Therapies Chapter 9
What is Psychotherapy? <ul><li>Systematic interaction  </li></ul><ul><li>psychological principles  </li></ul><ul><li>Explo...
Psychodynamic Therapy <ul><li>Psychodynamic theories are based on the thinking of Sigmund Freud, the founder of psychodyna...
Psychoanalysis <ul><li>Psychoanalysis seeks to help people develop insight into the dynamic struggles occurring within the...
Psychoanalysis Terms and Techniques <ul><li>Free Association :  In psychoanalysis, the uncensored uttering of all thoughts...
Psychoanalysis Terms and Techniques <ul><li>Transference:  Responding to one person in a way that is similar to the way on...
Activity <ul><li>“ Think of your partner or close friend.  Think about some aspect of their personality that you have a st...
Activity: <ul><li>Here are several possibilities of how transference may play out. </li></ul><ul><li>You see the other in ...
Client-Centered Therapy <ul><li>Carl Rogers’s </li></ul><ul><li>emphasizes the creation of a warm, therapeutic atmosphere ...
Gestalt Therapy <ul><li>Fritz Perls’s  </li></ul><ul><li>attempts to integrate conflicting parts of the personality throug...
Reflection Activity <ul><li>I need one volunteer to do a scripted role play with me. </li></ul><ul><li>Reflection: can be ...
Behavior Therapy <ul><li>Behavior Therapy:  Systematic application of the principles of learning to the direct modificatio...
Behavior Therapy  (Fear Reduction Methods) <ul><li>Flooding:  A person is exposed for prolonged intervals to a fear-evokin...
Behavior Therapy  (Aversive Conditioning) <ul><li>Aversive Conditioning:  A behavior therapy technique in which stimuli as...
Behavior Therapy  (Operant Conditioning Principles) <ul><li>The Token Economy:  A controlled environment in which people a...
Example of Behavioral Therapy <ul><li>Video with example of Behavioral Therapy - gradual exposure. </li></ul><ul><li>From ...
Cognitive Therapies <ul><li>Cognitive therapists focus on helping people change the  beliefs, attitudes  and  automatic ty...
Cognitive Therapies <ul><li>Beck’s Cognitive Therapy : A form of therapy that focuses on how clients’ cognitions (expectat...
Activity: “The Way I Think” <ul><li>Answer the following questions on a separate piece of paper.  </li></ul><ul><li>1) I o...
Activity: “The Way I Think” (cont’) <ul><li>3) What’s the worst thing that could possibly happen? What do you fear most of...
Activity: “The Way I Think” (cont’) <ul><li>6) Letter to your friend. </li></ul><ul><ul><li>Pretend your friend has some o...
Activity: “The Way I think” (cont’) <ul><li>7) Positive imagery antedotes </li></ul><ul><ul><li>Select 3 positive images (...
Convergence of Approaches <ul><li>Today, many therapists don’t adhere to a single approach.  </li></ul><ul><li>Many therap...
 
Group Therapy <ul><li>Group therapy has several advantages:  </li></ul><ul><li>It’s economical. Therapists can work with s...
Couples Therapy <ul><li>Couples therapy focuses on helping distressed couples resolve their conflicts and improve their co...
Family Therapy <ul><li>A form of therapy in which the family unit is treated as the client. </li></ul><ul><li>In a systems...
Effectiveness of Psychotherapy <ul><li>There are several problems that researchers must address when evaluating the effect...
 
Psychotherapy and Human Diversity <ul><li>In general:   Psychotherapists must attend to and respect their client’s sociocu...
Biomedical Therapies <ul><li>Biomedical therapies are administered by doctors, such as psychiatrists.  The three primary f...
Drug Therapy <ul><li>Psychotropic Drugs:  Prescription drugs that are widely used to help relieve disturbing emotional sta...
Drug Therapy <ul><li>Antianxiety:  Most antianxiety drugs belong to the chemical class known as benzodiazapenes.  Common d...
Electroconvulsive Therapy (ECT) <ul><li>Treats disorders like major depression by passing an electric current (that causes...
Evaluating Biomedical Therapies <ul><li>The introduction of antipsychotic drugs made it possible for hundreds of thousands...
Coping with Anxiety and Fear <ul><li>1. Define the feared object or situation. </li></ul><ul><li>2. List specific behavior...
Managing Anger <ul><li>Monitor your reactions in angering situations. </li></ul><ul><li>Stop and think </li></ul><ul><li>P...
