1 therapy approaches biomedical therapy psychotherapy alternative therapies the power of forgiveness
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Therapy Approaches• Biomedical Therapy
• Psychotherapy
• Alternative Therapies
• The Power of Forgiveness
Biomedical Therapies
1. Drug Therapies- Antipsychotic Drugs
- Antianxiety Drugs
- Antidepressant Drugs
- Mood-Stabilizing Medications
2. Brain Stimulation- Electroconvulsive Therapy
- Alternative Neurostimulation Therapy
3. Psychosurgery
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Biomedical Therapies(1) Drug Therapies
• 1-Antipshchotic Drugs
• 2-Antidepressant Drugs
• 3-Tranquilizers
• 4-Mood-Stabilizing Medicines
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1-Antipsychotic Drugsor Neuroleptics
Good for treating psychosis and schizophreniaExample: ThorazineReduce receptivity to dopamine or increase
serotoninReduce positive symptoms of schizophreniaDo not relieve other negative symptoms
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Antipsychotic Drugsand Schizophrenia
• Good for reducing:
• Agitation• Delusions• Hallucinations• Can shorten
schizophrenic episodes
• Offers little relief from:
• Jumbled thoughts• Difficulty
concentrating• Inability to interact
with others
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2-Antidepressant Drugs• Treat depression, anxiety, phobias, OCD• Example: Prozac, Zoloft, and Paxil• Non addictive but can cause side effects• 1-Monoamine oxidase inhibitors (elevate levels of
ser. & nor. by blocking inhibitors)• 2-Tricyclic antidepressants (boost nor. & ser. by
preventing their reabsorption)• 3-Selective serotonin reuptake inhibitors
(work on serotonin)
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3-Tranquilizers
• Prescribed for depressed mood, panic, and anxiety
• Example: Valium
• Increase activity of neurotransmitter GABA
• If overused can result in tolerance and withdrawal
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4-Mood-Stabilizing MedicationsLithium Carbonate
• Prescribed for bipolar disorder
• Can be dangerous if not given in the right doze
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Cautions about Drugs
• Placebo effect
• Relapse and drop out rates
• Dosage problems
• Long-term risks
• Overprescription
• Sometimes they have to be with therapy
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The Placebo EffectKirsch and Sapirstein (1998)
• 7315 participants
• 41% of those receiving antidepressants experienced reduced symptoms.
• 31% of those given placebos also received reduced symptoms.
Biomedical Therapies(2) Brain Stimulation
• Electroconvulsive Therapy
• Alternative Neurostimulation Therapies- Deep-Brain Stimulation- Magnetic Stimulation
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Biomedical TherapiesElectroconvulsive Therapy ECT
• After three sessions each week for two or four weeks, 80% of people receiving ECT improve markedly, showing no brain damage.
• ECT reduces suicidal thoughts and is credited with saving many from suicide.
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Biomedical TherapiesAlternative Neurostimulation Therapy
1. Deep-Brain Stimulation
• Helen Mayberg and her colleagues have been focusing on a cortex area that bridges the thinking frontal lobes to the limbic system.
• They have discovered that this area, which is overactive in the brain of a depressed or temporarily sad person, becomes calm when treated by ECT and antidepressants.
• Among 12 patients receiving implanted electrodes and a pacemaker stimulator, 8 experienced relief.
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Biomedical TherapiesAlternative Neurostimulation Therapy
2- Magnetic Stimulation• Unlike deep-brain stimulation, the magnetic energy
penetrates only the brain’s surface.• The painless procedure – called repetitive
transcranial magnetic stimulation (rTMS) – is performed on wide-awake patients over several weeks.
• In a study on 67 Israelis with major depression, at the end of two weeks, half the stimulated patients showed at least a 50%improvement in their scores on a depression scale.
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Psychosurgery• Egas Moniz who developed the Lobotomy in the
1930s found that cutting the nerves connecting the frontal lobes with the emotion-controlling centers of the inner brain calmed uncontrollably emotional and violent people (disconnecting emotion from thought).
• He was honored with a Nobel Prize for developing this procedure.
• It produced a permanently lethargic, immature, and uncreative people.
Three Elements Shares by All Forms of Psychotherapy
• Hope for Demoralized People
• A New Perspective
• An Empathetic, Caring, Trusting Relationship
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Psychodynamic Therapy
• Probes the past
• Doesn’t tackle the immediate problem
• The goal is insight
• Takes a long time
• Explores the unconscious
• Methods: free association, interpretation of dreams, & transference
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• InterpretationThe analyst noting supposed dream meanings,
resistances, and other significant behaviors in order to promote insight.
• ResistanceIn psychoanalysis, the blocking from
consciousness of anxiety-laden material.• TransferenceThe patient’s transfer to the analyst of
emotions linked with other relationships (such as love or hatred for a parent)
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Behavioral Techniques
Learning
Conditioning
Association between
Environmental Stimuli + ResponseClassical Conditioning Operant Conditioning
Association Reinforcement/
Stimulus-Response Punishment
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Behavioral Techniques
• There are no mental processes (will, mind)
• Derived from classical and operant conditioning
• The focus is on changing the behavior
• Works on the immediate problem
• Focuses on the present
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• Ivan Pavlov
• Conditioning
Learning that involves associations between environmental stimuli and the organism’s responses
• Stimulus-response Learning
Classical Conditioning
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Classical Conditioning in Real Life
• Learning to like
• Learning to fear
• Accounting for Taste
• Reacting to Medical Treatment
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Operant Conditioning
• The behavior is more likely or less likely to occur based on its consequences.
