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Psychological Therapies

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Erika LaRosa

on 10 December 2013

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Transcript of Psychological Therapies

Psychological Therapies
Two Kinds of Therapy:
Therapy: treatment methods aimed at making people feel better and help them function more effectively

What is therapy?
1. Psychotherapy- therapy for mental disorders in which a person with a problem talks with a psychological professional
2. Biomedical Therapy- therapy for mental disorders in which a person with a problem is treated with biological or medical methods to relieve symptoms
The Early Days: Ice Water Baths and Electric Shocks
Treatments include bloodletting, beatings, ice baths, induced vomiting, and elective shock treatments.

Discussion Questions:
Insight Therapies: therapies in which the main goal is helping people gain insight with respect to their behaviors, thoughts, and feelings

Action Therapies: therapies in which the main goal is to change disordered or inappropriate behavior directly

Freud and Psychotherapy
Impurities of the Unconscious Mind: disturbing thoughts, socially unacceptable desires, and immoral urges that originated in the id

Psychoanalysis: an insight therapy that emphasizes revealing the unconscious conflicts, urges and desires that are assumed to cause disordered emotions and behaviors

Components of Psychoanalysis:
Resistance- the point at which the patient becomes unwilling to talk about certain topics
Transference- when the therapist becomes a symbol of a parental authority figure from the past
Countertransference- the therapist has a transference reaction to the patient

Freud and Psychotherapy
Interpretation of Dreams: the analysis of the elemnts within a patient's reported dream
Manifest content: the actual content of one's dream
Latent content: the symbolic or hidden meaning of dreams that if correctly interpreted would reveal the unconscious conflicts that were creating the nervous disorder
Free Association: originally devised by Freud's coworker Josef Breuer that encourages patients to freely say whatever comes to mind without fear of being negatively evaluated or condemned

Psychotherapy Today
Psychodynamic Therapy: a newer and more general term for therapies based on psychoanalysis with an emphasis on transference, shorter treatment times, and a more direct therapeutic approach
1. Patient is now referred to as "client" instead of patient to promote the active role of the person seeking help and to avoid implying sickness.
2. The client may sit in a chair facing the therapist instead of always lying on a couch.
3. The modern psychoanalyst is more directive- asking questions, suggesting helpful behavior, and giving opinions and interpretations earlier in the relationship which helps speed up the process
4. Focus is less on the id and more on the ego or sense of self
Humanistic Therapy
Person-centered therapy: a nondirective insight therapy based on the work of Carl Rogers in which the client does all of the talking

Four Basic Elements to a Successful Person-Therapist Relationship:
1. Reflection: technique in which the therapist restates what the client says rather than interpreting those statements
2. Unconditional Positive Regard: the warmth, respect, and accepting atmosphere created by the therapist for the client
3. Empathy: the ability of the therapist to understand the feelings of the client
4. Authenticity: the genuine, open and honest response of the therapist to the client
Gestalt Therapy
Gestalt Therapy: form of directive insight therapy in which the therapist helps clients to accept all parts of their feelings and subjective experiences using leading questions and planned experiences such as role playing

Examples of Planned Experiences:
1. Clients may talk with an empty chair to reveal true feelings toward the person represented by the chair or take on a role of a parent or another figure in order to see themselves from the other person's point of view

Gestalt therapists focus on the denied past and do not talk about the unconscious mind because they believe everything is conscious.
Behavior Therapy
Behavior Therapies: action therapies based on the principles of classical and operant conditioning and aimed at changing disordered behavior without concern for the original causes of such behavior

Behavior therapy is action based rather than insight based because the abnormal or undesirable behavior is not seen as a symptom of anything else but rather the problem itself, so behavior therapists are looking to fix the problem itself through action.

Two Categories of Behavior Therapy:
1. Therapies Based on Classical Conditional
2. Therapies Based on Operant Conditioning
Types of Classical Conditioning Therapies
Systematic Desensitization: behavior technique in which the therapist guides the client through a series of steps meant to reduce fear and anxiety
1. Client must learn to relax through deep muscle relaxation training
2. The client and the therapist construct a list, beginning with the object or situation that causes the least amout of fear to the client, and eventually working up to the object or situation that produces the greatest degree of fear
3. Under the guidance of the therapist, the client begins with the first item on the list and looks at it, thinks about it, or actually confronts it all while remaining in a relaxed state

Types of Classical Conditioning Therapies
Aversion Therapy: reduces the frequency of undesired behaviors by teaching the client to pair an aversive (unpleasant) stimulus with the stimulus that results in the undesirable response

