Mental Health Therapy Techniques PDF

➔ Uses biometrics & pt monitors their progress to get reinforcement of effectiveness ◆ Good for migraines, asthma, chronic pain, GI, PTSD ➔ Neurofeedback: brainwaves ◆ Biometrics are specific relaxing/healing brain waves Body Therapy- Combining talk the...

➔ Uses biometrics & pt monitors their progress to get reinforcement of effectiveness ◆ Good for migraines, asthma, chronic pain, GI, PTSD ➔ Neurofeedback: brainwaves ◆ Biometrics are specific relaxing/healing brain waves Body Therapy- Combining talk therapy w/ physical activity or sensation ➔ Touching, Massage, Movement, Primal Screaming ➔ Yoga & Breathing Eye Movement Desensitization & Reprocessing- uses eye movements to create brain retraining & reprocessing ➔ Good for trauma/PTSD ➔ Vivid visual image related to memory Bibliotherapy- literature that explains psychological ‘issues’ & offering solutions ➔ Affirms pt & their condition & ‘normalizes’ decreasing sense of isolation or being different ➔ Depression, Anxiety, Personality Disorder, Eating Disorder, PTSD, Psychosis Family Therapy- Systems theory, assigning roles ➔ Hero- oldest; trustworthy, mature, dutiful, helpful, organized ➔ Placater- girl/oldest; caring, compassionate, giving, good listener ➔ Scapegoat- 2nd child; irritating, defiant, deceitful, hostile, disobedient ➔ Lost Child- disappear, quiet, shy, lonely, passive ➔ Mascot- youngest; outgoing, entertaining, excitable, cheerful, playful Group Therapy- Focus on education, skill development, emotional support, interdependence & well being ➔ Good for people dealing w/ the same issues ➔ Being w/ others who might understand your issue better ➔ Support, confrontation, recognizing ineffective behaviors & practices ➔ Selected participants!!! AKA you can’t sit w/ us. Psychotherapy, Cognitive Behavioral Therapy, Group Therapy Multidisciplinary VS Interdisciplinary Care (*know diff.) o Multidisciplinary = intentional communication btwn a variety of healthcare providers to support pt health and safety. o Participants include direct care providers + the patient. Sometimes case manager closes the loop. o Most commonly outpatient care o Interdisciplinary = intentional care planning by a team of healthcare providers. o Include psychiatrists, psychologists, counselors, RNs, PAs, social worker/case manager and the patient and family. Loop is closed through discussion, feedback, agreement. o Commonly inpatient/residential care Which is best: meds, therapy, or both o Always both! o Medications reduce/resolve symptoms o Therapy is a healing process that assists individuals to understand themselves and develop skills toward improving pt and family mental health Therapeutic Interventions o Evidence Based Therapy o Respective, non-coercive, non-abusive, pts/clients best interest o Individual Therapies (focuses on trusting relationship btwn patient/client and a therapist) o Psychoanalytic Involves talking more about how a patient’s past, influences what happens in the present and the choices they make  Lasts longer than CBT and counseling, sessions are usually an hour long Advantages: Explores early life experiences: childhood, parental relationships, Acknowledges the role of the unconscious: “Freudian slips,” dream analysis, free association, Rorschach test Disadvantages: Takes many months-years, expensive. Inappropriate for: actively psychotic patients, patients with poor insight, limited by finances and insurance benefits o Brief Insight-Oriented Psychotherapy Short-term: 10-40 sessions for a period of usually 1 year Goal: develop insight into issues and conflicts which will then lead to psychological and behavior changes Beneficial treatment for depressed, anxious, or experiencing adjustment reactions to stress Not useful for clients: poor impulse control, borderline personality, substance, antisocial personality o Therapy You Can Use- Unconditional Positive Regard Active listening, empathetic, supportive, patient-centered, genuine, eye contact, therapeutic touch Disadvantages: not always appropriate à psychosis + paranoia, history of physical/sexual abuse, mania, need for skills training/directions, time consuming, expensive Role Play Practice: When ____ happens, I feel ______. Reframing: Use alt. ways to remember and think about a problem or event o Jungian Psychology Explore and integrate the unconscious to become “Whole” Integration of shadow and projections: shadow = unacceptable aspect, projection = hero worship Uses ritual and symbolism Archetypes: thematic personalities à hero, villain, healer, trickster, etc. Disadvantages: same as psychoanalytic o Counseling Client encouraged to talk about feelings, works in emoting and finding solutions, not as “past” based as psychoanalytic o Behavior Therapies Change or reduce maladaptive behavior/actions (vs examining unconscious conflicts or aspects) Goal: eliminate the behavior (past doesn’t matter) Ex: learned helplessness, behavioral activation for depression (focus on pleasurable activities) Positive reinforcement: pleasant stimulus increases frequency of particular behavior: reward o To reinforce behavior, >5 positive to 1 negative ratio Systematic Desensitization or Exposure