Lifting your Mood <ul><li>Engage in pleasant activities:  Utilizing the list in your book, engage in at least three of the...
Homework <ul><li>Journal #5 </li></ul>
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  • Systematic – relationship between client and therapist. Therapist takes into consideration clients cultural and social background in structuring therapy based on their theoretical model. Psychological Disorders, adjustment problems, and personal growth: While psychotherapy is often used with people who have psychological disorders, it can also be used to help people with adjustment (loss of spouse, shyness) and personal growth. Psychological principles – even though the techniques may be different they all incorporate psychological theory and research in areas such as personality, learning, motivation, emotion, and abnormal behavior.
  • Before showing free association. Give students a word “grass” and have them write down all the words that come to mind.
  • Resistance: results when the ego tries to protect self from uncovering unconscious material. Resistance to recalling and discussing threatening ideas. Looks like – “my mind is blank”, might accuse therapist of being demanding or inconsiderate, might “forget” the next appointment when threatening information/memories are about to surface. Interpretation- may interpret resistance showing how it may suggest deep-seated feelings and conflicts. This leads to self-discovery and self-insight.
  • Transference: Responding to one person (such as a spouse or the psychoanalyst) in a way that is similar to the way one responded to another person (such as a parent) in childhood. (ex. Displace feelings of father onto male therapist) Transference – this is a key aspect of psychoanalysis. Clients reenact their childhood conflicts with their parents and other important figures in their lives during the course of therapy. Childhood conflicts often involve unresolved feelings of love, anger, or rejection. Therapist can help client see how their unresolved feelings from childhood are impacting their relationships with others in their life now. Dream Analysis: Freud believed that unconscious impulses tend to be expressed in dreams as a form of wish fulfillment. Dreams consist of both manifest (the reported content) content and latent (the symbolized or underlying meaning) content.
  • &amp;quot;Think of your boyfriend/girlfriend, or husband/wife, or a close friend. Think about some aspect of their personality that you have a strong reaction to, either positive or negative. Now write that down on a piece of paper. Describe what that aspect of their personality is like, and how you react in your thoughts, feelings, and behavior toward that part of their personality.” After the students are finished, I tell them to draw a box around what they have written , and to write at the top of the box , &amp;quot;Is this transference?” At this point, they are usually a bit puzzled . &amp;quot;Now think about your parents. Is the personality characteristic of the person you wrote about, and your reaction to it.... is it a kind of replay or recreation of something that went on in your relationship with one (or both) of your parents? For example, does your parent have that same personality trait that you react to so strongly? If so, maybe this reaction to the person you described is a kind of transference from your relationship with your parent.” Some students immediately see the connection. Some will not. To increase the power and complexity of the exercise, I explain that the transference may be more tricky than simply reacting to others the way you reacted to your parent. Here are several possibilities (which I write on the board): you see the other in the same way as you believed your parent to have been (simple transference) you see the other as being like what you WISH your parent COULD have been like you see the OTHER AS YOU were as a child and you act like your parent did you see the other as you were as a child and you act like you WISHED your parent could have acted With this added depth, a few more students make the connection. But a significant number still don&apos;t. That&apos;s OK.It&apos;s important to point out that the way &amp;quot;transference&amp;quot; is being used in this exercise is a bit different than how it is applied to psychoanalytic therapy. We&apos;re not talking about a neutral or &amp;quot;blank screen&amp;quot; therapist onto which the patient projects and recreates patterns from childhood. The person that the student describes in the exercise may indeed be something like the parent. Nevertheless, the &amp;quot;transference&amp;quot; may still be evident in the fact that the student has chosen someone with whom to recreate an old parental relationship, in how strong the person reacts to that characteristic of the other person, or in the whole variety of ways the person thinks, feels, and behaves in reaction to that characteristic in the other.
