Ciccarelli Chapter 15 Son
Ciccarelli Chapter 15 Son
Ciccarelli Chapter 15 Son
Chapter 15
Psychological Therapies
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Psychological Therapies Video
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Treatment of Psychological
Disorders: Past to Present
• Prior to the late 1700s, those suffering from mental
illness were thought to be possessed by demons or
evil spirits and «treatment» was deadly.
• Bethlehem Hospital in London;
- first organized effort for mental illnesses
- patients were chained to beds
- treatments were severe and deadly (bloodletting,
beatings, ice – baths, induced vomitting etc)
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Psychotherapy Begins: Freud’s
Psychoanalysis
Psychoanalysis: Insight therapy based on the theory
of Freud, which emphasizes revealing of unconscious
conflicts ,urges, and desires that are assumed to cause
disordered emotions and behaviour.
Psychotherapy often takes place one on one, with a client and therapist exploring various issues
together to achieve deeper insights or to change undesirable behavior.
https://youtu.be/HrClyDVL43I?si=UudlCAqpipyQOwqF
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Humanistic Therapy: To Err is Human
• Humanistic therapies focus on;
- Person-centered theraphy
- Gestalt theraphy
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Humanistic Therapy: To Err is Human
• Person-centered therapy: a nondirective insight
therapy in which the client (not patient) does much
of the talking and the therapist listens
– based on the work of Carl Rogers
– examines how person experiences real self v.s ideal self
– goal of therapist should be to provide unconditional positive
regard to help client recognizes the mismatch between real
self and ideal self
– Nondirective: therapy style in which the therapist remains
relatively neutral and does not interpret or take direct
actions with regard to the client, instead remaining a calm,
nonjudgmental listener while the client talks
A Rogerian person-centered therapist listens with calm acceptance to anything the client says. A
sense of empathy with the client’s feelings is also important.
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Humanistic Therapy: To Err is Human
• Gestalt therapy: form of directive insight therapy in which
the therapist helps clients accept all parts of their feelings
and subjective experiences, using leading questions and
planned experiences such as role-playing
• Gestalt therapy
- https://youtu.be/Ugv4Nns0XGc?si=0hwASPtm_vQK-Dp7
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Humanistic Therapy: To Err is
Human
In Gestalt therapy, it is not unusual to find a client talking to an empty chair. The chair represents
some person from the past with whom the client has unresolved issues; this is the opportunity to
deal with those issues.
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Action Therapies: Behavior
Therapies and Cognitive Therapies
• Action therapies focused on changing the
behavior itself
– Behavior therapies change behavior through learning
process
– Cognitive therapies change behavior through
changing maladaptive thought process
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Behavioral Therapies: Learning One’s
Way to Better Behavior
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Behavioral Therapies: Learning One’s
Way to Better Behavior
Systematic desensitization: behavioral technique used to
treat phobias, in which a client through a series of steps
meant to reduce fear or anxiety, is normally used to treat
phobic disorders and consists of 3 step process;
1. Client are taught deep muscle relaxation training
2. Client and therapist make a list of an object/situation
which cause least and greatest degree of fear
3. Client begins (with the guidance of therapist) with first
item that causes minimal fear and looks at it, thinks about
it, or actually confronts it. Client pairs old fearful stimulus
with new relaxation response. Then proceeds to other
item until phobia is gone.
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Table: Fear Hierarchy
Situation Fear Level
Being bitten by a rabbit 100
Petting a rabbit on the head 90
Petting a rabbit on the back 80
Holding a rabbit 70
Touching a rabbit held by someone else 60
Seeing someone I trust hold a rabbit 50
Being in a room with a rabbit 40
Thinking about petting a rabbit 30
Looking at pictures of a rabbit 20
Watching the movie “Hop” 10
Items are ranked by level of fear from most fearful, Fear = 100, to least fearful, Fear = 0.
