therapy Flashcards
Psychotherapy - means? aka? goal is to? don’t confuse with?
- psychological intervention meant to help resolve emotional, behavioural and interpersonal problems and to improve quality of life
- Aka psychological therapy
- Interaction b/w therapist and someone suffering from a psychological problem
- Goal is to provide support or relief from the problem
- Don’t confuse with psychodynamic (Freudian) approach
Goals of Psychotherapy? (4 steps)
- Forming a diagnosis: figure out what’s wrong, identifying illness, understand what’s going on
- Proposing an etiology: understand causes of illness
- Making a prognosis: what’s going to happen in a week, a month?
- Implementing treatment: change their thoughts/behaviour/emotions/coping skills
humanistic/existential - key beliefs? emergence? assumption about problems?
- human beings are basically positive
- something intrinsically good about people
- all have a tendency towards self-improvement
- emerged in middle of 20th century
- reaction against negative views of Freudian psychoanalysis (Europe) and lack of introspection of behaviourism (US)
- psychological problems stem from feelings of alienation and loneliness
- feelings traced to failures to reach one’s potential (humanistic) or failure to find meaning in life (existential
Who seeks therapy - how many people? gender? race? ST vs LT?
c) Who seeks therapy?
- 1 in 5 people suffer from some type of mental disorder
- Men & women: women more likely to seek help
- Caucasians, Asians & Aboriginals: Caucasians more likely to seek than minorities
- ST vs. long-term problems: often wait a very long time before seeking help
o People suffer from depression of years before asking for help
o ST problems fare better than LT (aka respond better to therapy)
d) Why do some people not seek treatment?
- People might not realize that their disorder needs to be treated:
o Mental illness not taken as seriously as physical illness
o Origin of mental illness “hidden”, not diagnosable by blood tests, x rays
o Stigma of mental illness: can be solved with mind over matter aka it is a sign of weakness
- Barriers to treatment like beliefs/circumstances that keep people from getting help:
o Some believe they should be able to handle things themselves
o Families discourage seeking help because of embarrassment
o Financial obstacles, lack of medical insurance, long waiting lists at facilities, etc
- Even people who acknowledge they have problem don’t know where to look for services
o And even when they seek and find help, they might not receive the most effect treatment
e) Would I be a good therapist?
- Warm & direct: honest and open to people
- Developing positive relationship with clients: respecting who they are, emphasizing with them, understanding them – if you’ve gone through your own problems = better empathy
- Your ethnicity: might think matching client’s ethnicity is important – study shows that it doesn’t matter
- Topic selection: choose most important for the session – session should have a focus
- Match treatment to needs of patient – most therapists don’t identify as one of the six kinds – they use whatever technique is most appropriate for patient
Eclectic psychotherapy: drawing on techniques from different forms of therapy depending on patient and the problem
Client centered approach - h or e? started by who? assumes? non-directive?
- humanistic approach
- Carl Rogers in 1940’s, aka person centered therapy
- assumes that all individuals have a tendency toward growth and that this growth can be facilitated by acceptance and genuine reactions from the therapist
- each individual is qualified to determine own goals for therapy, frequency and length of therapy
- Non directive treatment: Client is the centre/focus you are there as an aid
- not to tell what is right/wrong, we’re here to facilitate patient’s learning, doesn’t provide advice or suggestions, but instead paraphrases client’s words
Why not seek treatment?
- People might not realize that their disorder needs to be treated
- Stigma of mental illness: can be solved with mind over matter aka it is a sign of weakness
- Barriers to treatment like beliefs/circumstances that keep people from getting help - families, finances
- Even people who acknowledge they have problem don’t know where to look for services
Client Centered Approach - 3 components? overall goal?
Would I be a good therapist? qualities? realtionship? ethnicity? topics? ecletic?
