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Lecture 10

lecture 10

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PHSI 208
Neil Hibbert

Modifications in psychoanalytic therapy  One innovation was to apply it to groups of ppl rather than only to indiv. Some therapists focus on the psychodynamics of indiv in the group  The key issue is whether the group format dilutes the transference to the therapist and thus makes the therapy ineffective  Other current analytic therapies include ego analysis, brief psychodynamic therapy and interpersonal psychodynamic therapy  Ego analysis-------approach is sometimes described as psychodynamic rather than psychoanalytic  Those who subscribe to ego analysis place greater emphasis on a persons ability to control the environment and to select the time and the means for satisfying instinctual drives contending that the indiv is as much ego as id  They focus more on the persons current living conditions than did Freud  Ego analysis belief in a set of ego functions that are primarily conscious, capable of controlling both id instincts and the external environment and that significantly do not depend on the id for their energy  They assume that these egos functions and capabilities are present at borth and develop through experience.  Ego functions have energies and gratifications of their own usually separate from id impulses  Freud viewed society negatively, ego analysts hold that an indiv social interactions can provide their own special kind of gratification  Brief psychodynamic therapy----Freud originally conceived of psychoanalysis as a relatively short term process. Freud envisioned a more active and briefer psychoanalysis than what eventually developed  They found that 59% of those receiving psychoanalysis were women and that the mean # of current diagnoses was four. On average each patient had one diagnosable personality disorder.  Overall 82% of the patients had tired other forms of therapy including drug treatment. Most patients had received psychoanalytical treatment for many years. A follow up study found that the average length of treatment was 4.8 yrs  Patients from Canada, US and Australia and found many similarities across countries. The most common diagnoses were mood disorder, anxiety disorder, sexual dysfunctions and personality disorders  Time limited psychotherapy is available as an alternative to the many years sometimes required for classic psychodynamic treatment.  Brief therapy was developed to meet the expectations of the many patients who prefer therapy to be fairly short term and targeted to specific problems in their everyday lives  The growth of brief therapy also evolved from the need to respond to psychological emergencies. Cases of shell nd shock during the 2 world war led to classic short term analytic treatment of what is now called post traumatic stress disorder  Insurance companies and government health plans have played a role in shortening the duration of treatment by encouraging therapists to adapt their ideas to brief therapy. They gave become increasingly reluctant to cover more than a limited # of psychotherapy sessions in a given year and set limits on reimbursement  Stronger focus on time limit psychodynamic therapy. Brief therapies share several common elements:  Assessment tends to be rapid and early  It is made clear right away that therapy will be limited and that improvement is expected w
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