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Behavioral Therapies: Learning One’s
Way to Better Behavior
https://youtu.be/z0xgIE-SKpc?si=urCIGmZ29tZq_FcL
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Behavioral Therapy Video
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Behavioral Therapies: Learning One’s
Way to Better Behavior
• Exposure therapies: behavioral techniques that
expose individuals to anxiety- or fear-related stimuli,
under carefully controlled conditions, to promote new
learning
– In vivo (in life)
– Imaginal (client visualizes the stimulus)
– Virtual (virtual reality is used)
– Graded exposure (as in sytematic desensitization)
– Ex. If Chang-sun has social anxiety disorder, fon in vivo
exposure he might have to attend to a party or virtually
attend to it via VR
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Behavioral Therapies: Learning One’s
Way to Better Behavior
• Flooding: technique for treating phobias and other
stress disorders in which the person is rapidly and
intensely exposed to the fear-provoking situation or
object and prevented from making the usual
avoidance or escape response (under controlled
conditions)
- Ex. Chang sun would not be allowed to leave the party
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Behavioral Therapies: Learning One’s
Way to Better Behavior
• Eye-movement desensitization reprocessing (EMDR):
exposure-based therapy for PTSD and similar problems in
which client is directed to move the eyes rapidly back and
forth while thinking of a disturbing memory
• https://youtu.be/1IPsBPH2M1U?si=V1ylUum7X_pDNKgP
• Exposure and response prevention (EX/RP): one of the
most effective strategies for treating OCD. Individuals
encouraged to gradually and regularly expose themselves
to stimuli that triggers obsessive thoughts, but not to
engage in typical compulsive acts or process
• https://youtu.be/lxEHOh9c3D8?si=5HnNMK8nuaOtug2s
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Behavioral Therapies: Learning One’s
Way to Better Behavior
VR psychotherapy has been effective for many soldiers experiencing symptoms of PTSD .
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Behavioral Therapies: Learning One’s
Way to Better Behavior
Therapies based on operant conditioning
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Behavioral Therapies: Learning
One’s Way to Better Behavior
Token economies can be useful for encouraging and maintaining a variety of desired behaviors.
When positive behaviors are demonstrated, individuals earn tokens, such as these stars, which can
later be exchanged for desired items or privileges, which serve as reinforcers for the positive
behaviors.
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Behavioral Therapies: Learning One’s
Way to Better Behavior
• Behavioral activation;
- reintroducing individuals to their regular
environments and routines as one way to
increase opportunities for positive reinforcement.
- behavioral activation helps us understand how
behaviors influence emotions.
- it has been used successfully in depression
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Behavioral Therapies: Learning One’s
Way to Better Behavior
• Behavioral activation;
- For ex. Jim deals with depression and anxiety. He
has a hard time figuring out why his mood drastically
dips and also finds it difficult to understand why he
feels better for short periods of time. While working
with his schedule in therapy, he began to discover
specific mood triggers (how he spent his time or
random events). He was able to become more
aware of these triggers and change his approach,
ultimately allowing him to change his mood.
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Behavioral Therapies: Learning One’s
Way to Better Behavior
• Behavior therapies can be effective in treating
specific problems, such as bedwetting, drug
addictions, and phobias
• Behavior therapies can also help improve some of
the more troubling behavioral symptoms
associated with more severe disorders
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Cognitive Therapies: Thinking is
Believing
• Cognitive therapy;
- developed by Aaron T. Beck
- therapy in which the focus is on helping clients recognize
distortions in their thinking and replace distorted,
unrealistic beliefs with more realistic, helpful thoughts
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Cognitive Therapies: Thinking is
Believing
“Heather has left my text message unread for over an hour ... I must have done something to tick her
off ... ”
How many times have you jumped to a conclusion without first examining the actual evidence, or
getting the whole story?
Source: ChristianChan/Shutterstock.
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Cognitive Therapies: Thinking is
Believing
Common distortions in thought;
– Arbitrary inference: drawing a conclusion without any
evidence (ex. Tom didn’t respond to my message, he
thinks I'm a horrible person)
– Selective thinking: focusing on only one aspect of a
situation while ignoring all other relevant aspects (ex.Your
teacher says: «Your project is great, there are only
punctuation errors», you think: «My project is awful»
– Overgeneralization: drawing extensive conclusions
based on only one incident or event and applying those
conclusions to events that are unrelated to the original
(ex. Getting rejected from a job after an interview. Then
assuming you'll never get a job)
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Cognitive Therapies: Thinking is
Believing
Common distortions in thought;
– Magnification: blowing a negative event out of
proportion (ex. a person who is struggling with
magnification might believe that a small mistake they
made at work is a catastrophic event that will ruin their
career.
