Treatment of Psychological

Disorders

Desirée Adams 04/09/09

What we’ll cover

• Misconceptions of Therapy• Types of Therapy

• Psychoanalysis• Cognitive-Behavioral Therapy (CBT)• Mindfulness-Based Cognitive Therapy• Eclecticism

Misconceptions about Therapy

• Video: Analyze This• All “talk therapy” while laying on a

couch• Therapist dominated (therapist

knows more about you than you know about yourself)

• Must be in therapy for years• People in therapy are “weak”• One “a-ha” moment that solves all of

your problems

Psychoanalysis• Freud was the first formal

therapist (physician) • Insight therapy (aka Talk

therapy)• Talking about emotions “cured”

physical problems• Gain insight into self by exposing

unconscious thoughts• Free Association, Dream Analysis

• Insight therapy today

Cognitive-BehavioralTherapy

How CBT came about

• Spawned from Behavior Therapy• 1950’s – 1970’s –Behaviorism movement

• Focused on overt behaviors• Based on Learning Theories• Therapists attempt to change behaviors based

on classical, operant , and observational learning

• Cognitive Therapy• 1980’s – current – Cognition movement

• Focused on thoughts, thinking errors• Therapists attempt to change maladaptive

thoughts

CBT

• Cognitive = “cognitions” or “thoughts”• The way you THINK and what you THINK

• Behavioral = behaviors/actions• What you DO and how you ACT

• Use combinations of verbal/insight interventions with behavioral modifications to change maladaptive beliefs which often lead to maladaptive behaviors

CBT Techniques• Cognitive aspects:

• Identify negative maladaptive thought patterns (like bad habits - automatic)

• How? Thought records

• Challenge thoughts • How? Reality testing/providing evidence

• Create rational rebuttals to irrational thoughts

• How? Specific statements based on evidence

• Thought disorders (i.e., Schizophrenia)• Challenge thoughts• Remove aversive reaction to delusions

Activity Time!Cognitive Restructuring in Action

• Mr. Laurie has recently announced he has “mild depression.” I guess Dr. House is rubbing off on him. Let’s help him with some cognitive restructuring!

• Using the handout provided, give an example of:• Emotion tied to the

event• Automatic/irrational

thought• Rational response

CBT Techniques

• Behavioral Aspects – Depends upon disorder

• Anxiety symptoms• Muscle relaxation, sleep diary/sleep

hygiene, social skills training

• Depressive symptoms• Behavioral activation, pleasant events

schedule, sleep diary/sleep hygiene

• Schizophrenia• Social skills, behavior modification with

token economy (hygiene, social activities)

CBT Techniques

• Homework Assignments!!• Sports Team analogy• If you want to see improvement, you

need to practice outside of session• Cognitive- and behavioral-based

assignments (thought records, sleep diaries/sleep hygiene, social skills)

CBT video

• Aaron Beck treating client using CBT methods• What techniques are being used?• Note the client’s reactions

Mindfulness Based Therapy

Mindfulness-Based Therapy

• Recent adaptation of cognitive therapy

• View thoughts as mental events• Decenter from thoughts• “I am not my thoughts”

• Meditation

• Effective for recurrent depression

Eclecticism

Eclecticism

• Most psychologists practice “eclecticism”• “Melting pot” of therapies –

combining techniques from different types of therapy into one that will work best for the client. • CBT often serves as a basis for most

therapy strategies, but other techniques are incorporated

• Example: Using Free Association to discover the content and type of negative thought patterns

You Be the Psychologist!!

• JA was self-referred to the Psychology Clinic to address complaints of depression.

• Develop a treatment plan based on her clinical presentation and your understanding of appropriate treatment for such symptoms.

Resources

• The University of Alabama’s Counseling Center is open to students and is a great resource. Website:• http://www.sa.ua.edu/Counseling/cou

nseling.html

• Location: 225 Russell Hall• Phone Number: 205.348.3863