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Chapter 2 Wood Power Point2

  1. 1. Instructor Version
  2. 2. Chapter 14 Therapies This multimedia product and its contents are protected under copyright law.  The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program.
  3. 3. Chapter 14 Overview <ul><li>Insight Therapies </li></ul><ul><li>Relationship Therapies </li></ul><ul><li>Behavior Therapies </li></ul><ul><li>Cognitive Therapies </li></ul><ul><li>Biomedical Therapies </li></ul><ul><li>Evaluating the Therapies </li></ul><ul><li>The Therapeutic Relationship </li></ul>
  4. 4. Insight Therapies <ul><li>Approaches to psychotherapy based on the notion that psychological well-being depends on self-understanding </li></ul>
  5. 5. Psychodynamic Therapies <ul><li>Attempt to uncover repressed childhood experiences that are thought to cause the patient’s current problems </li></ul><ul><li>Free association: Explores the unconscious by having patients reveal whatever thoughts, feelings, or images come to mind </li></ul><ul><li>Dream analysis: Areas of emotional concern repressed in waking life are sometimes expressed in symbolic form in dreams </li></ul><ul><li>Transference: Emotional reaction that occurs during psychoanalysis, in which the patient displays feelings and attitudes toward the analyst that were present in another significant relationship </li></ul>
  6. 6. Psychodynamic Therapies cont… <ul><li>Object relations therapy </li></ul><ul><ul><li>Based on idea that early relationships form blueprints for future relationships </li></ul></ul><ul><ul><li>Therapist helps clients restructure current relationships, changing maladaptive patterns formed in early relationships </li></ul></ul><ul><li>Interpersonal therapy </li></ul><ul><ul><li>Brief psychotherapy that helps clients understand and cope with four interpersonal problems associated with depression </li></ul></ul>
  7. 7. Humanistic Therapies <ul><li>Humanistic therapies assume that people have the ability and freedom to lead rational lives and make rational choices </li></ul><ul><ul><li>Founded by Carl Rogers (1951) </li></ul></ul><ul><li>Therapists show empathy and create a climate of unconditional positive regard </li></ul><ul><ul><li>Goal is to allow the client to direct the therapy session and move toward self-actualization </li></ul></ul><ul><ul><li>The patient’s realization of his inner potential </li></ul></ul>
  8. 8. Gestalt Therapy <ul><li>Helps clients fully experience their feelings, thoughts, and actions </li></ul><ul><ul><li>Emphasizes clients taking responsibility for their behavior, instead of blaming society or parents </li></ul></ul><ul><ul><li>Goal is to help the client resolve past conflicts, achieve a more integrated self, and become more self-accepting </li></ul></ul><ul><li>Gestalt therapy is directive </li></ul><ul><ul><li>Therapist actively directs the therapy session </li></ul></ul><ul><ul><li>Provides answers and suggestions to the client </li></ul></ul>
  9. 9. Relationship Therapies <ul><li>Therapies that attempt to improve patients’ interpersonal relationships or create new relationships to support patients’ efforts to address psychological problems </li></ul>
  10. 10. Family Therapy and Couple Therapy <ul><li>Family therapy </li></ul><ul><ul><li>Parents and children enter therapy as a group </li></ul></ul><ul><ul><li>Goal is to help family members heal wounds to the family, improve communication, and create more understanding within the family </li></ul></ul><ul><li>Couple therapy </li></ul><ul><ul><li>Goal is to help partners in an intimate relationship communicate and manage conflicts more effectively </li></ul></ul><ul><ul><li>May focus on behavioral change or partners’ emotional responses to each other </li></ul></ul>
  11. 11. Group Therapy <ul><li>A group of clients (usually seven to ten) meets regularly with one or more therapists </li></ul><ul><li>Provides client with a sense of belonging and opportunity to </li></ul><ul><ul><li>Express feelings </li></ul></ul><ul><ul><li>Get feedback from other group members </li></ul></ul><ul><ul><li>Give and receive emotional support </li></ul></ul><ul><li>Self-help groups </li></ul><ul><ul><li>People with similar problems who meet regularly, usually without a professional therapist </li></ul></ul>
  12. 12. Behavior Therapies <ul><li>A treatment approach that is based on the idea that abnormal behavior is learned and that applies the principles of operant conditioning, classical conditioning, and/or observational learning to eliminate inappropriate or maladaptive behaviors and replace them with more adaptive responses </li></ul>
