Therapy Approaches

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Therapy Approaches

• Biological Treatment
• Surgery Electroshock
• Psychotherapy
• The Power of Forgiveness

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Biological TreatmentsDrugs

• 1-Antipshchotic Drugs
• 2-Antidepressant Drugs
• 3-Tranquilizers
• 4-Lithium Carbonate

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1-Antipsychotic Drugsor Neuroleptics

• Good for treating psychosis and schizophrenia
• Examople Thorazine
• Reduce receptivity to dopamine or increase
  serotonin
• Reduce positive symptoms of schizophrenia
• Do not relieve other negative symptoms
• Can have dangerous side effect tardive
  dyskinesia neurolyptic malignant syndrome

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Antipsychotic Drugsand Schizophrenia

• Good for reducing
• Agitation
• Delusions
• Hallucinations
• Can shorten schizophrenic episodes

• Offers little relief from
• Jumbled thoughts
• Difficulty concentrating
• Inability to interact with others

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2-Antidepressant Drugs

• Treat depression, anxiety, phobias, OCD
• Example Prozac, Zoloft, and Paxil
• Non addictive but can cause side effects
• 1-Monoamine oxidase inhibitors (elevate levels of
  ser. nor. by blocking inhibitors)
• 2-Tricyclic antidepressants (boost nor. ser. by
  preventing their reabsorption)
• 3-Selective serotonin reuptake inhibitors
• (work on serotonin)

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3-Tranquilizers

• Prescribed for depressed mood, panic, and anxiety
• Example Valium
• Increase activity of neurotransmitter GABA
• If overused can result in tolerance and withdrawal

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4-Lithium Carbonate

• Prescribed for bipolar disorder
• Can be dangerous if not given in the right doze

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Cautions about Drugs

• Placebo effect
• Relapse and drop out rates
• Dosage problems
• Long-term risks
• Overprescription
• Sometimes they have to be with therapy

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The Placebo EffectKirsch and Sapirstein (1998)

• 7315 participants
• 41 of those receiving antidepressants
  experienced reduced symptoms.
• 31 of those given placebos also received reduced
  symptoms.

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Surgery Electroshock

• Psychosurgery
• Shock Therapy

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Psychotherapy

• Psychodynamic
• Behavioral
• Cognitive
• Humanistic/Existential
• Therapy in Social Context

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Psychodynamic Therapy

• Probes the past
• Doesnt tackle the immediate problem
• The goal is insight
• Takes a long time
• Explores the unconscious
• Methods free association, interpretation of
  dreams, transference

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• Interpretation
• The analyst noting supposed dream meanings,
  resistances, and other significant behaviors in
  order to promote insight.
• Resistance
• In psychoanalysis, the blocking from
  consciousness of anxiety-laden material.
• Transference
• The patients transfer to the analyst of emotions
  linked with other relationships (such as love or
  hatred for a parent)

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Behavioral Techniques

• Learning
• Conditioning
• Association between
• Environmental Stimuli Response
• Classical Conditioning Operant Conditioning
• Association
  Reinforcement/
• Stimulus-Response Punishment

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Behavioral Techniques

• There are no mental processes (will, mind)
• Derived from classical and operant conditioning
• The focus is on changing the behavior
• Works on the immediate problem
• Focuses on the present

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Classical Conditioning

• Ivan Pavlov
• Conditioning
• Learning that involves associations between
  environmental stimuli and the organisms
  responses
• Stimulus-response Learning

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Classical Conditioning in Real Life

• Learning to like
• Learning to fear
• Accounting for Taste
• Reacting to Medical Treatment

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Operant Conditioning

• The behavior is more likely or less likely to
  occur based on its consequences.
• B. F. Skinner modified Pavlovs concept.
• Skinner used reinforcement and punishment to
  enhance learning.

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Skinners Box
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Behavioral Techniques

• Systematic Desensitization/Counter Conditioning
• Aversive Conditioning
• Exposure Treatment (Flooding)
• Behavioral Records Contracts
• Skills Training

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Systematic Desensitization

• Fear of Flying
• Read about safety
• Look at pictures of airplanes
• Visit an airport
• Take a short flight
• Take a long flight
• Fear is extinguished
• Counterconditioning

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Cognitive Therapy

• Albert Ellis
• (Rational Emotive Behavior Therapy)
• Aaron Beck

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Cognitive Distortions

• Labeling
• Mind Reading
• Exaggeration
• Unrealistic Expectations
• Belief in Entitlement
• Belief in Absolute Fairness

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Fighting Dysfunctional Thought

• Hot Thoughts
• He is always mean to me.
• I did a lousy job.
• I deserve better.
• Its not fair.
• That jerk!
• Theyre driving me crazy.

