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Introduction to Psychological Theories and Therapies

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Introduction to Psychological Theories and Therapies Noelle Robertson – PowerPoint PPT presentation

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Title: Introduction to Psychological Theories and Therapies


1
Introduction to Psychological Theories and
Therapies
  • Noelle Robertson

2
From this lecture you should be considering-
  • the main approaches to therapy and how they
    relate to models of psychological disorder
  • whether and how psychological therapies are
    effective
  • what elements are involved in effectiveness

3
  • Insight
  • to help client understand basis of behaviour,
    thoughts and feelings
  • understanding as a key to change
  • Action
  • more pragmatic
  • goal focused
  • here and now

4
Therapy
  • Physical
  • - drugs, ECT and surgery
  • Psychological
  • - psychotherapy

5
Psychological
  • insight based
  • - psychodynamic (Freudian, Kleinian, Contempt)
  • - humanistic
  • action based
  • - behavioural (CBT)
  • - cognitive (CBT)

6
Biomedical model/physical treatments
  • Manifestation of biological dysfunction
  • - defects
  • - biological imbalance
  • - infection
  • Diathesis - stress
  • Scull (1987) - Henry Cotton
  • Psychosurgery - Moniz - leukotomy

7
Assumptions of Psychodynamic Model
  • Symptoms adopted to protect patient from psychic
    conflict.
  • Psychic conflict usually constitutes that between
    an unexpressed impulse and the need for its
    expression.
  • Psychic conflict arises in childhood, in relation
    to parents or significant others. Frequently it
    concerns repressed sexual impulses.
  • Goal of therapy - to discover the essential
    conflict, allow the patient to re-experience it
    and work through it.
  • The patient will resist the therapists attempt
    to reveal conflict origins because it provokes
    psychological distress.
  • Resistance addressed via free association,
    interpretation and transference.

8
Behavioural model/therapies
  • Classical operant conditioning
  • Watson Rayner (1920) Little Albert
  • BF Skinner
  • Reward increases behaviour
  • Punishment decreases behaviour
  • Negative reinforcement
  • Change behaviour - feelings/thoughts
  • Systematic desensitisation (Wolpe 1958)
  • relaxation
  • anxiety hierarchy
  • Flooding - sudden/total exposure
  • Modelling

9
Cognitive Model
  • central assumptions -
  • there are cognitions
  • these cognitions mediate client problems
  • cognitions are available for the therapist and
    client to examine
  • cognitions are the primary targets for change in
    attempts to alleviate psychological distress

10
A Cognitive Framing of Aetiology
  • Dysfunctional assumptions
  • To be acceptable to self/others I must
  • achieve high standards of performance/responsibil
    ity
  • be in control of my emotions
  • Pre-morbid behaviour
  • striving for excellence
  • uncomplaining
  • neglecting own needs
  • Critical incidents
  • prolonged/excessive demands (eg work stress)
  • reduced ability to meet demands (health, life
    events)
  • ? failure to meet assumptions

11
Maintenance
Thoughts Im making myself ill I used
to do more I must rest to improve I
should try harder Behaviour Avoid
activity Burst of activity Consequence
Symptom reduction BUT Limited achievement BUT
failure to meet own standards increased
symptoms and poor perceived performance
12
Core features of conditions characterised by
anxiety about health
  • preoccupation
  • insufficient pathology
  • selective attention to body features/illness
  • negative interpretation of body signs/symptoms
  • selective attention to medical and non-medical
    communications
  • persistent reassurance seeking
  • checking body status

13
Principles of Cognitive Intervention
  • repeated reassurance not successful
  • clear demonstration of way anxiety and symptoms
    maintained and specific assignments
  • explicit engagement (difficult/different agendas)
  • possibility of alternative explanations (not
    physical tests/checks)
  • have they tested this before?
  • gathering evidence and testing hypotheses
  • use questions not combat

14
Do Psychotherapies Work?
  • Eysenck (1952)
  • Smith and Glass (1977) - meta-analysis
  • Linenan (1993)
  • How is therapy effective?
  • Common factors (warmth, acceptance, empathy etc)
    - 85 variance
  • Specific factors (Sloane 1975)
  • gaining understanding
  • facing difficulties
  • trained therapist
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