5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App Chapter 15 Psychotherapy Wednesday April 30 2014 12 30 AM Who Seeks Therapy About 15 of Americans seek mental health services each year Most commonly for anxiety an depression People commonly delay seeking help Costs no health insurance Denial Stigma Who to seek treatment with Those most likely are Woen White compared to individuals who identify as Black or Hispanic Have medical insurance Have higher education Who Provides Treatment Psychologists Clinical PH D Psy D Counseling Ph D Psychiatrists MD Social Worker M S W Counselors M A or M S Insight Therapies Psychoanalysis Sigmund Freud Psychodynamic treatment Unconscious Conflict childhood Defense Mechanisms Free Association Clients spontaneously express their thoughts and feelings as they occur with little censorship as possible Dream Analysis Interpretation Resistance Transference Significance conflict in clients basic words Unconscious defensive maneuvers that hinder the progression of therapy Client relates to therapists in ways that mimic critical relationships in their lives Encouraged by reenactments Intentionally set up conversation Client Centered Therapy Emphasizes supportive emotional climate Client determines pace Humanistic perspective Carl Rogers Self acceptance leads to personal growth Re structure self concept to better correspond with reality Therapist reflects mirrors client https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 1 4 5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App Therapeutic Climate 3 elements believed necessary to promote positive changes Genuineness Honest communication Unconditional positive regard Support non judgement Empathy Understanding issues from client s point of view Make an effort to understand Therapeutic Process Little guidance advice or interpretation Reflection Therapist provides feedback clarification Reflecting the client s statements with enhanced clarity mirror Main goal help clients become more aware of and comfortable with their genuine selves Motivational interviewing A beginning definition Motivational interviewing is a collaborative conversation style for strengthening a person s own motivation and commitment to change Substance abuse An approach to conversation about change b tw client and therapist A collaborative way to address client ambivalence A matter of guiding the intersection of directing and following Focuses on client voiced argument for change MI is Ambivalence Ambivalence simutaneously wanting and not wanting something Normal Path out of ambivalence is to choose a direciton and follow it Have the client not the therapist voice reason for change Directive style can evoke defensiveness an resistance to change Collaborative style helps client voice own motivations for change working together People learn about their attitudes beliefs by hearing themselves talk The dynamics of change conversations Five questions to give beginners a feel for MI 1 Why would you want to make this change 2 How might you go about it in order to succeed 3 What are the three best reasons for you to do so 4 How important is it for you to make this change and why 5 So what do you think you ll do MI style above leads to engaged empowered open understood Vs directive sytle leads to anger defensive uncomfortable powerless Give client power Evaluating Insight Therapies Common factors that make various insight therapies effective Developing a therapeutic alliance Emotional support and empathy https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 2 4 5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App cultivation of hope and positive expectations Gives a rationale for one s problems and plausible methods for alleviating them Client express feelings confront problems gain new insights and learn new patterns of behavior Controversy Therapy and Recovered Memories Recovery of forgotten memories of traumatic events eg Parental abuse sexual abuse Controversial because it s impossible to know if the memory is real Power of suggestion could therapists persuade clients into believing that they experienced a trauma Group Therapy Simulatneous treatment of several or more clients into a group Therapist usually screens participants Ideal number 6 8 Compatibility Participants function like therapist for each other Provide emotional support for fellow members Share coping strategies and experiences Reduces feelings of being alone Opportunity to practice and enhance social skills in a safe environment Some problems may be best suited to group therapy Maximize support Advantages of Group Therapy Reduced Cost time and money More affordable Can see several clients at once Social skills groups Social anxiety Substance abuse Support groups may not have a therapist Behavior Therapies Based on 2 primary assumptions Behavior is a product of learning past conditioning What has been learned can be unlearned Client s vague complaints are redefined in terms of concrete specific goals Specific procedures are used for specific kinds of problems Systematic Desensitization Joseph Wolpe Reduces clients anxiety responses through counterconditioning Breaks down association between the conditioned stimulus and anxiety conditioned response Steps Create a fear hierarchy Fear of Flying Hierarchy List of progressively more frightening scenarios ranked by anxiety level Train client in deep muscle relaxation Clients work through hierarchy using exposures together with relaxation until anxiety to feared stimulus is reduced Use both imagined and in vivo exposures https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 3 4 PSYC 2101 Notes Microsoft OneNote Web App 5 2 2014 Class activity https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 4 4