Psychotherapies - PowerPoint PPT Presentation


PPT – Psychotherapies PowerPoint presentation | free to view - id: 779bd9-ZTViO


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation



Psychotherapies 2 Types of Therapy Psychotherapy use of psychological techniques to treat emotional, behavioral, and interpersonal problems Biomedical use of ... – PowerPoint PPT presentation

Number of Views:96
Avg rating:3.0/5.0
Slides: 86
Provided by: Neta227


Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Psychotherapies

2 Types of Therapy
  • Psychotherapyuse of psychological techniques to
    treat emotional, behavioral, and interpersonal
  • Biomedicaluse of medications and other medical
    therapies to treat the symptoms associated with
    psychological disorders

  • A planned, emotionally charged, confiding
    interaction between a trained therapist and
    someone who suffers from psychological
  • There are over 250 different types of therapy.

Four Types of Psychotherapy
  • Most therapies can be divided into
  • Psychoanalytic
  • Humanistic
  • Behavioral
  • Cognitive

Eclectic Approach
  • An approach to psychotherapy that, depending on
    the persons problems, uses techniques from
    multiple forms of therapy
  • Carefully tailor the therapy approach to the
    problems and characteristics of the person
    seeking help

  • Developed by Sigmund Freud based on his theory of

Freuds Office
  • Freuds therapeutic technique that attributes
    ones thoughts and actions to unconscious motives
    and conflicts

Psychoanalysis Assumptions
  • Psychological problems are the result of
    repressed conflicts and impulses from childhood.
  • The therapist must bring the repressed problems
    into the conscious mind to help patients have an
    insight about the original cause of the problem.

Causes of Psychological Problems
  • Undesirable urges and conflicts are repressed
    or pushed to the unconscious
  • Unconscious conflicts exert influence on
    behaviors, emotions, and interpersonal dynamics
  • Understanding and insight into repressed
    conflicts leads to recognition and resolution

Psychoanalytic Methods
Free Association
  • Freudian technique of discovering the unconscious
    mind--where the patient relaxes and says whatever
    comes to mind, no matter how trivial or
  • A way of revealing unconscious thoughts and

  • Unconscious attempts to block the revelation of
    repressed memories and conflicts.

  • A technique in which the psychoanalyst offers a
    carefully timed explanation of the unconscious
    meaning of the patients behavior, thoughts,
    feelings, or dreams to facilitate the recognition
    of unconscious conflicts or motivations
  • Dream Interpretation - Manifest content of dreams
    is analyzed for disguised or symbolic wishes,
    meanings, and motivations (latent content)
  • Freud considered dreams to be the royal road to
    the unconscious

  • Patients transfer to the analyst of emotions
    linked with other relationships
  • The patient projects feeling from the past to the

Using Psychoanalysis
  • All these psychoanalytic techniques are designed
    to help the patient achieve insight into how past
    conflicts influence her current behavior and
    relationships and then replace maladaptive
    behavior patterns with adaptive ones.
  • On average, the traditional psychoanalyst sees
    the patient four or five times a week over the
    course of four years or longer

Psychoanalytic Influence
  • Few therapists follow strict Freudian therapy.
  • Heavily influenced other types of therapy
    (interpersonal therapy)
  • Modern approach is the psychodynamic perspective

The Psychodynamic Perspective
Psychodynamic Approach
  • A more modern view that retains some aspects of
    Freudian theory but rejects other aspects
  • Retains the importance of the unconscious mind
  • Less emphasis on unresolved childhood conflicts

Common Features of Short-Term Dynamic Therapies
  • Most therapies today are shorter-term
  • Patients problems are quickly assessed at the
    beginning of therapy.
  • Based on goals that are specific and attainable
  • Therapists are more directive than traditional
  • Therapist uses interpretations to help the
    patient recognize hidden feelings and
    transferences that may be occurring in important
    relationships in her life
  • Therapy focuses on helping the patient identify
    psychological resources that she can use to cope
    with the current difficulty as well as with
    future problems