  13. 13. Behavior Modification Techniques Based on Operant Conditioning <ul><li>Uses reinforcement to shape or increase frequency of desirable behavior </li></ul><ul><ul><li>Token economy </li></ul></ul><ul><li>Extinguishes undesirable or maladaptive behavior by terminating or withholding reinforcement that maintains the behavior </li></ul><ul><ul><li>Timeout </li></ul></ul>
  14. 14. Behavior Modification Techniques Based on Learning Theories <ul><li>Systematic desensitization is behavior therapy based on classical conditioning used to treat fears </li></ul><ul><li>Client is trained to relax while being confronted with a graduated series of anxiety-producing situations </li></ul><ul><li>Eventually, client can stay relaxed while confronting even the most feared situation </li></ul>
  15. 15. Behavior Modification Techniques Based on Learning Theories cont… <ul><li>Participant modeling is behavior therapy based on Albert Bandura’s principles of observational learning </li></ul><ul><li>A model demonstrates appropriate responses to a feared stimulus in graduated steps </li></ul><ul><li>Client then imitates the model with encouragement of a therapist </li></ul><ul><li>Using this technique, most specific phobias can be extinguished in 3 to 4 hours </li></ul>
  16. 16. Behavior Modification Techniques Based on Learning Theories cont… <ul><li>Flooding is behavior therapy based on classical conditioning </li></ul><ul><li>Used to treat phobias </li></ul><ul><li>Client is exposed to the feared object or event for an extended period </li></ul><ul><li>Until their anxiety decreases </li></ul>
  17. 17. Behavior Modification Techniques Based on Learning Theories cont… <ul><li>Exposure and response prevention </li></ul><ul><li>Exposes patients with obsessive-compulsive disorder to stimuli that trigger obsessions and compulsive rituals </li></ul><ul><li>Patients resist performing the compulsive rituals for progressively longer periods of time </li></ul>
  18. 18. Behavior Modification Techniques Based on Learning Theories cont… <ul><li>Aversion therapy </li></ul><ul><li>An aversive stimulus is paired with a harmful or socially undesirable behavior </li></ul><ul><li>Until the behavior becomes associated with pain or discomfort </li></ul>
  19. 19. Cognitive Therapies <ul><li>Therapies that assume maladaptive behavior can result from irrational thoughts, beliefs, and ideas </li></ul>
  20. 20. Rational Emotive Therapy <ul><li>Developed by Albert Ellis </li></ul><ul><li>A directive form of psychotherapy </li></ul><ul><li>Goal is to challenge and modify a client’s irrational beliefs about themselves and others </li></ul><ul><li>Irrational beliefs are believed to be the causes of personal distress </li></ul>
  21. 21. Figure 14.1 The ABCs of Rational Emotive Therapy
  22. 22. Cognitive Therapy <ul><li>Designed by Aaron Beck, helps clients stop their negative thoughts as they occur and replace them with more objective thoughts </li></ul><ul><li>Depression is treated by brief cognitive therapy, usually 10-20 sessions, and is more effective than antidepressant drugs </li></ul><ul><li>Panic disorder is treated by teaching clients to change the catastrophic interpretations of their symptoms to prevent them from escalating into panic, usually effective with 3 months of treatment </li></ul>
  23. 23. Biomedical Therapies <ul><li>Therapies (drug, therapy electroconvulsive therapy, or psychosurgery) that are based on the assumption that psychological disorders are symptoms of underlying physical problems </li></ul>
  24. 24. Drug Therapy <ul><li>Antipsychotic drugs </li></ul><ul><ul><li>Prescribed primarily for schizophrenia </li></ul></ul><ul><ul><li>Used to treat symptoms such as hallucinations, delusions, and disorganized behavior </li></ul></ul><ul><ul><li>Work by inhibiting dopamine activity </li></ul></ul><ul><li>Lithium </li></ul><ul><ul><li>Used to treat bipolar disorder </li></ul></ul><ul><ul><li>Reduces both manic and depressive episodes </li></ul></ul><ul><li>Antianxiety drugs </li></ul><ul><ul><li>Benzodiazepines are effective for treating generalized anxiety disorder and panic disorder </li></ul></ul>
  25. 25. Figure 14.2 Decrease in Patient Populations in State and County Mental Hospitals (1950-2000)
  26. 26. Drug Therapy cont… <ul><li>Antidepressant drugs </li></ul><ul><li>Act as mood elevators for people who are severely depressed </li></ul><ul><li>Selective serotonin reuptake inhibitors (SSRIs) </li></ul><ul><ul><ul><li>Block the reuptake of serotonin , increasing its availability at the synapses of the brain </li></ul></ul></ul><ul><ul><ul><li>Are effective for treating major depression, OCD, social phobia, panic disorder, generalized anxiety disorder, and binge eating </li></ul></ul></ul>