• B. F. Skinner modified Pavlov’s concept.
• Skinner used reinforcement and punishment to enhance learning.
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Behavioral Techniques
• Systematic Desensitization/Counter Conditioning
• Aversive Conditioning
• Exposure Treatment (Flooding)
• Behavioral Records & Contracts
• Skills Training
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Systematic Desensitization
• Fear of Flying– Read about safety– Look at pictures of airplanes– Visit an airport– Take a short flight– Take a long flight
• Fear is extinguished• Counterconditioning
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Cognitive TherapyAeron Beck
• Aaron Beck and his colleagues (1979) came to believe that cognitive therapy could reverse people’s catastrophizing beliefs about themselves, situations, and their futures
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Cognitive Distortions
• Labeling
• Mind Reading
• Exaggeration
• Unrealistic Expectations
• Belief in Entitlement
• Belief in Absolute Fairness
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Fighting Dysfunctional Thought
• Hot Thoughts• He is always mean to
me.• I did a lousy job.• I deserve better.• It’s not fair.• That jerk!• They’re driving me
crazy.
• Cool Thoughts• Maybe he had a bad
day.• It’ll be better next time• But people are people• Life is not fair.• It’s his problem!• Just don’t accept the
ride.
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Dysfunctional ThoughtSituation Emotion
Rate
1-100%
Automatic Thought
Cognitive Distortion
Rational Response
Outcome
Rate
0-100%
Fight with spouse
Angry, 99%
Sad, 50%
-I’ll never have a normal marriage
-I deserve better
-He’s stubborn
Magnificat-ion
Entitlement
Labeling
-It’s not the end of the world
-That’s normal
-Maybe he had a bad day
Angry,
50%
Sad, 10%
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Humanistic Therapy
• Works on self-fulfillment and self-actualization
• Does not delve into the past• Helps the client think about the present and
the future• Helps people feel good about themselves• Tackles conscious rather than unconscious
thoughts
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Carl RogersClient-Centered TherapyPerson-Centered Therapy
• The therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to facilitate clients’ growth.
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Carl RogersClient-Centered Therapy
• Offers unconditional positive regard
• No specific techniques
• Therapist should be warm, genuine and empathetic
• Client adopts these views and becomes self-accepting
• Promotes growth instead of curing illness.
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Effective Listening
Client’s Remark
Closed Response
Open Response
I can’t do it. Don’t talk like that.
It seems very difficult to you.
I will never be able to have a good life.
We’ve discussed that before. Stop being negative.
It may look very discouraging now.
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Active Listening
• Paraphrase.Summarize the speakers words in your own
words.• Invite Clarification.Encourage the speaker to say more.• Reflect Feelings.Reflect what you’re sensing from the speakers
words and body language.
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Family Therapy
• The therapist helps family members understand how their ways of relating to one another create problems.
• The treatment’s emphasis is not on changing the individuals, but on changing their relationships and interactions.
Relative Effectiveness of Different Therapies
• Behavioral Conditioning Therapies – have achieved favorable results with specific behavior problems, such as bed-wetting, phobias, compulsions, marital problems, and sexual disorders.
• Studies confirm that Cognitive Therapy is effective in coping with depression and reducing suicidal risks
• Biomedical Therapy – is particularly essential for the treatment of the positive symptoms of schizophrenia
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Alternative Therapy(1) Eye Movement Desensitization and
reprocessing (EMDR)
• Francine Shapiro had people imagine traumatic scenes while she triggered eye movement by waving her finger in front of their eyes, supposedly enabling them to unblock and reprocess previously frozen memories.
• This therapy helps reduce traumatic memories.
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Alternative Therapy(2) Light Exposure Therapy
• It is used to treat people who suffer from seasonal affecive disorder (SAD).
• After 4 weeks of treatment:
- 61% of those exposed to morning light greatly improved.
- 50% of those exposed to evening light greatly improved.
- 32% of those exposed to the placebo greatly improved.
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When Therapy Helps
• When clients have enough sense of self• When clients have enough distress to
motivate them to change• When therapists are warm and empathetic• When client and therapist establish a good
rapport• Hostile, negative clients are less likely to
benefit
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When Therapy Harms
• Bias on the therapist’s part because of gender, religion, or race
• Coercion by the therapist to accept his/her advice
• Coercion by the therapist to have sexual intimacy
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The Power of Forgiveness
• Giving up grudges can reduce chronic back pain• Forgiveness limited the number of relapses among
women battling substance abuse problems.• Using MRI scans to explore how just thinking
about empathy and reconciliation sparks activity in the brains left middle gyrus, suggesting we all have a mental forgiveness center set to be tapped.
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The Power of Forgiveness
• Cortisol’s depressive effect on the immune system has been linked to serious disorders.
• Forgiveness stops the cortisol and adrenaline from flowing.