Interpersonal Therapy (IPT)
  • Influential short-term psychodynamic therapy,
    focuses on current relationships and social
    interactions and is highly structured
  • 4 categories of personal problems
  • unresolved grief
  • role disputes
  • role transitions
  • interpersonal deficits
  • 1st phase of treatment, the therapist identifies
    the interpersonal problem that is causing
  • Next phase, the therapist helps the person
    understand his or her particular interpersonal
    problem and develop strategies to resolve it

Humanistic Therapies
Humanistic Therapies
  • Humanistic perspective emphasizes human
    potential, self-awareness, and free-will
  • Humanistic therapies focus on self-perception and
    individuals conscious thoughts and perceptions
  • Client-centered (or person-centered) therapy is
    the most common form of humanistic therapy
  • Carl Rogers (19021987)developed this technique

Nondirective Client-Centered Therapy
  • Therapist listens without interpreting and does
    not direct the client (patient) to any particular
  • Therapist must not make decisions for the client,
    offer solutions, or pass judgment on the clients
    thoughts or feelings.
  • Rogers deliberately used the word client rather
    than patient to avoid the idea that the person
    was sick and could be cured

Client-Centered Therapy
  • Therapist uses techniques such as active
    listening within a genuine, accepting, empathic
    environment to facilitate the clients growth.
    The therapy stresses
  • Empathy
  • Acceptance
  • Genuineness

Therapeutic Conditions
  • Genuinenesstherapist openly shares thoughts
    without defensiveness
  • Unconditional positive regard for clientno
    conditions on acceptance of person
  • Empathetic understandingcreates a psychological
    mirror reflecting clients thoughts and feelings

Active Listening
  • Empathic listening in which the listener echoes,
    restates and clarifies.

Active Listening Characteristics
  • Active listening entails
  • Paraphrasing uses the words of the client to
    summarize the conversation
  • Clarifying encouraging the client to say more by
    asking leading questions
  • Reflecting feelings mirrors the feelings of the

The Results of Good Humanistic Therapy
  • Rogers thought if clients are treated with
    unconditional positive regard, empathy,
    genuineness, the client will explore their
    feelings thoughts.
  • Exploring their thoughts feelings in an
    accepting environment will lead the client to
    change their attitudes behavior.
  • This approach very successful with dealing with
    clients day-to-day concerns but not very
    successful in treating psychotic patients like
    those with severe schizophrenia.

(No Transcript)
Gestalt Therapy
  • A type of Humanistic Therapy
  • Developed by Fritz Perls
  • Believed that people create their own
    understanding of the world and continue to grow
    as long as they have insight into their feelings.
  • More directive and confrontational than
    client-centered therapy.
  • Therapist tries to help clients identify
    inconsistencies between the statements they make
    about how they see the themselves how they
    really interact with the world.

Boundaries to the TherapistClient Relationship
TherapistClient Relationship
  • Therapy is a collaborative effort between you and
    the therapist.
  • Dont expect your therapist to make decisions for
  • Your therapist is not a substitute friend
  • Therapeutic intimacy does not include sexual
    intimacy it is never ethical or appropriate for
    a therapist to have any form of sexual contact
    with a client
  • Expect therapy to challenge how you think and act
  • Dont confuse insight with change
  • Dont confuse catharsis with change
  • Dont expect change to happen overnight

Behavior Therapies
Behavior Therapy
  • Behavioristic perspective emphasizes that
    behavior (normal and abnormal) is learned
  • Applies classical and operant conditioning to the
    elimination of unwanted behaviors
  • Primary concern is to eliminate the disorders
    behavior, not find the cause of the disorder
  • Often called behavior modification

Behavior Therapies Classical Conditioning
Mary Cover Jones The First Behavior Therapist
  • Demonstrated that conditioning could be used to
    remove fears.
  • Treated three-year-old Peters fear of rabbits,
    using counterconditioning
  • Involves modifying behavior by conditioning a new
    response that is incompatible with a previously
    learned response
  • Jones also used social imitation, or
    observational learning, techniques

