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Psychology 1000 - March 27.docx

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Psychology 1000
Laura Fazakas- De Hoog

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Psychology 1000 Thursday March 20 Lecture 11 Psychological Treatment Ch. 17 (continued), Chapter 15 Exam Review Session • Mon. April 21 • 7-10pm • NCB 101 Practice Exam Question: The personality disorder characterized by sexualized behaviour and an excessive need for attention is: a) Histrionic Personality Disorder b) Antisocial Personality Disorder c) Borderline Personality Disorder d) Dependent Personality Disorder e) Narcissistic Personality Disorder Answer: A - Histrionic Practice Exam Question: The medication used to treat bipolar disorder is: a) Lithium b) SSRIs c) Haloperidol d) MAO Inhibitors e) Trycylics Answer: A – Lithium Outline: I. Biological Treatments a. Medication b. ECT II. Behaviorally Based Treatments a. Systematic Desensitization b. Flooding III. Psychodynamic Treatments IV. Object Relations Therapy V. Humanistic Therapy VI. Treatment Effectiveness Exposure Based Treatments 1) Systematic Desensitization: Reducing anxiety through counter-conditioning • Develop a fear hierarchy o eg. if someone has a fear of spiders, you would show them a picture of a spider, have them hold the picture, look at a dead spider, watch a spider from behind glass, watch someone hold the spider, then hold the spider herself o Relaxation training:  Gradually increase exposure to the feared stimulus while going through relaxation techniques 2) Flooding • Reducing anxiety through extinction: complete exposure to the feared stimulus, and eventually habituation occurs • This isn’t well tolerated, but it does work 3) Behaviour Therapy • Using positive reinforcement to change behaviour while ignoring the behaviours you don’t want and positively reinforcing the behaviours you do want • eg. token economies – giving tokens out for good behaviour and taking them away for bad behaviour (and then you can turn the tokens in for a reward) 4) Aversive Conditioning • Pairing an aversive (negative) stimulus with an undesired behaviour • Substance Abuse – They use antabuse, which makes the person violently ill when it is combined with alcohol • Sexual Offenders – give them shock therapy while looking at sexual abuse images o The problem is that you need the person’s consent Cognitive-Behavioural Therapy • Combines cognitive factors with learning theory • Assumption: Thoughts and attitudes effect feelings and behaviour • Concentrates on alternating maladaptive or distorted thinking • Rational-Emotive Therapy (Ellis): o Overcoming irrational beliefs to correct emotional problems o The therapist’s role is to detect and challenge these beliefs • Beck’s Cognitive-Behavioural Therapy o Focus on restructuring automatic negative thinking patterns o Detect cognitive tendencies that lead to depression (eg. distorted thinking) o Blend of insight and behavioural therapy o The person has “homework assignments” where they are taught to monitor their thoughts/feelings/behaviour Psychotherapies • Psychoanalysis: o Based on Freud’s psychodynamic theory o Goal is insight (to bring to awareness one’s unconscious motivations) o By exposing these repressed desires, patients are freed from the anxiety they create o Resolves emotional problems • Psychoanalysis as a Treatment o Repression – patients often block shameful, repulsive, or anxiety- provoking material during free association o Freud therefore found other ways to Accessing the Unconscious  He used dream analysis  Forbidden desires are hidden in latent meaning (vs. manifest or obvious meaning) o Freudian slips (parapraxes) – Freud believed slips of the tongue revealed unconscious content o Treatment Goals: i. Bring unconscious conflicts into conscious awareness ii. “Work through” these conflicts • Must uncover the root of the symptoms • Expression is seen as catharsis/relief • The therapist is a “blank projection screen” (the patient is supposed to project their unconscious conflicts) iii.Interpretation • The therapist points out, explains, and teaches the meanings of whatever is revealed iv. Transference • Patient will react to therapist as they did towards the conflict • Feelings and reactions including sexual • Helps them develop insight v. Counter Transference • The therapist’s reaction to the patient (Freud thought therapists needed to do psychoanalysis themselves) o Treatment Process:  1) Dream Analysis (latent and manifest meaning)  2) Free Association  3) Resistance – patient will become avoidant when approaching difficult anxiety-provoking material Analytic Psychology (Carl Jung)  Goals of Treatment Process: o Facilitate wholeness and the integration of opposites o Establish a dialogue between the conscious and unconscious in order to achieve psychic equilibrium o Free word association o Used dreams and artistic expression to tap collective unconscious and archetypes o An individual’s images to reveal hidden possibilities and thereby help the person find meaning and wholeness in life Variations of Psychodynamic Theory:  Object Relations Therapy o Goal: Replace “bad relational experiences with good ones” (a corrective emotional experience) o The therapeutic relationship is the primary vehicle of change  It is a real relationship (they are not a blank screen)  They process the comments and use interpretation to help the client gain insight  Humanistic Therapy o Assumptions:  Each client is unique and has the potential for reflective consciousness and self-determination • Here the client rather than the therapist is the expert  Self-actualizing or growth tendency  Individuals are not determined by their past or environmental factors  Treatment involves removing environmental conditions that block growth and development Humanistic Therapies:  Client-Centred Therapy (Carl Rogers) o Emphasizes supportive emotional climate o Concentrates on eliminating irrational conditions of worth o 3 Conditions for a Therapeutic Climate:  1) Genuineness  2) Unconditional positive regard • Feeling positively about the client no matter what  3) Empathy • Trying to understand how the client thinks and feels o The role of the therapist is clarification (through reflection)  Gestalt Therapy (Fritz Perls) o Goal: Increase the individual’s awareness of their own feelings  Help clients rebuild thinking, feeling, and acting into connected wholes o It is more directive and confrontational than other types of humanistic therapy o It has a present focus o Techniques:  Role playing  Imaginary dialogue  Expressing pent-up feelings  Logo Therapy (meaning therapy) o Developed by Victor Frankl  A concentration camp survivor  He found that each individual’s unique quest for meaning was what made them survive o Helps the client become aware of their uniqueness and the unique meaning of their experience o Stresses personal responsibility o 3 Therapeutic Techniques:  1) Paradoxical Intention • Humorous exaggeration of symptoms • eg. if a client fears sweating in public, they would imagine sweating buckets in public  2) Deflexion • Draw attention away from the symptom • Especially useful for pain  3) Socratic dialogue: modification of attitudes • Specific questions to raise into consciousness life’s meaning • eg. asking what you would do if you only had a year to live  Evaluation of Humanistic Therapy: o Strengths:  Empathy, positive regard – very important in developing therapeutic alliance  Client as the “expert” o Limitations:  Not sufficient for severe pathology (eg. treating personality disorder) Factors Affecting Therapy:  Client Variables: o Openness to therapy o Self-relatedness  The ability to experience and understand internal states, thoughts, and feelings  Therapy Variables: o Quality of the therapeutic relationship  Empathy  Genuineness  Unconditional acceptance o Fit between the problem and type of treatment  eg. if someone had a simple phobia, you wouldn’t want to put them through years of psychoanalysis o Fit between client and
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