11TherapyChapter 17PSY12000.003Spring, 20092History of Insane TreatmentMaltreatment of the insane throughout the ageswas the result of irrational views. Manypatients were subjected to strange, debilitating,and downright dangerous treatments.The Granger CollectionThe Granger Collection3History of Insane TreatmentPhilippe Pinel in France and Dorthea Dix inAmerica founded humane movements to carefor the mentally sick.http://wwwihm.nlm.nih.govPhilippe Pinel (1745-1826) Dorthea Dix (1745-1826) Culver Pictures4TherapiesPsychotherapy involves an emotionallycharged, confiding interaction between atrained therapist and a patient/client.Biomedical therapy uses drugs or otherprocedures that act on the patient’s nervoussystem, with the aim of curing him or her ofpsychological disorders.An eclectic approach uses various forms ofhealing techniques depending upon the client’sunique problems.5Psychological TherapiesWe will look at four major forms ofpsychotherapies based on different theories ofhuman nature: Psychoanalytical theory Humanistic theory Behavioral theory Cognitive theory6PsychoanalysisThe first formal psychotherapy to emerge waspsychoanalysis, developed by Sigmund Freud.Sigmund Freud's famous couchEdmund Engleman27Psychoanalysis: AimsSince psychological problems originate fromchildhood repressed impulses and conflicts, theaim of psychoanalysis is to bring repressedfeelings into conscious awareness where thepatient can deal with them.When energy devoted to id-ego-superegoconflicts is released, the patient’s anxietylessens.8Psychoanalysis: MethodsDissatisfied with hypnosis, Freud developedthe method of free association to unravel theunconscious mind and its conflicts.The patient lies on a couch and speaks aboutwhatever comes to his or her mind.http://www.english.upenn.edu9Psychoanalysis: MethodsDuring free association, the patient editshis/her thoughts, resisting his/her feelings toexpress emotions. Such resistance becomesimportant in the analysis of conflict-drivenanxiety.Eventually the patient opens up and reveals his/her innermost private thoughts, developingpositive or negative feelings (transference)towards the therapist.10Psychoanalysis: Criticisms1. Psychoanalysis is hard to refute because itcannot be proven or disproven.2. Psychoanalysis takes a long time and is veryexpensive.3. But, some folks really like it, and they find itto be (an expensive) journey of self-discovery.11Psychodynamic TherapiesInfluenced by Freud, in a face-to-face setting,psychodynamic therapists seek to understandsymptoms and themes across importantrelationships in a patient’s life.12Psychodynamic TherapiesInterpersonal psychotherapy, a variation ofpsychodynamic therapy, is effective in treatingdepression. It focuses on symptom relief hereand now, not an overall personality change.313Humanistic TherapiesHumanistic therapists aim to boost self-fulfillment by helping people grow in self-awareness and self-acceptance.14Person-Centered TherapyDeveloped by Carl Rogers, person-centered(client centered) therapy is a form of humanistictherapy.The therapist listens to the needs of the patientin an accepting and non-judgmental way,addressing problems in a productive way andbuilding his or her self-esteem.15Humanistic TherapyThe therapist engages in active listening andechoes, restates, and clarifies the patient’sthinking, acknowledging expressed feelings.Michael Rougier/ Life Magazine © Time Warner, Inc.16Behavior TherapyTherapy that applies learning principles(classical and operant) to the elimination ofunwanted behaviors.To treat phobias or sexual disorders, behaviortherapists do not delve deeply below thesurface looking for inner causes.17Classical Conditioning TechniquesCounterconditioning is a procedure thatconditions new responses to stimuli that triggerunwanted behaviors.It is based on classical conditioning andincludes exposure therapy and aversiveconditioning.18Exposure TherapyExpose patients tothings they fear andavoid. Throughrepeated exposures,anxiety lessensbecause they habituateto the things feared.The Far Side © 1986 FARWORKS. R eprinted with Permissi on. All Rights Reserved .419Exposure TherapyExposure therapy involves exposing people tofear-driving objects in real or virtualenvironments.N. Rown/ The Image WorksBoth Photos: Bob Mahoney/ The Image Works20Systematic DesensitizationA type of exposure therapy that associates apleasant, relaxed state with gradually increasinganxiety-triggering stimuli commonly used totreat phobias.21Aversive ConditioningA type ofcounterconditioningthat associates anunpleasant state withan unwantedbehavior. With thistechnique, temporaryconditioned aversionto alcohol has beenreported.See Clockwork Orange; sexualarousal paired with shock22Operant ConditioningOperant conditioning procedures enable therapiststo use behavior modification, in which desiredbehaviors are rewarded and undesired behaviorsare either unrewarded or punished.A number of withdrawn, uncommunicative 3-year-old autistic children have been successfully trainedby giving and withdrawing reinforcements fordesired and undesired behaviors.Not always effective!23Token EconomyIn institutional settings therapists may create atoken economy in which patients exchange a tokenof some sort (chips, points, etc.), earned forexhibiting the desired behavior, for variousprivileges or treats.Advantages are that immediate reinforcements candisrupt the flow of learning and the individual canhabituate quickly to their reinforcing properties.Tokens require delay of reinforcement and rewardsaving, both ways to reduce habituation.24Cognitive TherapyTeaches people adaptive ways of thinking andacting based on the assumption that thoughtsintervene between events and our emotionalreactions.525Cognitive Therapy for DepressionAaron Beck (1979) suggests that depressedpatients believe that failure means they can neverbe happy (thinking) and thus associate minorfailings (e.g. failing a test [event]) in life as majorcauses for their depression.Beck believes that cognitions such as “I can neverbe happy” need to change in order for depressedpatients to recover. This change is brought aboutby gently questioning patients.26Cognitive Therapy for DepressionRabin et al., (1986)trained depressedpatients to recordpositive events each day,and relate how theycontributed to theseevents. Compared toother depressed patients,trained patients showedlower depression scores.Critique the method?27Stress Inoculation
View Full Document
Unlocking...