Chapter 12

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Chapter 12

  1. 1. Treatment: Healing Actions, Healing Words
  2. 2. Assumptions of Psychotherapy <ul><li>The therapist should be: </li></ul><ul><li>An expert vs. An equal </li></ul><ul><li>Passive vs. Active </li></ul><ul><li>Psychotherapy should focus mostly on the: </li></ul><ul><li>Present vs. Past influences on the present </li></ul><ul><li>Conscious control vs. Unconscious forces </li></ul><ul><li>Behaviors vs. Thoughts </li></ul>
  3. 3. How Psychoanalysis Works Hidden conflicts / Repressed Impulses Bring to Consciousness Insight into cause Disorder Improves
  4. 4. Insight-Oriented Therapy <ul><li>Psychoanalysis </li></ul><ul><ul><li>First use of a “talking cure” </li></ul></ul><ul><ul><li>Developed by Sigmund Freud </li></ul></ul><ul><ul><li>Identify unconscious motivations </li></ul></ul><ul><ul><li>Techniques </li></ul></ul><ul><ul><li>Free association </li></ul></ul><ul><ul><li>Dream analysis </li></ul></ul><ul><ul><li>Resistance </li></ul></ul><ul><ul><li>Transference </li></ul></ul>
  5. 5. Insight-Oriented Therapy <ul><li>Psychodynamic therapy </li></ul><ul><ul><li>Similar to psychoanalytic therapy </li></ul></ul><ul><ul><li>Less frequent sessions </li></ul></ul><ul><ul><li>Less emphasis on sexual and aggressive drives </li></ul></ul><ul><ul><li>Techniques </li></ul></ul><ul><ul><ul><li>Interpretation </li></ul></ul></ul><ul><ul><ul><li>Resistance </li></ul></ul></ul><ul><ul><ul><li>Transference </li></ul></ul></ul>
  6. 6. Insight-Oriented Therapy <ul><li>Humanistic therapy </li></ul><ul><ul><li>Carl Rogers </li></ul></ul><ul><ul><li>Client-centered therapy </li></ul></ul><ul><ul><li>Incongruence </li></ul></ul><ul><ul><ul><li>Real self </li></ul></ul></ul><ul><ul><ul><li>Ideal self </li></ul></ul></ul>
  7. 7. Client-Centered Therapy Unrealistic conditions of worth Distortions of self concept Client-Centered Therapy Move toward self-acceptance
  8. 8. Insight-Oriented Therapy <ul><li>Client-centered therapy techniques </li></ul><ul><ul><li>Reflection </li></ul></ul><ul><ul><li>Empathy </li></ul></ul><ul><ul><li>Unconditional positive regard </li></ul></ul>
  9. 9. Evaluating Insight-Oriented Therapies <ul><li>Difficult to evaluate </li></ul><ul><li>Who benefits from them? </li></ul><ul><ul><li>Healthy </li></ul></ul><ul><ul><li>Articulate </li></ul></ul>
  10. 10. Behavior Therapy <ul><li>A type of therapy based on learning principles that focuses on changing observable, measurable behaviors </li></ul><ul><li>The ABCs </li></ul><ul><ul><li>Antecedents </li></ul></ul><ul><ul><li>Behavior </li></ul></ul><ul><ul><li>Consequences </li></ul></ul>
  11. 11. Behavior Therapy <ul><li>Techniques based on classical conditioning </li></ul><ul><ul><li>Exposure </li></ul></ul><ul><ul><ul><li>Imaginable exposure </li></ul></ul></ul><ul><ul><ul><li>In vivo exposure </li></ul></ul></ul><ul><ul><ul><li>Virtual reality exposure </li></ul></ul></ul><ul><ul><li>Systematic desensitization </li></ul></ul><ul><ul><ul><li>Progressive muscle relaxation </li></ul></ul></ul>
  12. 12. Cognitive Therapy <ul><li>A type of therapy that focuses on thoughts rather than feelings or behaviors </li></ul><ul><li>Cognitive distortions </li></ul><ul><li>Psychoeducation </li></ul>
  13. 13. Common Cognitive Distortions <ul><li>Dichotomous thinking </li></ul><ul><li>Mental filter </li></ul><ul><li>Mind reading </li></ul><ul><li>Catastrophic exaggeration </li></ul><ul><li>Control beliefs </li></ul>
  14. 14. Cognitive Therapy Techniques <ul><li>Beck’s cognitive therapy </li></ul><ul><ul><li>Cognitive restructuring </li></ul></ul><ul><ul><li>Daily record of dysfunctional beliefs </li></ul></ul><ul><ul><li>Identify automatic thoughts </li></ul></ul><ul><ul><li>Identify rational responses </li></ul></ul>
  15. 15. Biomedical Therapies
  16. 16. Psychopharmacology: Schizophrenia <ul><li>Antipsychotic medications </li></ul><ul><ul><li>Target positive symptoms </li></ul></ul><ul><ul><li>Tardive dyskinesia </li></ul></ul><ul><li>Atypical antipsychotics </li></ul><ul><ul><li>Newer </li></ul></ul><ul><ul><li>Target positive and negative symptoms </li></ul></ul>
  17. 17. Antidepressants: Help or Hype? <ul><li>Tricyclic antidepressants (TCAs) </li></ul><ul><li>Monoamine oxidase inhibitors (MAOIs) </li></ul><ul><ul><li>Food interactions </li></ul></ul><ul><li>Selective serotonin reuptake inhibitors (SSRIs) </li></ul><ul><ul><li>Prozac, Zoloft, Paxil </li></ul></ul><ul><li>Serotonin/norepinephrine reuptake inhibitors (SNRIs) </li></ul><ul><ul><li>Serzone, Effexor </li></ul></ul><ul><li>St. John’s wort </li></ul><ul><li>Lithium </li></ul>
  18. 18. Psychopharmacology: Anxiety Disorders <ul><li>Benzodiazepines </li></ul><ul><ul><li>Xanax, Valium </li></ul></ul><ul><ul><li>Often for short periods </li></ul></ul><ul><li>Antidepressants </li></ul><ul><ul><li>TCAs </li></ul></ul><ul><ul><li>SSRIs </li></ul></ul><ul><ul><li>SNRIs </li></ul></ul>
  19. 19. Electroconvulsive Therapy (ECT) <ul><li>Used when medication and therapy is ineffective </li></ul><ul><li>Depression </li></ul><ul><li>Fell out of favor </li></ul><ul><ul><li>Abuse </li></ul></ul><ul><ul><li>Movie, One Flew Over the Cuckoo’s Nest </li></ul></ul><ul><li>Regaining popularity </li></ul><ul><li>Memory loss </li></ul>
  20. 20. Transcranial Magnetic Stimulation (TMS) <ul><li>New technique </li></ul><ul><li>100- to 200- microsecond bursts of high-intensity magnetism </li></ul><ul><li>May replace ECT </li></ul>
  21. 21. Modalities <ul><li>Individual therapy </li></ul><ul><li>Group therapy </li></ul><ul><li>Family therapy </li></ul><ul><li>Self-help therapies </li></ul><ul><ul><li>Support groups </li></ul></ul><ul><ul><li>Bibliotherapy </li></ul></ul>

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