Psychotherapy (Chapter 19)

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Psychotherapy (Chapter 19)

• First Lecture Outline
• History of psychotherapy
• Psychotherapy approaches
• Foundations of counselling
• Video 101 Psychodynnamics

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Mondays midterm

• Results will not be finalized until Monday
• Many did well!! Keep it up!!
• Multiple choice (out of 40) were done well
• Average around 27 or 28/40
• Score is out of 30 for both quizzes

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History

• Mental illness demonic possession
• Exorcism, flogging, torture, bleeding, enemas
• Braveheart purification of spirit
• Middle ages Asylum
• St. Mary of Bethlehem Bedlem, uproar, confusion
• over-crowded prison for social outcasts
• 1800s Mesmer, Charcot, Breuer, Freud
• origins of hypnosis and cathartic methods

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Other interventions from the 1900s

• Psychosurgery 1930s to 1950s Prefrontal
  lobotomy
• left patients vegetative, replaced by very
  specific microsurgery for lesions

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Electroconvulsive therapy (ECT) in 1940s

• 150 volts run through the head for 1-2 seconds
• leads to memory loss, broken bones, still used as
  last resort for depression
• Today the patient is usually placed under general
  anesthesia, paralysed with drugs, monitored and
  assisted with breathing.
• Antipsychotic medications in the 1950s

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What is a clinical interview?

• Psychotherapy involves talking to people
• Structured and unstructured interviews
• Model of psychotherapy directs attention of
  interview
• Psychodynamic Focus on early experiences
• Behavioral Focus on symptoms, ABCs
• Cognitive Questions about specific thought
  patterns
• Humanistic Unconditional positive regard

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Interviewing in an assessment

• Focus depends on what you are assessing,
  diagnosis
• Background includes medical, school/work, family,
  hobbies, description of symptoms, and other
  sources of information
• Tests then augment interview
• Intelligence, neuropsychological, memory tests
• Personality and behavioral measures
• Psychophysiological and computer tasks

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Who can conduct therapy

• Anyone can offer themselves to the public as a
  therapist or counsellor
• These are not protected titles or services watch
  out!
• Only a psychologist can say they offer
  Psychological intervention or Psychological
  assessment
• Title and services of a psychologist governed
  by provincial statute

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Psychodynamic therapy approaches

• Patients improve once they become conscious of
  ego-threatening material
• Free association Client says whatever comes to
  mind Dream analyysis
• Resistance is an impediment to progress
• Transference of feelings from significant others
  to therapist Countertransference
• Website listing psychotherapy approaches for
  personality disorder

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Evolution of psychoanalysis

• Originally it could take years at 3-5 sessions
  per week
• Unstructured and relaxed approach necessitated
  comfortable seating, surroundings
• Change to become more task-oriented and time
  limited
• Contracting with clients for a specific number
  of sessions to reach a goal