows the therapist unconditionally accepts him or her and what they have

done or have experienced

Patient: “I have done a lot of bad things.”

Therapist: “You are a good person, we have all done things

that we are ashamed of- I am not perfect.”

HUMANISTIC THERAPY: EMPATHY

• Empathy is the therapist responding to the client in a

way that shows that he or she understands what the

client is going through

Therapist: “I remember when I was scared to ask someone to prom.”

Patient: “You were scared to ask someone out?”

Therapist: “Just like you”

• Clients will have a

tendency to be more open

if they know the therapist

understands why they are

experiencing certain

conflicts and problems

HUMANISTIC THERAPY: GESTALT

• Gestalt therapy, another type of humanistic therapy

developed by Fritz Perls and his wife

• Both believed that a

patient experienced

psychological

problems because

his or her perception

or version of reality

was not consistent

with what actually was occurring.

HUMANISTIC THERAPY: GESTALT

• Gestalt therapists believe that a patient could not begin

to grow psychologically unless his or her thoughts

matched the reality of a situation or circumstances.

• It is the role of a gestalt therapist to make the reality clear to the patient either by reminding them of what they are not doing

enough of- like not trying in a relationship, or what they might

never be able to do- like making a professional football team

Therapist: “The reality is that you have not been there for your wife

as she has asked you to be.”

Client: “Yes I have.”

Therapist: “You have not been home enough.”

Client: “I work a lot”

Therapist: “No, you are hanging with your friends too much.”

BEHAVIORAL THERAPIES

TYPES OF THERAPY- BEHAVIORAL

• Behavior therapy is a type of therapy, which uses

classical conditioning techniques to treat

psychological problems- especially phobias

• Behavioral therapy believes that patients have learned, or formed certain associations, which were responsible for

psychological problems

• for example a fear of heights associated with dying

BEHAVIORAL THERAPY: COUNTERCONDITIONING

• Mary Cover Jones was one of the first behavioral

therapist to use counterconditioning, a technique that

involved modifying behavior through establishing a

new and better conditioned response to a stimulus

• For example, instead of having fear

of riding in a elevator (old

conditioned response) each time a

person would goes up in an elevator

(stimulus) a therapist teaches a

client to remain calm (new

conditioned response) each time he

or she uses an elevator

BEHAVIORAL THERAPY: COUNTERCONDITIONING

• Jones was interested in the study of “Little Albert”

and wondered if it was possible to reverse his

established fear of white rats.

• She utilized countercondtioning with her subject Peter, who was afraid of rabbits, to form a new response of happiness

to replace his fear of rabbits.

• She did this through having Peter do something positive,

like eat his favorite food, while she presented the rabbit, and also have Peter watch other children play presently

with the rabbits.

BEHAVIORAL THERAPY: SYSTEMATIC DESENSITIZATION

• Systematic desensitization, developed by Joe

Wolpe, was a treatment used for anxiety- related

problems.

• This approach would have clients visualize, or

confront, an anxiety provoking stimuli (like a

snake), but instead of becoming anxious the

therapist would help the client develop a better,

more productive response.

• A Four-step process

BEHAVIORAL THERAPY: SYSTEMATIC DESENSITIZATION

• Step 1

• Clients made a desensitization hierarchy, or anxiety

provoking hierarchy, which is a list from least to most of

what causes them to experience anxiety

Clients who have a fear of riding in an elevator Most stressful: Riding in an elevator Stressful: Pressing a button on an elevator Least stressful: Looking at an elevator

BEHAVIORAL THERAPY: SYSTEMATIC DESENSITIZATION

• Step 2

• Clients then learn progressive relaxation techniques, which

are techniques that show to relax when confronted with an

anxiety- provoking thought

Therapist: “What do you like to do that makes you feel good?”

Client: “Cook.”

Therapist: “From now on, when you get nervous, you are going to

think about cooking.”

