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Western University
Psychology 1000

THE HELPING RELATIONSHIP -the relationship between the patient and the person providing the help is very important; different people will use different techniques to change the patients behaviour (ex. antipsychotic drugs) -distressed people first seek help from relatives or friends, but this may not be enough so they get medical help -people receive treatment from different groups of mental health professionals -counseling and clinical psychologist: hold a PhD and have received 5 or more years of intensive training for psychological assessment techniques -psychiatrists: medical doctors who specialize in psychotherapy and biomedical treatments (ex. drug therapy) Psychiatric social workers: work in community agencies Marriage and family counselors: problems arising from family problems Pastoral counselors: focus on spiritual issues Abuse counselors: work with substance and sexual abusers and victims PSYCHODYNAMIC THERAPIES -focuses on internal conflict and unconscious factors that underlie maladaptive behaviour PSYCHOANALYSIS Goal: help patients achieve insight; the conscious awareness of the psychodynamics that underlie their problems which causes them to change their maladaptive behaviour -as the client repeatedly encounters buried emotions, motives, and conflicts, the psychic energy that was previously used for keeping unconscious conflict under control, can be redirected and released to more adaptive ways of living Free Association: -asked clients to report whatever they were thinking in a continuous thought pattern believing that mental events are associated with one -will provide clues concerning important themes or issues Ex. a patient’s thoughts may stop when mentioning her father meaning it was a heavy topic that was being repressed Dream Interpretation: -dreams express impulses, and wishes that the client’s defenses keep in the unconscious during waking hours -in dreams, defensive processes disguise the material to prevent the dreamer from experiencing anxiety Dream interpretation – helps the client search for unconscious material Ex. can used free association to each element so the client understands the meaning of the dream Resistance: -avoidance patterns (the ego using defense mechanisms to deal with unconscious impulses) emerge in resistance (defensive patterns that hinder therapy) Ex. a client may have difficulty free associating, “forget” about an appointment, avoid talking about certain topics; ultimate resistance is dropping out of therapy -a sign that anxiety arousing material is being approached Transference: -the analyst sits our of view of the client and reveals nothing about themselves Transference: when the patient reacts irrationally towards the analyst as if the person was someone important from their past; brings out the repressed and maladaptive behaviour Positive transference: when the client transfers feelings of affection, love (positive emotions) Negative transference: irrational expression of anger, or disappointment (negative emotions) -until transference reactions are resolved, there can be no resolution of the client’s problems Interpretation: -any statement by the therapist intended to provide the client with insight to their problems; confronts clients with something that they had previously not allowed into their conscious -interpret what is already near the surface and just beyond the client’s awareness; if you offer interpretations of something that is deep in the client’s unconscious, they are so far beyond their conscious that they cant be informative or useful BRIEF PSYCHODYNAMIC THERAPIES Classical Psychoanalysis: -practiced by Freud; time consuming and unlikely that the analyst can see the patient as often as it demands -impractical and unnecessary -not a high correlation between this technique and resolution of client; no evidence supports that a long therapy is better than a brief psychodynamic therapy Brief psychodynamic therapies: -emphasize understanding the influences of the past and relating them to current behaviours; utilize basic concepts of psychoanalysis in a focused and active fashion (ex. insight and interpretation) -the client and analyst sit facing one and other and converse rather than use free association Goal: to deal with specific problems rather than completely rebuilding their personality Focus on current situations rather than childhood experiences Interpersonal Therapy: takes longer than 15-20 sessions; focuses on their current interpersonal problems -analyst collaborates very actively with clients (Ex. marital problems) HUMANISTIC PSYCHOTHERAPIES -view humans as consciously able to control their behaviours; everyone possesses inner resources for personal growth and self-healing -disordered behaviours represents a blocking of personal growth; blockings are brought by negative self image Goal: the create an environment where clients can engage in self-exploration and remove barriers that block their natural tendencies towards growth -believe that the barriers could have occurred from childhood when you focus on what others want from you rather than your own personal desires -focuses on the present and future instead of the past CLIENT-CENTERED THERAPY -developed by Carl Rogers; focused on the relationship between client and therapist in succeeding Attributes of the therapist: 1) Unconditional positive regard: therapists show that they care and accept the client; communicates trust that the client will work through their problems-the therapist refuses to advise or give guidance (just listens) 2) Empathy: the ability to view the world through the client’s eyes; therapist reflects back to the client what they are feeling 3) Genuineness: consistency between the way the therapist feels and the way they behave; must be able to express feelings whether negative or positive; -the most effective is when a therapist can express displeasure with a clients poor behaviour, but still show acceptance for the client as a person -clients will then exhibit increased self-acceptance and self-awareness -would tape record the session and then later analyze them GESTALT THERAPY Gestalt: organized as a whole; people organize stimulus elements into “whole patterns” -we usually concentrate on parts of something rather than the whole experience; people with disorders will ignore the background information that includes important feelings and thoughts (they are blocked because they arouse anxiety) Goal: to bring the blocked thoughts into immediate awareness -carried out in groups: -therapists use techniques to bring out the client’s “inner self’ - techniques are more dramatic and active than client-centered therapy -clients may be asked to role play aspects of themselves to experience their inner dynamics Empty-chair technique: imagine his mother on a chair and then role play a conversation between them and their mother expressing how they feel about their relationship; brings out unresolved issued -didn’t use science and therefore prevented systematic research COGNITIVE THERAPIES -Focus on irrational thought patterns – therapists try and change the cognitions that underlie their client’s problems -clients need help identifying the beliefs, and self statements that trigger maladaptive behaviour; once identified these cognitions can be challenged and with effort, changed ALBERT ELLIS’S RATIONAL EMOTIVE THEORY ABCD Model: A- activating event that triggers the emotion B- belief system that underlies the way in which a person appraises the event C- the emotional and behavioural consequences of the appraisal D- the key to challenging maladaptive behaviours; disputing, or challenging an erroneous belief system -people believe that their emotions (C ) are a response to (A) Ex. a man being turned down for a date causes depression -Ellis believes that the woman turning him down is not the true reason, -the reaction is caused by the man’s belief that “to be worthwhile, I must be loved” Therefore, for the man to not be depressed, the belief must be countered and replaced by a rational interpretation Rational Emotive Therapists: -introduce clients to irrational ideas and then train them to get rid of the ideas that underlie their irrational behaviour -clients are given homework assignments to analyze self-statements, or placed in a challenging situation and must control their emotions Ex. a shy patient with social anxiety may be asked to go to a party and practice rational thoughts AARON BECK’S COGNITIVE THERAPY -like Ellis, Beck tries to point out errors of thinking and helps clients identify and reprogram their over learned “automatic” thought patterns Ex. treating depressed client, first they must point out that it is their thoughts, not the situation, that cause their emotional reactions -cognitive therapy became the choice treatment for patients with depression; now also extended to people with anger and anxiety disorders Self-instructional training: influential in treatments related to stress and coping BEHAVIOUR THERAPIES 1) behaviour disorders and learned in the same ways normal behaviours are learned 2) maladaptive behaviours can be unlearned by applications of classical and operant conditioning CLASSICAL CONDITIONING TREATMENTS Used in Two ways: 1) used to reduce or decondition an anxiety response 2) used to condition new anxiety responses to a particular class of stimuli (ex. alcohol) Exposure Therapy: Phobias develop by… -a pairing of a phobic object (neutral stimulus) with an unconditioned stimulus (UCS) so that the phobic stimulus becomes the conditioned stimulus (CS) which produces the conditioned response (CR) (classical conditioning) -Two factor learning theory: avoiding the phobic situation is reinforced by anxi
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