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Psychotherapy Ch. 15

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  1. Psychotherapy Ch. 15 Music: “Therapy” India Arie “Mr. Therapy Man” Justin Nozuka

  2. Today’s Agenda • 1. Seeking Professional Help • When, where and how? • Which therapy works best? • 2. Different Therapeutic Approaches: • i) Psychodynamic Therapy • Clip illustration • ii) Behavioural Therapies • Example of behavioural technique • Movie: Virtual Reality Therapy (5 min.) • iii) Cognitive Therapy • Clip illustration • Distinction with CBT • iv) Client-Centred Therapy • v) Biomedical Treatments • Movie: Deep Brain Stimulation (10 min.) • 3. Basic Counseling Skills

  3. Seeking Professional Help: When, Where and How? • When: • 1. You’re feeling significant levels of discomfort • 2. Your functioning is impaired • 3. Someone else tells you that you need help • 4. Have have persistent suicidal thoughts • Where do you find help? • Ontario Psychological Association: (416) 961-0069 • Your physician can refer you • Local Hospitals: • North York General 416-756-6316 • Humber River Regional 416-747-3833 • Distress Centers: (416) 598-1211 or (416) 486-1456 • Counseling and Development Center: 736-5297 • York University Psychology Clinic: 650-8488 • Free online mental health advice and information for young people: • www.yoomagazine.net • How to pay? • Distinction between psychologists, psychiatrists, social workers and other “therapists”

  4. Most people don’t get the help they need!

  5. Which therapy works best? • Depends on the problem • Depends on the technique • Depends on the therapist • But overall, studies show that different therapies have comparable results • Common therapeutic ingredients: • Alliance with the therapist * • Emotional support and empathic understanding allowing emotional expression • Rationale for one’s problems and provision of hope • Gaining new insights and learning more adaptive ways to relate to others and the self

  6. 2. Different Therapeutic Approaches • All approaches differ on: • Assumptions regarding the origins of the problem • Therapist’s stance • Method of treatment • Goals of treatment • 2. i) Psychodynamic Therapy: • Problem: resides in unconscious conflicts, repressed memories • Therapist: “blank-screen” • Method: free-association, dream analysis, transference analysis • Goal: make the unconscious conscious • Case illustration: http://www.youtube.com/watch?v=_KjmLNuyuuA&feature=related

  7. 2. Different Therapeutic Approaches • 2. ii) Behaviour Therapy • Problem: resides in faulty learning • Therapist: examines current conditions that elicit the problem • Method: apply learning principles to get rid of symptoms • training/ exposure/ counter-conditioning • Goal: alleviate symptoms/ modify behavior

  8. 2. ii) Example of behavioural techniques • a) Systematic Desensitization: • Effective with phobias • Use “counterconditioning” • Steps: • Set-up a hierarchy of anxiety-triggering situations • Learn relaxation response • Imagine least anxiety-provoking situation while maintaining a relaxed state • Imagine more difficult situations until most difficult is imagined while maintaining a relaxed state • Practice with real-life situations • b) “Virtual Reality Therapy” (movie 5 min.) • Virtual reality moves into the clinician’s office • Makes use of behavioural principle of “exposure” to treat phobias

  9. 2. iii) Cognitive Therapy • Problem: is a function of the way you think • Therapist: more directive and challenging • Method: Challenge your automatic thoughts and underlying beliefs • Use of homework exercises • Goal: Realistic thinking/ Better perspective • p. 672

  10. 2. iii) Cognitive Therapy (cont’d) • Examples of cognitive techniques • Clip: The case of Tim • http://www.youtube.com/watch?v=LIzm4jiyvXI&feature=related • Cognitive-Behaviour Therapy (CBT): • Combines elements of both cognitive and behavioural therapies • Recommended for depression and anxiety • http://www.youtube.com/watch?v=B5Z-dvL-qo8 • Mindfulness-based cognitive therapy: • Learn to watch the contents of your consciousness and to label thoughts and feelings • Prevents people from spiraling down and ruminating (getting “caught” in their dysfunctional thinking)

  11. 2. iv) Client-Centered Therapy • Problem: incongruence with one’s true self • Therapist: Non-directive, genuine, empathic and unconditional • Method: therapeutic relationship allows fuller experiencing and greater acceptance of the self • Goal: self-actualization / greater congruence • Clip with Carl Rogers • http://www.youtube.com/watch?v=HarEcd4bt-s&feature=related

  12. 2. v) Biomedical Approach • Problem: • Chemical imbalance/ Structural abnormalities in the brain • Therapist: • Medical doctor (family or psychiatrist) will monitor symptoms and adjust medication/ monitor treatment • Method: psychopharmacological drugs • Depression: Antidepressants, ECT • Bipolar Disorders: Mood stabilizers • Anxiety: Tranquilizers • Schizophrenia: Anti-psychotics • Goal: reduce symptoms • Movie: “Deep Brain Stimulation” (10 min.) • A new invasive brain surgery to alter patterns of thinking and emotions • Impressive results with treatment resistant cases

  13. 3. Basic Counseling Skills • Or how to better help your family and friends: • Active listening: really listen • Try to avoid giving advice or telling the person what to do • Avoid judgment • Better not expressed • Clarify the problem • Empathize with the feelings • Maintain confidentiality!

  14. 4. See you next week!