METHODS OF THERAPY

WHAT IS THERAPY? Therapy is a general term for the variety of approaches that mental health professionals use to treat psychological problems and disorders.

All therapies fall into two categories: psychologically based therapy and biologically based therapy.

Psychologically based therapy, known as psychotherapy, involves verbal interactions between a trained professional and a person (client or patient) who is seeking help for a psychological problem.

Biologically based therapies involve the use of drugs or other medical procedures to treat psychological disorders.

GOALS OF PSYCHOTHERAPY Help troubled individuals by giving them hope for recovery; helping individuals gain new insights or perspectives on their problems; and providing the individual with a caring, trusting relationship with a mental health professional.

Bring about changes in the individual seeking help.

TYPES OF MENTAL HEALTH PROFESSIONALS

Counseling Psychologist- Master’s degree or Ph.D. (Doctorate) in counseling psychology. Usually works in educational or business setting. Refers serious cases to a clinical psychologist.

Clinical Psychologist- Ph.D. in Psychology. Works in hospitals and clinics; assists and treats people with psychological problems.

Psychiatrist- M.D. with a specialization in psychiatry and postgraduate training in abnormal behavior. Able to prescribe medicine and perform operations.

Psychiatric social worker- Master’s degree in social work with additional practical training and two years of graduate-level courses in psychology.

Psychiatric nurse- Standard nursing license with advanced training in psychology. Dispenses medicine and acts as a contact person between counseling sessions.

INDIVIDUAL VERSUS GROUP THERAPYIndividual Therapy Some people need more personal attention than they would receive in a group.

Some feel uncomfortable talking in front of a group.

It is more expensive. Some switch from individual to group.

Group TherapyIt helps people realize they are not alone.Members benefit from the insights gained by other group members who have gone through similar struggles.Members can support each other.Members can see therapy works as they see others recovering.It is more affordable.

THE PSYCHOANALYTIC APPROACH

FREE ASSOCIATION In free association the analyst asks the client to relax and then say whatever comes to mind.

The topic may be a memory, dream, fantasy, or recent event.

The idea is that as long as the client is associating freely, unconscious thoughts and feelings break through in what the client says.

Resistance is the term psychoanalysts use to refer to a client’s hesitancy to discuss issues raised during free association.

DREAM ANALYSIS In dream analysis, the analyst interprets the content of clients’ dreams to unlock their unconscious thoughts and feelings.

Manifest content refers to actual content of the dream as it is remembered by the client.

Latent content refers to hidden meaning in dreams.

TRANSFERENCE Many clients begin to view their relationship with their analyst as similar to one they have or had with another important person in their lives, often a parent.

They feel similar feelings towards the analyst and expect the analyst to feel and behave just as the other person did.

In other words, the client is transferring feelings and emotions from one person to another. This process is called transference.

The analyst remains neutral and helps the patient examine their feelings.

The patient gains insight and begins to understand their problems.

THE HUMANISTIC APPROACH

WHAT ARE THE GOALS OF HUMANISTIC THERAPY?

The primary goal of humanistic therapy is to help individuals reach their full potential by helping develop self-awareness and self acceptance.

The belief is that people strive for self-actualization, that is, to become all that they are capable of being.

The method also assumes that people with psychological problems merely need help tapping into their inner resources so that they can grow and reach their full potential.

PERSON-CENTERED THERAPY

In person-centered therapy it is believed that psychological problems arise when people stop being true to themselves and instead act as others want or expect them to act.

The role of the therapist is to help clients find their true selves and realize their unique potential.

In nondirective therapy, clients are encouraged to take the lead in the therapy with the therapist acting as a mirror, reflecting clients’ thoughts and feelings back so the client can see themselves more clearly.

TECHNIQUES OF PERSON-CENTERED THERAPY Active listening is a widely used communication technique in which the listener repeats, rephrases, and asks for clarification of the statements made by the speaker.

The goal is to convey to the speaker that his words are being heard and his thoughts and feelings are being understood.

The therapist must also remain nonjudgmental and supportive regardless of what the client says. This is known as unconditional positive regard. The acceptance and support of the therapist helps the client accept himself or herself and his or her true feelings.

This gives the client the confidence to make tough decisions, take responsibility, and form healthy relationships.

COGNITIVE THERAPY

WHAT ARE THE GOALS OF COGNITIVE THERAPY?

The goals are to help people to learn to think about their problems in more productive ways.

Cognitive psychologists focus on beliefs, attitudes, and thought processes that create and compound their client’s problems.

They believe that some people develop ways of thinking that are illogical.

This can lead to emotional and behavior problems for these people.

Cognitive therapists help people change their way of thinking.

They also help people develop more realistic and logical ways of thinking.

Then the patient is more capable of solving their emotional and behavioral problems.

RATIONAL-EMOTIVE BEHAVIOR THERAPY

REBT is based on the belief that people are basically logical in their thinking and actions.