Systematic Desensitization
  • Developed by Joseph Wolpe
  • Based on counter conditioning
  • Usually used to treat phobias
  • phobic responses are reduced by pairing
    relaxation with a series of mental images or
    real-life situations that the person finds
    progressively more fear-provoking
  • Uses three steps
  • Progressive relaxation
  • Development of anxiety hierarchy and control
  • Combination of progressive relaxation with
    anxiety hierarchy

Systematic Desensitization Process
  • Establish a hierarchy of the anxiety- triggering
  • Learning relaxation methods (progressive
  • Slowly think through the hierarchy from least
    anxiety-provoking to most anxiety-provoking ,
    working to relax whenever anxiety is felt
  • Once you can maintain complete relaxation, you
    move on to the next scene, and so on

Sample Anxiety Hierarchy
Systematic Desensitization
Systematic Desensitization Variations
  • Virtual reality--systematic desensitization by
    way of computerized, anxiety-triggering 3-D
  • Combined with models by having the subjects watch
    someone perform the anxiety-causing behavior
  • Just as effective as graduated exposure to the
    actual feared objects or situations

  • Method of extinction usually used to rid a
    patient of phobias (Exposure Therapy)
  • The patient is inundated with repeated exposures
    to what they fear until they realize they can
    remain calm in the presence of the feared object.
    (view video of this process for phobias 2 min)

Virtual Systematic Desensitization
  • Play Virtual Fear (757) Segment 30 from
    Scientific American Frontiers Video Collection
    for Introductory Psychology (2nd edition).

Arachnophobia and Virtual Reality
  • Play Arachnophobia (931) Segment 31 from
    Scientific American Frontiers Video Collection
    for Introductory Psychology (2nd edition).

Bell Pad Treatment for Bed Wetting
  • Conditioning arousal from sleep in response to
    bodily signals of a full bladder.
  • Pair an alarm (US) that will awaken child (UR).
  • When moisture hits pad (bladder tension NS) the
    Alarm sounds (US) waking the child (UR).
  • Eventually bladder tension (CR) causes the child
    to awaken (CR).
  • It is effective in about 75 percent of school-age
    children who have difficulties with bedwetting.

Aversive Conditioning
  • A type of counterconditioning that associates an
    unpleasant state (such as nausea) with an
    unwanted behavior
  • The person is replacing a positive but harmful
    response with a negative response
  • Example with alcoholism Lace a drink with a drug
    that makes the person becomes sick
  • Aversive conditioning is not very effective, and
    its use has declined in recent years.

Aversion Therapy for Alcoholism
  • Relatively ineffective, does not generalize very
    well beyond therapy
  • Pairs and aversive stimulus with the undesired

Behavior Therapies Operant Conditioning
Operant Conditioning
  • Behavior therapists have developed a variety of
    techniques based on B. F. Skinners operant
    conditioning model of learning
  • Shaping involves reinforcing successive
    approximations of a desired behavior
  • Positive reinforcement is used to increase the
    incidence of desired behaviors
  • Extinction, or nonreinforcement, is used to
    reduce the occurrence of undesired behaviors

Token Economy
  • An operant conditioning procedure that attempts
    to modify behavior by giving tokens (rewards) for
    desired behavior.
  • Use for behavior modification in group settings
    (prisons, classrooms, hospitals)
  • The tokens can be exchanged for various
    privileges or treats
  • Form of secondary reinforcement
  • Proven to be especially effective in the
    outpatient treatment of substance abuse and
    dependence and with severely disturbed people

(No Transcript)
Cognitive Therapies
Cognitive Therapy
  • Based on the assumption that psychological
    problems are due to maladaptive patterns of
  • Thoughts intervene between events and our
    emotional reactions
  • Therapy focuses on recognition and alteration of
    unhealthy thinking patterns
  • Teaches people new, more adaptive ways of
    thinking and acting

