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1
Therapy Approaches
• Biological Treatment
• Surgery & Electroshock
• Psychotherapy
2
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 schizophreniaExample: ThorazineReduce receptivity to dopamine or increase
serotoninReduce positive symptoms of schizophreniaDo not relieve other negative symptomsCan have dangerous side effect: tardive
dyskinesia & neurolyptic malignant syndrome
4
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: Vlium
• 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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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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Cautions about Drugs
• Placebo effect
• Relapse and drop out rates
• Dosage problems
• Long-term risks
• Overprescription
• Sometimes has to be with therapy
10
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
• Doesn’t 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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• InterpretationThe analyst noting supposed dream meanings,
resistances, and other significant behaviors in order to promote insight.
• ResistanceIn psychoanalysis, the blocking from
consciousness of anxiety-laden material.• TransferenceThe patient’s 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 + ResponseClassical 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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• Ivan Pavlov
• Conditioning
Learning that involves associations between environmental stimuli and the organism’s responses
• Stimulus-response Learning
Classical Conditioning
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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 Pavlov’s concept.
• Skinner used reinforcement and punishment to enhance learning.
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Skinner’s 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.• It’s not fair.• That jerk!• They’re driving me
crazy.
• Cool Thoughts• Maybe he had a bad
day.• It’ll be better next time• But people are people• Life is not fair.• It’s his problem!• Just don’t accept the
ride.
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Dysfunctional ThoughtSituation Emotion
Rate
1-100%
Automatic Thought
Cognitive Distortion
Rational Response
Outcome
Rate
0-100%
Fight with spouse
Angry, 99%
Sad, 50%
-I’ll never have a normal marriage
-I deserve better
-He’s stubborn
Magnificat-ion
Entitlement
Labeling
-It’s not the end of the world
-That’s 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-Centered 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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Active Listening
• Paraphrase.Summarize the speakers words in your own
words.• Invite Clarification.Encourage the speaker to say more.• Reflect Feelings.Reflect what you’re sensing from the speakers
words and body language.
31
Existential Therapy
• Helps client explore meaning of existence
• Helps client choose a destiny
• Helps client accept self-responsibility.
32
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)
35
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
36
The Structural ApproachSalvador Minuchin
• The individual’s symptoms are best understood as rooted in the context of family transaction patterns.– The family’s hierarchical organization– The wholeness of the family system– The interdependent functioning of its subsystems
• EnmeshmentThe family boundaries are too diffuse to allow for individual autonomy
37
Strategic ApproachJay Haley
• The therapist devices a strategy for solving the client’s present problems
• Goals are clearly set
• Therapy is carefully planned to achieve these goals
38
Object Relations
• Introjects – the psychological representations of external objects
• The most powerful obstacle to change is people’s attachment to their parental introjects
39
Family Systems TheoryMultigenrationalMurray 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
40
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
41
When Therapy Harms
• Bias on the therapist’s part because of gender, religion, or race
• Coercion by the therapist to accept his/her advice
• Coercion by the therapist to have sexual intimacy
42
Alternatives to Psychotherapy
• Community Psychologists– Half-way houses– Clubhouse model– Foster care– Family support groups
• Rehabilitation Psychologists– Half-way houses– Clubhouse model– Foster care– Family support groups