Copyright © Houghton Mifflin Company. All rights reserved. 14–1 Chapter Fourteen Methods of Therapy

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<ul><li>Slide 1</li></ul><p>Copyright Houghton Mifflin Company. All rights reserved. 141 Chapter Fourteen Methods of Therapy Slide 2 Copyright Houghton Mifflin Company. All rights reserved. 142 Did You Know That Sigmund Freud believed that clients bring into the therapeutic relationship the conflicts they have had with important persons in their lives? Gestalt therapists have their clients talk to an empty chair? Behavior therapists have used virtual reality to help people overcome fear of heights? Slide 3 Copyright Houghton Mifflin Company. All rights reserved. 143 Did You Know That (cont.) Cognitive therapists believe that emotional problems, such as anxiety and depression, are caused not directly by troubling events we experience but by the ways in which we interpret these events? Antidepressant drugs have been used to treat not only depression but other disorders as well, such as panic disorder and even bulimia? Slide 4 Copyright Houghton Mifflin Company. All rights reserved. 144 Did You Know That (cont.) Stimulant drugs are widely used to improve attention spans and reduce disruptive behavior of hyperactive children and adolescents? Sending jolts of electricity through a persons head can relieve severe depression? In many states, anyone can practice psychotherapy? Slide 5 Copyright Houghton Mifflin Company. All rights reserved. 145 Module 14.1 Pathways to the Present: A Brief History of Therapy Slide 6 Copyright Houghton Mifflin Company. All rights reserved. 146 Module 14.1 Preview Questions How has the treatment of people with disturbed behavior changed over time? What are community-based health centers? How successful is the policy of deinstitutionalization? Slide 7 Copyright Houghton Mifflin Company. All rights reserved. 147 Moral Therapy Philosophy that mentally disturbed people should be treated with compassion and humane care. Reaction against prevailing view that deranged people were threats to society. Leading proponents Jean-Baptiste Pussin &amp; Philippe Pinel Dorothea Dix Fell out of favor during later half of 19 th century. Slide 8 Copyright Houghton Mifflin Company. All rights reserved. 148 Community-Based Care Community mental health system began in 1960s in response to poor conditions in mental hospitals. Provided alternatives to long-term hospitalization. Deinstitutionalization: The social policy that redirected care from state mental hospitals toward community-based treatment settings. Slide 9 Copyright Houghton Mifflin Company. All rights reserved. 149 Community-Based Care (cont.) Variety of services offer include: Outpatient care Day treatment Crisis intervention Has deinstitutionalization reintegrated mental patients into their communities? Mixed results Slide 10 Copyright Houghton Mifflin Company. All rights reserved. 1410 Module 14.2 Types of Psychotherapy Slide 11 Copyright Houghton Mifflin Company. All rights reserved. 1411 Module 14.2 Preview Questions What is psychotherapy? What are the major types of mental health professionals? What are the major forms of psychotherapy? Is psychotherapy effective? What cultural factors do therapists need to consider when working with members of diverse groups? Slide 12 Copyright Houghton Mifflin Company. All rights reserved. 1412 What Is Psychotherapy? A psychologically based form of treatment used to help people better understand their emotional or behavioral problems and resolve them. Called talk therapy because consists of a series of verbal interactions between therapist and client. Slide 13 Copyright Houghton Mifflin Company. All rights reserved. 1413 Mental Health Professionals Clinical psychologists Doctoral degree in psychology, licensing exam Psychological testing, diagnosing mental disorders, psychotherapy Counseling psychologists Doctoral degree in psychology, licensing exam Counseling for milder range of problems Slide 14 Copyright Houghton Mifflin Company. All rights reserved. 1414 Mental Health Professionals Psychiatrists Medical degree, residency Physicians specializing in diagnosis and treatment of mental illness May prescribe psychiatric drugs or practice psychotherapy Slide 15 Copyright Houghton Mifflin Company. All rights reserved. 1415 Mental Health Professionals Clinical or psychiatric social workers Masters degree in social work Help individuals with severe mental illness to receive services from community agencies and organizations Psychoanalysts Psychologist or psychiatrist with additional training in psychoanalysis Slide 16 Copyright Houghton Mifflin Company. All rights reserved. 1416 Mental Health Professionals Counselors Masters degree in counseling field Varied settings and types of counseling Psychiatric nurses R.N. with masters degree in psychiatric nursing Working with people who have severe psychological disorders Slide 17 Copyright Houghton Mifflin Company. All rights reserved. 