Psychological Therapies
History of Treatment Video
Trephing – YouTube (2:00)??
Early Treatment of Mental Disorders
For The Incurable Insane
Dorothea Dix- reform treatment of
mentally ill.
 Pinel – The medical Model which
changed the paradigm (view) of
mental illness as a curable disease
just some physical diseases.




Deinstitutionalization
 1950’s because of development of
drugs (especially anti-psychotic),
local clinics did not take care of led to
boom in homeless population. (686)
 Sick: A Documentary
 YOUTUBE: Bellevue inside and out
Preventative efforts (suffering and costs will be
less if we can be proactive with treatment.)
 Primary- decrease joblessness, homelessness,
prejudice, economic inequality, HS drop out
rates.
 Secondary- treat at-risk such as PTSD for war
veterans, traumatic event survivors,
community health.
 Tertiary- those with disorders that could get
worse without treatment.
Psychotherapy
 Psychotherapy – an emotionally
charged, confiding interaction
between a trained therapist and
someone who suffers from
psychological difficulties.
 At least 250 types of
psychotherapies exist
 Most influential – Psychoanalytic,
Humanistic, Behavioral, Somatic
and Cognitive
 Many therapists today use an
eclectic approach – using
techniques from various therapies
Types of Therapists
 Psychiatrists – medical doctors, can
prescribe medication, oftentimes favor the
biomedical model
 Clinical psychologists – doctoral degrees
in psychology
 Counseling psychologists – graduate
degrees in psychology
 Psychoanalysts – people trained in
Freudian methods (may or may not hold
medical degrees)
Psychoanalysis
 Sigmund Freud’s therapeutic
technique.
 Cause of psychological disorders Repressed conflicts (in the
unconscious)
 Focus – Identify the underlying cause
of the problem
 Must find the underlying cause, otherwise
you are simply treating symptoms of the
disorder and not the disorder itself.
 To release repressed feelings and thus
allowing the patient to gain self-insight.
Sybil and Psychoanalytic
Treatment using Hypnosis
 Sybil and Hypnosis: Psychologist
trying to figure out what causes
Sybils’ Dissociation. Sybil is unaware
of other personalities. She is unaware
of the abuse that her mother did to
her. Therapist is beginning to make
breakthrough.
 Video: beginning Part 2 (11:00)
Psychoanalysis
 Techniques – (Insight Therapies)
 Free Association – saying whatever comes to mind
(thought, feeling or image)
 Resistance – blocks in the flow of a free association
(evidence of anxiety and repression), could also refer to
a patient’s tendency to disagree with the therapist’s
interpretation
 Psychoanalysts will oftentimes use interpretation to
analyze a resistance.
 Transference may occur – patient redirects emotion
from their troubled relationships to their therapist (love
or aggression)
 Analysis of a dream’s latent content
 Psychodynamic Therapy – Search for repressed
childhood experiences that explain current
symptoms. (Practiced by Neo-Freudians)
Ordinary People and
Psychoananlysis
 Ordinary People. Best Picture 1981
Upper class family Conrad 17 years
old who just returned from spending
3 months in a mental institution after
he tried to kill himself. Suffering from
depression (quit the swim team) lost
interest in friends, activities, weight
loss, sleeping 12 hours per day.
Ordinary People and
Psychonanlysis
 During that time the mother never came
to visit him in the hospital. He also
suffers from PTSD the event was a
boating accident which killed his older
brother. He begins to see a
psychotherapist that comes from the
psychoanalytic perspective. Also uses a
little Cognitive Therapy in which he
challenges the assumptions, way of
thinking of Conrad.
Insight Therapies
 Freudian Slips
 Hypnosis
 Assignment: During these clips find the
following:
 Sybling Rivalry (Neo-Freudian)
 Resistance Transference
 Freudian Slips
 Cognitive Therapy
Psychoanalysis and Ordinary
People.
(
 Ordinary People part 8 – YouTube
 ordinary people part 10 – YouTube
(begin 4:00)
 Ordinary People Conrad's
Breakthrough
Humanistic Therapy
 Cause of psychological disorders –
failure to strive towards one’s
potential. (Patient has the opportunity
to change due to free-will)
 Focus – Goal is to encourage selffulfillment by the therapist helping
the patient grow in self-awareness
and self-acceptance
Humanistic Therapy
 Techniques –
 Client-centered therapy (Carl Rogers)
 Focus on client’s conscious self-perceptions
rather than therapist’s interpretations
 Therapist is empathetic, genuine and offers
unconditional positive regard
 Use active listening – repeating what you’ve
heard (Re: p. 664)
 Carl Rogers Client Centered Therapy
Beginning 1:30
Gestalt Therapy
 Gestalt therapy
 Developed by Fritz Perls
 Get in touch with your whole self Encourage their client to integrate
all of their actions, feelings and
thoughts into a harmonious whole.