Self-Serving Bias
  • Tendency to judge oneself favorably
  • Severely depressed patients tend to not have a
    self-serving bias and tend to blame themselves
    for problems and credit the environment for

Rational Emotive Therapy
  • Developed by Albert Ellis
  • Peoples difficulties are caused by their faulty
    expectations and irrational beliefs
  • ABC model
  • Activating Event
  • Beliefs
  • Consequences
  • When an Activating event (A) occurs, it is the
    persons Beliefs (B) about the event that cause
    emotional Consequences (C)
  • Goal of therapy is expose and confront the
    persons core irrational beliefs
  • Effective in the treatment of depression, social
    phobia, and certain anxiety disorders, and in
    helping people overcome self-defeating behaviors

(No Transcript)
(No Transcript)
How RET Works
  • Step 1 Identify the core irrational beliefs or
    self talk that underlie personal distress
  • Step 2 Vigorously dispute and challenge the
    irrational beliefs. Therapist acts as a teacher
    to show patient how to do this.
  • Rational-emotive therapists tend to be very
    direct and even confrontational
  • From the clients perspective, rational-emotive
    therapy requires considerable effort
  • person must admit her irrational beliefs and
    accept the fact that those beliefs are irrational
    and unhealthy
  • client must radically change her way of
    interpreting and responding to stressful events

  • PROBLEM Social Phobic concerned they will be
    publicly embarrassed when giving a class
  • SOLUTION Therapist questions the likelihood of
    such embarrassment occurring and impact of it.
  • Therapists goal is to show the client that not
    only is their failure unlikely, but even if it
    did happen, it would not be a big deal.

RET Therapy
  • A Activating Events
  • B Irrational Beliefs
  • C Inappropriate Consequences
  • D Disputing these Beliefs
  • E Effects of disputing Rational beliefs,
    appropriate feelings, desirable behaviors.

Aaron Becks Cognitive Therapy
  • Based on the assumption that thoughts, moods, and
    behaviors are interrelated
  • Beck believes that depression and other
    psychological problems are caused by distorted
    thinking and unrealistic beliefs
  • Schemas methods for organizing the way we view
    the world have evolved into a distorted
  • Focuses on changing the clients unrealistic
  • Therapist acts as model and aims for a
    collaborative therapeutic climate
  • Therapy includes homework of writing down
    automatic thoughts or habits

(No Transcript)
Cognitive Therapy How it Works
  • CT therapist encourages the client to empirically
    test the accuracy of his or her assumptions and
  • The client learns to recognize and monitor the
    automatic thoughts that occur without conscious
    effort or control
  • The client learns how to empirically test the
    reality of the automatic thoughts that are so
  • CT is very effective in treating depression,
    anxiety disorders, eating disorders, PTSD, and
    relationship problems. It may also help prevent
    depression from recurring

Whats the Difference Between Ellis RET
Becks Cognitive Therapy?
  • RET therapists logically debate and vigorously
    challenge or dispute the irrationality of a
    clients beliefs
  • Becks Cognitive Therapy give the client
    homework to empirically test the accuracy of
    his or her assumptions and beliefs.

Cognitive Behavioral Therapy
  • An integrated therapy that combines cognitive
    therapy (changing self-defeating thinking) with
    behavior therapy (changing inappropriate
  • Based on the assumption that cognitions,
    behaviors, and emotional responses are
  • Cognitive-behavioral therapists challenge
    maladaptive beliefs and substitute more adaptive
  • They use behavior modification, shaping,
    reinforcement, and modeling to teach problem
    solving and change unhealthy behavior patterns

(No Transcript)
Prevalence of Cognitive Therapy
Half of all faculty in accredited clinical
psychology doctoral programs now align themselves
with a cognitive or cognitive-behavior therapy
orientation. (Data from Mayne others, 1994.
Note Some faculty identify with more than one
Family and Group Therapies
Group and Family Therapy
  • Group therapyone or more therapists working with
    several people at the same time.
  • Family therapybased on the assumption that the
    family is a system and treats the family as a
  • Couple therapyrelationship therapy that helps
    with difficulty in marriage or other committed

Group Therapy
  • Having a therapist work with a number of patients
    at one time
  • Groups usually consist of 6 to 10 people
  • Cognitive, behavior, and humanistic therapists
    all can lead group therapies.

