Psychotherapy clients Marital Status Age Education Insurance Type of Disorder Psychotherapy therapistssts psychologist PhD with clinical training clinical vs counselling psychiatrist MD with clinical internship others Insight Therapies Psychoanalysis free association dream analysis interpretation resistance transference Modern Psychodynamic Therapy Client-Centred Therapy Carl Rogers non-directive incongruence therapeutic climate genuineness unconditional positive regard empathy therapeutic process Gestalt Therapy Fritz Perls developed 1950s figure-ground relationships skillful frustration role playing Cognitive Therapies Albert Ellis Rational-Emotive Therapy catastrophic thinking ABC model activating event belief system consequence Rational-Emotive Therapy D component of the model detecting instances of catastrophic thinking disputing irrationality of this thinking Becks Cognitive Theory depressives: blame setbacks on themselves focus on negative events unduly pessimistic make overly negative evaluations Behavioural Therapies General Principles behaviour is the product of learning what has been learned can be unlearned Systematic Desensitization Wolpe, 1950s based on classical conditioning phobias relaxation training anxiety hierarchy Anxiety Hierarchy Behavioural Therapies Exposure Therapies Flooding Implosion Aversion Therapy UCS (Drug in Alcohol) UCR (Nausea) CS (Alcohol) CR (Nausea) Behavioural Therapies Social Skills Training Token Economies Theoretical Orientations eclecticism Biomedical Therapies Psychosurgery Golz Burkhardt Jacobsen lobotomy (lobe-cutting) Dr. Antnio Egas Moniz leukotomy (white matter cutting) Psychosurgery Walter Freeman 1936 initial procedure Freeman-Watts Standard Procedure prefrontal lobotomy cingulotomy ice-pick lobotomy (1945) 18,000+ between 1939 & Nobel Prize Psychopharmacotherapy Antianxiety drugs e.g., Valium, Xanax, BuSpar Psychopharmacotherapy Antipsychotics e.g., Thorazine, Haldol side effects tardive dyskinesia Antidepressants tricyclics MAO inhibitors selective serotonin reuptake inhibitors (SSRIs) Prozac, Paxil, Zoloft Psychopharmacotherapy Lithium tx for bipolar mood disorder Electroconvulsive Therapy (ECT) volt AC 1-3 times/week 2-4 weeks side-effects total amnesia retrograde amnesia anterograde amnesia Evaluating Therapeutic Outcomes Eysencks (1952) criticism 2/3 rds spontaneous remission same as success rate later spontaneous remission revised to 30% meta analysis (Smith, 1980) people who were treated were better off than 80% of non-treated Evaluating Therapeutic Outcomes Changes in Treatment of Disorders Community Health Movement local, community-based care reduced reliance on hospitalization focus on prevention deinstitutionalization Changes in Treatment of Disorders deinstitutionalization Advantages: more cost effective improved tx in hospitals Disadvantages: increased re-admissions lack of appropriate alternatives results in increased # of homeless