BEHAVIORAL THERAPY: SYSTEMATIC DESENSITIZATION

• Step 2

• Clients then learn progressive relaxation techniques, which

are techniques that show to relax when confronted with an

anxiety- provoking thought

Therapist: “What do you like to do that makes you feel good?”

Client: “Cook.”

Therapist: “From now on, when you get nervous, you are going to

think about cooking.”

BEHAVIORAL THERAPY: SYSTEMATIC DESENSITIZATION

• Step 3

• Wolpe would then have clients’ progress through their

anxiety- provoking list, starting with the least stressful aspect

and then progressing to the next aspect.

Client’s Anxiety Hierarchy

• First: Looking at an elevator

• Second: Pressing a button on an elevator

• Third: Riding in an elevator

BEHAVIORAL THERAPY: SYSTEMATIC DESENSITIZATION

• Step 4

• If any anxiety appeared in response to the list, clients were

instructed to utilize one of the progressive relaxation

techniques- once better, the client returned back to the list.

First: Looking an elevator- client can do it without any problem

Second: Pressing a button on an elevator- client starts to shake so

therapist has client imagine buying groceries to cook

Third: Riding in an elevator-client again starts to experience anxiety so therapist has client picture self cooking

BEHAVIORAL THERAPY: EXPOSURE TECHNIQUES

• Exposure techniques are techniques in which the

client stays in contact or is exposed to an anxiety-

evoking stimuli long enough for their anxiety to

disappear- this is referred to as flooding

• Ex: Making a person ride a roller coaster.

• Some people may be very scared when they get on the roller

coaster, but as the ride continues their fear decreases.

• However, for some people exposure techniques do not work

and actually make their anxiety worse.

BEHAVIORAL THERAPY: AVERSIVE CONDITIONING

• Aversive conditioning is a type of counterconditioning,

which associates an unpleasant state with an unwanted

behavior

• Person with an alcohol problem takes a drug

(UCS) that when combined with alcohol

automatically causes nausea (UCR)

Unpleasant state- nausea

Unwanted behavior- drinking alcohol

BEHAVIORAL THERAPY: AVERSIVE CONDITIONING

• Alcohol becomes the (CS) from being paired with the

drug that automatically causes nausea (UCS) and the

nausea now becomes the (CR)

• Result: Each time the person drinks alcohol while taking

this drug he or she would get sick as resulting in the

person forming an association of vomiting with alcohol

Acquisition: (NS) Alcohol + drug (UCS)= nausea (UCR)

BEHAVIORAL THERAPY: BELL AND PAD TREATMENT

• Bell and Pad treatment is used to treat nighttime

bedwetting

• Body arousal (UCS) should automatically cause child to get out

of bed (UCR)

• Some children however, have a difficult time making this

association. A bell is then hooked up to their sheets and anytime

pee hits the sheet the bell goes off- taking the place of their

body waking him or her up

(NS) Bell + body arousal (UCS) causes getting

out of bed (UCR)

Bell (CS)= getting out of bed (CR)

BEHAVIOR MODIFICATION

• Behavior modification is a type of behavioral treatment,

which uses operant conditioning techniques to treat

psychological problems

BEHAVIOR MODIFICATION: TOKEN ECONOMY

• Token economy, based on positive reinforcement, modifies behavior through giving rewards following desired behavior • Rehabilitation centers often use

token economies to help patients develop better habits and social skills.

• Patients earn tokens for exhibiting desired behavior, which they then can exchange for desired merchandise.

BEHAVIOR MODIFICATION: EXTINCTION

• Extinction is used to

eliminate a negative

behavior through the

gradual disappearance

of a conditioned

response through

nonreinforcement

BEHAVIOR MODIFICATION: EXTINCTION

• Some children learn that if they scream and throw a temper tantrum then they can get what they want.

• This occurs because parents reinforce (increasing) their child’s behavior of temper tantrums by giving the child what they want- attention. • What type of reinforcement is

this?

BEHAVIOR MODIFICATION: EXTINCTION

• In order for a parent to

extinguish (stop) their

child’s temper tantrums,

then the parent has to

ignore (nonreinforcement)

their child when he or she

displays a tantrum- in other

words, not give positive

reinforcement after the

temper tantrum.

