What is Therapy? mental behavioral social functioning

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2 PSYCHOTHERAPY

3 What is Therapy? Therapy for psychological disorders takes a variety of forms, but all involve some relationship focused on improving a person s mental, behavioral, or social functioning

4 Goals: PSYCHODYNAMIC THERAPY Healthy individuals are able to release their unconsciously repressed feelings Techniques Free association: the patient speaks freely about memories, dreams, feelings Interpretation: the therapist suggests unconscious meanings and underlying wishes to help the client gain insight and release tension TAKES A LONG TIME! Insight therapy - Focused on developing an understanding of the problem Psychoanalysis refers to a set of techniques for releasing the tension of repression and resolving unconscious inner conflicts.

5 Interpretation in Psychoanalysis The therapist may see unconscious meaning in resistance, dreams, and transference. Resistance: the therapist notices times when the patient seems blocked in speaking about certain subjects Dreams: there may be themes or latent content behind the plot of a patient s dream Transference: the patient may have reactions toward the therapist that are actually based on feelings toward someone from the past

6 Psychotherapy Examples

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8 HUMANISTIC THERAPY Goals: Healthy individuals focus on conscious conflicts and strive for self-growth and awareness instead of curing inner conflicts Remember Gloria and her difficulty with relationships? Techniques Insight therapy & Gestalt therapy Client-centered therapy Active listening & Reflection Unconditional positive regard

9 Active Listening Paraphrasing a client s words to capture the emotional tone expressed You seem as if you re upset. You look as if you re a bit down. You act as if you are irritated So what I hear you saying is The tone of voice and body language accompanying the words must be compassionate, gentle and accepting. Other techniques used are empathy, genuineness, and unconditional positive regard.

10 Psychotherapy Examples Client-Centered approach to Psychotherapy: Carl Rogers & Gloria

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12 BEHAVIORAL THERAPY Goals: Healthy individuals eliminate unwanted behaviors or other difficulties by using learning principles Techniques Counterconditioning Aversive conditioning Systematic desensitization Exposure/Flooding therapies Token economy

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18 Behavior modification refers to shaping a client s chosen behavior to look more like a desired behavior, by making sure that desired behaviors are rewarded and problematic behaviors are unrewarded or punished.

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20 COGNITIVE THERAPY Goals: Healthy individuals to become aware of own thoughts and emotions and emphasize rational thinking for treatment Techniques Albert Ellis s rational-emotive behavior therapy challenging irrational beliefs and assumptions Aaron Beck s cognitive therapy for depression correcting cognitive distortions Donald Meichenbaum s stress inoculation training practicing healthier thinking before facing a stressor, disappointment, or frustration Group therapy Family therapy & Marriage counseling

21 A cognitive therapist would be most likely to say: A. That sounds quite frustrating. It isn t easy to be in a situation like that. B. Can you think of a more positive interpretation of what happened? C. Just say whatever comes to mind, no matter how trivial or irrelevant it might seem. D. Next time you start to feel anxious, you can use the relaxation techniques we ve been working on.

22 I got an F on an important test Belief Belief Misconception I must be perfectly competent & successful in achieving before I can think of myself as worthwhile. Counterbelief Failure is not a sign of personal worthlessness. I can learn from this experience. Perception Perception This situation is overwhelming This situation can be somewhat helpful to me Emotion Depression, discouragement Emotion Encouragement Behavior Stop studying for the course Behavior Use better study skills, devote more time, get help from teacher

23 REBT Rational-Emotive Behavior Therapy [REBT] helps people: 1) notice that they are operating on self-defeating assumptions, and 2) reward themselves for replacing these assumptions with realistic beliefs. For example, a more realistic belief might be, some people won t like me, many will have no opinion; it doesn t matter. Copyright Allyn & Bacon 2007

24 Aaron Beck s Therapy for Depression Aaron Beck helped people see how their depression was worsened by errors in thinking such as catastrophizing, (interpreting current events as signs of the worst possible outcome). For example: Now that I ve made a mistake in my lecture, I ve failed as a professor. Students can t take me seriously, and they can t learn from me. Beck s style of therapy helps clients notice and challenge these errors in thinking. Good for treating depression

25 The ABC s of REBT A = Activating Event What do you think happened? What would a camera see? B = Beliefs about Activating Event What did you tell yourself? C = Consequences How did you act? How did you feel? While it may seem odd at the beginning, you want to start somewhat backwards. Start with the (C).

26 Psychotherapy Examples Rational-Emotive Behavior (REBT) approach to Psychotherapy: Albert Ellis & Gloria

27 Cognitive Behavioral Therapy Cognitive behavioral therapy [CBT] works to change both cognitions and behaviors that are part of a mental health disorder. Using cognitive behavioral therapy, people with OCD 1. Feel obsessive urge to wash hands 2. Relabel obsessive thought -- I m having a compulsive urge 3. Spend 15 minutes doing something enjoyable

28 Psychotherapy Examples Cognitive-Behavioral (CBT) approach to Psychotherapy: How thoughts and emotions interact with behavior

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30 Group Therapy Psychotherapy with more than one client Advantages: Economical, support of the group, non-threatening atmosphere, provides more information and life experiences for clients to draw upon.

31 Self-Help Support Groups Groups that provide social support and an opportunity for sharing ideas about dealing with common problems; typically organized/run by laypersons (not professional therapists) Copyright Allyn & Bacon 2007

32 Couples Counseling or Family Therapy These can often be more effective than individual therapy with one individual at a time. Copyright Allyn & Bacon 2007

33 The Relative Effectiveness of Different Therapies Which psychotherapy would be most effective for treating a particular problem? Disorder Depression Anxiety Bulimia Phobia Bed Wetting Therapy Behavior, Cognition, Interpersonal Cognition, Exposure, Stress Inoculation Cognitive-behavior Behavior Behavior Modification 34