Therapies for Psychological Disorders PDF

Therapies for Psychological Disorders 1 Definition of Psychotherapy A form of therapy in which a trained professional uses methods based on psychological theories/research to help a person with psychological problems 2 T...

Therapies for Psychological Disorders 1 Definition of Psychotherapy A form of therapy in which a trained professional uses methods based on psychological theories/research to help a person with psychological problems 2 The Therapeutic Context  Four primary goals of therapy: - Reaching a diagnosis about what is causing impairment - Proposing a probable etiology - Making a prognosis of course of problem - Carrying out some form of treatment – i.e., to change thinking, feeling, behaving in order to lead to recovery 3 Major Types of Therapies Biomedical therapies Focus on changing the mechanisms that run the central nervous system Psychotherapies Focus on changing the faulty behaviours people have learned (words, thoughts, interpretations, and feedback that direct daily strategies for living) Psychodynamic, behaviour, cognitive, humanistic 4 Therapeutic Settings  Several types of therapists: 1) Clinical social worker 2) Pastoral counsellor 3) Clinical psychologist 4) Counselling psychologist 5) Psychiatrist 6) Psychoanalyst 7) Marriage & Family Therapist 8) General Practitioner  Therapists vary in approaches and treatment provided – empirically proven treatment choices are key 5 Therapeutic Context Individuals with psychological problems may be considered: Patients (biomedical approach) Client (life & social problems) Effective therapy dependent upon the therapeutic alliance Mutual relationship that a client or patient establishes with a therapist (collaboration to bring about relief) 6 Psychotherapy - Ethics Relationship involves power of therapist, emotional patient divulging personal data Ethical Standards Goals of treatment understood/agreed to by client; in best interest of client and society Careful consideration given to alternatives Therapist treats only within limits of expertise (e.g., life coach) 7 Psychotherapy - Ethics Ethical Standards Effectiveness of treatment must be evaluated Rules and laws of confidentiality followed No abuse of therapist-client relationship Therapist must treat all humans with dignity; respecting all genders, races, sexual orientation, and other sociocultural factors 8 Psychodynamic Therapies Assumption that problems are caused by psychological tension between unconscious impulses and life constraints (developed by Freud) Most prominent is psychoanalysis Freudian ideas on exploring relationship between current symptoms & inner conflicts Goal to establish intrapsychic harmony, release repression & gain insight into problems Also called insight therapy Interpretation – an interpretation is a question or comment made by the therapist after examining all of the information given by the client 9 Psychodynamic Techniques Free Association Reporting thoughts, wishes, physical sensations, and mental images as mind wanders freely Catharsis – release repressed material Resistance Inability or unwillingness to discuss certain ideas, desires, or experiences Analysis of these barriers used to help patient understand 10 Psychodynamic Techniques Dream Analysis Examining the content of a person’s dreams to discover the underlying or disguised motivations and symbolic meanings of significant life experiences and desires Manifest & latent content Transference & Countertransference Transference - therapist becomes identified with person who has been associated with emotional conflicts (positive and negative) – example on page 686 Countertransference – when therapist projects feelings of likes or dislikes onto clients that resemble other’s in therapists life 11 Behaviour Therapies Focus on observable behaviours and learning processes – they have learned this behaviour The goal is to unlearn maladaptive behaviour and to replace them with adaptive behaviour Behaviour therapy / modification Systematic use of principles of learning to increase the frequency of desired behaviours and/or decrease that of problem behaviours Often used in treating fears, compulsions, depression, addictions, aggression, delinquency Key issue of generalization from therapy to real-life 12 Behaviour Therapies Counterconditioning When a new response is conditioned to replace (or counter) a maladaptive response Mary Cover Jones – “unlearning” fear Involves techniques such as systematic desensitization, implosion, flooding, and aversion therapy 13 Counterconditioning Exposure therapy involves confronting anxiety- causing situations (using imagination, reality, or virtual reality) Systematic desensitization Psychologically confronting the feared stimulus while being relaxed and doing so in a graduated sequence 3 steps: identification of stimuli (rate the stimuli), progressive relaxation, imagined exposure to stimuli 14 Counterconditioning Flooding – Intensive Exposure Therapy Being placed directly into a phobic situation Aversion therapy Uses counterconditioning procedures to pair harmful stimuli that people are attracted to with strong noxious stimuli  e.g., shock, nausea-producing drugs  May be used for self-injurious behaviours or violence 15 Contingency Management Contingency management General treatment strategy of changing behaviour by modifying its consequences Positive reinforcement strategies  Modifies frequency of desirable response as it replaces an undesirable response  E.g., shaping, token economies Extinction strategies  Withholding subtle positive reinforcements in the presence of undesirable behaviour 16 Cognitive Therapies  Cognitive therapy  Attempts to change problem feelings and behaviours by changing the way a client thinks about significant life experiences  Based on cognitive content & processes  Some therapies try to change false beliefs based on: 1) Unreasonable attitudes 2) False premises 3) Rigid rules of behaviour patterns 17 Cognitive Therapies Cognitive therapy (Beck)  Challenge client’s basic assumptions (i.e., autonomic thought patterns), evaluate evidence for accuracy of thoughts, reattribute blame, discuss alternative solutions (used most often for depression) Rational-emotive therapy (Ellis)  Transformation of irrational beliefs that cause undesirable behaviours & emotional reactions  Identifying antecedents, behaviours, and consequences – ABCD Model (activating event, belief, consequences, and disputing) Cognitive behavioural therapy  Combines cognitive emphasis on changing false beliefs with behavioural focus on reinforcement contingencies (self-efficacy) 18 Humanistic Therapies Core belief of person in continual process of change with the freedom to choose Goal to seek self-actualization Human-potential movement Encompassed methods to enhance the potential of the average human being toward greater levels of performance and greater richness of experience 19 Humanistic Therapies Client-centred therapy (Rogers) Promotes the healthy psychological growth of the individual (nondirective) Develop atmosphere of unconditional positive regard to process incongruence (use of empathy and genuiness) Gestalt therapy (Perls) Focuses on ways to unite mind and body to make a person whole Fosters self-awareness through empty-chair technique 20