Psychological Therapies

1. Psychological Therapies Psychoanalysis Humanistic Therapies Psycho- Therapies Behavioral Therapies Cognitive Therapies (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

2. Psychoanalysis Many Y problems are due to repressed childhood impulses & conflicts Historical Reconstruction to Shed Light on the Present Patientprovides Free Association & Dreams • Analystprovides Interpretations: • Aim to provide insight into • patient’s underlying conflicts • Understanding of Transference • Problem - Slow & Expensive $ (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

3. Humanistic Therapies Emphasis on people’s inherent potential for self-fulfillment • Humanists focus on: • the present, not the past • awareness of feelings, not childhood origins • of feelings • conscious thoughts, not unconscious ones • taking responsibility for feelings & actions, • not uncovering hidden(?) causes • promoting growth, not curing illness (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

4. Person-Centered Therapy Focus is on client’s self-perceptions, not interpretations of the therapist Non-Directive Therapy Listen, without judging, interpreting or directing the client toward certain insights Carl Rogers Active Listening - echoing, restating, clarification and acknowledgment of the client’s feelings. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

5. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

6. Gestalt Therapy Combine unconscious feelings with “getting in touch with oneself” and taking responsibility for oneself. Fritz Perls Make client “whole” by breaking through their defenses & helping them sense and express their moment-to-moment feelings. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

7. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

8. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

9. Behavior Therapies Behaviors are the problems ! Q: Does knowing why you are afraid of heights make you not afraid of heights? A: NO…So why bother with “WHY”? Learning Principles are used to eliminate unwanted behaviors (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

10. Treatment of Psychological Disorders • Psychotherapy • the process in which a patient (often referred to as a client) and a professional attempt to remedy psychological difficulties (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

11. Psychotherapy: Psychological Approaches to Treatment • Psychodynamic therapy • based on the premise that the primary sources of abnormal behavior are unresolved past conflicts and the possibility that unacceptable unconscious impulses will enter consciousness • Psychoanalysis • psychodynamic therapy that involves frequent sessions and often lasts for many years (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

12. Behavioral Approaches to Treatment • Behavioral treatment approaches • build upon the basic processes of learning embodied in classical and operant conditioning (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

13. Behavioral Approaches to Treatment • Classical conditioning approaches • aversive conditioning • create unpleasant reactions to stimuli that an individual previously enjoyed • systematic desensitization • person is taught to relax and then is gradually exposed to an anxiety-producing stimulus in order to extinguish the response of anxiety (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

14. Behavioral Approaches to Treatment • Observational learning • learning by watching others’ behavior and the consequences of that behavior • Modeling • systematically teach people new skills and ways of handling their fears and anxieties • Operant conditioning • token system of rewarding desired behavior (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

15. Classical Conditioning Counter-Conditioning Pairing the CS with a new, “fear-less” response Systematic Desensitization Aversive Conditioning (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999) Swap (+) for (-) Swap (-) for (+)

16. Operant Conditioning Behaviors are influenced by their consequences Rewards used to modify behavior varies (e.g., attention, praise or food) Token Economy Rewards = tokens to be redeemed for desirable items like candy, TV, trips, etc. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

17. Cognitive Therapies Thinking affects our feelings - change patterns of thinking and you change feelings (major depression & general anxiety) Happy Depressed (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

18. Cognitive Approaches to Therapy • Cognitive-behavioral approach • people’s faulty cognitions about themselves and the world are changed to more accurate ones • Rational-emotive therapy • attempts to restructure a person’s belief system into a more realistic, rational, and logical set of views (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

19. Cognitive Approaches to Therapy • Cognitive therapy • psychotherpay based on Beck’s goal to change people’s illogical thoughts about themselves and the world • less confrontational and challenging than rational-emotive therapy (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

20. Rational-Emotive Therapy Many problems arise from irrational thinking Show client the absurdity of their ideas and they will realize that their problems aren’t really “problems”. Confrontational Style (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

