The treatment psychotherapy was fathered by Freud who took Josef Breurs research with Anna O that proved that talking to clients helped relieve some physical ailments.
How many types of treatments are there?
Procedures can be classified into three main categories; insight therapies, behavioural therapies, and biomedical therapies.
What are insight therapies?
This is the traditional Freudian “talk therapy”. This can be done on individual to individual or in groups.
What are behavioural therapies?
This is based off of learning. The psychotherapist tries to directly alter behaviour (phobias, maladaptive behaviour) through classical, operant, or observational conditioning.
What are biomedical therapies?
These therapies attempt to work on the biological level. Drug therapy and electro shock therapy are often in this category. There are limitations on what kind of psychological, usually only a psychiatrist or a person with a medical degree, that can conduct these sorts of therapies.
Who can provide treatment for mental disorders?
There are several ways to get professional mental health. However the two primary careers are for psychologists and psychiatrists. Clinical social workers, counsellors and marriage counsellors can also do some treatment.
What are psychologists?
There are two kinds that can provide therapy; clinical psychologists (treatment of full-fledged disorders) and counselling psychologists (everyday adjustment problems). Both require a doctoral degree, which is a highly competitive degree to get accepted into. It is followed by a one year internship. Their techniques are usually behavioural. However they also do psychological testing, psychotherapy and conducting of research.
What are psychiatrists?
This profession specializes in diagnosis and treatment of psychological disorders. The disorders they treat are often some of the more severe, such as schizophrenia. This profession requires an M.D degree, four years of course work in medical school, and a four year apprenticeship in a residency at a hospital. There is an increase in drug therapy in this profession. They use more psychoanalysis then psychologists.
What other kinds of people can provide professional treatment?
Clinical social workers: Masters degree. Work with patients to ease way back into community. Psychiatric nurses: hospital inpatient treatment. Bachelors or masters in their field.
Counsellors: Schools, colleges, youth centers, etc. Masters degree. Usually have a specific kind of counselling (marital, etc).
What are insight therapies?
These therapies use verbal interaction to solve the patients problems. There are several ways to go about doing this.
What is psychoanalysis?
This was developed by Freud. He believed that getting to the root problems hidden in the unconscious would alleviate psychological problems. These problems were often caused by our pleasure principle and the constant aggression between the Id, the superego and the ego. In order to hide some of our unconscious emotions we would use defence mechanisms.
What is the therapeutic procedure used in psychoanalysis.
Probing the unconscious is the technique that psychoanalysis uses. It relies on two things; free association and dream analysis. Often, transference is encouraged during sessions.
Free association is allowing the client to talk with no censorship. This often leads to the client pouring out very deep secrets, feelings or ideas.
Dream analysis is the training of clients to remember their dreams and recall them in sessions so that the counsellor can weed out hidden meanings or etc.
Transference is the process or behaviour that the client unconsciously starts treating his therapist as one of his relationship partners. So he or she might start treating the therapist like an overprotecting mother or inadequate father.
These processes are often meet with resistance, especially to the interpretations the counsellor has.
What is the psychodynamic approach to therapy?
Psychodynamic therapy is a modern version of Freud’s original psychoanalytical therapy. This was necessary to do for changing times and changing clientele. Such revisions where those that where made by Carl Jung and Alfred.
What is client-centered therapy?
This came from the human potential movement which was stimulated by Carl Rogers. It focuses on providing emotional support. The theory behind this therapy is in contradiction to Freud’s; people are anxious because they have an incongruence between their self-concept and reality and the fear of people telling you, or recognizing that. This is ultimately rooted in peoples need of acceptance from others. This is what client-centered therapy tries to stop and tries to, instead, foster personal acceptance and growth. An important factor of this therapy is therapeutic climate. Interpretation and advice on the part of the therapist is kept at a minimum.
What did Rogers mean by therapeutic climate?