BEHAVIOR MODIFICATION: MODELING

• Modeling- demonstrating positive behavior for those who need more positive role models • Parents who do not

want their son or daughter to drink or smoke should not be partaking in these activities in front of their children

COGNITIVE-BEHAVIORAL THERAPY

TYPES OF BEHAVIORAL THERAPY

COGNITIVE-BEHAVIORAL THERAPY

• Cognitive-behavioral therapy

is based on learning

techniques and

help clients to

change the way

they not only think,

but also the way they act

THE CBT MODEL

RATIONAL-EMOTIVE THERAPY

• Rational Emotive therapy- ABC model- written by

Albert Ellis; developed a

therapy that corrected and improved a person’s

beliefs that surrounded an

activating event.

• According to Ellis, negative

beliefs are responsible for

the consequences, like

depression a person

experienced

RATIONAL-EMOTIVE THERAPY

The Scenario

• A person believes that

he or she has a fear of

talking in front of

people and therefore

refuses to take a job

that has employees

give presentations.

Rational-Emotive Treatment

• Ellis would tell the patient that it is not their fear of talking in front of people that causes their anxiety, but their negative belief that they may embarrass themselves that is actually causing their anxiety

RATIONAL-EMOTIVE THERAPY IN ACTION

• A- activating event- talking in front of people

• B- beliefs- will embarrass himself or herself in public

• C- anxiety

• Solution: help the client realize that their anxiety is caused by their negative belief of embarrassing him or herself and then try to eliminate this negative belief by replacing it with a positive belief- like “I can speak in public.”

COGNITIVE THERAPIES

PSYCHOTHERAPY

COGNITIVE THERAPY

• Cognitive therapy teaches

people new and better

methods of thinking and

acting through the belief

that a patient’s negative

thoughts are responsible for

psychological problems.

• The goal of cognitive

therapy is to improve the

way a person thinks.

CT-COGNITIVE THERAPY

• Cognitive therapy (CT), developed by Aaron Beck,

addresses a patient’s negative thoughts and irrational

beliefs through having the patients actively go out

and test new types of thinking and beliefs

• Beck would teach a client a

better type of thinking and

then have the client go into

a realistic situation and try

that type of thinking in actual

situations

CT-COGNITIVE THERAPY IN ACTION

• Patient: “No girls find me interesting and want to go out with me”

• Ellis: “Next time you are out I want you to initiate a conversation with a girl.”

• Patient: “What if the girl does not take an interest in me”

• Ellis: “You will not know until you try!”

Next session:

• Ellis: “How did it go?”

• Patient: “I went up to a girl, but she said she did not want talk?”

• Ellis: “Maybe she had a boyfriend?”

• Patient: “I did not think about that.”

OTHER THERAPIES

PSYCHOTHERAPY

GROUP THERAPIES

• Group therapy

involves one or

more therapists

working together

with a small

group of clients

Advantages: helping more people, sessions cost

less for the patient, and observing other people

with similar problems help others understand

their own problems as well as provide support

and empathy for fellow group members

GROUP THERAPIES--FAMILY

• Family therapy is aimed

at teaching the family

that they a are system

meant to work together

not to be individuals

and stay apart

Families who experience problems often do not work

together as a system, but rather do their own thing and

expect the other family members to understand.

In response, a family therapist will often have families

work on projects and partake in activities together to

regain their sense of togetherness.

GROUP THERAPIES--COUPLES

• Couples therapy

teaches better

communication skills to

solve problems

Most couple therapists find that lack of

communication or not talking about problems affects

relationships.

One of the first steps a couple’s therapist will perform is

to have the couple talk about their problems.

LIGHT-EXPOSURE THERAPY

• Light-exposure therapy is used to treat seasonal affective disorder, which occurs when patients become depressed in association with certain seasonal changes especially winter • Light-exposure therapy

sometimes helps these people through exposing patients to artificial light.