However, sometimes assumptions upon which they base their behavior are incorrect.

People may develop emotional problems when they base their behavior on these faulty assumptions.

The role of the therapist is to identify and then challenge the false assumptions.

They use role-playing and modeling techniques.

BECK’S COGNITIVE THERAPY Beck’s cognitive therapy is based on restructuring illogical thought processes.

Several illogical thought processes have been noted that lead to emotional problems including:

Arbitrary Inference- drawing conclusions from where there is no evidence. For example, when a teacher passes a student in the hall and does not say hi, the student may arbitrarily conclude that the teacher will fail her.

Selective Abstraction- Drawing conclusions based on a single detail or ignoring other details. For example, a person looks in the mirror and instead of seeing all of the good features, only sees the zit on their chin.

Overgeneralization- Drawing a general conclusion from a single experience. For example a person may conclude they are worthless because they failed one test.

Therapist’s gently guide clients in testing the logic of their thoughts and developing more logical ways of thinking.

BEHAVIOR THERAPY

WHAT ARE THE GOALS OF BEHAVIOR THERAPY?

The goal of behavior therapy, which is called behavior modification, is to help people develop more adaptive behavior.

Behaviorists believe that behaviors are largely learned and that people with psychological problems have learned unhealthy ways of behaving.

The aim of behavior therapy is to teach more desirable or healthier ways of behaving.

For behaviorists, the reasons for the behavior are unimportant. Changing the behavior is what matters.

COUNTERCONDITIONING Counterconditioning assumes that the undesirable behavior is learned and therefore, can be unlearned.

Systematic desensitization has the therapist train the client to relax in the presence of an anxiety-producing situation. The person is trained to respond with relaxation until the stimulus no longer causes anxiety.

Aversive conditioning works the opposite way. The therapist replaces a positive response to a stimulus to a negative response. For example, for a person who wants to stop smoking, the pleasant smoking feelings would be replaced with unpleasant ones.

OPERANT CONDITIONING Operant conditioning is based on the assumption that behavior that is reinforced tends to be repeated and behavior that is not reinforced tends to be extinguished.

Behavior therapists reinforce desired behavior with rewards and at the same time withhold reinforcement for undesired behavior.

A token economy is used in some mental hospitals. When people demonstrate desired behavior they are given a plastic coin. Accumulated coins can be exchanged for snacks, extra TV time, trips to town, or a private room.

Successive approximations refers to a series of behaviors that gradually become more similar to a target behavior.

For example, a student wants to increase studying to 2 hours a day. However, he is not used to more than 30 minutes and then loses concentration. Each night he adds 5 minutes to his study time, and each time he reaches his new goal he reinforces his behavior with a small reward. Within a few weeks he is studying 2 hours a night.

BIOLOGICAL THERAPY

DRUG THERAPY Drug therapy is the most widely used biological treatment for psychological disorders.

It works well for several different problems.

Four major types of medications are commonly used: antianxiety drugs, antidepressant drugs, lithium, and antipsychotic drugs.

All of these medications require a prescription.

ANTIANXIETY DRUGS Also known as tranquilizers, antianxiety drugs are used to help people with anxiety disorders or panic attacks.

Antianxiety drugs work by depressing the activity of the nervous system. They lower the heart rate and respiration rate. They also decrease feelings of nervousness and tension.

These drugs are not a cure, but they help with the symptoms while the patient goes to psychological therapy.

ANTIDEPRESSANT DRUGS People who suffer from major depression are often treated with antidepressant drugs.

Theses drugs work by increasing the amount of one or both neurotransmitters norepinephrine and serotonin.

In order to work effectively, the medications must build up in the body to a certain level. This may take anywhere from several days to several weeks.

LITHIUM Ancient Greeks and Romans used the metal lithium to treat psychological disorders.

Lithium carbonate, a salt of the metal is given in tablet form to help people with bipolar disorder. It flattens out their cycle of mania and depression.

It affects the function of neurotransmitters.

ANTIPSYCHOTIC DRUGS People with schizophrenia are likely to be prescribed antipsychotic drugs.

They are effective for reducing agitation, delusions, and hallucinations.

They work to block activity of dopamine in the brain which is in high levels in schizophrenics.

ELECTROCONVULSIVE THERAPY

ECT has been used since the 1930s.

Before ECT, anesthesia is administered. Then an electric current is passed through the brain. The electric current produces convulsions throughout the body.

ECT has been used less as antipsychotics became available.

Some have complained of memory loss yet ECT has been very effective with some patients.

PSYCHOSURGERY Psychosurgery is brain surgery that is performed to treat psychological disorders.

The best known technique is the prefrontal lobotomy, which has been used to reduce the agitation and violence of people with severe psychological disorders.

This is very rare now and some times ECT is used instead. Much more common is medicine and/or psychotherapy.