Therapeutic climate is a climate of emotional security that is essential for the therapy to work. It was to be achieved in three ways;
Genuineness: Honest and spontaneous communication Unconditional positive regard: Acceptance of person. Empathy: Understand world from clients point of view.
What is the function of client-centered therapy?
The therapist is to act like a mirror to the client; bouncing back ideas, thoughts, or feelings with heightened clarity. This is supposed to help the client realize things and grow further.
What is emotion-focused couples therapy?
Helping couples work out what emotional needs are not meet in their relationship.
What is emotion-focused therapy?
Based off of the work of Carl Rogers, emotion focused therapy on acknowledging and working with the underlying emotions of the client.
What are positive psychology inspired therapies?
These therapies have grown from positive psychology (a psychology that looks at all the positive aspects of humans). In this field are therapies like well-being therapy and positive psychotherapy.
What is well-being therapy?
Created by Giovanni Fava it attempts to allow the person self-acceptance, personal growth and etc. Great for treatment of anxiety and mood disorders.
What is positive psychotherapy?
Created by Martin Seligman, it attempts to help the client recognize their strengths, find meaning in their life, try to make positive experiences and savour them as well as forgive those who have wronged them. It has proven to be very effective for depression.
What is group therapy?
This type of therapy came out during World War II and was based off of insight therapies. The only difference is that instead of one client the therapist treats several at a time.
What is the function of the participants in group therapy?
The participants are screened so that there will be congruency between the people. Most often you are not there for only yourself but to act as a therapist to the others as well. The therapists main responsibility lies in selecting the participants, making sure the participants are going in the right direction and protecting them from harm. The therapist and participants are mainly on equal footing with the therapist remaining mostly in the background and being a model for behaviour.
What are the advantages of group therapy?
Group therapy is often cheaper but it is also a good way to realize that you are not alone in your problems and have an opportunity to work on your social skills.
Why is evaluating treatment important and difficult?
The fact of the matter is that some patients have spontaneous remission. So after therapy you cannot always conclude that the disorder has passed because of the therapy. The difficulty in evaluating insight therapies in particular is the subjective nature of the therapy. Many client evaluations are slanted towards attempting to make the therapy sound better then it might have been just so they feel that the time and effort has paid off.
What is the general belief about insight therapies with evaluation?
Even though it is difficult, there have been evaluations that look at different aspects of insight therapies. Together they show that insight therapy is superior to no treatment or placebo treatment and that the effects are fairly stable. They show similar results to those of drug therapies.
What are the common practices between different approaches to therapy?
There are approximately five; 1) therapeutic alliance with the therapist, 2) emotional support and understanding from therapist, 3) beginning to hope and have positive expectations about ones life, 4) understanding what is causing anxiety and learning ways to get rid of it, 5) expression of feelings and learning new things
What are behaviour therapies?
Behaviour therapies treat the symptoms as the problem and not an extension of deeper issues. They attempt to treat maladaptive behaviour with the principles of learning. This approach came from the work of B.F. Skinner. It works on two assumptions; 1) that behaviour is a product of learning and 2) what has been learned can be unlearned.
What is systematic desensitization?
This was developed by Joseph Wolpe. This is a therapy that attempts to get rid of phobias their client may have by counter conditioning (learning relaxation instead of anxiety towards stimuli). In other words, it attempts to lessen the conditioned bond between a conditioned stimulus and response. This works great for phobic clients and other anxiety disorders
What is the process of systematic desensitization?
This therapy works in three ways;
1) You identify and make a list and/or rate stimuli that arouses anxiety. This is called an anxiety hierarchy.
2) Training of deep muscle relaxation
3) Imagining each stimulus on the hierarchy, the client attempts to remain calm while thinking of each by using the deep muscle relaxation techniques.
This is often followed by presentation of the real stimulus in order to see if the patient has gotten rid of the conditioned links.
What is aversion therapy?
This takes advantage of the physical nature of classical conditioning and attempts to pair current behavioural problems or etc with physically unpleasant responses (drugs that make you feel bad) in order to strengthen the bond between a behavioural problem and negative consequences. This works for drug and alcohol abuse, sexual deviance, gambling, stuttering, smoking and overeating.
