Psychological Therapies
History
1793
1887
Mid-1500s
Mentally ill people confined to institutions called asylums
Treatments were harsh and often damaging
Philippe Pinel(psychiatrist) becomes famous for demanding that the mentally ill be treated with kindness
Personally unlocks the chains of inmates in France
Nellie Bly (journalist) intentionally gets committed to Blackwell’s Islandto investigate conditions
Writes Ten Days in a Mad-House
Therapy Today
Two broad categories of therapy:
Eclectic approach
Therapy: treatment methods aimed at making people feel better and function more effectively
Medical intervention to bring symptoms under control (Biomedical therapies)
Psychological theory and techniques (Psychotherapies)
approach to therapy that results from combining elements of several different approaches or techniques
Types of Therapies
Psychotherapy
Biomedical therapy
Insight therapies :psychotherapies in which the main goal is helping people to gain insight with respect to their behavior, thoughts, and feelings
Action therapy : psychotherapy in which main goal is to change disordered or inappropriate behavior directly
therapy for mental disorders in which a person with a problem talks with a psychological professional
therapy for mental disorders in which a person with a problem is treated with biological or medical methods to relieve symptoms
Psychotherapies
Action Therapies
Group Therapies
Insight Therapies
Interpersonal psychotherapy (IPT)
Humanistic therapies
Psychoanalysis and psychodynamic therapy
Person-centered therapy, motivational interviewing (MI), gestalt therapy
Behavior therapies
Cognitive therapies
Classical conditioning techniques, operant conditioning techniques
Beck’s cognitive therapy, cognitive-behavioral therapy (CBT), rational emotive behavior therapy (REBT)
problem-based groups
self-help groups
Family counseling
Psychoanalytic/Psychodynamic
Psychoanalysis: based on the theory of Freud, emphasizing revealing of unconscious conflicts
Psychodynamic therapy: newer and more general term for therapies based on psychoanalysis
Free association
Resistance and transference
Dream interpretation (manifest content vs. latent content)
Modern approach is client-centered and directive
Directive: actively giving interpretations of a client’s statements in therapy, even suggesting certain behavior or actions
Emphasis on transference, shorter treatment times, and a more direct therapeutic approach
Interpersonal Psychotherapy
Incorporates multiple approaches (eclectic)
Seems to be an effective treatment for depression
Interpersonal psychotherapy (IPT)
Derived from psychodynamic approach
Combines aspects of humanistic and cognitive-behavioral therapies
Especially when combined with medication
focus on interpersonal relationships and the interplay between mood and everyday events
Humanistic therapies
Emphasizes
Two most common humanistic therapies
focus on conscious, subjective experiences of emotion and people’s sense of self
The importance of the choices made by individuals
The potential to change one’s behavior
Person-centered therapy (Carl Rogers)
Gestalt therapy (Fritz Perl)
a nondirective insight therapy in which the client (or person) does all the talking and the therapist listens
Three elements of Roger’s therapy
Based on the work of Carl Rogers
Nondirective: therapeutic style in which therapist remains relatively neutral and does not interpret or take direct actions with regard to the client
Authenticity
Unconditional positive regard
Empathy
the genuine, open, and honest response of the therapist to the client
he warmth, respect, and accepting atmosphere created by the therapist for the client in person-centered therapy
he ability of the therapist to understand the feelings of the client
Problems come from people not accepting some of their feelings
Gestalt therapy vs. person-centered therapy
form of directive insight therapy in which the therapist helps clients accept all parts of their feelings and subjective experiences
Created by Fritz Perls
Therapist uses leading questions and planned experiences such as role-playing
Person hides behind “mask” of accepted behavior
Problems occur when inner self doesn’t match the mask
Personality may conflict with societal expectations
Similar because they’re both based in humanism
Gestalt therapy is directive (unlike person-centered therapy)
Behavior Therapies
al and operant conditioning and aimed at changing disordered behavior without concern for the original causes of such behavior
Applied behavior analysis (behavior modification): use of learning techniques to modify or change undesirable behavior and increase desirable behavior
Uses for behavior therapies
Can be effective in treating specific problems, such as bedwetting, drug addictions, and phobias
Can help improve some of the more troubling behavioral symptoms associated with more severe disorders
Classical Conditioning Techniques (Behavior Therapies)
Aversion therapy
Exposure therapy
Systematic desensitization
Used to treat phobias
Counterconditioning: replacing an old conditioned response with a new one by changing the unconditioned stimulus
client is asked to make list of ordered fears and taught to relax while concentrating on those fears
an undesirable behavior is paired with an aversive stimulus to reduce the frequency of the behavior
introduce client to controlled situations that are related to their anxieties or fears
Flooding: person is rapidly and intensely exposed to fear-provoking situation or object and prevented from making usual avoidance or escape response
Eye-movement desensitization reprocessing (EMDR): client is directed to move the eyes rapidly back and forth while thinking of a disturbing memory
Controversial therapy for PTSD and similar problems
Operant Conditioning Techniques (Behavior Therapies)
Reinforcement
Extinction
Modeling
Participant modeling: a model demonstrates the desired behavior in a step-by-step, gradual process
Client is encouraged to imitate the model
learning through observation and imitation of others
Token economy: use of objects called tokens to reinforce behavior
Contingency contract: a formal, written agreement between the therapist and client
strengthening of a response by following it with a pleasurable consequence or removal of an unpleasant stimulus
okens can be accumulated and exchanged for desired items or privileges
Clearly states goals for behavioral change, reinforcements, and penalties
removal of reinforcer to reduce frequency of behavior
Time-out: an extinction process in which a person is removed from situation that provides reinforcement for undesirable behavior
Person is usually placed in a quiet corner or room away from possible attention and reinforcement opportunities
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Cognitive Therapies
Types of cognitive therapies
Evaluation of cognitive therapies
focus is on helping clients recognize distortions in their thinking and replace distorted, unrealistic beliefs with more realistic, helpful thoughts
Especially distortions relating to depression
Developed by Aaron T. Beck
Beck’s cognitive therapy
Cognitive-behavioral therapy (CBT)
CBT has seemed successful in treating depression, stress disorders, and anxiety
CBT has been criticized for focusing on the symptoms, not the causes, of disordered behavior
Magnification and minimization: blowing a negative event out of proportion (magnification) while ignoring relevant positive events (minimization)
Overgeneralization: drawing sweeping conclusions based on only one incident or event and applying those conclusions to events that are unrelated to the original
Selective thinking: focusing on only one aspect of a situation while ignoring all other relevant aspects
Personalization: taking responsibility or blame for events that are unconnected to the person
Arbitrary inference: drawing a conclusion without any evidence
Three goals
Rational emotive behavior therapy (REBT)
action therapy in which the goal is to help clients overcome problems by learning to think more rationally and logically
Assumes disorders come from illogical, irrational cognitions
Help develop strategies for solving future problems
Help change irrational, distorted thinking
Relieve the symptoms and solve the problems
cognitive-behavioral therapy
clients are directly challenged in their irrational beliefs and helped to restructure their thinking into more rational belief statements
Challenges all or nothing beliefs