Therapy Approaches • Biological Treatment • Surgery & Electroshock • Psychotherapy • The Power of Forgiveness 1 Biological Treatments Drugs • 1-Antipshchotic Drugs • 2-Antidepressant Drugs • 3-Tranquilizers • 4-Lithium Carbonate 2 1-Antipsychotic Drugs or Neuroleptics Good for treating psychosis and schizophrenia Examople: Thorazine Reduce receptivity to dopamine or increase serotonin Reduce positive symptoms of schizophrenia Do not relieve other negative symptoms Can have dangerous side effect: tardive dyskinesia & neurolyptic malignant syndrome 3 Antipsychotic Drugs and Schizophrenia • Good for reducing: • • • • • Offers little relief from: • Jumbled thoughts Agitation • Difficulty Delusions concentrating Hallucinations • Inability to interact Can shorten with others schizophrenic episodes 4 2-Antidepressant Drugs • • • • Treat depression, anxiety, phobias, OCD Example: Prozac, Zoloft, and Paxil Non addictive but can cause side effects 1-Monoamine oxidase inhibitors (elevate levels of ser. & nor. by blocking inhibitors) • 2-Tricyclic antidepressants (boost nor. & ser. by preventing their reabsorption) • 3-Selective serotonin reuptake inhibitors (work on serotonin) 5 3-Tranquilizers • Prescribed for depressed mood, panic, and anxiety • Example: Valium • Increase activity of neurotransmitter GABA • If overused can result in tolerance and withdrawal 6 4-Lithium Carbonate • Prescribed for bipolar disorder • Can be dangerous if not given in the right doze 7 Cautions about Drugs • • • • • • Placebo effect Relapse and drop out rates Dosage problems Long-term risks Overprescription Sometimes they have to be with therapy 8 The Placebo Effect Kirsch and Sapirstein (1998) • 7315 participants • 41% of those receiving antidepressants experienced reduced symptoms. • 31% of those given placebos also received reduced symptoms. 9 Surgery & Electroshock • Psychosurgery • Shock Therapy 10 Psychotherapy • Psychodynamic • Behavioral • Cognitive • Humanistic/Existential • Therapy in Social Context 11 Psychodynamic Therapy • • • • • • Probes the past Doesn’t tackle the immediate problem The goal is insight Takes a long time Explores the unconscious Methods: free association, interpretation of dreams, & transference 12 • Interpretation The analyst noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight. • Resistance In psychoanalysis, the blocking from consciousness of anxiety-laden material. • Transference The patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent) 13 Behavioral Techniques Learning Conditioning Association between Environmental Stimuli + Response Classical Conditioning Association Stimulus-Response Operant Conditioning Reinforcement/ Punishment 14 Behavioral Techniques • There are no mental processes (will, mind) • Derived from classical and operant conditioning • The focus is on changing the behavior • Works on the immediate problem • Focuses on the present 15 Classical Conditioning • Ivan Pavlov • Conditioning Learning that involves associations between environmental stimuli and the organism’s responses • Stimulus-response Learning 16 17 Classical Conditioning in Real Life • Learning to like • Learning to fear • Accounting for Taste • Reacting to Medical Treatment 18 Operant Conditioning • The behavior is more likely or less likely to occur based on its consequences. • B. F. Skinner modified Pavlov’s concept. • Skinner used reinforcement and punishment to enhance learning. 19 Skinner’s Box 20 Behavioral Techniques • Systematic Desensitization/Counter Conditioning • Aversive Conditioning • Exposure Treatment (Flooding) • Behavioral Records & Contracts • Skills Training 21 Systematic Desensitization • Fear of Flying – Read about safety – Look at pictures of airplanes – Visit an airport – Take a short flight – Take a long flight • Fear is extinguished • Counterconditioning 22 Cognitive Therapy • Albert Ellis (Rational Emotive Behavior Therapy) • Aaron Beck 23 Cognitive Distortions • • • • • • Labeling Mind Reading Exaggeration Unrealistic Expectations Belief in Entitlement Belief in Absolute Fairness 24 Fighting Dysfunctional Thought • Hot Thoughts • He is always mean to me. • I did a lousy job. • I deserve better. • It’s not fair. • That jerk! • They’re driving me crazy. • Cool Thoughts • Maybe he had a bad day. • It’ll be better next time • But people are people • Life is not fair. • It’s his problem! • Just don’t accept the ride. 25 Dysfunctional Thought Situation Emotion Automatic Cognitive Thought Distortion Rate 1-100% Fight with spouse Angry, 99% Sad, 50% -I’ll never have a normal marriage -I deserve better -He’s stubborn Rational Outcome Response Rate 0-100% Magnificat- -It’s not ion the end of the world Entitlement -That’s normal -Maybe Labeling he had a bad day Angry, 50% Sad, 10% 26 Humanistic/Existential Therapy • Works on self-fulfillment and selfactualization • Does not delve into the past • Helps the client think about the present and the future • Helps people feel good about themselves • Tackles conscious rather than unconscious thoughts 27 Carl Rogers Client-Centered Therapy Person-Centered Therapy • The therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to facilitate clients’ growth. 