PSY341H1S L4; July 15, 2013 o If children do not have chance to tell therapist what
Next class: midterm! is wrong w them tend to not get better
o Everything up to end of Treatment is testable
o The end of this class: DSM categories for childhood o 3 types:
disorders – not on midterm Classical psychoanalytical play therapy – what
was first proposed by Anna Freud, believe children
Treatment Approaches unmotivated to participate in verbal therapy, child
Current approach: Biomedical often brought by adult
a. Assess fantasies, unconscious beliefs
o Pharmacotherapy & envt’al
b. Children can externalize internal or
A) Psychological Approaches unconscious material
c. Children played out intrapsychic
Influence of psychologists
Changing the person’s envt & the way they think conflicts
d. Physical games, pretend games, imitating
e. More telling: Fantasy games, conflict
1. Individual Psychotherapies aka “Talk Therapy” (medium games (ex. cops and robbers), make-
is talk)
o Often referred to as Verbal psychotherapy aka believe, modelling bhvrs
Main Category: Non-directed Play Therapy
Psychoanalysis a. Carl Rogers – Humanism (Helping to
Some validity but not very reliable
1 time we looked at ppl’s thoughts reach your potential)
b. Ppl possess the drive for self-
Motivations, emotions, deep-seated problems actualization, finding self role & role of
Does not work w children since not as verbal –
not as articulate, hard to have convo others in society
o Invented by Freud c. Client centred therapy
d. Technique: Unconditional (+)ve Regard
Free association – let them talk about whatever
they want to e. No fdbk necessary
Gain insight f. Giving child complete freedom of choice,
expression, to develop as human beings
Slips of tongue – At some pts your subconscious – that in of itself is therapeutic
will appear – he’ll ask you to repeat what you just
said (reflecting is back to you) – you might g. Therapist free to reflect the child’s feelings
back to the child to clarify the child’s
respond in dif ways thoughts & feelings gain better self-
Interested in thoughts, memories, feelings,
sensations understanding
Filial play therapy
a. Variant of non-directed play therapy
a. Play therapy
o 1 proposed by Freud’s daughter Anna famous where parents trained to give child envt
psychotherapist where they can freely express
themselves & trained to provide fdbk
Substitute play for talk b. Research has shown it’s more effective
Natural communication channel for children
Added benefit of rapport btwn child & therapist than non-directed therapy w psychologists
c. Parents gain empathy, more
Therapeutic for child, and you get assessment info understanding of children
– child purging thoughts (analytical &
therapeutic & same time)
o How they interact w toys, what they play w, how b. Verbal one-on-one therapy
o Common way to conceptualize psychotherapy
they interact w peers
May ask “why” Qs sometimes o Client meets therapist at set intervals for set periods of
o Still use to treat children even though psychoanalysis time
o When children at older age or in adolescence
not used Younger children won’t respond well to
o Use assessment that is therapeutic – still used
o The office is a play room psychoanalysis or humanistic psychotherapy
o What are you thinking & why?
o Does not exclude verbal interactions (ex. “You be the
cop, I’ll be the robber”
o When is play therapy useful, and when is it not? c. Cognitive therapy
o Why?”
Unrestricted envt is not useful for children o “Why do you think what you’re thinking is right or
who show a high degree of emotional arousal,
low impulse control: conduct-disorder, ADHD – wrong?
want to give them a restrictive envt o Learning paradigms
o Why do you think that way? Why do you think those
Not useful for children w low level of affect:
depression, high-anxiety thoughts?
Useful for children w limited verbal abilities, o Thinking, cognition
o Need to be sophisticated enough to understand why
socially-withdrawn children you’re asking “Why..?”
