Psychotherapy involves a wide range of treatments

to help troubled individuals overcome their problems

Involves 3 things

a. Verbal interaction between therapist and client

b. Development of a supportive and trusting

relationship

c. Analysis by the therapist of the client’s problems

2. Nature of Psychotherapy

a. “Healing of the Soul”

i. Usually thought of a moral or religious

problem

ii. Inhabited by demons

iii. Treatments included exorcisms

a. Religious ceremonies or physical

punishment

iv.“Mental illness” is losing favor; may leave

the person feeling passive, even helpless

2. Nature of Psychotherapy

b. Functions of Psychotherapy

i. Help people realize that they are responsible

for their own problems

ii. Only they can solve those problems

iii. Major task of psychotherapist to help patient:

a. Examine their way of living

b. Understand how that way causes

problems

c. Start living in a new beneficial way

2. Nature of Psychotherapy

c. Main Kinds of Therapy

i. Each based on a theory of how human

personality works

ii. Each is carried out in a different style

iii. Many stick to one single approach, while

others are eclectic

2. Nature of Psychotherapy

d. Goals of Therapy

i. Primary Goal - Strengthen a person’s control

over their life

ii. One of the biggest factors in treatment is a

patient’s hope and belief that they will get

better – placebo effect

3. Who are Therapists

i. What Makes a Good Therapist

a. More skillful than friends in encouraging a

person to examine uncomfortable feelings

and problems

b. 3 Characteristics found in effective therapists

a) Be psychologically healthy

b) Have empathy – capacity for warmth and

understanding

c) Experienced in dealing with people and

understanding their complexities

4. Group Therapies

i. Patient is in the company of others not alone

ii. Chance to see others struggling with similar problems

iii. Sees others recovering and gets hope from that

iv. Family Therapy

a. Focus is on the interactions among family members

b. Untangles the twisted webs of relationships in the families

c. Psychologist is an objective viewpoint and can suggest ways

of improving communications

v. Self-Help Groups

a. Voluntary groups of people that share similar problems

b. Discuss difficulties and provide one another with support and

possible solutions

c. Alcoholism, overeating, drug addiction, child abuse, cancer

survivors, etc.

d. Most famous is AA

5. Does Psychotherapy Work?

i. Studies clash; yes and no

ii. Therapy can improve the quality of life for

patients and is better than no treatment at all

1. What is Psychoanalysis

i. Based on the theories of Sigmund Freud

ii. Psychoanalysis – therapy aimed at making

patients aware of their unconscious motives so

that they can gain control over their behavior

iii. Psychological disturbances are caused by

hidden conflicts

iv.Make patient aware of unconscious impulses,

desires and fears that cause anxiety

v. Insight – the apparent sudden solution to a

problem, first step to gaining control of their

behavior and problems

vi. Free Association

i. Psychoanalysis is a slow procedure

ii. Years of 50 minute sessions, several times a week

a. Average of 600 sessions and years of meeting

iii. Begins with the analyst having the patient relax and talk

about everything that comes to mind – Free

Association

a. Everything should be expressed; nothing too

unimportant or embarrassing

b. Describe dreams, private thoughts, long-forgotten

experiences

a. Analyst says nothing, most of the work is done by

the patient

c. Any behavior that impedes the course of therapy

(painful feelings or not examining long-standing

behavior patterns) is called resistance

vii. Dream Analysis

a. Freud also believed that dreams expressed

unconscious thoughts and feelings

b. Dream Analysis – analyst interprets the dreams of

the patient to find the unconscious thoughts and

feelings

c. Freud believed that dreams contained two types of

content

a) Manifest content

i. What you remember about your dream

b) Latent Content

i. Refers to the hidden meanings represented

symbolically in the dream that the analyst

interprets from the manifest content

viii. Transference – the process experienced by

the patient of feeling towards the analyst the

way they feel toward some other important figure

in their life

a. Can be good or bad

b. Analyst can’t let this happen

2. Humanistic Therapy

a. Focuses on the value, dignity and worth of each

person. It holds that healthy living is the result of

realizing one’s full potential

i. Can be reached through personal

responsibility, freedom of choice and

authentic relationships

2. Humanistic Therapy

b. Client-Centered Therapy

a) Based on theories of Carl Rogers

b) Uses “client” to imply an equal relationship

(returns: positive regard, empathy and

genuineness)

c) Assumes that people are good and that they

are capable of handling their own lives

d) One goal: to help a person recognize their

own strength and confidence, this way they

will learn to be true to their standards and

ideas about how to live effectively

2. Humanistic Therapy

b. Client-Centered Therapy

e) Techniques of Client-Centered Therapy

i. Topics are entirely up to the patient – nondirective

therapy

ii. Therapist listens and encourages but avoids giving

opinions

iii. Therapist echoes back what they hear – active

listening

iv. Client and therapist work together to see how the

client feels about themselves, their life and others.