1417 Psychodynamic Therapy Based on belief that psychological problems are rooted in unconscious psychological conflicts dating from childhood. Assumption that gaining insight into conflicts and working through them are key steps to restoring psychological health. Traditional psychoanalysis developed by Freud. Slide 18 Copyright Houghton Mifflin Company. All rights reserved. 1418 Traditional Psychoanalytic Techniques Free association Dream analysis Latent versus manifest content Interpretation of: Resistance Transference relationship Countertransference Slide 19 Copyright Houghton Mifflin Company. All rights reserved. 1419 Modern Psychodynamic Approaches Less focus on sexual issues More focus on Adaptive functioning of ego Clients current relationships Briefer, more direct approach Slide 20 Copyright Houghton Mifflin Company. All rights reserved. 1420 Humanistic Therapy Based on belief that humans possess free will and ability to make conscious choices. Emphasis on the clients subjective, conscious experience. Focus is on the here-and-now, not the past. Slide 21 Copyright Houghton Mifflin Company. All rights reserved. 1421 Rogers Client-Centered Therapy Based on belief that psychological problems stem from blocked self-actualization. Focus of therapy is on the person. Therapist strives to create warm, accepting atmosphere for client. Nondirective approach. Necessary qualities of an effective therapist: Unconditional positive regard Empathy Genuineness Slide 22 Copyright Houghton Mifflin Company. All rights reserved. 1422 Perls Gestalt Therapy Important to help clients blend conflicting parts of personality into an integrated whole or Gestalt. Characteristics Direct, confrontational approach Identifying feelings Use of role playing, such as empty chair technique Slide 23 Copyright Houghton Mifflin Company. All rights reserved. 1423 Behavior Therapy Behavior therapy or behavior modification Application of principles of learning to help person make adaptive changes in behavior. Assumption that psychological problems are learned. Focus is on the present situation. Slide 24 Copyright Houghton Mifflin Company. All rights reserved. 1424 Behavior Therapy: Fear Reduction Systematic desensitization Construction of a fear hierarchy Gradual exposure (or in-vivo exposure) Modeling Virtual therapy Slide 25 Copyright Houghton Mifflin Company. All rights reserved. 1425 Behavior Therapy: Aversive Conditioning Form of classical conditioning Objects paired with aversive stimuli Electric shock, nausea-inducing drug Effects often temporary. Slide 26 Copyright Houghton Mifflin Company. All rights reserved. 1426 Figure 14.1: Model of Aversive Conditioning Slide 27 Copyright Houghton Mifflin Company. All rights reserved. 1427 Other Behavior Therapy Methods Operant Conditioning Methods Reinforcement and punishment Token economy Cognitive-Behavioral Therapy (CBT) Combines behavioral techniques with cognitive techniques. Slide 28 Copyright Houghton Mifflin Company. All rights reserved. 1428 Cognitive Therapy Focus on helping people change how they think. Assumption that distorted thinking underlies: Emotional problems Self-defeating behaviors Maladaptive behaviors Slide 29 Copyright Houghton Mifflin Company. All rights reserved. 1429 Ellis Rational-Emotive Behavior Therapy (REBT) Irrational beliefs lead to problems Often take the form of shoulds and musts ABC approach: Activating events Beliefs Consequences Goal is to recognize irrational beliefs and replace them with more logical, self- enhancing beliefs. Slide 30 Copyright Houghton Mifflin Company. All rights reserved. 1430 Slide 31 Copyright Houghton Mifflin Company. All rights reserved. 1431 Figure 14.2: The Ellis ABC Model Slide 32 Copyright Houghton Mifflin Company. All rights reserved. 1432 Becks Cognitive Therapy Goal is to help clients identify and correct errors in thinking. Cognitive distortions Clients given homework assignments. E.g., Reality testing Although similar to REBT, differs in therapeutic style. Slide 33 Copyright Houghton Mifflin Company. All rights reserved. 1433 Eclectic Therapy Draws upon principles and techniques representing different schools of therapy. Most widely endorsed theoretical orientation. Some argue that therapeutic integration is neither desirable nor achievable. Slide 34 Copyright Houghton Mifflin Company. All rights reserved. 1434 Figure 14.3: Clinical and Counseling Psychologists Identifying with each theoretical orientation Slide 35 Copyright Houghton Mifflin Company. All rights reserved. 1435 Group Therapy People brought together to explore and resolve problems. Advantages over individual therapy Less costly Helps with interpersonal problems, social skills Share coping strategies Drawbacks No one-on-one attention Reluctance to disclose Feelings of inhibition Slide 36 Copyright Houghton Mifflin Company. All rights reserved. 1436 Family Therapy Helps troubled families learn to communicate better and resolve their differences. Family, not individual is the unit of treatment. Individual problems symptomatic of family system breakdown. Slide 37 Copyright Houghton Mifflin Company. All rights reserved. 