Useful to diagnose autism but not for assessment,
particularly useful for the role-modelling aspect o “Where does that come from?”
o Much more invasive than other types of therapy o Need to re-teach you, challenge what you think about situations – children often have these
yourself irrational fears, which prevent them from
o Very sophisticated technique of therapy fn’ing normally
I’m going to try to challenge your thoughts & i. Fear of spiders – irrational, no
reprogram them poisonous spiders in Ontario; rational
Doesn’t have to be aggressive, just challenging if live in country w many poisonous
o Current paradigm of psychotherapy is cognitive-bhvr’al spiders
ii. Fear of heights – irrational
d. Bhvr therapy aka Bhvr Modification iii. Fear of falling – rational
o Treated of abnormal, unwanted bhvr, by methods j. Very effective, can sometimes take a long
derived from expt’al psychologists – learning time
principles (classical, operant conditioning) k. Can increase # of stimuli
o Treatment strategies to increase or decrease bhvr Flooding – conditioning/bhvr’al modification
o Used quite extensively in children since for the most technique where we subject them to the extreme of
part don’t require a lot of verbal interaction their anxiety-provoking envt or situation
o Goes back to 1920s, 30s – pair sound of bell w wet bed a. Ex. lock door then turn on lights in room full
o Not looking for reasons or origins of bhvr; just want to of spiders
modify bhvr b. The phobia tends to be eliminated
o Only look at observable, overt bhvr c. Not particularly ethical – not very pleasant
What we have to go by in young children d. Frequently used on children w OCD
Very easy to change overt bhvr e. Can tell them upfront that you’re going to
o Chief mechanism of assessment & widely used in expose them to something uncomfortable,
treatment and for them to withstand it for as long as
Children not sophisticated enough to hide bhvr possible
o Punishment Modeling – therapist models the appropriate bhvr
Problem: modeling aggressive bhvr (fearful child, & asks the client to copy the bhvr
CS is pain or something you don’t like), also often a. “You try it!”
punishment is delayed b. Very effective
Bhvr & punishment have to occur together to be c. Ex. petting a cooperative dog
effective Extinction – way to change bhvr by not rewarding
Not the preferred method it anymore
Immediate, unpleasant, not abusive – more a. in terms of operant conditioning, you could
appropriate use (+)ve reinforcement – but not all of
There are conditions in which punishment can those bhvrs are desirable
change bhvr in (+)ve ways (ex. swatting kid’s hand i. ex. kid walking down street w mom,
away from electrical socket) sees candy store excited gives in
increases likehood of bhvr – learned
o Methods: thru conditioning that a display likely
Systematic desensitization – usually used for causes reward
anxiety disorders (the most common b. Stop rewarding the bhvr bhvr is
disorders, separation anxiety disorder usually extinguished w/o reward
occurs in middle childhood) c. after a few days: Extinction burst – large
a. Pair an incompatible experience/stimulus w emotional display
gradual presence of the fear evoking stimuli i. parents often give in
b. Often used w cognitive-bhvr’al therapy ii. BAD – kid learns he’ll be
c. Explain to you why it’s irrational, explain intermittently reinforced – doesn’t
that you’re going to turn down the lights know when he’ll be reinforced, but
and relax (ex. meditation tape), and that knows he will some time
you’re then going to show a stimulus that d. One of most significant rewards is
will remind you of the scary thing – attention
concentrate on how calm you felt (+)ve reinforcement – increase frequency of a
d. Similar to hypnosis procedure desired bhvr by rewarding it
e. W children specifically, use biofeedback a. Research shows this will eventually replace
– ex. sensors to monitor breathing, heart the undesired bhvrs w desired bhvrs
rate, sweat – they can hear the fdbk b. Ex. token economy
f. The person eventually gets expert at c. No time anymore for the undesired bhvr
controlling their level of arousal to the
stimulus 2. Grp & Family Therapies
g. Systemically increase the anxiety- a. Grp therapy
provoking stimuli while you desensitize o Becoming more common that therapy is conducted in
them to it grps
h. Relaxation techniques, meditation o Cheaper (>1 person treated at same time)
i. Ex. useful for Phobias – irrational (not o Recognizes that humans are social animals & their
dangerous) anxiety to specific objects, development is influenced by other ppl Electrodes applied to head current sent thru
o 3 types often conducted w children & adolescents seizure (all neurons in brain stimulated & fire at
Activity Grp Therapy
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