  • Intro: Client centered therapy: If when we are young, other people only approve of us when we are doing what they want us to do, we may learn to disown the parts of ourselves to which they object. We may don social masks or facades to garner approval to such an extent that we become strangers to ourselves. We may learn to be seen but not heard – not even by ourselves. As a result, we may experience anxiety when our true feelings begin to surface. Client centered therapy aims to provide insight into the parts of us that we have disowned so that we can feel whole. Warm and therapeutic atmosphere that encourages self-exploration and self-expression. The therapists acceptance of the client is intended to foster self-acceptance and self-esteem. Nondirective –client takes the lead, stating and exploring problems. 3 main qualities: unconditional positive regard (unconditional respect for clients as human beings w/ unique values and worth regardless of behavior, empathic understanding (accurate recognition of the client’s experiences and feelings) , 3) genuineness – modeling genuine or authentic feelings in the therapy session to encourage clients to do the same. (open expression of the therapist’s own feelings)
  • Exercises: The dialogue (client undertakes verbal confrontations between opposing wishes and ideas to heighten awareness of internal conflict), I take responsibility ( clients end statements about themselves by adding, “and I take responsibility for it” ) and Playing the projection (clients role-play people with whom they are in conflict). Help clients see their role in contributing to how they feel. Thus they are no longer a victim but an active player in influencing how they feel. This empowers them.
  • I tell my students this joke to illustrate the opinion that the basic technique of reflection, by itself, is not sufficient for effective psychotherapy. But then I go on to emphasize how reflection is deceptively simple. While it may be used in a clumsy, superficial manner, it can also be applied as a versatile and powerful lens for helping a client uncover and clarify extremely important intrapsychic issues - as in Rogerian therapy. To demonstrate this, I set up a chair in front of the room, sit down, and role play a client for three or four minutes. The class just listens while I talk about my &amp;quot;problem.&amp;quot; I may role play some real person that I know (but whom the students don&apos;t), or I just improvise an imaginary client. When I finish, I ask the students to write down in their notebook what they would reflect back to the client. It&apos;s important that they write down EXACTLY what they would say, word for word, for their &amp;quot;reflection.&amp;quot; We then go around the room and have each student read what they wrote. It quickly becomes apparent that even only three or four minutes of a client talking produces an amazing amount of material. The variety of reflections posed by the students reveal that there are many different themes that could be reflected - and many important subtleties in how to word those reflections. What each student chooses to reflect might also reveal something important about the student. The bottom line: reflection is an art
  • What does that mean? It’s a therapy that uses manipulation of environment to modify person’s behaviors. Can add the cognitive component to help clients figure out how their thoughts impact their behaviors as well.
  • Example of flooding: we learn through associations, so if we have a phobia it is because we associate the feared object or stimulus with something negative. if the patient suffered from arachnophobia, the therapist might lock them in a room full of spiders.[1] While the patient would initially be very anxious, the mind cannot stay anxious forever. When nothing bad happens the patient begins to calm down and so from that moment on associate a feeling of calm with the previously feared object.[1] Example of gradual exposure: Fear of elevators: 1) first stand outside the elevator, 2) stand outside with the door open, 3) taking the elevator down one floor, 4) then up one floor, 5) then down two floors, 6) etc. Examples of systematic desensitization: First taught relaxation skills. Once the individual has been taught these skills, he or she must use them to react towards and overcome situations in an established hierarchy of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy.
  • Example of aversive conditioning: An example would be rapid smoking or pairing a pill that makes you sick with alcohol to stop drinking.
  • Ex of biofeedback training: Clients are hooked up to physiological recording devices that measure bodily functions such as heart rate or muscles tension to make the person become more aware of their physical symptoms that lead to anxiety.
  • For this exercise I write on the board, one by one, a series of questions. I pause for a few minutes between each question so students have time to complete their responses. Each question illustrates a different type of cognitive therapy technique (interventions that also can be found in psychodynamic therapy). After we complete the exercise, we go back over the questions and discuss the intended purpose of that technique. 
1. I often worry that I _________. (fill in the blank) I then say and write on the board,
2. If this worry of yours was indeed true, what does it mean to you and why does it bother you so much? Students then write their response. After they finish, I repeat the question , &amp;quot;If what you JUST wrote was indeed true, what does it mean to you and why does it bother you so much?&amp;quot; Once they finish writing, I AGAIN repeat the question , &amp;quot;&amp;quot;If what you JUST wrote was indeed true, what does it mean to you and why does it bother you so much?&amp;quot; Repeating this question helps uncover various layers or clusters of beliefs that may be &amp;quot;irrational,&amp;quot; &amp;quot;faulty,&amp;quot; or &amp;quot;pathogenic&amp;quot; (the term varying according to the specific theory). Next slide. I then say, &amp;quot;Look back over the various things you wrote so far and answer this question:&amp;quot;3. What&apos;s the worst thing that could possibly happen? What do you fear most of all? This question uncovers possible catastrophizing.
