Module 24

Therapies

HISTORICAL BACKGROUND

• Definition of psychotherapy– Three basic characteristics

1.verbal interaction between therapist and client

2.development of a supportive relationship in which a client can bring up and discuss traumatic or bothersome experiences that may have led to current problems

3.analysis of the client’s experiences and/or suggested ways for the client to deal with or overcome his or her problems

HISTORICAL BACKGROUND (CONT’D)

• Early treatments– 1400 to 1700, people who today would be diagnosed

as schizophrenics were considered insane and called lunatics

– Late 1800s, Dr. Benjamin Rush (considered the father of American psychiatry), developed the “tranquilizing chair”

– Believed that mental disorders were caused by too much blood to the brain

HISTORICAL BACKGROUND (CONT’D)

HISTORICAL BACKGROUND (CONT’D)

• Reform movement– Moral therapy, popular in the early 1800s

• patients could be helped to function better by providing humane treatment in a relaxed and decent environment; late 1800s, it was abandoned

• 1930s, Sigmund Freud developed psychoanalysis• early 1950s, wretched conditions and inhumane

treatment of patients persisted• mid 1950s, two dramatic changes happened:

discovery of antipsychotic drugs and development of community mental health centers

HISTORICAL BACKGROUND (CONT’D)

• Phenothiazines and deinstitutionalization– Phenothiazines

• discovered in the early 1950s, block or reduce the effects of the neurotransmitter dopamine and reduce schizophrenic symptoms, such as delusions and hallucinations

• chlorpromazine (Thorazine)– Deinstitutionalization

• refers to the release of mental patients from mental hospitals and their return to the community to develop more independent and fulfilling lives

HISTORICAL BACKGROUND (CONT’D)

• Community mental health centers– Offer low-cost or free mental health care to members

of the surrounding community, especially the underprivileged

– Provide briefer forms of therapy that are needed in emergencies and focus on the early detection and prevention of psychological problems

QUESTIONS ABOUT PSYCHOTHERAPY

• Are there different kinds of therapists?– Psychiatrists

• go to medical school, receive M.D. degree, and then take a psychiatric residency; additional training in pharmacology, neurology, psychopathology, and psychotherapeutic techniques

– Clinical psychologists• go to graduate school in clinical psychology and earn a

doctorate degree (Ph.D., Psy.D., or Ed.D.)

– Counseling psychologists• go to graduate school in psychology or education and

earn a doctorate degree (Ph.D., Psy.D., or Ed.D)

QUESTIONS ABOUT PSYCHOTHERAPY (CONT’D)

• Are there different approaches?– Insight therapy

• therapist and client talk about the client’s symptoms and problems with the goal of reaching or identifying the cause of the problem

– Cognitive-behavior therapy• involves the application of principles of learning • therapist focuses on the client’s problem, identifies

specific thoughts and behaviors that need to be changed, and provides techniques based on learning principles to make desired changes

QUESTIONS ABOUT PSYCHOTHERAPY (CONT’D)

• Are there different approaches?– Eclectic approach

• involves combining and using techniques and ideas from many different therapeutic approaches

– Medical therapy• involves the use of various psychoactive drugs to

treat mental disorders by changing biological factors, such as the levels of neurotransmitters

INSIGHT THERAPIES

• Psychoanalysis– Focuses on the idea that each of us has an

unconscious part that contains ideas, memories, desires, or thoughts that have been hidden or repressed because they’re psychologically dangerous or threatening to our self-concept

• Unconscious conflicts – Chief reason for the development of psychological

problems (paranoia) and physical symptoms (loss of feeling in a hand)

INSIGHT THERAPIES (CONT’D)

• Psychoanalysis– Three techniques

• free association, dream interpretation, and analysis of slips of the tongue

– Transfer• patient reacts to the therapist as a substitute

parent, lover, sibling, or friend and projects strong emotions onto the therapist

INSIGHT THERAPIES (CONT’D)

INSIGHT THERAPIES (CONT’D)

• Techniques to reveal the unconscious– Neuroses

• maladaptive thoughts and actions that arise from some unconscious thought or conflict and indicate feelings of anxiety

– Free association• technique that encourages clients to talk about any

thoughts or images that enter their heads• assumption is that this kind of free-flowing,

uncensored talking will provide clues to unconscious material

INSIGHT THERAPIES (CONT’D)

• Techniques to reveal the unconscious– Dream interpretation

• psychoanalytic technique based on the assumption that dreams contain underlying, hidden meanings and symbols that provide clues to unconscious thoughts and desires

INSIGHT THERAPIES (CONT’D)

• Problems during therapy– Transference

• client expresses strong emotions toward the therapist as a substitute for someone important in the client’s life, such as mother or father

– Resistance• client reluctant to work through or deal with feelings or

to recognize unconscious conflicts and repressed thoughts

– Short-term dynamic psychotherapy• emphasizes a limited time for treatment (20-30

sessions) and focuses on limited goals

INSIGHT THERAPIES (CONT’D)

• Problems during therapy– Short-term dynamic psychotherapy

• therapists take more active and directive role– identify and discuss client’s problems– resolve issues of transference– interpret client’s behaviors– offer opportunity for the client to foster changes

in behavior and thinking– results in more active coping and important

image of oneself

INSIGHT THERAPIES (CONT’D)

• Client-centered therapy– Also called person-centered therapy; assumes that each

person has an actualizing tendency to develop one’s full potential

• Therapist’s traits– Empathy

• ability to understand what the client says, feels

– Positive regard

• ability to communicate caring, respect, and regard

– Genuineness

• ability to be real and nondefensive in interactions

INSIGHT THERAPIES (CONT’D)

INSIGHT THERAPIES (CONT’D)

• Cognitive therapy– Developed by Aaron Beck– Assumes that we have automatic negative thoughts

that we typically say to ourselves without much notice– Repeating these automatic negative thoughts causes

distortion in how we perceive and interpret our world and influences how we behave and feel

BEHAVIOR THERAPY

• Definition– Also called behavior modification

• uses the principles of classical and operant conditioning to change disruptive behaviors and improve human functioning

• focuses on changing particular behaviors rather than the underlying mental events or possible unconscious factors

– Systematic desensitization• technique of behavior therapy in which the client is

gradually exposed to the feared object while simultaneously practicing relaxation

BEHAVIOR THERAPY (CONT’D)

• Cognitive-behavior therapy– Combines the cognitive therapy technique of

changing negative, unhealthy, or distorted thought patterns with behavior therapy

– Technique of changing maladaptive or disruptive behaviors by learning and practicing new skills to improve functioning