28 Carl Rogers Client-Centered Therapy • Offers unconditional positive regard • No specific techniques • Therapist should be warm, genuine and empathetic • Client adopts these views and becomes selfaccepting • Promotes growth instead of curing illness. 29 Effective Listening Client’s Remark Closed Response Open Response I can’t do it. Don’t talk like that. It seems very difficult to you. I will never be able to have a good life. We’ve discussed It may look very that before. Stop discouraging being negative. now. 30 Active Listening • Paraphrase. Summarize the speakers words in your own words. • Invite Clarification. Encourage the speaker to say more. • Reflect Feelings. Reflect what you’re sensing from the speakers words and body language. 31 Existential Therapy • Helps client explore meaning of existence • Helps client choose a destiny • Helps client accept self-responsibility. 32 Therapy in Social Context • • • • Family Therapy Family Kaleidoscope Family Systems Group Therapy 33 34 Communication Approach Virginia Satir • Offered description of conjoint family therapy • Emphasized growth enhancing techniques to evoke feeling and clarify family communications patterns – (dance, massage, sensory awareness, group encounter techniques) 35 Contextual Family Therapy Ivan Boszormenyi-Nagy • Effective family therapy must attend to family context especially to those dynamic and ethical connections – past, present, future – that bind families together 36 The Structural Approach Salvador Minuchin • The individual’s symptoms are best understood as rooted in the context of family transaction patterns. – The family’s hierarchical organization – The wholeness of the family system – The interdependent functioning of its subsystems • Enmeshment The family boundaries are too diffuse to allow for individual autonomy 37 Strategic Approach Jay Haley • The therapist devices a strategy for solving the client’s present problems • Goals are clearly set • Therapy is carefully planned to achieve these goals 38 Object Relations • Introjects – the psychological representations of external objects • The most powerful obstacle to change is people’s attachment to their parental introjects 39 Family Systems Theory Multigenrational Murray Bowen • Conceptualizes the family as an emotional unit, a network of interlocking relationships, best understood when analyzed within a multi generational or historic framework • Genograms 40 When Therapy Helps • When clients have enough sense of self • When clients have enough distress to motivate them to change • When therapists are warm and empathetic • When client and therapist establish a good rapport • Hostile, negative clients are less likely to benefit 41 When Therapy Harms • Bias on the therapist’s part because of gender, religion, or race • Coercion by the therapist to accept his/her advice • Coercion by the therapist to have sexual intimacy 42 Alternatives to Psychotherapy • Community Psychologists – – – – Half-way houses Clubhouse model Foster care Family support groups • Rehabilitation Psychologists – Epilepsy, physical injury, arthiritis, chronic pain 43 The Power of Forgiveness • Giving up grudges can reduce chronic back pain • Forgiveness limited the number of relapses among women battling substance abuse problems. • Using MRI scans to explore how just thinking about empathy and reconciliation sparks activity in the brains left middle gyrus, suggesting we all have a mental forgiveness center set to be tapped. 44 The Power of Forgiveness • Cortisol’s depressive effect on the immune system has been linked to serious disorders. • Forgiveness stops the cortisol and adrenaline from flowing. 45 American Psychosomatic Society A Study • 36 male veterans who had coronary artery disease and who were also burdened by other war-related issues • Those who received forgiveness training showed greater blood flow to the heart. 46