therapy the type of therapy used depends on the problem. psychotherapyinteraction between a trained...
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Therapy
The type of therapy used depends on the problem.
Psychotherapy Interaction between a trained therapist and someone who suffers from psychological difficulties
EX: treating phobias that are psychologically learned
Biomedical Therapy
Prescribed medications or medical procedures that act directly on the patient’s nervous system.
EX: treating schizophrenia with medication because it is biologically rooted in the brain
Psychoanalysis Based upon the ideas of
Freud
Goal Techniques Criticisms
Try to help patients gain insight into the subconscious origins and roots of their disorders and work through anxiety-ridden feelings.
•Free association - patient relaxes and starts talking about anything
•Dream interpretation
•Interpretation – the analyst’s noting supposed dream meanings, and other significant behaviors and events in order to promote insight into the subconscious
•Interpretations cannot be proven or disproven; psychoanalysts say that psychoanalysis is therapy, not a science.
•Time consuming – years long
•Expensive – several sessions a week
Psychoanalysis
Transference – in psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent). Patients can develop
strong negative or positive feelings for the therapist, including dependency, mingled love and anger.
Example Session
Psychodynamic Therapy Influenced by Freud, but
not the same as psychoanalysis
Goal Techniques
Try to understand a patient’s current symptoms by focusing on themes across important relationships
•Face-to-face conversation•Once a week for a few weeks/months•Look for patterns in behaviors/relationships
Humanistic Therapy Emphasis on human
potential and self-fulfillment
Goal Techniques Criticisms
Aim to boost self-fulfillment by helping people grow in self-awareness and self-acceptance
•Focusing on the future instead of the past•Focusing on conscious rather than unconscious thoughts
•“Clients” rather than “patients” client-centered therapy in which the client feels unconditionally accepted.•Active listening – therapist echoes, restates, and clarifies
•Not scientific enough
With a neighbor… Think of the last thing recently that:
Made you angry Made you sad Made you anxious/nervous
For 2-3 minutes, talk about the event and feelings. The active listener should: Remain unbiased and nonjudgmental Paraphrase statements Ask for clarification Reflect the feelings of the speaker with, “I understand” or “Yes,
that would be frustrating” etc
Did you notice any differences when you were active listening compared to how you listen everyday?
Behavioral Therapy Behavioral therapists do not emphasize the mental root of a
disorder as they assume that the problem behaviors are the problems
Goal Techniques Criticisms
Applies learning principles to the elimination of unwanted behaviors (useful for phobias)
•Counter-conditioning – using classical conditioning to produce new responses to stimuli that trigger unwanted behaviors• Aversive therapy - associates
an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol or smoking)
• Systematic desensitization - associates a pleasant relaxed state with anxiety-triggering stimuli
•Token economy – uses operant conditioning principles to produce new behaviors based on rewarding good behaviors and punishing bad behaviors
•Doesn’t address mental processes behind disorders
•When reinforcement disappears/stops, behaviors may come back.
Cognitive Therapy Best for disorders in which the roots are
unclear, like generalized anxiety disorder and major depressive disorder
Goal Techniques
Tries to change unhealthy or maladaptive patterns in thinking
•Ex: a depressed person writes 3 positive things that happened that day and how they contributed to them
•Ex: a person with test-anxiety repeats positive things to themselves before an exam
Cognitive-Behavioral Therapy a popular integrated therapy that
combines cognitive therapy (changes in thinking) with behavior therapy (changing behaviors)
Goal Techniques
Seeks to make people aware of maladaptive thinking patterns and replace them with new ways of thinking, AND to practice the more positive approaches and behaviors as well.
•EX: OCD sufferers – changing thinking patterns concerning obsessive thoughts and changing behaviors concerning compulsions
•EX: Anorexia nervosa – changing thinking patterns concerning depression and negative body image and changing behaviors concerning eating.
Group Therapy and Support Groups Except for psychoanalytic therapies, these techniques
can be used in therapist-led small groups. Group therapy does not allow for the same degree of
individual attention, but it is time and cost effective and has often been found no less effective than individual therapy.