4. When you think of the worst thing that could happen, do you really think that it&apos;s likely to happen? If so, how could you learn to cope with it?The first question attempts to stimulate more rational, realistic thinking. The second encourages cognitive adapting to the situation. I then say, &amp;quot;Look back over the worrisome thoughts that you have written about so far, and answer this question:&amp;quot;
5. What do I (perhaps &amp;quot;secretly&amp;quot;) get out of thinking like this? How does it work to my advantage?This question encourages the student to look at what might be called the &amp;quot;secondary gain,&amp;quot; &amp;quot;ambivalence,&amp;quot; or &amp;quot;conflict&amp;quot; related to those worrisome beliefs.
6. Persuade a FriendHere I tell the students to carry on a dialogue - in writing - with a friend. &amp;quot;Pretend that your friend has some of the same worrisome beliefs that you do. Look back over the things you wrote for questions 1-3. Pick out one of those statements and write it down, as if your friend just said it. Now skip a line, and write a response to your friend&apos;s statement. In that reponse, be a compassionate, rational, and realistic thinker. After you write your response, skip a line and have your friend reply. Maybe your friend is a bit stuck in his/her thinking. Then skip a line, and respond again to your friend. Keep this conversation going for 10 lines or so.This exercise encourages students to identify with and develop the rational, compassionate side of themselves.
7. Positive imagery antedotesI ask the students to select three positive images, real memory or imagination, related to: confidence &amp; strength in your life... safety and peacefulness in your life... love in your life...I ask them to see each one clearly. Once those images are established, I ask them to imagine a real or imaginary scene related to one of their negative thoughts. I tell them that when the time feels right, they should move from the negative image to the positive one that feels like the right antedote, then back again to the negative image, repeating the cycle until they feel comfortable ending the exercise with the positive image firmly in mind.
8. I accept myself even though I __________ (do not use the word &amp;quot;am&amp;quot;)I tell the students to write this sentence 10 times! This encourages &amp;quot;adaptive self talk&amp;quot; and &amp;quot;positive (healthy) thinking.&amp;quot; Telling the students not to use the word &amp;quot;am&amp;quot; bypasses the tendency towards global labelling of oneself (&amp;quot;I accept myself even though I am a failure&amp;quot;) and encourages them instead to focus on specific traits or behaviors.
  • I then say , &amp;quot;Look back over the various things you wrote so far and answer this question:” 3. What&apos;s the worst thing that could possibly happen? What do you fear most of all? This question uncovers possible catastrophizing. 
 4. When you think of the worst thing that could happen, do you really think that it&apos;s likely to happen? If so, how could you learn to cope with it? The first question attempts to stimulate more rational, realistic thinking. The second encourages cognitive adapting to the situation. I then say, &amp;quot;Look back over the worrisome thoughts that you have written about so far, and answer this question:&amp;quot; 
5. What do I (perhaps &amp;quot;secretly&amp;quot;) get out of thinking like this? How does it work to my advantage? This question encourages the student to look at what might be called the &amp;quot;secondary gain,&amp;quot; &amp;quot;ambivalence,&amp;quot; or &amp;quot;conflict&amp;quot; related to those worrisome beliefs. 

  • 6. Persuade a Friend Here I tell the students to carry on a dialogue - in writing - with a friend. &amp;quot;Pretend that your friend has some of the same worrisome beliefs that you do. Look back over the things you wrote for questions 1-3. Pick out one of those statements and write it down, as if your friend just said it. Now skip a line, and write a response to your friend&apos;s statement. In that reponse, be a compassionate, rational, and realistic thinker. After you write your response, skip a line and have your friend reply. Maybe your friend is a bit stuck in his/her thinking. Then skip a line, and respond again to your friend. Keep this conversation going for 10 lines or so .This exercise encourages students to identify with and develop the rational, compassionate side of themselves.
7. Positive imagery antedotes I ask the students to select three positive images, real memory or imagination, related to: confidence &amp; strength in your life... safety and peacefulness in your life... love in your life...I ask them to see each one clearly. Once those images are established, I ask them to imagine a real or imaginary scene related to one of their negative thoughts. I tell them that when the time feels right, they should move from the negative image to the positive one that feels like the right antedote, then back again to the negative image, repeating the cycle until they feel comfortable ending the exercise with the positive image firmly in mind.
