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Lecture 4

PSY341 Lecture 4 Notes.docx

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Hywel Morgan

PSY341 Lecture 4 - July 15, 2013 Treatment Approaches ● types of treatments that are available ● 2 different ways to view psychopathology: ○ 1) Psychological approach ■ ->change the environment or way of thinking ○ 2) Somatic approach -> physiology 1. Psychological Approaches a. “individual psychotherapy” through talking as the medium ■ verbal psychotherapy invented by Sigmund Freud ■ historically most common b. Sigmund Freud’s approach/tool: Free Association ■ just talk about anything you want ■ Psychoanalysis ■ the unconscious peeking out through the free association talking. Therapist catches it and reflects it back to the client ■ “Freudian slips of tongue” ■ SOME validity but not entirely reliable ■ motivations, emotions, deep thinking, feelings, memories revealed ■ *this is not going to work with children for obvious reasons -> not verbal! a. Play Therapy ■ Play for children as the medium of articulating their inner feelings. Psychotherapy is modified for play to substitute verbal ● how they play and what they play with ■ Rapport!! ■ NOT just therapy but also analytical of the child! ■ play therapy can also utilize group settings to observe social interactions ■ 3 Types of Play therapy: ■ Psychoanalytic (Classical) ● first proposed by Anna Freud ● she realize children are unmotivated to participate in “therapy” bc they are usually brought to therapy ● fantasies, unconscious beliefs are analyzed ● child externalizes internal/unconscious material ● in play, child playing out intrapsychic conflicts ○ e.g. drawing + painting (art therapy), physical toys (e.g. twisting off the legs of power ranger), playing “house”, imitation, *fantasy/”conflicts” (e.g. cops and robbers), *make belief ● “purging and cathartic” ● if children do not have the opportunity to tell the therapist what’s going on with them, they bottle it up and never get better ■ Non-directive ● Karl Rogers -> Humanism (touchy feely stuff) ● Self-actualization, understanding themselves, potential ● his therapeutic approach : Unconditional Positive Regard ● No interpretation in what the child does ● Not directing the child anywhere, but instead giving the child complete freedom of choice and freedom of expression to develop as human beings as the therapy in and of itself ● therapist free to express back to the child the feelings and attitudes expressed by the child to clarify their thoughts and feelings and therefore gain better self-understanding ■ Filial ● a variant of non-directive play therapy where the parents are trained to provide the feedback ○ trained to provide the play/freedom of expression environment ● studies found this therapy to be most effective than non-directive play therapy with a therapist ■ WHEN IS PLAY THERAPY PARTICULARLY USEFUL? ● NOT useful: aggressive behaviour, CD, depression, high anxiety, ADHD ○ it may be diagnostic but NOT therapeutic for these ○ not useful for children with high emotional impulsivity BC these children are unable to control or restrict themselves. Giving them a place of no restrictions is not therapeutic ○ also not useful for children with low affect ● USEFUL: pre-adolescent children or any children with limited verbal abilities, socially withdrawn children ● Play therapy does not exclude verbal interaction though b. Verbal One-On-One (also psychoanalytical) ● one client, one therapist -> meet at regular intervals ● typically for older children and adolescent who are sophisticated enough to understand why you are asking why ● children are not particularly amenable to psychoanalysis or humanistic c. Cognitive Therapies -> “What are you thinking and why?” ● e.g. for depression ● much more invasive type of therapy bc the client provides the why ● “you learned that thought somewhere and you learned it wrong. I’m going to change that” (e.g. someone told you that you’re worthless and I’m going to challenge that) d. Behaviour Therapies (behaviour modification) ● overt, observable behaviour ● chief mechanism of assessment/treatment for younger children BC they are not sophisticated enough to hide behaviour ● NOT effective sometimes at home (punishment) because often models aggression or punishment is delayed (“wait till your father is home!”) ○ MAY BE appropriate when immediate, appropriate and not abusive or not when parent is mad ● Classical/Operant conditioning ● therapist not looking at the reasoning behind behaviour but just focus on modifying it ● strategies derived from desired behaviours ● for the most part, doesn’t require a lot of verbal interactions ● Systematic Desensitization ○ usually used for anxiety disorders (e.g. phobia, separation anxiety) ○ “slowly adapt” while increasing the anxiety-provoking stimuli while desensitizing them to it ○ could take a longgg time ○ pair an incompatible experience (something that makes you happy and relaxed) with the anxiety-provoking stimuli ○ e.g. complete relaxation -> show a pic of spiders ○ lots of children have these irrational fears (something that’s not going to hurt you) that prevent them from functioning ○ e.g. fear of spiders, fear of heights . these are irrational ○ works extremely well for fear/anxiety for ANYTHING ● Flooding -> conditioning technique, behaviour modification as well ○ also very ef
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