  27. 27. Drug Therapy cont… <ul><li>Drugs can have unpleasant or dangerous side effects </li></ul><ul><li>It is difficult to establish proper dosages </li></ul><ul><li>Drugs do not cure psychological disorders so relapse is likely if drug therapy is discontinued </li></ul><ul><li>Availability of antipsychotic drugs led to a trend away from hospitalization, which may have increased homelessness among people with schizophrenia </li></ul>
  28. 28. Electroconvulsive therapy (ECT) <ul><li>Electric current is administered to the right cerebral hemisphere </li></ul><ul><ul><li>While patient is under anesthesia </li></ul></ul><ul><ul><li>Usually reserved for severely depressed patients who are suicidal </li></ul></ul><ul><li>ECT was misused and overused in the 1940s and 1950s, leading to a bad reputation </li></ul><ul><li>But it can be a highly effective treatment for major depression </li></ul>
  29. 29. Psychosurgery <ul><li>Brain surgery performed to alleviate serious psychological disorders or unbearable chronic pain </li></ul><ul><li>Lobotomy </li></ul><ul><li>Cingulotomy </li></ul><ul><li>Psychosurgery is controversial, and is considered experimental and a last resort </li></ul><ul><ul><li>Because results are unpredictable and permanent </li></ul></ul>
  30. 30. Evaluating the Therapies <ul><li>Therapies share many similarities. </li></ul><ul><li>Therapists use a core set of techniques no matter which perspective of therapy session they adopt, but at the same time, each therapeutic approach has elements that distinguish it from others. </li></ul>
  31. 31. Evaluating the Therapies cont… <ul><li>Smith et al. (1980) analyzed 475 studies with 25,000 clients </li></ul><ul><ul><li>Found that psychotherapy was better than no treatment </li></ul></ul><ul><ul><li>But no one type of psychotherapy was more effective than another </li></ul></ul><ul><li>Eysenck (1994) reanalyzed the same studies </li></ul><ul><ul><li>Reported that behavior therapy has a slight advantage over other types of therapies </li></ul></ul>
  32. 32. Consumer Reports Survey <ul><li>Overall, clients believed that they benefited substantially from psychotherapy </li></ul><ul><li>Clients were equally satisfied with therapy provided by psychologists, psychiatrists, and social workers </li></ul><ul><li>The longer clients stayed in therapy, the more they improved </li></ul><ul><li>Clients believed that antidepressant and antianxiety drugs helped them; but overall psychotherapy alone worked as well as psychotherapy plus drugs </li></ul>
  33. 33. The Therapeutic Relationship <ul><li>When establishing a relationship with a therapist, it is important to become familiar with the various professionals who offer therapeutic services. </li></ul>
  34. 34. Choosing a Therapist <ul><li>A Psychologist </li></ul><ul><ul><li>Has an advanced degree, usually a doctorate, in psychology </li></ul></ul><ul><ul><li>Clinical psychologists generally diagnose and treat psychological disorders </li></ul></ul><ul><ul><li>Counseling psychologists generally provide therapy for normal problems of life, such as divorce </li></ul></ul><ul><li>A Psychiatrist </li></ul><ul><ul><li>Is a medical doctor </li></ul></ul><ul><ul><li>Can prescribe drug therapy </li></ul></ul>
  35. 35. Choosing a Therapist cont… <ul><li>Therapists are forbidden to engage in any kind of intimate relationship with a client or anyone close to the client </li></ul><ul><li>They are prohibited from providing therapy to former intimate partners </li></ul><ul><li>They are obligated to use tests that are reliable and valid </li></ul><ul><ul><li>And they must have appropriate training for all tests that are used </li></ul></ul>
  36. 36. Culturally Sensitive Therapy <ul><li>An approach to therapy in which knowledge of clients’ cultural backgrounds guides the choice of therapeutic interventions </li></ul><ul><li>This approach emphasizes that cultural variables may influence the diagnosis and treatment of psychological disorders </li></ul>
  37. 37. Gender-Sensitive Therapy <ul><li>An approach to therapy that takes into account the effects of gender on both the therapist’s and the client’s behavior </li></ul><ul><li>This approach emphasizes how a therapist’s gender biases may affect the techniques that they choose and their assessments of clients’ progress </li></ul>