Advantage of Group Therapy
  • Therapists can help more than one person at a
  • Overall session cost is lower.
  • Patients interact with others having the same
    problems as they have.
  • Builds a sense of community

Self-help groups Helping yourself by helping
  • Self-help groups and support groups are typically
    organized and led by nonprofessionals
  • The groups are either free or charge nominal fees
    to cover the cost of materials.
  • Typically, members have a common problem and meet
    for the purpose of exchanging support
  • The format of such groups varies enormously, but
    many follow a 12-step approach
  • Self-help groups can be as effective as therapy
  • More research is needed on why self-help groups
    are effective and on the kinds of people and
    problems that are most likely to benefit from

Family Therapy
  • Therapy that treats the family as a system
  • Views the patients problems as influenced by or
    directed at family members
  • Every family has certain unspoken rules of
    interaction and communication.
  • As such, issues are explored, and unhealthy
    patterns of family interaction can be identified
    and replaced with new rules that promote the
    psychological health of the family
  • Attempts to guide the family toward positive
    relationships and improved communication

Evaluating Psychotherapys Effectiveness
Are Psychotherapies Effective?
  • Most people do not seek help with problems
  • Spontaneous Remission - Some people improve with
    nothing more than the passage of time
  • Meta-analysis used to combine and interpret the
    results of large numbers of studies has found
  • On average, the person who completes treatment is
    better off than about 80 percent of those in the
    untreated control group.
  • Benefits are usually apparent in a relatively
    short period of time
  • Gains that people make tend to endure
  • Brain-imaging technologies show that
    psychotherapy alone produces distinct
    physiological changes in the brain that are
    associated with a reduction in symptoms

Studies on Psychotherapy
  • Studies researching the effectiveness of
    psychotherapy have found
  • Clients believe therapy is effective.
  • Clinicians believe therapy is effective.
  • Researchers are still debating psychotherapys
  • The more clear cut the problem, the more
    effective the therapy is.
  • No one therapy is absolutely more effective than
    the others.

Evaluating Therapies
  • Play Empirically Validated Therapies (329)
    Segment 41 from Psychology The Human

Factors in Successful Therapy
  • Therapeutic relationshipcaring and mutually
  • Therapist characteristicscaring attitude,
    ability to listen, sensitive
  • Client characteristicsmotivated, actively
    involved, emotionally and socially mature
  • External circumstancesa stable living situation
    and supportive family members

The rates of improvement for more than 2,000
people in weekly psychotherapy and for 500 people
who did not receive psychotherapy. Clearly,
psychotherapy accelerates both the rate and the
degree of improvement for those experiencing
psychological problems. SOURCE McNeilly
Howard, 1991.
Are Alternative Therapies Effective?
Eye movement desensitization reprocessing (EMDR)
  • Treatment technique in which patients suffering
    from traumatic memories visually follow her
    waving finger while simultaneously holding a
    mental image of disturbing memories, events, or
  • EMDR is more effective than no treatment at all
  • EMDR is no more effective than exposure therapy
    and other standard treatments for anxiety
  • Several research studies have found no difference
    in outcome between treatments that incorporated
    eye movements and sham EMDR

Therapeutic Touch Therapy
  • Therapists move their hands above the persons
    body to push energy fields into balance.
  • No evidence has been found to support the
    effectiveness of this therapy

Light Exposure Therapy
  • Therapy for Seasonal Affective Disorder by
    exposing the patient to artificial light
    mimicking that of the sun
  • Research supports a connection between exposure
    to light and melatonin levels in the blood, which
    affects levels of alertness

Expectation Effect
  • Person feels better after therapy because they
    thought or expected to become better