8. I accept myself even though I __________ (do not use the word &amp;quot;am&amp;quot;)I tell the students to write this sentence 10 times! This encourages &amp;quot;adaptive self talk&amp;quot; and &amp;quot;positive (healthy) thinking.&amp;quot; Telling the students not to use the word &amp;quot;am&amp;quot; bypasses the tendency towards global labelling of oneself (&amp;quot;I accept myself even though I am a failure&amp;quot;) and encourages them instead to focus on specific traits or behaviors.
  • 7. Positive imagery antedotes I ask the students to select three positive images, real memory or imagination, related to: confidence &amp; strength in your life... safety and peacefulness in your life... love in your life...I ask them to see each one clearly. Once those images are established , I ask them to imagine a real or imaginary scene related to one of their negative thoughts . I tell them that when the time feels right, they should move from the negative image to the positive one that feels like the right antedote, then back again to the negative image, repeating the cycle until they feel comfortable ending the exercise with the positive image firmly in mind.
 8. I accept myself even though I __________ (do not use the word &amp;quot;am&amp;quot;)I tell the students to write this sentence 10 times! This encourages &amp;quot;adaptive self talk&amp;quot; and &amp;quot;positive (healthy) thinking.&amp;quot; Telling the students not to use the word &amp;quot;am&amp;quot; bypasses the tendency towards global labelling of oneself (&amp;quot;I accept myself even though I am a failure&amp;quot;) and encourages them instead to focus on specific traits or behaviors.
  • Please replace this image with a clean copy. You will need to ungroup and regroup with black frame.
  • When a therapist has several clients with similar problems, it often makes sense to treat them together in a group rather than individually.
  • Chapter 9 powerpoint

    1. 1. Therapies Chapter 9
    2. 2. What is Psychotherapy? <ul><li>Systematic interaction </li></ul><ul><li>psychological principles </li></ul><ul><li>Explores and influences thoughts, feelings, and behavior to help that client overcome abnormal behavior or adjust to problems in living. </li></ul>
    3. 3. Psychodynamic Therapy <ul><li>Psychodynamic theories are based on the thinking of Sigmund Freud, the founder of psychodynamic theory. </li></ul><ul><li>Focus upon the conflict amongst the three psychic structures (id, ego and superego). </li></ul><ul><li>Freud’s method of therapy, psychoanalysis, was the first psychodynamic therapy. </li></ul>
    4. 4. Psychoanalysis <ul><li>Psychoanalysis seeks to help people develop insight into the dynamic struggles occurring within the psyche between the three psychic structures. </li></ul><ul><li>The goal is to bring conflicts between the psychic structures into conscious awareness and “work through” them. </li></ul><ul><li>Activity for free association. </li></ul>
    5. 5. Psychoanalysis Terms and Techniques <ul><li>Free Association : In psychoanalysis, the uncensored uttering of all thoughts that come to mind. </li></ul><ul><li>Resistance: The tendency to block the free expression of impulses and primitive ideas—a reflection of the defense mechanism of repression. </li></ul><ul><li>Interpretation: An explanation of a client’s remarks according to psychoanalytic theory. </li></ul>
    6. 6. Psychoanalysis Terms and Techniques <ul><li>Transference: Responding to one person in a way that is similar to the way one responded to another person in childhood. (ex. Displace feelings of father onto male therapist) </li></ul><ul><li>Dream Analysis: unconscious impulses tend to be expressed in dreams as a form of wish fulfillment. Dreams consist of both manifest content and latent content. </li></ul>
    7. 7. Activity <ul><li>“ Think of your partner or close friend. Think about some aspect of their personality that you have a strong reaction to, either positive or negative. </li></ul><ul><li>Now write that down on a scratch piece of paper. </li></ul><ul><li>Describe what that aspect of their personality is like, and how you react in your thoughts, feelings, and behavior toward that part of their personality. </li></ul>
    8. 8. Activity: <ul><li>Here are several possibilities of how transference may play out. </li></ul><ul><li>You see the other in the same way as you believed your parent to have been (simple transference). </li></ul><ul><li>You see the other as being like what you WISH your parent COULD have been like </li></ul><ul><li>You see the OTHER AS YOU were as a child and you act like your parent did </li></ul><ul><li>You see the other as you were as a child and you act like you WISHED your parent could have acted. </li></ul>
