1

Therapy Approaches

• Biological Treatment

• Surgery & Electroshock

• Psychotherapy

2

Biological TreatmentsDrugs

• 1-Antipshchotic Drugs

• 2-Antidepressant Drugs

• 3-Tranquilizers

• 4-Lithium Carbonate

3

1-Antipsychotic Drugsor Neuroleptics

Good for treating psychosis and schizophreniaExample: ThorazineReduce receptivity to dopamine or increase

serotoninReduce positive symptoms of schizophreniaDo not relieve other negative symptomsCan have dangerous side effect: tardive

dyskinesia & neurolyptic malignant syndrome

4

Antipsychotic Drugsand Schizophrenia

• Good for reducing:

• Agitation• Delusions• Hallucinations• Can shorten

schizophrenic episodes

• Offers little relief from:

• Jumbled thoughts• Difficulty

concentrating• Inability to interact

with others

5

2-Antidepressant Drugs• Treat depression, anxiety, phobias, OCD• Example: Prozac, Zoloft, and Paxil• Non addictive but can cause side effects• 1-Monoamine oxidase inhibitors (elevate levels of

ser. & nor. by blocking inhibitors)• 2-Tricyclic antidepressants (boost nor. & ser. by

preventing their reabsorption)• 3-Selective serotonin reuptake inhibitors

(work on serotonin)

6

3-Tranquilizers

• Prescribed for depressed mood, panic, and anxiety

• Example: Vlium

• Increase activity of neurotransmitter GABA

• If overused can result in tolerance and withdrawal

7

4-Lithium Carbonate

• Prescribed for bipolar disorder

• Can be dangerous if not given in the right doze

8

The Placebo EffectKirsch and Sapirstein (1998)

• 7315 participants

• 41% of those receiving antidepressants experienced reduced symptoms.

• 31% of those given placebos also received reduced symptoms.

9

Cautions about Drugs

• Placebo effect

• Relapse and drop out rates

• Dosage problems

• Long-term risks

• Overprescription

• Sometimes has to be with therapy

10

Surgery & Electroshock

• Psychosurgery

• Shock Therapy

11

Psychotherapy

• Psychodynamic

• Behavioral

• Cognitive

• Humanistic/Existential

• Therapy in Social Context

12

Psychodynamic Therapy

• Probes the past

• Doesn’t tackle the immediate problem

• The goal is insight

• Takes a long time

• Explores the unconscious

• Methods: free association, interpretation of dreams, & transference

13

• InterpretationThe analyst noting supposed dream meanings,

resistances, and other significant behaviors in order to promote insight.

• ResistanceIn psychoanalysis, the blocking from

consciousness of anxiety-laden material.• TransferenceThe patient’s transfer to the analyst of

emotions linked with other relationships (such as love or hatred for a parent)

14

Behavioral Techniques

Learning

Conditioning

Association between

Environmental Stimuli + ResponseClassical Conditioning Operant Conditioning

Association Reinforcement/

Stimulus-Response Punishment

15

Behavioral Techniques

• There are no mental processes (will, mind)

• Derived from classical and operant conditioning

• The focus is on changing the behavior

• Works on the immediate problem

• Focuses on the present

16

• Ivan Pavlov

• Conditioning

Learning that involves associations between environmental stimuli and the organism’s responses

• Stimulus-response Learning

Classical Conditioning

17

18

Classical Conditioning in Real Life

• Learning to like

• Learning to fear

• Accounting for Taste

• Reacting to Medical Treatment

19

Operant Conditioning

• The behavior is more likely or less likely to occur based on its consequences.

• B. F. Skinner modified Pavlov’s concept.

• Skinner used reinforcement and punishment to enhance learning.