Example: Rapid-Smoking Technique
Types of Classical Conditioning Therapies
Exposure Therapies: behavior techniques that introduce the client to situations, under carefully controlled conditions, which are related their anxieties or fears and is intended to promote new learning
Types of Exposure Therapies:
In Vivo (in life): where the client is exposed to the actual anxiety- related stimulus
Example: Paul would have to attend a social event.
Imaginal- where the client visualizes or imagines the stimulus
Example: Paul would visualize himself attending a social event.
Virtual- virtual reality (VR) technology is used
Example: Paul would virtually attend a social event.
Exposure Therapies Continued
Exposure Methods Introduce Stimulus at Different Speeds:
Graded Exposure: involves the client and therapist developing a fear hierarchy as in systematic desensitization; exposure begins at the lest feared event and progresses through the most feared similar to desensitization
Flooding: the person is rapidly and intensely exposed to the fear-provoking situation or object and prevented from making the usual avoidance or escape response

Types of Operant Conditioning Therapies
Modeling: learning through the observatoin and imitation of a model based on the work of Albert Bandura
Participant modeling: a model demonstrates the desired behavior in a step-by-step, gradual process and the client is encouraged by the therapist to imitate the model in the same gradual, step-by-step manner

Types of Operant Conditioning Therapies
Reinforcement: the strengthening of a response by following it with some pleasurable consequence (positive reinforcement) or the removal of an unpleasant stimulus (negative reinforcement)
1. Token Economy
2. Contingency Contracting

Types of Operant Conditioning Therapies
Extinction: involves the removal of a reinforcer to reduce the frequency of a particular response
Example: placing a child in time-out in which the child is removed from the situation that provides reinforcement

All together, behavior therapies have a high success rate in treating specific behavior problems like bed wetting, phobic reactions, or drug addiction however more serious psychological disorders such as severe depression or schizophrenia do not respond well to behavioral treatments.
Cognitive Therapies
Cognitive Therapy: developed by Aaron T. Beck and is focused on helping people change their ways of thinking
1. Identify an illogical or unrealistic belief, which the therapist and client do in their initial talks
2. The client is guided by the therapist through a process of asking questions about that belief such as "when did the belief begin?" or "what is the evidence of this belief?"
Cognitive Therapies
Common Distortions in Thoughts:
Arbitrary Inference: refers to "jumping to conclusions" without any evidence
Example: Matt canceled our lunch date-I'll bet he's seeing someone else!
Selective Thinking: the person focuses only on one aspect of a situation, leaving out other relevant facts that might make things seem less negative
Example: Peter's teacher praised his paper but made one comment about needing to check his punctuation. Peter assumes that his paper is lousy and that the teacher really didn't like it, ignoring the other praise and positive comments
Overgeneralization: a person draws a conclusion from one incident and then assumes that the conclusion applies to areas of life that has nothing to do with the original event
Example: "I insulted my math teacher. I'll flunk and never be able to get a decent job. I'll end up on welfare."

Cognitive Therapies
Common Distortions in Thoughts:
Magnification and Minimization: a person blows bad things out of proportion while not emphasizing good things
Example: A student who has received good grades on every other exam believes the C she got on the last quiz means she's not going to succeed in college.
Personalization: an individual takes responsibility or blame for events that are not really connected to the individual
Example: When Sandy's husband comes home in a bad mood because of something that happened at work, she immediately assumes that he is angry with her.
Group Therapy
Family Counseling: all members of a family who are experiencing some type of problem are seen by the therapist as a group
Self-Help Groups: a group composed of people who have similar problems and who meet together without a therapist or counselor for the purpose of discussion, problem solving and social and emotional support

Advantages of Group Therapy
Disadvantages of Group Therapy
1. Lower cost
2. Exposure to the wain which other people view and handle the same kinds of problems
3. The opportunity for both the therapist and the clients to see how that person interacts with others
4. Social and emotional support
5. An extremely shy person may initially have great difficulty speaking up in a group setting but cognitive-behavioral group therapy can be effective for social phobia
1. The therapist is no longer the only person to who secrets and fear are revealed which may some people reluctant to speak freely
2. The client must share the therapist's time during the session
3. People with severe psychiatric disorders involving paranoia, such as schizophrenia, may not be able to tolerate group-therapy settings
1. Did any of the early psychological therapies treatments surprise you?
2. Which psychological therapy do you think is most effective?
3. Would you prefer a group therapy session or an individual session?
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