v. Session held in an Unconditional positive regard –

therapists consistent expression of acceptance of the

client no matter what the client says or does

No opinions are made or spoken

All speech and actions are accepted

No emotion showed

Behavior Modification – a systematic method of changing

the way a person acts and feels

1. Cognitive Therapy

a. Focuses on changing the way people think

b. To improve our lives, we must work to change our

pattern of thinking

c. Disconfirmation – clients may be confronted with

evidence that directly contradicts their existing beliefs

d. Reconceptualization – clients work toward an

alternative belief system to explain their experiences or

current observations

e. Insight – clients work toward understanding and

deriving new or revised beliefs

1. Cognitive Therapy

f. Rational-Emotive Therapy –

form of help aimed at changing

unrealistic assumptions about

oneself and other people

i. Goal is to correct false and

self-defeating beliefs

a) Use of role-playing,

modeling, humor,

persuasion or a

homework type approach

1. Cognitive Therapyg. Beck’s Cognitive Therapy – Focuses on illogical

thought processes

i. Maladaptive Thought Patterns –

Overgeneralization, Polarized Thinking and

Selective Attention

2. Behavior Therapies – changing undesirable behavior through

conditioning techniques

i. Counterconditioning – pairs the stimulus that triggers an

unwanted behavior (or fear) with a new, more desirable

behavior

a. Systematic Desensitization – technique used to

overcome irrational fears and anxieties that patient has

learned

a) Encourages people to imagine a feared situation while

relaxing thus extinguishing the fear response.

b. Flooding – therapist exposes the client to a feared object

or situation

c. Modeling – therapist models/demonstrates behavior

d. Aversive Conditioning – links an unpleasant state with an

unwanted behavior in an attempt to eliminate that behavior

2. Behavior Therapies

ii. Operant Conditioning

a. Based on the assumption that behavior that is reinforced

tends to be repeated, whereas behavior that isn’t

reinforced tends to be extinguished

b. Contingency Management – therapist and patient decide

what old, undesirable behavior needs to be eliminated and

which new, desirable behavior needs to appear.

a) Old behavior is unrewarded and desired behavior is

positively reinforced

b) If you do X, I will give you Y

c. Token Economies – desirable behavior is reinforced with

valueless objects or points, which can be accumulated and

exchanged for various rewards

3. Cognitive-Behavior

Therapy – based upon a

combination of

substituting healthy

thoughts for

negative thoughts and

beliefs and changing

disruptive behaviors in

favor of healthy

behaviors

1. Biological Therapy

i. Assumes that there is an underlying

physiological reason for disturbed

behavior, faulty thinking and inappropriate

emotions

ii. Medication, shock therapy and surgery are

examples

iii. Psychologists may decide that a biological

approach is necessary but a physician or

psychiatrist administer them

2. Drug Therapy – biological therapy that uses medications

● Usually only treats the symptoms but doesn’t cure the cause

● Anti-Psychotic Drugs – medication to reduce agitation, delusions and

hallucinations by blocking the activity of dopamine in the brain, tranquilizers

a) Long time use for dangerous and overactive schizophrenics

was straightjacket, wet-sheet wrapping or isolation

b) Calmed by ECT or lobotomy

c) Now (with meds) become less withdrawn, confused and

agitated, fewer auditory hallucinations, less irritable and

hostile

d) Theory

a) When a person’s dopamine neurotransmitter becomes

overactive, the person develops schizophrenia

e) Side effects

a) Muscular rigidity, impaired coordination and tremors

f) Best Known

a) Thorazine, Haldol, Closaril

iii. Anti-Depressant Drugs – medication used to

treat major depression by increasing the

amount of one or both of the neurotransmitters

noradrenaline and serotonin

a) Side effects

i. Dizziness, fatigue, forgetfulness, weight

gain

b) Best Known

i. Nadril, Prozac

iv. Lithium Carbonate – Chemical used to

counteract mood swings of bipolar disorder

(natural compound)

v. Anti-Anxiety Drugs – Medication that

relieves anxiety and panic disorders by

depressing the activity of the central nervous

system

a) Best used for acute not chronic anxiety

b) Side effects

i. Short term – drowsiness

ii. Long term – dependence and with

alcohol death results

c) Best Known

i. Xanax, Librium, Valium

2. Electroconvulsive Therapy – electrical shocks sent through

the brain to try to reduce symptoms of mental disturbance

i. No one understands how it works, it induces a

convulsion like an epileptic seizure that may last up to a

minute

ii. Used lots in the past

iii. Very little pain today due to sedatives and muscle

relaxants

iv. Drastic treatment, used with great caution today

v. Current was run through both hemispheres of the brain,

now only through the right hemisphere

vi. Side effects

a. Extensive amnesia

b. Language and verbal abilities

vii.Highly effective for depression

3. Insulin Shock Therapy– a form of psychiatric

treatment in which patients were repeatedly injected

with large doses of insulin in order to produce daily

comas over several weeks.

4. Psychosurgery – medical operation that

destroys part of the brain to make the patient calmer

and freer of symptoms

i. Prefrontal Lobotomy – section of the frontal

lobe of the brain is destroyed;

contains the nerve connections that control

emotions