• Cool Thoughts
• Maybe he had a bad day.
• Itll be better next time
• But people are people
• Life is not fair.
• Its his problem!
• Just dont accept the ride.

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Dysfunctional Thought
Situation Emotion Rate 1-100 Automatic Thought Cognitive Distortion Rational Response Outcome Rate 0-100
Fight with spouse Angry, 99 Sad, 50 -Ill never have a normal marriage -I deserve better -Hes stubborn Magnificat-ion Entitlement Labeling -Its not the end of the world -Thats normal -Maybe he had a bad day Angry, 50 Sad, 10
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Humanistic/ExistentialTherapy

• Works on self-fulfillment and self-actualization
• Does not delve into the past
• Helps the client think about the present and the
  future
• Helps people feel good about themselves
• Tackles conscious rather than unconscious thoughts

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Carl RogersClient-Centered TherapyPerson-Centere
d Therapy

• The therapist uses techniques such as active
  listening within a genuine, accepting, empathetic
  environment to facilitate clients growth.

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Carl RogersClient-Centered Therapy

• Offers unconditional positive regard
• No specific techniques
• Therapist should be warm, genuine and empathetic
• Client adopts these views and becomes
  self-accepting
• Promotes growth instead of curing illness.

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Effective Listening
Clients Remark Closed Response Open Response
I cant do it. Dont talk like that. It seems very difficult to you.
I will never be able to have a good life. Weve discussed that before. Stop being negative. It may look very discouraging now.
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Active Listening

• Paraphrase.
• Summarize the speakers words in your own words.
• Invite Clarification.
• Encourage the speaker to say more.
• Reflect Feelings.
• Reflect what youre sensing from the speakers
  words and body language.

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Existential Therapy

• Helps client explore meaning of existence
• Helps client choose a destiny
• Helps client accept self-responsibility.

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Therapy in Social Context

• Family Therapy
• Family Kaleidoscope
• Family Systems
• Group Therapy

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Communication ApproachVirginia Satir

• Offered description of conjoint family therapy
• Emphasized growth enhancing techniques to evoke
  feeling and clarify family communications
  patterns
• (dance, massage, sensory awareness, group
  encounter techniques)

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Contextual Family TherapyIvan Boszormenyi-Nagy

• Effective family therapy must attend to family
  context especially to those dynamic and ethical
  connections past, present, future that bind
  families together

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The Structural ApproachSalvador Minuchin

• The individuals symptoms are best understood as
  rooted in the context of family transaction
  patterns.
• The familys hierarchical organization
• The wholeness of the family system
• The interdependent functioning of its subsystems
• Enmeshment
• The family boundaries are too diffuse to allow
  for individual autonomy

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Strategic ApproachJay Haley

• The therapist devices a strategy for solving the
  clients present problems
• Goals are clearly set
• Therapy is carefully planned to achieve these
  goals

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Object Relations

• Introjects the psychological representations of
  external objects
• The most powerful obstacle to change is peoples
  attachment to their parental introjects

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Family Systems TheoryMultigenerationalMurray
Bowen

• Conceptualizes the family as an emotional unit, a
  network of interlocking relationships, best
  understood when analyzed within a multi
  generational or historic framework
• Genograms

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When Therapy Helps

• When clients have enough sense of self
• When clients have enough distress to motivate
  them to change
• When therapists are warm and empathetic
• When client and therapist establish a good
  rapport
• Hostile, negative clients are less likely to
  benefit

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When Therapy Harms

• Bias on the therapists part because of gender,
  religion, or race
• Coercion by the therapist to accept his/her
  advice
• Coercion by the therapist to have sexual intimacy

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Alternatives to Psychotherapy

• Community Psychologists
• Half-way houses
• Clubhouse model
• Foster care
• Family support groups
• Rehabilitation Psychologists
• Epilepsy, physical injury, arthiritis, chronic
  pain

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The Power of Forgiveness

• Giving up grudges can reduce chronic back pain
• Forgiveness limited the number of relapses among
  women battling substance abuse problems.
• Using MRI scans to explore how just thinking
  about empathy and reconciliation sparks activity
  in the brains left middle gyrus, suggesting we
  all have a mental forgiveness center set to be
  tapped.

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The Power of Forgiveness

• Cortisols depressive effect on the immune system
  has been linked to serious disorders.
• Forgiveness stops the cortisol and adrenaline
  from flowing.

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American Psychosomatic SocietyA Study

• 36 male veterans who had coronary artery disease
  and who were also burdened by other war-related
  issues
• Those who received forgiveness training showed
  greater blood flow to the heart.