    9. 9. Client-Centered Therapy <ul><li>Carl Rogers’s </li></ul><ul><li>emphasizes the creation of a warm, therapeutic atmosphere that frees clients to engage in self-exploration and self-expression. </li></ul><ul><li>Frame of Reference: One’s unique patterning of perceptions and attitudes, according to which one evaluates events. </li></ul><ul><li>3 main qualities: </li></ul><ul><li>Unconditional positive regard </li></ul><ul><li>Empathic understanding </li></ul><ul><li>Genuineness </li></ul>
    10. 10. Gestalt Therapy <ul><li>Fritz Perls’s </li></ul><ul><li>attempts to integrate conflicting parts of the personality through directive methods designed to help clients perceive their whole selves. </li></ul><ul><li>Gestalt exercises include: </li></ul><ul><li>The dialogue </li></ul><ul><li>“ I take responsibility” </li></ul><ul><li>Playing the projection </li></ul><ul><li>The empty chair </li></ul><ul><li>Body language </li></ul>
    11. 11. Reflection Activity <ul><li>I need one volunteer to do a scripted role play with me. </li></ul><ul><li>Reflection: can be applied as a versatile and powerful lens for helping a client uncover and clarify extremely important intrapsychic issues </li></ul><ul><li>Part 2: Listen to role play of client with problem (video). http://www.aetv.com/obsessed/episode-guide/?bcpid=30881450001&bctid=28981312001 </li></ul><ul><li>On scratch piece of paper, write down EXACTLY what you would reflect back to the client based on what you heard (word for word). </li></ul><ul><li>Sharing of reflections. </li></ul>
    12. 12. Behavior Therapy <ul><li>Behavior Therapy: Systematic application of the principles of learning to the direct modification of a client’s problem behaviors. </li></ul><ul><li>Behavior therapists draw upon the principles of classical and operant conditioning as well as observational learning . </li></ul>
    13. 13. Behavior Therapy (Fear Reduction Methods) <ul><li>Flooding: A person is exposed for prolonged intervals to a fear-evoking but harmless stimulus until fear is extinguished. </li></ul><ul><li>Gradual exposure: Similar to flooding, but works upward in a hierarchy of progressively more fearful stimuli. </li></ul><ul><li>Systematic Desensitization: Wolpe’s method for reducing fears by associating a hierarchy of images of fear-evoking stimuli with deep muscle relaxation. </li></ul><ul><li>Modeling: A technique in which a client observes and imitates a person who approaches and copes with feared objects or situations. </li></ul>
    14. 14. Behavior Therapy (Aversive Conditioning) <ul><li>Aversive Conditioning: A behavior therapy technique in which stimuli associated with undesired responses become aversive by pairing noxious stimuli with them. </li></ul><ul><li>Rapid Smoking: An aversive conditioning method for quitting smoking in which the smoker inhales every 6 seconds, thus rendering once-desirable cigarette smoke undesireable. </li></ul>
    15. 15. Behavior Therapy (Operant Conditioning Principles) <ul><li>The Token Economy: A controlled environment in which people are reinforced for desired behaviors with tokens (such as poker chips) that may be exchanged for later privileges (Ex. Incentive plan). </li></ul><ul><li>Social Skills Training: Behavior therapists help people alleviate social anxiety and build social skills through having participants rehearse social behaviors in a group setting. </li></ul><ul><li>Biofeedback Training: The systematic feeding back to an organism of information about a bodily function so that the organism can gain control of that function. </li></ul>
    16. 16. Example of Behavioral Therapy <ul><li>Video with example of Behavioral Therapy - gradual exposure. </li></ul><ul><li>From A&E show, “Obsessed”. </li></ul><ul><li>http://www.aetv.com/obsessed/video/index.jsp?bcpid=45697868001&bclid=23151005001&bctid=25714299001&baseURL=/bcconfig/Player/3Tier/Obsessed_ws/config-xml/&baseDIR=/bcplayers/Player/3Tier_ws/baseDIR/ </li></ul>
    17. 17. Cognitive Therapies <ul><li>Cognitive therapists focus on helping people change the beliefs, attitudes and automatic types of thinking that are believed to underlie psychological problems such as anxiety and depression. </li></ul><ul><li>The two most common cognitive therapies are Aaron Beck’s cognitive therapy and Albert Ellis’s rational-emotive behavior therapy. </li></ul>