21. Humanistic Approaches to Therapy • Humanistic therapy • the underlying assumption is that people have control of their behavior, can make choices about their lives, and are essentially responsible for solving their own problems (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

22. Humanistic Approaches to Therapy • Client-centered therapy • goal is to reach one’s potential for self-actualization • Existential therapy • addresses the meaning of life and human freedom • Gestalt therapy • attempts to integrate a client’s thoughts, feelings, and behavior into a whole (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

23. Biomedical Therapies Rapid decline in the “resident patient” population due to advances in Psychopharmacology in ‘50s Has the net result been “Good” or “Bad”? (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

24. Biomedical Therapy: Biological Approaches to Treatment • Biomedical Therapy • therapy that relies on drugs and other medical procedures to improve psychological functioning • Drug Therapy • control of psychological problems through drugs (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

25. Antipsychotic Drugs Thorazine Calms (+) symptom Clozaril May “awaken” (-) symptom How? By occupying Dopamine receptor sites at neuron and blocking it’s activity (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

26. Drug Therapy • Antipsychotic drugs • drugs that temporarily alleviate psychotic symptoms such as agitation and overactivity • chlorpromazine • clozapine • haloperidol (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

27. Antianxiety Drugs Work by depressing CNS activity Drugs like Valium & Librium reduce tension and anxiety without causing excessive sleepiness. Psychological Dependence! Prince Valium (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

28. Drug Therapy • Lithium • a form of simple mineral salts that has been used very successfully in cases of bipolar disorder • Antianxiety drugs • reduce the level of anxiety a person experiences, essentially by reducing excitability and in part by increasing drowsiness (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

29. Antidepressant Drugs Increase availability of Norepinepherine or Seratonin Prozac blocks reuptake/removal of seratonin from the synapse $1 Billion in sales in ‘93 Manic-Depressive Disorder Lithium - simple salt Prozac (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

30. Drug Therapy • Antidepressant drugs • medication that improves a depressed patient’s mood and feeling of well-being • Prozac (fluoxetine) • Zoloft • Paxil (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

31. Therapies of Last Resort Electroconvulsive Therapy & Psychosurgery ECT - limited to severely depressed patients How Does It Work? Good Question. Lobotomy - cut nerves connecting frontal lobes with inner brain (fad of ‘40s & ‘50s ...very nasty) (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

32. Psychosurgery • Psychosurgery • brain surgery once used to alleviate symptoms of mental disorder but rarely used today • Prefrontal lobotomy • surgically destroying or removing parts of a patient’s frontal lobes that were thought to control emotionality (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

33. Electroconvulsive Therapy (ECT) • Electroconvulsive therapy (ECT) • a procedure in which an electric current of 70 to 150 volts is briefly administered to a patient’s head, causing a loss of consciousness and often seizures (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

34. Evaluating Psychotherapy: Does Therapy Work? (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

35. Evaluating Psychotherapy: Does Therapy Work? • Spontaneous recovery • recovery without treatment • Eclectic approach to therapy • an approach to therapy that uses techniques taken from a variety of treatment methods, rather than just one (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

36. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

37. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

38. Group Therapy • Group therapy • therapy in which people discuss problems with a group • Family therapy • an approach that focuses on the family as a whole unit to which each member contributes (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

39. Community Psychology: Focus on Prevention • Community psychology • a movement aimed toward preventing or minimizing psychological disorders in the community • Deinstitutionalization • the transfer of former mental patients from institutions into the community (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)

40. References • Feldman, M. (1999). McGraw Hill Company. Retrieved May 2002 from World Wide Web at: http://www.mcgrawhill.com. • Kohn, A. J. & Kohn, W. (1998). The Integrator 2.0. CD-Rom. Brooks/Cole Thomson Learning. • Richardson, K. (1999). Retrieved May 2002 from the World Wide Web at: http://www.monmouth.edu. (Feldman, 1999; Kohn & Kohn, 1998; Richarson, 1999)