– Minimization: ignoring relevant positive events (ex. after
receiving a praise from your manager after a very
important project you have achieved, to say that I did not
do it alone, it was teamwork)
– Personalization: taking responsibility or blame for events
that are unconnected to the person (Ex, when you see
your boyfriend/girlfriend is upset or angry, to think that it is
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Cognitive Therapies: Thinking is
Believing
• Cognitive-behavioral therapy (CBT): action
therapy in which the goal is to help clients overcome
problems by learning to think more rationally and
logically
• Has three basic elements
1. Cognitions affect behaviour
2. Cognition can be changed
3. Behaviour change can result from cognitive
change
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Cognitive-Behavioral Therapy Video
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Effective Treatment of Panic Disorder Using
CBT Video
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Cognitive Therapies: Thinking is
Believing
• Rational emotive behavior therapy (REBT):
cognitive-behavioral therapy in which clients are
directly challenged in their irrational beliefs and helped
to restructure their thinking into more rational belief
statements
• Proposed by Albert Ellis
• Clients taught to challenge irrational, all-or-nothing
beliefs;
- Everyone should love and approve me
- When things do not go the way I planned it is terrible
https://youtu.be/OqZ-fjOLK6o?si=gAtOvXw1k0QWTIey
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Cognitive Therapies: Thinking is
Believing
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Cognitive Therapies: Thinking is
Believing
• Evaluation of Cognitive and Cognitive-
Behavioral Therapies
– CBT has been used with considerable success in
the treatment of many types of disorders
Depression
Stress disorders
Anxiety
Insomnia
Eating disorders
– CBT has been criticized for focusing on the
symptoms, not the causes, of disordered behavior
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Table: Characteristics of Psychotherapies
Type of Therapy (Key People) Goal Methods
Psychodynamic therapy (Freud) Insight Aims to reveal unconscious conflicts through
dream interpretation, free association,
resistance and transference
Humanistic therapy Insight Non-directive therapy; client does most of the
Person-centered therapy talking; key elements are authenticity,
(Rogers) unconditional positive regard, and empathy.
Gestalt therapy (Perls) Directive therapy; therapist uses leading
questions and role-playing to help client accept
all parts of their feelings and experiences
Behavior therapy (Watson, Action Based on principles of classical and operant
Jones, Skinner, Bandura) conditioning; aimed at changing behavior
without concern for causes of behavior
Cognitive therapy (Beck) Action Aims to help clients overcome problems by
CBT (various professionals) learning to think more rationally and logically
REBT (Ellis) Clients are challenged in their irrational beliefs
and helped to restructure their thinking
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Group Therapies: Not Just for the
Shy
• Group therapy: form of therapy or treatment during
which a small group of clients with similar concerns
meet together with a therapist to address their issues
- Therapist may use either psychological theraphy but
person-centered, Gestalt and behaviour therapies seem
to work better
- Group structures may vary; small groups related, groups
of unrelated etc
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Types of Group Therapies
In family therapy, a therapist will often meet with the entire family in the effort to identify what
aspects of the family dynamic are contributing to a problem, such as conflict between different family
members.
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Types of Group Therapies
In self-help groups, the person or persons leading a group are not specialists or therapists but just
members of the group. They often have the same problem as all of the other people in the room,
which is the strength of this type of program—people may be more likely to trust and open up to
someone who has struggled as they have.
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Evaluation of Group Therapy
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Biomedical Therapies
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Psychopharmacology
- Antipsychotic Drugs
- Antianxiety Drugs
- Mood-Stabilizing Drugs
- Antidepressant Drugs
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Psychopharmacology
• Psychopharmacology (continued)
Antipsychotic: Positive and some Fewer than typical aripiprazole (Abilify), clozapine
Atypical negative symptoms antipsychotic; clozapine (Clozaril), lurasidone (Latuda),
antipsychotic of psychoses may cause serious olanzapine (Zyprexa), quetiapine
blood disorders (Seroquel), risperidone (Risperdal)
Antianxiety: Symptoms of Slight sedative effect; alprazolam (Xanax), clonazepam
Benzodiazepines anxiety and phobic potential for physical (Klonopin), diazepam (Valium),
reactions dependence lorazepam (Ativan)
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Table: Types of Drugs Used in
Psychopharmacology
Classification Treatment Side Effects Examples
Areas
Antidepressants: Depression Weight gain, constipation, dry isocarboxazid (Marplan), phenelzine
MAOIs mouth, dizziness, headache, (Nardil), tranylcypromine (Parnate)
drowsiness, insomnia, some
sexual arousal disorders
Antidepressants: Depression Skin rashes, blurred vision, amitriptyline (Elavil), clomipramine
Tricyclics lowered blood pressure, weight (Anafranil), desipramine
loss (Norpramin),
imipramine (Tofranil), nortriptyline
(Pamelor)
Antidepressants: Depression Nausea, nervousness, citalopram (Celexa), escitalopram
SSRIs insomnia, diarrhea, rash, (Lexapro), fluoxetine (Prozac),
agitation, some sexual arousal paroxetine (Paxil), sertraline (Zoloft)
problems
Antidepressants: Depression Anxiety, insomnia, nausea, bupropion (Welbutrin),
Atypical, SNRIs, headache, duloxetine
NRIs
sedation, dizziness, weight (Cymbalta), mirtazapine
gain (Remeron),
venflaxine (Effexor)
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ECT and Psychosurgery
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ECT and Psychosurgery
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What Is Psychosurgery? Video
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Emerging Techniques
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THANK YOU
ANY QUESTIONS?
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