The social context of group therapy often allows client to feel as if they are not alone in their problems. It can be a relief to find that others share your problems and feelings.
EX: AA and cancer, AIDS support groups
Go On Trailer
Relative Effectiveness Therapy is most effective when the
problem is clear-cut and specific. Phobias or panic disorder sufferers can hope for
improvement.
Less-focused problems, such as depression and anxiety, usually benefit in the short-run but often relapse later.
Those who have chronic schizophrenia or who wish to change their personality are unlikely to benefit from psychotherapy alone.
Effective Therapy Depends on the Problem
Psycho-dynamic
ExposureTherapy
BehavioralTherapy
CognitiveTherapy
Depression X X X
Anxiety X X
Bulimia X X
Phobias X X
OCD X X
Marital problems
X
Reducing suicide risk
X
When Should You Consider Therapy? The APA suggests considering seeking a
mental health profession if you display:
Feelings of hopelessness
Deep and lasting depression
Self-destructive behaviors
Disruptive fears
Sudden mood shifts
Thoughts of suicide
Compulsive rituals
The Biomedical Therapies
“Medicine, the only profession that labors incessantly to destroy the reason for its existence,”
- James Bryce
Psychopharmacology The study of the effects of drugs on mind and
behavior. Led to more independent lives for sufferers of
psychological disorders Reduced hospitalization of many people
To evaluate the effectiveness of new drugs, researchers use the double-blind experimental technique to reduce researcher bias.
Antipsychotic DrugsGoal Useful for… Example
sNegative Effects
Lessen responsiveness to random stimuli by blocking dopamine receptors
Schizophrenia (regulates dopamine)
Lessens hallucinations, delusions, and inappropriate or disorganized behaviors
Clozapine
Risperdal
Zyprexa
Long-term use can lead to increased risk of obesity and diabetes
Anti-anxiety DrugsGoal Useful for… Examples Negative
Effects
Depress central nervous system reactivity
AnxietyPhobias
Can help a person learn to cope with frightening situations and fear-triggering stimuli.
Xanax
Ativan
Can be used a crutch, without actually solving the root of the anxiety.
Users can become tolerant, addicted, and dependent on the medication.
Anti-depressant Drugs
Zoloft commercial
Goal Useful for…
Examples Negative Effects
Regulate levels of neurotransmitters in the brain (serotonin and norepinephrine) that can elevate mood
DepressionAnxiety
Selective-serotonin-reuptake-inhibitors (SSRIs)
ZoloftProzacPaxil
Full effects take 4 weeks – high suicide risk when starting medication
Mood Stabilizing Drugs
Goal Useful for…
Examples Negative Effects
Stabilize fluctuating moods
Bipolar Disorder
Lithium
Unclear how it works – maybe strengthens nerve connections in brain that regulate mood?
Increased thirstHeadachesMemory lossSome tremors or twitches
Brain Stimulation
Goal Useful for…
Examples Negative Effects
Send an electric current through the brain while the patient is anesthetized
Severe depression that does not respond to medication
Electroconvulsive therapy
Not exactly sure how it works – maybe calms the area of the brain that is over active and causing depression?
Memory loss
Stigmatized (bad reputation)
Psychosurgery
Lobotomy – a now-rare psychosurgical procedure that cut the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain. Developed in the 1930s Shock the patient into a coma Hammer an ice pick-like instrument
through each eye socket into the brain, then wiggle it to sever connections running up tothe frontal lobes.
Goal Useful for…
Examples Negative Effects
Remove or destroy brain tissue to change behavior
Epilepsy Cutting the corpus callosum
Lobotomy – NOT performed anymore
Irreversible – least used therapy
Lobotomies Crude but easy and
inexpensive (10 minutes) Tens of thousands of
severely disturbed people were lobotomized during the 1940s-50s
The lobotomy usually produced a permanently lethargic, immature, impulsive personality.
In the 1950s, calming drugs were introduced and lobotomized fell out of favor in the US.
Other early therapies
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