1437 Couples Therapy Often called marital therapy. The couple is the unit of the treatment. Goal is to build healthier relationships. Acquire more effective communication and problem-solving skills. Resolve power struggles. Typically focus on disturbed role relationships. Slide 38 Copyright Houghton Mifflin Company. All rights reserved. 1438 Figure 14.4: Effectiveness of Psychotherapy Slide 39 Copyright Houghton Mifflin Company. All rights reserved. 1439 Slide 40 Copyright Houghton Mifflin Company. All rights reserved. 1440 Which Therapy Is Best? Little difference between kinds of therapy overall. Effectiveness may rely on matching problem to therapy. Slide 41 Copyright Houghton Mifflin Company. All rights reserved. 1441 What Accounts for the Benefits of Psychotherapy? Interpersonal relationship with therapist Therapeutic alliance Expectation of improvement Self-fulfilling prophecy Placebo or expectancy effects Slide 42 Copyright Houghton Mifflin Company. All rights reserved. 1442 Multicultural Issues African Americans Asian Americans Hispanic Americans Native Americans Slide 43 Copyright Houghton Mifflin Company. All rights reserved. 1443 Module 14.3 Biomedical Therapies Slide 44 Copyright Houghton Mifflin Company. All rights reserved. 1444 Module 14.3 Preview Questions What are the major types of psychotropic or psychiatric drugs? What are the advantages and disadvantages of psychiatric drugs? What is ECT, and how is it used? Slide 45 Copyright Houghton Mifflin Company. All rights reserved. 1445 Antianxiety Drugs Also called minor tranquilizers Effects Reduces anxiety Produces calmness Reduces muscle tension Effect on GABA receptors Examples Valium, Librium, Xanax Slide 46 Copyright Houghton Mifflin Company. All rights reserved. 1446 Antidepressants Increases availability of neurotransmitters Serotonin, norepinephrine Major types Tricyclics MAO inhibitors Selective serotonin-reuptake inhibitors (SSRIs) Therapeutic benefits for both depression and anxiety disorders. Slide 47 Copyright Houghton Mifflin Company. All rights reserved. 1447 Antipsychotics Sometimes called major tranquilizers Treatment for schizophrenia, other psychotic disorders Blocks action of dopamine at receptor sites in brain Slide 48 Copyright Houghton Mifflin Company. All rights reserved. 1448 Other Psychiatric Drugs Mood stabilizers to reduce mood swings E.g., Lithium Stimulants used to improve attention spans and reduce disruptive behavior in hyperactive children. E.g., Ritalin, Cylert Slide 49 Copyright Houghton Mifflin Company. All rights reserved. 1449 Evaluating Psychotropic Drugs Limitations May reduce or control symptoms, but not a cure. Does not teach how to resolve problems or develop necessary life skills. Risks of adverse side effects E.g., tardive dyskinesia with antipsychotics Can lead to psychological or physical dependence. Slide 50 Copyright Houghton Mifflin Company. All rights reserved. 1450 Evaluating Psychotropic Drugs (cont.) Relapses common when stop taking drugs. 15-20% of schizophrenics relapse even when reliably taking medication. May be seen as a quick fix Useful for temporary relief Usually used in tandem with psychotherapy. Slide 51 Copyright Houghton Mifflin Company. All rights reserved. 1451 Other Biomedical Therapies Electroconvulsive therapy (ECT) can produce dramatic relief from severe depression. Psychosurgery involves surgically altering the brain to control deviant or violent behavior. Prefrontal lobotomy Newer more specified techniques rarely used as a last resort. Slide 52 Copyright Houghton Mifflin Company. All rights reserved. 1452 Module 14.4 Application: Getting Help Slide 53 Copyright Houghton Mifflin Company. All rights reserved. 1453 Module 14.4 Preview Question What steps can people take to find qualified mental health professionals? Slide 54 Copyright Houghton Mifflin Company. All rights reserved. 1454 Choosing a Therapist Seek recommendations from respected sources. Seek a referral from a local medical center or local community mental health center. Seek consultation from college counseling center or health services Contact professional organizations for recommendations. Slide 55 Copyright Houghton Mifflin Company. All rights reserved. 1455 Choosing a Therapist (cont.) Use Yellow Pages, but be wary. Check for proper licensing Ask about type of therapy being provided. Ask about providers background and experience. Slide 56 Copyright Houghton Mifflin Company. All rights reserved. 1456 Working with Therapist Discuss diagnosis and treatment plan before committing. Ask about costs and insurance. Find out about late/missed session policy. If medication is to be prescribed, inquire about delay, side effects. Slide 57 Copyright Houghton Mifflin Company. All rights reserved. 1457 Working with Therapist (cont.) Openly discuss concerns about treatment. Request a second opinion if in d...</p>

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