Treatment:Healing Actions,Healing Words

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Insight-Oriented Therapy������

�Psychoanalysis����(p.687)

� First use of a “talking cure”� Developed by Sigmund Freud� Identify unconscious motivations��������� Free association � �� Dream analysis � � �

Insight-Oriented Therapy������(p.686)

�Psychodynamic therapy��� � � �� Similar to psychoanalytic therapy� Less frequent sessions� Less emphasis on sexual and aggressive drives � � � � � � � � � �

� Techniques � � (p.688)• Interpretation��

• Resistance � � / � �

• Transference� � (countertransference� � �

Insight-Oriented Therapy������

�Humanistic therapy � � (p.689)

�Carl Rogers����Client-centered therapy� � � ! � " #

�Incongruence � � �•Real self$ %• Ideal self& � %

Insight-Oriented Therapy������

�Client-centered therapy techniques(p.689)

� � � � � � � � � �

� Reflection��� Empathy� �� Unconditional positive regard � � � � �

Evaluating Insight-Oriented Therapies��������

�Difficult to evaluate� � � ��Who benefits from them?(p.691)� � � � � � �

�Healthy�Articulate� Interested in motives

Behavior Therapy� � ��

A type of therapy based on learning principles that focuses on changing observable, measurable behaviors

�The ABCs(p.692)�Antecedents � � ��Behavior� ��Consequences

Behavior Therapy ��

� Techniques based on classical conditioning� � � � � � � � � � � � � � �

� Exposure' ( (p.693)• Imaginable exposure• In vivo exposure• Virtual reality exposure

� Stimulus control ) * + ,� Systematic desensitization- . / 0 1 p.695

• Progressive muscle relaxation�������

Behavior Therapy� � ��

� Techniques based on operant conditioning� � � � � � � � � � � � � � �

� Behavior modification2 � 3 4� Primary and secondary reinforcers� Token economies5 6 * p.696

� Self-monitoring techniques % 7 ) � � p.696

� Observational learning� � � �

Cognitive Therapy ��

A type of therapy that focuses on thoughts rather than feelings or behaviors

� Cognitive distortions � ! "� Psychoeducation # $ % & ' (

Common Cognitive Distortions�������p.698

�Dichotomous thinking� � � ! �Mental filter " # $ % & ' ( %�Mind reading) � *�Catastrophic exaggeration+ # , ��Control beliefs- . / 0

Cognitive Therapy Techniques��� �

� Albert Ellis’s rational-emotive behavior therapy) * � � +REBT,

� Activating event 8 9 : ; (p.699)� Beliefs < =� Consequences > ?� Dispute@ A� Effect > ? B C� Further actionD E F 2 �

Cognitive Therapy Techniques��� �

�Beck’s cognitive therapy- . � � � p.699

�Cognitive restructuring � / 0�Daily record of dysfunctional beliefs1 2 3 4 5 6 7 � 8 9 (p.700)

� Identify automatic thoughts : � ; < = >� Identify rational responses : � ) ? @ A

Biomedical Therapies� � � ��

�Psychopharmacology� 1 2 3 4 p.702

5 6 2 3 � � ��7 8 9 : ;

�Electroconvulsive therapy<ECT=p.705

> ? @ A �

�Transcranial magnetic stimulation p.706

Psychopharmacology: Schizophrenia � � � �

� Antipsychotic medications B # $ C D E� Target positive symptoms G H 4 � I J� Tardive dyskinesia(TD) K 9 � L � M �

� Atypical antipsychoticsF G H I J K B # $ C D E

� Newer� Target positive and negative symptomsG H 4 � � N � I J I J

� Early treatment

Psychopharmacology:Mood Disorders� � � �

� Tricyclic antidepressants (TCAs) O P Q� Monoamine oxidase inhibitors (MAOIs)

� Food interactions R S T U V W� Selective serotonin reuptake inhibitors

(SSRIs) X Y Z [ \ ] * Q� Prozac���, Zoloft� � � , Paxil

� Serotonin/norepinephrine reuptake inhibitors (SNRIs) X Y Z - 4 ^ _ ` Z a [ \ ] * Q� Serzone, Effexor � �

� St. John’s wort� Lithiumb c

Psychopharmacology: Anxiety Disorders � � �

� Benzodiazepines(BZD) � � �� Xanaxd e f , Valiumg h� Often for short periods

� Antidepressants � !� TCAs� SSRIs� SNRIs

Electroconvulsive Therapy (ECT)

� Used when medication and therapy is ineffective

� Depression� Fell out of favor

� Abusei W� Movie, One Flew Over the Cuckoo’s Nest�� � � � � �

� Regaining popularity� Memory loss

Transcranial Magnetic Stimulation (TMS)p706

� New technique� 100- to 200- microsecond bursts of high-

intensity magnetism� May replace ECT

Modalities����(p707)

� Individual therapyj k " #� Group therapyl m " #� Family therapyn o " #� Systems therapy

� Paradoxical intention� Reframing� Validation

� Self-help therapies p " #� Support groups�����

� Bibliotherapy� � �

Innovations in Psychotherapy� � � � � ��(p.710)

� Psychotherapy integration L M ? N ) � �� Technical eclecticism� � � q r

� Managed care� Financial concernss t u v

� Therapy protocols� Brief therapyO P � �� Cybertherapy

Prevention� � (p.713)

�Universal preventive interventions� Target all members of a group

�Selective preventive interventions� Target high-risk subgroups w x y z

� Indicated preventive interventions� Target those with symptoms but not

disorder

Researching Psychotherapy� � ��� � �

�Challenges in psychotherapy research� Common factors� Specific factors� Allegiance effect� Control group� Confounds

Researching Psychotherapy� � ��� � �

�Randomized controlled trials� Random assignment { �| }� Specific disorders and exclusion criteria� Reducing confounds� Generalizability~ �� Outcome measures� Drop-outs � � �� Follow-ups � �

Which Treatment forWhich Disorder?� � ��

�Empirically supported treatments� Evidence-based treatments� � � � � " #

�Therapy, medication, or both?� Depression� Anxiety disorders� Other disorders