    18. 18. Cognitive Therapies <ul><li>Beck’s Cognitive Therapy : A form of therapy that focuses on how clients’ cognitions (expectations, attitudes, beliefs, etc.) lead to distress and may be modified to relieve distress and promote adaptive behavior. </li></ul><ul><li>Ellis’s Rational-Emotive Behavior Therapy (REBT) : A form of therapy that encourages clients to challenge and correct irrational expectations and maladaptive behaviors. </li></ul>
    19. 19. Activity: “The Way I Think” <ul><li>Answer the following questions on a separate piece of paper. </li></ul><ul><li>1) I often worry that I _____________. </li></ul><ul><li>2) If this worry of yours was indeed true, what does it mean to you and why does it bother you so much? </li></ul><ul><li>2b) If what you JUST wrote was indeed true, what does it mean to you and why does it bother you so much? </li></ul><ul><li>2c) if what you JUST wrote was indeed true, what does it mean to you and why does it bother you so much? </li></ul>
    20. 20. Activity: “The Way I Think” (cont’) <ul><li>3) What’s the worst thing that could possibly happen? What do you fear most of all? </li></ul><ul><li>4) When you think of the worst thing that could happen, do you really think that it’s likely to happen? If so, how could you learn to cope with it? </li></ul><ul><li>5) What do I (perhaps “secretly”) get out of thinking like this? How does it work to my advantage? </li></ul>
    21. 21. Activity: “The Way I Think” (cont’) <ul><li>6) Letter to your friend. </li></ul><ul><ul><li>Pretend your friend has some of the same worrisome beliefs that you do. </li></ul></ul><ul><ul><li>Pick out one of the statements from questions 1-3 and write it down. </li></ul></ul><ul><ul><li>Write a compassionate, rational, and realistic response to your friend’s statement </li></ul></ul><ul><ul><li>Next line: Have your friend reply. </li></ul></ul><ul><ul><li>Next line: respond again to your friend…try to keep the conversation going for 10 lines or so. </li></ul></ul>
    22. 22. Activity: “The Way I think” (cont’) <ul><li>7) Positive imagery antedotes </li></ul><ul><ul><li>Select 3 positive images (real or imaginary) related to: 1) confidence and strength in your life, 2) safety and peacefulness in your life, 3) love in your life </li></ul></ul><ul><li>8) I accept myself even though I _____________. </li></ul><ul><ul><li>Now write this down 10 times!! </li></ul></ul>
    23. 23. Convergence of Approaches <ul><li>Today, many therapists don’t adhere to a single approach. </li></ul><ul><li>Many therapists utilize an eclectic approach. </li></ul><ul><li>These therapists tend to be older and/or more experienced. </li></ul>
    24. 25. Group Therapy <ul><li>Group therapy has several advantages: </li></ul><ul><li>It’s economical. Therapists can work with several clients at once. </li></ul><ul><li>It can provide more information and life experience for clients to draw upon. </li></ul><ul><li>Appropriate behavior receives support from the group. </li></ul><ul><li>Affiliating with people with similar problems is reassuring that we’re not alone. </li></ul><ul><li>Group members who improve provide hope for other group members,. </li></ul><ul><li>Group therapy can help those who are seeking therapy because of problems in relating to other people. </li></ul>
    25. 26. Couples Therapy <ul><li>Couples therapy focuses on helping distressed couples resolve their conflicts and improve their communication skills. </li></ul><ul><li>Couples therapy helps correct power imbalances in the relationship so that partners can explore alternative ways of relating to one another. </li></ul><ul><li>The leading contemporary approach to couples therapy is based on cognitive-behavioral principles. </li></ul>
    26. 27. Family Therapy <ul><li>A form of therapy in which the family unit is treated as the client. </li></ul><ul><li>In a systems approach to family therapy, the therapist helps the family change the system by which the family functions in order to enhance growth of individual family members and of the family as a whole. </li></ul>
    27. 28. Effectiveness of Psychotherapy <ul><li>There are several problems that researchers must address when evaluating the effectiveness of psychotherapy. These problems include comparing different forms of psychotherapy, measuring outcomes of therapy and determining whether effectiveness is due to nonspecific factors or the therapeutic alliance. However… </li></ul><ul><li>Meta-analyses by Smith and Glass (1977) and Shadish (2000) have found that psychotherapy is effective. </li></ul><ul><li>Smith and Glass: Those who receive psychodynamic therapy showed better results, on average, than 70-75% of those who did not receive treatment. Similarly, nearly 75% of those who received client-centered therapy were better off than control groups. </li></ul>
