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