20

Skinner’s Box

21

Behavioral Techniques

• Systematic Desensitization/Counter Conditioning

• Aversive Conditioning

• Exposure Treatment (Flooding)

• Behavioral Records & Contracts

• Skills Training

22

Systematic Desensitization

• Fear of Flying– Read about safety– Look at pictures of airplanes– Visit an airport– Take a short flight– Take a long flight

• Fear is extinguished• Counterconditioning

23

Cognitive Therapy

• Albert Ellis

• (Rational Emotive Behavior Therapy)

• Aaron Beck

24

Cognitive Distortions

• Labeling

• Mind Reading

• Exaggeration

• Unrealistic Expectations

• Belief in Entitlement

• Belief in Absolute Fairness

25

Fighting Dysfunctional Thought

• Hot Thoughts• He is always mean to

me.• I did a lousy job.• I deserve better.• It’s not fair.• That jerk!• They’re driving me

crazy.

• Cool Thoughts• Maybe he had a bad

day.• It’ll be better next time• But people are people• Life is not fair.• It’s his problem!• Just don’t accept the

ride.

26

Dysfunctional ThoughtSituation Emotion

Rate

1-100%

Automatic Thought

Cognitive Distortion

Rational Response

Outcome

Rate

0-100%

Fight with spouse

Angry, 99%

Sad, 50%

-I’ll never have a normal marriage

-I deserve better

-He’s stubborn

Magnificat-ion

Entitlement

Labeling

-It’s not the end of the world

-That’s normal

-Maybe he had a bad day

Angry,

50%

Sad, 10%

27

Humanistic/ExistentialTherapy

• Works on self-fulfillment and self-actualization

• Does not delve into the past• Helps the client think about the present and

the future• Helps people feel good about themselves• Tackles conscious rather than unconscious

thoughts

28

Carl RogersClient-Centered TherapyPerson-Centered Therapy

• The therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to facilitate clients’ growth.

29

Carl RogersClient-Centered Therapy

• Offers unconditional positive regard

• No specific techniques

• Therapist should be warm, genuine and empathetic

• Client adopts these views and becomes self-accepting

• Promotes growth instead of curing illness.

30

Active Listening

• Paraphrase.Summarize the speakers words in your own

words.• Invite Clarification.Encourage the speaker to say more.• Reflect Feelings.Reflect what you’re sensing from the speakers

words and body language.

31

Existential Therapy

• Helps client explore meaning of existence

• Helps client choose a destiny

• Helps client accept self-responsibility.

32

Therapy in Social Context

• Family Therapy

• Family Kaleidoscope

• Family Systems

• Group Therapy

33

34

Communication ApproachVirginia Satir

• Offered description of conjoint family therapy

• Emphasized growth enhancing techniques to evoke feeling and clarify family communications patterns– (dance, massage, sensory awareness, group

encounter techniques)

35

Contextual Family TherapyIvan Boszormenyi-Nagy

• Effective family therapy must attend to family context especially to those dynamic and ethical connections – past, present, future – that bind families together

36

The Structural ApproachSalvador Minuchin

• The individual’s symptoms are best understood as rooted in the context of family transaction patterns.– The family’s hierarchical organization– The wholeness of the family system– The interdependent functioning of its subsystems

• EnmeshmentThe family boundaries are too diffuse to allow for individual autonomy

37

Strategic ApproachJay Haley

• The therapist devices a strategy for solving the client’s present problems

• Goals are clearly set

• Therapy is carefully planned to achieve these goals

38

Object Relations

• Introjects – the psychological representations of external objects

• The most powerful obstacle to change is people’s attachment to their parental introjects

39

Family Systems TheoryMultigenrationalMurray Bowen

• Conceptualizes the family as an emotional unit, a network of interlocking relationships, best understood when analyzed within a multi generational or historic framework

• Genograms

40

When Therapy Helps

• When clients have enough sense of self• When clients have enough distress to

motivate them to change• When therapists are warm and empathetic• When client and therapist establish a good

rapport• Hostile, negative clients are less likely to

benefit

41

When Therapy Harms

• Bias on the therapist’s part because of gender, religion, or race

• Coercion by the therapist to accept his/her advice

• Coercion by the therapist to have sexual intimacy

42

Alternatives to Psychotherapy

• Community Psychologists– Half-way houses– Clubhouse model– Foster care– Family support groups

• Rehabilitation Psychologists– Half-way houses– Clubhouse model– Foster care– Family support groups