BIOMEDICAL THERAPIES

BIOMEDICAL THERAPY

• Includes the use of

prescription drugs,

ECT therapy,

psychosurgery to

treat psychological

disorders because

they believe the

brain is responsible

for psychological

disorders

BIOMEDICAL THERAPY-ANTIPSYCHOTIC DRUGS

• Antipsychotic drugs called neuroleptics are used to treat severe psychotic disorders, like schizophrenia through blocking the high activity of dopamine, which could be responsible for delusions and hallucinations

BIOMEDICAL THERAPY-ANTIPSYCHOTIC DRUGS

• Thorazine was one of the

first drugs used to treat

schizophrenia

• A side effect of thorazine was

tardive dyskinesia, that is

characterized by involuntary

muscle tremors resulting from

low levels of dopamine-

similar to Parkinson’s disease

*remember antipsychotic

drugs reduce levels of

dopamine*

video

BIOMEDICAL THERAPY- ANTIANXIETY DRUGS

• Antianxiety drugs are used to treat

symptoms of anxiety through boosting the

neurotransmitter GABA, which slows down

activity in the brain

• Valium and Xanax are examples of antianxiety

medications

These drugs should not be taken with alcohol

because the combination could slow the brain

activity to a dangerous level/ alcohol slows down

neural activity

BIOMEDICAL THERAPY- ANTIDEPRESSANT DRUGS

• Antidepressant drugs are used to treat

depression

• Selective serotonin reuptake inhibitors (SSRIs), like

Prozac, Zoloft, Paxil, are designed to keep the

neurotransmitter serotonin active in the synapse

longer by slowing down the reuptake process

resulting in serotonin having more of an effect in

the brain and body

SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS)

• When sending neurons release neurotransmitters

there are some

neurotransmitters that are not absorbed by other

receiving neurons, leaving

them in the synapse.

• Normally, the

neurotransmitters are sucked

back like a vacuum (referred

to as the reuptake process)

by the sending neuron to be

used later.

SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS)

• SSRI’s slow down the

reuptake process allowing

the neurotransmitters to go

to the next neuron and have

an effect on the brain and

body

• However, some people who experience depression

have sending neurons that suck back (reuptake

process too fast) the neurotransmitters too quickly--

before the neurotransmitters ever have a chance to

go to the receiving neuron.

video

BIOMEDICAL THERAPY- ANTIDEPRESSANT DRUGS

• Lithium is used to

treat bipolar

disorder by

equalizing the

manic and

depressive episodes

• Depakote is a new

drug used to treat

bipolar that is

becoming more

popular than lithium

because of fewer

side effects and

does not require as

high of a dose

compared to

lithium

BIOMEDICAL THERAPY- ANTIDEPRESSANT DRUGS

• Electroconvulsive therapy (ECT) is used to treat major depression in which a brief electrical current is sent to the brain to speed up activity • Side effects of ECT

include memory loss, and often is only temporary in treating depression

BIOMEDICAL THERAPY- ANTIDEPRESSANT DRUGS

• Lobotomies were performed to treat patients with psychotic behaviors such as inappropriate emotions and thoughts

• severing neural tissue in the frontal lobes (lobe in charge of thinking and planning)- the problem is that once a lobotomy is performed, the procedure cannot be reverse

• Psychosurgery is a surgical

procedure that

destroys tissue in the brain to treat

psychological

disorders

COMMUNITY PSYCHOLOGY

COMMUNITY PSYCHOLOGY

• Community psychology is a movement to minimize or prevent psychological disorders through changing the way patients seeks and is given help.

• Community psychologists visit poverty or low-income environments and make sure that residents have adequate assistance

DEINSTITUTIONALIZATION

• Deinstitutionalization

was the release of

patients from

hospitals due to

cutbacks in mental

health programs-

patients were

released with no

further treatments.

EVALUATING THE VARIOUS THERAPIES

WHAT CAN WE DO?

PERSPECTIVE REVIEW