Psychotherapy

1

• Chapter 16
• Psychotherapy
• The Elements of the Treatment Process
• Therapy Types (Insight, Behavior, Biomedical,
  Blended)
• Application Looking for a Therapist

2
The Elements of the Treatment Process

• Treatments How Many Types Are There?
• All psychotherapies involve a helping
  relationship (treatment) between a professional
  (therapist) and another person in need of help
  (client).
• There are three main categories of therapy
• Insight therapies.
• Behavior therapies.
• Biomedical therapies.

3

• Clients Who Seeks Therapy?
• Approximately 15 of Americans seek mental health
  services each year.
• Most common problems are excessive anxiety and
  depression.
• Milder problems, including a career decision and
  relationships.
• Women, people with medical insurance, and people
  with more education are more likely to seek
  treatment.
• many who need therapy do not receive it

4

• Therapists Who Provides Treatment?
• Psychologists and psychiatrists are the most
  common providers of treatment.
• Therapy is also provided by
• Psychiatric social workers.
• Psychiatric nurses.
• Counselors and social workers
• Clinical psychologists and counseling
  psychologists specialize in the diagnosis and
  treatment of psychological disorders and everyday
  behavioral problems.

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• Psychiatrists are physicians who specialize in
  the treatment of psychological disorders.
• focus on more severe disorders
• earn an M.D. degree and typically emphasize drug
  therapies
• Psychiatric social workers work as part of a
  treatment team with a psychologists or
  psychiatrist.
• They have a masters degree and usually help
  patients integrate back into the community.
• Psychiatric nurses earn a bachelors or masters
  degree and usually work with hospitalized
  patients.

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Insight Therapies

• Insight therapies involve verbal interactions
  intended to enhance clients self-knowledge and
  thus promote healthful changes in personality and
  behavior.
• Insight therapies include
• Psychoanalysis.
• Client-centered therapy.
• Cognitive therapy.
• Group therapy.

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• Psychoanalysis was developed by Sigmund Freud,
  and emphasizes the recovery of unconscious
  conflicts, motives, and defenses through
  techniques such as free association, dream
  analysis and transference.
• Client-Centered Therapy (Carol Rogers) is an
  insight therapy that emphasizes providing a
  supportive emotional climate for clients, who
  play a major role in determining the pace and
  direction of their therapy.
• Group therapy is the simultaneous treatment of
  several or more clients (typically five to ten
  people) in a group

8
Behavior Therapies

• Insight therapists believe that behaviors are
  symptoms of underlying psychological issues.
• In contrast, behavior therapists argue that the
  behaviors themselves are the problem.
• Behavior therapies involve the application of
  the principles of learning to direct efforts to
  change clients maladaptive behaviors.

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• Behavior therapy is based on two assumptions
• Behavior is a product of learning.
• What has been learned can be unlearned.
• Clients vague complaints are redefined in terms
  of concrete, specific goals.
• Specific procedures are then used for specific
  kinds of problems to reach the goal.

10
Biomedical Therapies

• Biomedical therapies are physiological
  interventions intended to reduce symptoms
  associated with psychological disorders.
• Two prominent biomedical therapies are
• Drug therapy.
• Electroconvulsive (ECT).

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• Treatment with Drugs
• Psychopharmacotherapy (or drug therapy) is the
  treatment of mental disorders with medication.
• Therapeutic drugs fall into four main categories
• Antianxiety drugs.
• Antipsychotic drugs.
• Antidepressant drugs.
• Mood stabilizers.

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• Antianxiety drugs relieve tension, apprehension,
  and nervousness.
• Antipsychotic drugs are used to gradually reduce
  psychotic symptoms, including hyperactivity,
  mental confusion, hallucinations, and delusions.
• Antidepressant drugs gradually elevate mood and
  help bring people out of a depression.
• Mood stabilizers are drugs used to control mood
  swings in patients with bipolar mood disorders.

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• Electroconvulsive therapy (ECT) is a biomedical
  treatment in which electric shock is used to
  produce a cortical seizure accompanied by
  convulsions.
• ECT is primarily used to treat depression.
• Patients are given a light anesthetic and muscle
  relaxers to prevent spinal fractures.
• Electric current is applied for about a second,
  which triggers a brief seizure.
• Typically, patients receive six to twelve
  treatments over the course of a month.

14

• Blending Approaches to Treatment
• It is becoming increasingly common for therapists
  to draw from various therapeutic approaches to
  treat a client.
• Studies show that there is, indeed, merit to this
  idea.
• Today, most therapists describe themselves as
  eclectic drawing ideas from two or more
  systems of therapy.

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Application Looking for a Therapist

• When Should You Seek Professional Treatment?
• In general, you should seek treatment when
• You have no one to lean on.
• The people you do lean on are tiring of providing
  advice and emotional support.
• You feel helpless and overwhelmed.

16

• Where Do You Find Therapeutic Services?
• Most therapists do not operate in private
  practice.
• Many work in
• Institutional settings (such as community mental
  health centers).
• Human service agencies.

17

• Is the Therapists Profession or Sex Important?
• Researchers have not found any reliable link
  between the therapists profession (e.g.,
  psychologist versus psychiatrist) and therapeutic
  efficacy.
• This is a subjective matter.
• Thus, if the client thinks they will feel more
  comfortable with a therapist of the same gender,
  then they should find one that is the same gender.

18

• Is Therapy Always Expensive?
• Not necessarily. Costs can be reduced by
• Seeking treatment from providers who are not in
  private practice (e.g., human service agencies).
• Using health insurance.

19

• Is the Therapists Theoretical Approach
  Important?
• For certain types of problems, certain
  theoretical approaches are a better fit.
• For example
• Cognitive therapy is best for panic disorders.
• Behavior therapy (systematic desensitization) is
  best for phobias.
• OCD is best treated with behavior therapy and
  medication.

20

• What is Therapy Like?
• It is important to have realistic expectations
  about therapy.
• Therapy is usually a slow process.
• Therapy is hard work.
• Your therapist is only a facilitator. Ultimately
  you have to make changes in your behavior or
  personality in order to see improvement.