Trreatment & Therapy (Chap 17)

Third Lecture Outline:

Group interventions

Community-based approachesEffectiveness of therapy

Psychotherapy videotape

Group therapy

• What group therapies are you aware of?

• Example: Parenting group

• Anger, Agoraphobia groups

• Advantages: Less expensive, group support, social pressure to change

• Disadvantages: Less intensive, conflicts within group, side-tracking

• Focus on teaching skills or support

Family Therapy

• Dad

Looses job

Dad

Looses job

Mom

Gets depressed

Joe

Trouble at School

Julie

Parent conflict

Couples therapy

• Focus on interpersonal communication – What does the other person think?

– How is your behavior actually seen by another?

– Concerns raised as “I feel” instead of “you should”

– Growth and change in relationship

• Empathy– What does the other person feel?

– What kind of behavior is “sensitive”

Treatment Effectiveness• Short-term treatment for common problems is usually

sufficient• Psychotherapy better than doing nothing• Motivation, therapeutic alliance, and (lack of) severity are

related to effectiveness• Therapy can be harmful if

– therapist is out of realm of competence– has biases against person– is behaving unethically (e.g., sexual intimacies with clients used

to be common, now seen as a most serious breech of professional responsibility)

– Problems are induced such as false memories for trauma

Effectiveness of an intervention

Group of 150

similar clients

Random assignment

Cognitive-Behavioral Therapy

Supportive counseling (Attention)

Wait-list control (Time)

Follow up

Follow up

Follow up

Client-intervention interaction

• Different therapies are effective for different people

• If you are verbal, “talking” therapy is fine because insight is needed

• If intelligence is low, behavioral approach may be more appropriate

• Group/couple therapy only if you have a group

• Self-help: Motivation, organization

Community psychology

• Example: Dealing with teen depression• Primary prevention

– Prevent disorders before they happen– Teens could have self-esteem groups in school

• Secondary prevention– Detect disorders early on– Screen for depression in schools using BDI

• Tertiary prevention: Treat known problems and thus “prevent” ongoing problem

Other community-based approaches

• “Hotlines” such as suicide hotlines, 911

• Trauma response teams in response to disasters– Psychologists were at Peggy’s Cove

• Community mental health clinics

• Support groups for high risk clients– Parents of chronically ill children

• Transition homes to deal with family violence

Self-help

• Bibliotherapy: Self-help books from the bookstore

• Surf the net: You can join “chat lines” of people with similar problems

• Videotapes: How to parent, how to communicate, how to be assertive are at “Blockbuster”

• Lifestyle: General health and fitness improves mental health