Therapy

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Therapy
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What is Psychotherapy?

• A partnership between an individual and a
  professional such as a psychologist who is
  licensed and trained to help people understand
  their feelings and assist them with changing
  their behavior (APAs website).
• Psychotherapy is NOT advice-giving, fixing a
  persons problems for them, only for crazy
  people.

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Who Can Provide Psychotherapy?

• Licensed Psychologists or, rarely, Psychiatrists
• Licensed Social Workers (LMSW or LCSW)
• Licensed Professional Counselors (LPC)
• Licensed Marriage and Family Therapists (LMFT)
• Other individuals (such as those who are not
  licensed as mental health professionals) can
  provide therapy, but it is best to seek someone
  who is licensed in some field

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What Happens During Psychotherapy?

• What actually occurs in therapy depends a great
  deal on what approach the therapist uses, but
  there are some things they all have in common.
• The therapist listens to the client, tries to get
  to know them and understand their problems and
  concerns, helps the client decide what they hope
  to gain from therapy, and then works to help the
  client understand and change the thoughts,
  feelings, and/or behaviors contributing to the
  problem.

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Psychoanalysis

• The goal of psychoanalysis is to make the
  unconscious conscious, meaning to increase
  awareness of unconscious needs, desires, and
  wishes.
• Freud believed that, as ones insight into
  oneself increased, symptoms such as depression
  and anxiety would begin to decrease.
• Contrary to what your book may say, the focus is
  not exclusively on childhood! Patients often
  discuss current problems in sessions.

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Psychoanalysis

• Several methods of accessing unconscious material
  are used, including free association (saying
  whatever comes to mind) and dream analysis.
  Eventually, analyst begins offering
  interpretations of what the dreams or
  associations might mean, with the help of the
  patient.

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Transference

• An important part of analysis is analyzing the
  transference relationship.
• Transference occurs when the patient reacts to
  the therapist based on unresolved issues from
  another relationship.
• Transference occurs in all relationships, not
  just therapy. E.g., if your father was demanding
  and controlling, you may react (overreact!)
  harshly to anything you perceive as controlling
  in your relationships, even if that is not the
  other persons intention.

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Psychodynamic Therapy

• Psychodynamic therapy includes all therapies
  based on the idea that people sometimes act from
  unconscious motivations. Again, does not mean it
  focuses on childhood!
• For example, looking at connections between past
  relationships, present relationships, and their
  relationship with the therapist may allow the
  client to gain insight into some patterns across
  situations that they may have been enacting
  without thinking (unconsciously).

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Humanistic Therapies

• Humanistic therapies focus on creating the right
  therapeutic situation to allow a persons natural
  growth and self-actualization to occur.
• Most commonly used is Rogers person-centered
  therapy. Therapist offers empathy, genuineness,
  and unconditional positive regard. Rogers
  believed these conditions were necessary and
  sufficient for change to occur in therapy.

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Behavior Therapies

• Behavior therapy is therapy based on the
  principles of learning, such as the classical and
  operant conditioning principles discussed earlier
  in semester.
• Insight or understanding are not goals of
  behavior therapy behavior change and symptom
  relief are the goals.

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Therapy Based on Classical Conditioning
Systematic Desensitization

• Based on the assumption that you cannot
  simultaneously be anxious and relaxed. Learn to
  associate the feared stimulus with a relaxation
  response to change the conditioning.
• First, anxiety hierarchy created, from least
  feared to most feared stimuli progressive
  relaxation is taught. Then, therapist helps pt.
  work his/her way up the anxiety hierarchy until
  they can imagine each stimulus and remain relaxed
  at the same time.

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Therapy Based on Classical Conditioning Flooding

• Another form of counterconditioning (changing the
  conditioning that has paired anxiety or fear with
  a given stimuli, such as a spider) is flooding.
• In flooding, the person is exposed to the feared
  stimulus all at once for a long period of time
  until the connection between the stimuli and fear
  is broken (extinction takes place).

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Therapy Based on Classical Conditioning Aversive
Conditioning

• Aversive conditioning occurs when the therapist
  tries to associate an unpleasant state with an
  unwanted behavior.
• Examples include associating nausea with alcohol
  use (Anabuse), or associating shocks with
  inappropriate arousal in sex offenders.
• Usually not effective in the long term, so often
  used in conjunction with other methods if used at
  all.

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Therapy Based on Operant Conditioning Behavior
Modification

• In behavior modification, reinforcers or
  punishers are used consistently to reward desired
  behavior or punish unwanted behavior.
• One example of a reinforcing is when a token
  economy is used this means that each good
  behavior gets a small token that can be saved and
  later spent as money to buy various rewards.

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Cognitive Therapies

• Cognitive therapists believe that our thoughts
  about ourselves and others impact on our feelings
  and behavior it is not the things that happen
  but our interpretation of those things that cause
  us pain, problems.
• Often, they work to help people change their
  self-talk, or internal dialogue, making it less
  negative and more positive.
• Often used to treat depression.

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Group and Family Therapies

• Many of these approaches can also be used with
  groups. Group often focuses on the dynamics
  between the members and serves to help people
  work on their relating and interacting skills.
• Family therapy works from different theories that
  look at the family as a single, functioning unit
  and attempt to treat it as such.

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Evaluating Therapy

• To sum up the many studies that have been done
  into therapy, some of which were discussed in
  your book in greater detail
• Overall, therapy tends to be helpful to people,
  and, although some types of therapy may work
  slightly better with some problems, all forms of
  mainstream therapy seem to be about equally
  effective for most people.

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Common Factors in Therapy

• Hope that something can change, that things can
  be different.
• The knowledge that someone cares and wants you to
  be better.
• An empathic, trusting relationship in which you
  feel you can share without being judged harshly.
• A new perspective on problems from an unbiased,
  outside source.