Therapy o For phobias, fears, aversions o Training to replace feelings of anxiety w/ feelings of relaxation  o Cognitive Behavioral Therapy (CBT) The present is more important than the past, how one thinks of an event/situation determines how one feels, which influences behavior Our feelings do not have to be dictated by the event but can be changed by the way we think about our situation. Automatic strong feelings are made aware Thought→Behavior→Emotion all connected Therapy lasts 12-20 weeks, time efficient Used for a variety of disorders: anxiety, insomnia, depression, phobias Effective, sometimes superior to meds Promotes pt autonomy Psychoanalytic Concepts: o Transference: patients begin to transfer their feelings of a particular person in their lives to the therapist/provider (patient falls in love with their therapist), feelings could be positive or negative, part of the therapeutic process and therapist facilitates patient “working through” unresolved feelings. You could use the role-playing technique or the “chair technique” to help with this o Countertransference: The therapist develops positive or negative feelings toward the patient. Therapist’s unconscious feelings are stirred up during therapy which the therapist directs toward the patient. Therapist starts feeling unhappy with the way therapy is going, or unhappy with themselves. Very common: the therapist seeks “supervision” to process their feelings o Resistance: a disruptive response by the client to some topic they find sensitive which is the source or close to the source of anxiety o Example the client might make an off-handed remark or joke, claim they forgot the information, or pick a fight with the therapist o The therapist is getting closer to the root of the problem o Attachment Theory: quality of a child’s attachment during the formative years affects the quality of relationships throughout life. As the caregiver affects the child, the child also affects the caregiver. o Proximity maintenance: wanting to be physically close to the therapist o Separation distress: separation anxiety o Safe haven: retreating to the therapist when sensing danger/feels anxious o Secure base: exploration of the world knowing that the therapist will protect them o Dependence, then healthy independence, interdependence, and connection Other Therapies o Meditation: paying attention in a particular way, on purpose, being present in the moment. o 3 core skills: concentration, sensory clarity, equanimity o Mindfulness Meditation is for 8 weeks associated with changes in gray matter concentration in brain regions involved in learning and memory processes. o PTSD and MDD associated with decreased density or volume of the hippocampus o *helps brain, improves brain function, changes it physiologically o Guided imagery + Hypnosis: a suggestion given during a time of receptivity and focused attention, a relaxed-trusting state or given in a stressed state o Useful in giving injection or burn patients o Disadvantages: painful, distressing memories o Avoid in: actively psychotic pts, depersonalization, derealization  o Spiegel eye roll test for hypnotic susceptibility o Metaphors: stories, images, idioms, analogies, which describe a person’s feelings or situation o What you don’t say is as important as what you do say o Body therapy biofeedback: behavior therapy involving relation and the power of suggestion. Uses biometrics to monitor the patients progress so they know they are accomplishing their goals (migraines, asthma, chronic pain, GI) o Talk therapy that is combined with physical “work” (yoga, breathing) o Eye Movement Desensitization and Reprocessing (EMDR) o Uses eye movements to facilitate brain retraining and reprocessing o Bibliotherapy: literature which explains psychological issues and dealing effectively o Affirms the patient and their condition and “normalizes,” decreasing a sense of isolation and being “different,” can be done on their own or in conjunction with therapy. Offers solutions, one time cost o Family therapy: focuses on the family as a unit, systems theory, development of individual insights and the development of skills to promote communication, empathy, roles, responsibilities and the success of the family unit o Role playing, assignments o Marriage/ Couples/ Relationship Therapy: to improve communication, identify shared goals, confront concerns honestly, honor individual needs. Develop plans to continue, change, modify, or dissolve the relationship in a respectful manner that reduces harm and collateral damage o Group Therapy: effective for persons dealing with the same issues, being with others who may better understand the problem (drug abuse, loss of loved one), peer support, confrontation, recognizes ineffective behavior and practices effective. Can be topic driven, time limited or ongoing. Focuses on education, skill development, emotional support, support independent and well being Class Q o Which therapy should be avoided in psychotic patients? (hypnotherapy) o Which therapy is based on systems theory? (family therapy) o Changing one’s thoughts and taking different actions are characteristic of which therapy? (cognitive behavioral therapy)