    28. 30. Psychotherapy and Human Diversity <ul><li>In general: Psychotherapists must attend to and respect their client’s sociocultural and individual differences. Therapists must also recognize their own ethical responsibilities if they are not comfortable with, or lack the skills to work with, a particular client. </li></ul>
    29. 31. Biomedical Therapies <ul><li>Biomedical therapies are administered by doctors, such as psychiatrists. The three primary forms of biomedical therapy are drug therapy, electroconvulsive therapy and psychosurgery. </li></ul>
    30. 32. Drug Therapy <ul><li>Psychotropic Drugs: Prescription drugs that are widely used to help relieve disturbing emotional states, such as anxiety or depression, or to control symptoms of severe disorders. </li></ul><ul><li>There are three major classes of psychotropic drugs: antianxiety, antipsychotic, and antidepressants. </li></ul>
    31. 33. Drug Therapy <ul><li>Antianxiety: Most antianxiety drugs belong to the chemical class known as benzodiazapenes. Common drugs include Valium and Xanax. These drugs depress the activity of the central nervous system. Many people quickly develop a tolerance to antianxiety drugs. </li></ul><ul><li>Antipsychotic: Are a group of drugs that help relieve psychotic symptoms. These drugs are believed to act by blocking dopamine receptors in the brain. </li></ul><ul><li>Antidepressants: A group of drugs that primarily help relieve depression, but also are used to treat obsessive-compulsive disorder, bulimia and panic disorder amongst others. Three major classes include Monoamine Oxidase (MAO) inhibitors (such as Nardil), Tricyclics (such as Tofranil) and Selective Serotonin-Reuptake Inhibitors (SSRIs) such as Prozac and Zoloft. </li></ul>
    32. 34. Electroconvulsive Therapy (ECT) <ul><li>Treats disorders like major depression by passing an electric current (that causes a convulsion) through the head. </li></ul><ul><li>People usually receive ECT in a series of 6 to 12 treatments spread over several weeks. </li></ul><ul><li>Problems with ECT include potential memory loss and high relapse rates. </li></ul>
    33. 35. Evaluating Biomedical Therapies <ul><li>The introduction of antipsychotic drugs made it possible for hundreds of thousands of mental hospital patients to return home. </li></ul><ul><li>However, psychiatric drugs are not a cure all. They can have troubling side effects. </li></ul><ul><li>Also, psychotherapy has been found to be as effective (if not more so) than drug therapies for certain disorders (such as depression). </li></ul><ul><li>Ultimately, a combination of psychotherapy and biomedical treatment may be the best course of action. </li></ul>
    34. 36. Coping with Anxiety and Fear <ul><li>1. Define the feared object or situation. </li></ul><ul><li>2. List specific behaviors that make up a gradual approach of the target. </li></ul><ul><li>3. Create a hierarchy of fears. </li></ul><ul><li>4. Utilize gradual exposure, starting with the least threatening item of your hierarchy. </li></ul><ul><li>5. Pay attention to your cognitions. </li></ul>
    35. 37. Managing Anger <ul><li>Monitor your reactions in angering situations. </li></ul><ul><li>Stop and think </li></ul><ul><li>Practice competing responses and competing thoughts. </li></ul><ul><li>Practice self-relaxation. </li></ul><ul><li>Don’t impose unrealistic expectations on others. </li></ul><ul><li>Replace anger with empathy. </li></ul><ul><li>Depersonalize the situation. </li></ul><ul><li>Keep your voice down. </li></ul><ul><li>Act assertively, not aggressively. </li></ul><ul><li>Express positive feelings. </li></ul><ul><li>Give yourself a pat on the back for keeping your cool. </li></ul>
    36. 38. Lifting your Mood <ul><li>Engage in pleasant activities: Utilizing the list in your book, engage in at least three of these events each day. Record your activities in a diary and toward the end of each day, rate your response to each activity. After a week or so, check the items in your diary that received positive ratings and repeat successful activities while experimenting with new ones. </li></ul><ul><li>Think Rationally: Recognize and change distorted thoughts into rational thoughts. </li></ul><ul><li>Exercise: Exercise can enhance psychological well-being and help us cope with depression. </li></ul>
    37. 39. Homework <ul><li>Journal #5 </li></ul>

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