What is social skills training?
Because people are not born great at socializing and have to learn to it may cause great anxiety to those who have not properly learned to. Hence this training works on the principles of operant conditioning and observational learning in order to help quell some of the anxieties people may be feeling due to lack of social skills. It emphasizes modelling, behavioural reversal and shaping.
1) Modelling: observational learning. The patient is encouraged to watch socially skilled friends at “work”
2) Behavioural reversal: role playing exercises where the patient is encouraged to try out techniques they’ve observed.
3)Shaping: are asked to handle more delicate and complicated real-life situations.
What are cognitive-behavioural treatments?
Uses verbal and behavioural modifications in order to change maladaptive patterns of thinking. This includes Albert Ellis’s rational emotive behaviour, Aaron Beck’s cognitive therapy (both from insight therapies), Donald Meichenbaum and Michael Mahoney have treatments that emerged from the behavioural tradition.
What is cognitive therapy?
This attempts to chance thinking patterns that underlie disorders. This was originally used more for depression. It uses modelling, systematic monitoring of behaviour and behavioural rehearsal.
How was cognitive therapy used for depression?
The idea was that depressed people where prone to certain negative types of feelings. There are four specific types; 1) blame experiences on their own personal inadequacies, 2) focus selectively on negative events, 3)are pessimistic about their future, 4) draw bad conclusions about themselves from insignificant events.
What is self-instructional training?
Made by Meichenbaum. This is where patients are taught to use verbal statements in order to help cope with difficult situations.
What are biomedical therapies?
These are psychical therapies that attempt to reduce the symptoms of disorders so that people can go on with their lives. Two most prominent types are drug therapies and electroconvulsive therapy (shock therapy).
What does drug therapy include?
There are three areas of drug therapies; anti-anxiety drugs, antipsychotic, and antidepressant (most widely prescribed).
Anti-anxiety drugs: relieve tension, apprehension and nervousness.
Valium (diazepam) and xanax (alprazolam).This is in the benzodiazepine family. Are often called tranquilizers. Immediate effects and relatively short- lived. Some have withdrawal symptoms when treatment stops. Common side effects include drowsiness, light-headedness, dry mouth and depression. Increase activity of GABA
Antipsychotic Drugs: reduce psychotic symptoms, including hyperactivity, mental confusion, hallucinations and delusions. Treatment of schizophrenia and severe mood disorders. Decrease dopamine synapses. Common side effects include drowsiness, constipation and dry mouth. Can produce symptoms of muscle tremors and impaired motor coordination. Can sometimes produce tardive dyskinesia, which is incurable. Take a while to take effect
Atypical Antipsychotic Drugs; clozapine, olanzapine, quetiapine. Have less side-effects. Treatment of schizophrenia.
These drugs are often more effective for positive symptom schizophrenia (hallucinations) not negative (absence of effect). Positive symptoms are probably induced by too much dopamine so antipsychotic drugs act as dopamine antagonists to decrease the amount. Negative symptoms on the other hand are seen as happening due to bran damage and enlarged ventricles.
Antidepressant Drugs: take a time to exhibit effect. Tricyclis (block reuptake of Norepinephrine and serotonin) ; fewer side-effects and complications than MAO inhibitors (allows transmitter to work for longer periods of time).
Selective Serotonin Reuptake Inhibitors (SSRIs); sloes the reuptake at serotonin synapses. Includes flexitime, paroxetine, sertraline. Less dangerous side- effects. Can treat OCD, panic disorders, anxiety disorders. May increase suicide risk, around 2-4% more than placebos.
SNRIs: Inhibit reuptake of serotonin and Norepinephrine. Venlafazine and duloxetine. Stronger but more side-effects.
Mood Stabilizers: Controls mood swings in bipolar people. Lithium; better for future episodes but can bring someone out of a current episode.