 - Gestalt Therapy (1:50)
Humanistic Therapy
 Existential therapy – helping clients achieve a
subjectively meaningful perception of their lives.
 Believes client’s problems are due to loss of purpose
 Therapist helps client form a worthwhile vision
 Group Therapy – people meet regularly (with those
with similar issues) to interact and help one another
achieve insight into feelings and behaviors.
 Ex. Family Therapy
 Ex. Couple Therapy
 Ex. Self-help groups – AA
Behavior Therapy
 Cause of psychological disorder – due
to the environment and can be
changed with a change in one’s
surroundings . People have been
conditioned into a behavior
 Focus – apply learning principles
(Operant and Classical Conditioning)
to eliminate unwanted behavior,
replace maladaptive symptoms with
constructive behavior
Behavior Therapy
 Techniques
 Counter conditioning - reversing the present
conditioned response. (Classical Conditioning)
 Systematic Desensitization – conditioning a patient
to replace anxious feelings with relaxed feelings. (used
to treat phobias)



Anxiety (fear) hierarchy – ranking fear of a particular
object/experience from least to most fear provoking P.667
Exposure Therapy – treating anxiety through exposure to
that which you normally avoid (in imagination or actuality)
Ex. – virtual reality therapy . Treating Arachnophobia
Implosive Therapy – exposure to the most frightening
scenario first. Client should eventually realize that their
behavior is irrational. Intensive Exposure Therapy
 Aversive Conditioning - An unpleasant state is
associated with an unwanted behavior. (Ex. Shocking
bed wetters, pill causing nausea in an alcoholic's drink,
terrible tasting nail polish for nail biting)
Behavior Therapy
 Techniques
 Modeling – observe appropriate
behavior and then reenact that behavior.
 Ex. Watch people who act calm and you
will act calm.
 Token Economy - Rewarding desired
behavior (operant conditioning) Ex.
Reward a child with ADHD when they
takes notes and participate in class.
Reward could be candy, points, etc.)
Cognitive Therapy
 Causes of psychological disorders –
irrational or dysfunctional ways of
thinking. A Patients interpretation of
events including a realistic appraisal
of the consequences. Ex. Biff thinks “I
will never get another girlfriend
again”
 Focus – teaching clients new and
rational ways of thinking
Cognitive Therapy
 Techniques –
 Aaron Beck’s Cognitive Therapy – seek to reverse
client’s beliefs about themselves, their situations and
their futures.
 Read dialogue on page 670
 Changing negative thoughts to more positive thinking.
 Ex Halle Berry
 Albert Ellis’ Rational Emotive Therapy (RET) –
therapist points out dysfunctional thinking. Many
patients in therapy have an irrational set of beliefs
that include “musts? and “shoulds” (Ex. I should be
competent at everything. I must be liked by
everyone.) Therapists challenge this thinking.
 Ellis’s RET is more confrontational than Beck’s CT
 Re: P. 669 bottom
 Ellis and Gloria
Stress Inoculation Therapy
 Changing the conversations that one
has in his/her head.
 Ex. Ben Stein, Alex Rodriquez
Biomedical (Biological /
Somatic Therapy)
 Causes of psychological disorders –
genetic predisposition to the disorder,
biochemical (neurotransmitter)
imbalance
 Focus – advocate somatic therapies
that produce bodily change.
How Psychoactive Drugs work
LIVE!Psych
Biomedical (Biological /
Somatic Therapy)
 Techniques –
 Prefrontal lobotomy - cutting the nerves
connecting the frontal lobes with the inner
brain’s thalamus.
 Rarely used today – but in the 1940s and 1950s
– thousands of lobotomies were administered
 Used on patients with extreme schizophrenia,
high anxiety or uncontrollably violent patients.
 Lobotomy - PBS documentary
 Electroconvulsive Therapy (ECT) – brief
electric current is sent through the brain of an
anesthetized person.
 maj depressive disorder and ECT
 Used for severe depression
ECT
Biomedical (Biological /
Somatic Therapy)
 Psychopharmacology (Drug Therapy) – the
study of the effects of drugs on the mind and
behavior (p. 686 – review double-blind
technique)
 Antianxiety drugs – Xanax, Valium
(barbiturates) – depress the central nervous
system (Re:p.687)
 Antidepressant drugs – Prozac, Zoloft, Paxil
(all three are SSRIs – increase the amount of
serotonin) MAO inhibitors (inhibits the
breakdown of serotonin)- Do antidepressants
help teens or hurt them Re: 686)
 Antipsychotic drugs – Thorazine
(Chlorpromazine), Haldol (Haloperidol)– block
receptor sites for dopamine – Antagonist drugs
 Mood Stabilizers – Lithium (used to treat
bipolar disorder)
review
 YOUTUBE- Bellevue- inside and out