therapy psychology 1107. introduction remember trephining? bloodletting? beatings? changed with...

Therapy

Psychology 1107

Introduction

Remember Trephining? Bloodletting? Beatings?

Changed with PinelIn general there are two approaches

Psychological biomedical

Eclectic Approach

Today most people take bits and pieces form each

There are, literally, hundreds of types of ‘talking therapies’

A wee bit of history

Psychoanalysts got it all goingDisorders come from childhood

experience and unresolved conflictsRepression etc.Bring repressed feelings to conscious

awarenessGet rid of energy directed at id-

superego conflict

Lie back and tell me whatever comes to mind….Free associationPausesSlips

Show resistanceAnalyst interprets for you, provides

insight transferrence

The key

The key to the whole idea is repressed memories

HmmmmmImpossible to disprove analyst’s

interpretationsAnd at 100 bucks an hour, three times a

week….

The Humanistic approach

When we talked about personality we talked about how humanistic psychologists are interested in ‘self-actualization’

Humanistic therapy focuses on thisCare about the present and the futureCare about the conscious

La la la la la la live for todaaay

Take responsibilityGrowth and fulfillment, not curing some

diseaseClients, not patientsHelp them reach their potential

Mr. Rogers Neighbourhood

Carl Rogers Person’s interpretations not therapist’s No judgement Non directive Genuineness Openness Acceptance empathy

It all sounds so nice…

Therapist must show unconditional positive regard

Echoing and restatingBasically a mirror the client can use

Gestalt Therapy

Fritz PerlsKind of humanistic and unconsciousMake client self aware by breaking

down defensesStill emphasizes the here and now, not

the pastStill about responsibility

Behaviour therapies

Instead of urges, actualization and all of that, what about the BEHAVIOUR?

Use of learning theoryBasically classical and operant

conditioning approaches applied

Classical conditioning

Systematic desensitizationUse of counter conditioningWolpe’s ideas, based on Cover-Jones

Anxiety hierarchy Progressive relaxation Pairing the two

FloodingAversive counter conditioning

Operant approaches

Modify behaviour with rewardToken economiesWhat about when they leave?Ethics?

Cognitive Therapy

Thinking affects feelingFeeling affects thinkingWell stop blaming yourself, it is not your

faultBasically learn new thinking patterns

Rational Emotive

EllisConfront illogical thinkingBluntSort of the anti RogersBeck’s approach for depression is a bit

differentNot as blunt

It is not all about you

Teach clients how non depressed people think

Can ‘vaccinate’ at risk peopleCognitive and behavioural approaches

often combined into Cognitive Behaviour Therapy

Family/Group Therapy

Hell of a lot cheaper…Support groupsFamily therapists treat the whole familyThere are many talking therapies, many

approaches, but one question lingers…..

DOES IT WORK?

Ask the clients, they like itAsk the therapists….Oh how about SCIENCE?Eyesenk estimated that 67 percent

recover on their own!Not many studies then, many today

Meta analysis

More improvement than chance for those in therapy

Very generalWhat type is the best?Phobias bestSchizophrenia, personality disorders,

not so much….

Seems the therapy type is not as important as the therapistHopePerspectiveEmpathy‘pseudotherapists’ can be as good for

small problemsCultural differences between therapists

and clients

Biomedical

Drugs!Sounds good, but we still have to worry

about the outcomesSchizophrenia, very effectiveDopamine hypothesis, pretty much

confirmed

Antidepressants

Increase NE and 5Ht SSRI and TCA

Some block breakdown MAOI

Side effectsLi

ECT

Now for sever depression that does not respond to drugs

RareDoes work thoughWhy?

dunno

Surgery

Even rarerI’d rather have a bottle in front of me….SeizuresMay come back now that we are

learning more about the braim

Prevention

PovertyStressAt risk peopleGenetic markers