Psychotherapy Ch. 15

Music: “I Wanna be Sedated”

Ramones

“Just like a Pill” Pink

Today’s Agenda 1. Seeking Professional Help

When, where and how? Which therapy works best?

2. Different Therapeutic Approaches: i) Psychodynamic Therapy ii) Behavioural Therapies

Example of behavioural technique Movie: Virtual Reality Therapy (5 min.)

iii) Cognitive Therapy Distinction with CBT

iv) Client-Centered Therapy v) Biomedical Treatments

Movie: Deep Brain Stimulation (10 min.) 3. Basic Counseling Skills

1. Seeking Professional Help: When, Where and How?

When: 1. You’re feeling significant levels of discomfort 2. Your functioning is impaired 3. Someone else tells you that you need help 4. Have persistent suicidal thoughts

Where do you find help? Ontario Psychological Association: (416) 961-0069 Your physician can refer you Local Hospitals:

North York General 416-756-6316 Humber River Regional 416-747-3833

Distress Centers: (416) 598-1211 or (416) 486-1456 Counseling and Development Center: 736-5297 York University Psychology Clinic: 650-8488 Free online mental health advice and information for young people:

www.yoomagazine.net Costs?

1. Most people don’t get the help they need!

1. Which Therapy Works Best?

• Depends on the problem• Depends on the technique• Depends on the therapist

• But overall, studies show that different therapies have comparable results

• Common therapeutic ingredients:• Alliance with the therapist * • Emotional support and empathic understanding:

• Allowing emotions to be expressed• Rationale for one’s problems • Gaining new insights and new coping tools

2. Different Therapeutic Approaches

All approaches differ on: Assumptions regarding the origins of the problem Therapist’s stance Method of treatment Goals of treatment

2. i) Psychodynamic Therapy: Problem: resides in unconscious conflicts, repressed memories Therapist: “blank-screen” Method: free-association, dream analysis, transference analysis Goal: make the unconscious conscious Case illustration:

2. Different Therapeutic Approaches (cont’d)

2. ii) Behaviour Therapy Problem: resides in faulty learning Therapist: examines current conditions that elicit the

problem Method: apply learning principles to get rid of symptoms

training/ exposure/ counter-conditioning Goal: alleviate symptoms/ modify behavior

2. ii) Example of Behavioural Techniques

a) Systematic Desensitization: Effective with phobias Use “counterconditioning” Steps:

Set-up a hierarchy of anxiety-triggering situations Learn relaxation response Imagine least anxiety-provoking situation while maintaining a

relaxed state Imagine more difficult situations until most difficult is imagined

while maintaining a relaxed state Practice with real-life situations

b) “Virtual Reality Therapy for PTSD” 5 min.

2. iii) Cognitive Therapy

Problem: is a function of the way you think Therapist: more directive and challenging Method: Challenge your automatic

thoughts and underlying beliefs Use of homework exercises

Goal: Realistic thinking/ Better perspective p. 672

2. iii) Cognitive Therapy (cont’d)

Examples of cognitive techniques Clip: Tim http://www.youtube.com/watch?v=LIzm4jiyvXI&feature=related

Cognitive-Behaviour Therapy (CBT): Combines elements of both cognitive and behavioural therapies Recommended for depression and anxiety

http://www.youtube.com/watch?v=GqW8p9WPweQ&feature=related

Mindfulness-Based Cognitive Therapy: Learn to watch the contents of your consciousness and to bring

attention back to the “here and now” Prevents people from spiraling down and ruminating (getting

“caught” in their dysfunctional thinking)

2. iv) Client-Centered Therapy

Problem: incongruence with one’s true self Therapist: Non-directive, genuine,

empathic and unconditional Method: therapeutic relationship allows

fuller experiencing and greater acceptance of the self

Goal: self-actualization / greater congruence

2. v) Biomedical Approach

Problem: Chemical imbalance/ Structural abnormalities in the brain

Therapist: Medical doctor (family or psychiatrist) will monitor

symptoms and adjust medication/ monitor treatment Method: psychopharmacological drugs

Depression: Jogging, antidepressants, TMS, ECT, deep brain stimulation

Bipolar Disorders: Mood stabilizers, neuroleptics Anxiety: Tranquilizers Schizophrenia: Anti-psychotics (neuroleptics)

Goal: reduce symptoms Movie: “Deep Brain Stimulation” (10 min.)

3. Basic Counseling Skills

Or how to better help your family and friends: Try to listen and avoid giving advice Don’t express judgment Try to clarify the problem Empathize with the feelings Maintain confidentiality!

4. See you next week!