- Warm & direct: honest and open to people
- Developing positive relationship with clients: respecting who they are, emphasizing with them, understanding them – if you’ve gone through your own problems = better empathy
- Your ethnicity: doesn’t matter
- Topic selection: choose most important for the session – session should have a focus
- Match treatment to needs of patient – most therapists don’t identify as one of the six kinds – they use whatever technique is most appropriate for patient
- Eclectic psychotherapy: drawing on techniques from different forms of therapy depending on patient and the problem
Gestalt Therapy - h or e? founded by? goal? focuses on? empty chair technique?
a) Gestalt Therapy existential approach
- Founded by Frederick Perls in 40’s/50’s
- Goal of helping client become aware of his thoughts, behaviour, experiences, feelings and to own or take responsibility of them
- focuses on present experience and immediate awareness of direct sensations & emotions
- enthusiastic and warm towards clients (just like person centered)
- Focus on the gestalt gestalt = whole want to understand whole person, context, etc
- Empty chair technique: putting their feelings into action
o Client pretends that another person (spouse, parent, co-worker) is in an empty chair sitting directly across from client roleplaying what he’d say and what the other person would respond
o practice things out in a safe environment
Therapyp - two categories: psychotherapy? Medical approaches? .. Insight Therapy?
- P: person interacts with a psychotherapist
- psychodynamic, cognitive-behavioural, humanistic/existential, groups
- M: drugs or surgery = medications, other biological approaches
- Goals are the same: relief and support to someone suffering
- IT: People normal, but have learned some kind of maladaptive behaviour
- Insight: you don’t know what’s bothering you, but that “ah-ha” moment provides relief
Group therapy - family/couples? group? community?
- family and couples: people who live together, somehow related, etc
- group: stragners with similar problems
- community: after natural disasters, etc
Psychodynamic Approach - roots in? what is it? what unifies all approaches?
- roots in Freud’s personality theory
- Explores childhood events and encourages individuals to use this understanding to develop insight into their psychological problems
- emphasis on the unconscious: huge part of the mind, and it is in here that the problem resides
- Inadequately defended urges or incomplete development during psychosexual stages
- path to overcoming problem is to develop insight into unconscious memories, impulses, wishes, conflicts underlying these problems
Group Therapy - advantages and disadvantages
- Provide context in which clients can practice relating to others, they have people who they have to talk to/get along with on a regular basis
- Attending group with others who have similar problems shows clients they are not alone
- Group models model appropriate behaviours for another and share their insights about how to deal with problems, people can learn by observation - social learning
- Group therapy often just as effective as individual therapy but cheaper
- Can use peer pressure for positive outcome
- CONS: hard to assemble group, some can undermine others, less attention
Beyond Freud - Alfred and Jung?
a) Beyond Psychoanalysis
- Broke away from Freud, developed their own approaches to psychotherapy
- Alfred Adler and Carl Jung: Agreed insight was key therapeutic goal, but disagreed that insight usually involves unconscious conflicts about sex/aggression
- Alfred Adler:
o Not as bleak as Freud: still believed unconscious important
o Didn’t reduce people down to single instances, looked at them in their entirety, context, how they’re connected to people around them, etc Connectedness to family, environment very important Holist not a reductionist
o Believed emotional conflicts were result of perceptions of inferiority, and psychotherapy should help people overcome problems from inferior social status, sex roles, discrimination
o Pro-feminist: equality in relationships very important
o Recognized that we all have goals, driven goals
o While we have id, ego, etc they are a source of creativity
o Coined the term “inferiority complex”
o Talked about importance of self-esteem, self-esteem has important impact on mental health
- Carl Jung:
o Emphasize collective unconscious: culturally determined symbols and myths that are shared among all people that could serve as a basis for interpretation beyond sex or aggression
- Melanie Klein
o Primitive fantasises of loss and persecution like worrying about a parent dying or about being bullied, were important factors underlying mental illness
o Karen Jorney
Disagreed with Freud about inherent differences in the psychology of men and women – traced differences to society and culture instead of biology
- All approaches: individual is part of a larger society, and conflicts can reflect the individual’s role in society
Alfred Adler?
- Alfred Adler:
o Not as bleak as Freud: still believed unconscious important
o Didn’t reduce people down to single instances, looked at them in their entirety, context, how they’re connected to people around them, etc Connectedness to family, environment very important Holist not a reductionist
o Believed emotional conflicts were result of perceptions of inferiority, and psychotherapy should help people overcome problems from inferior social status, sex roles, discrimination
o Pro-feminist: equality in relationships very important
o Recognized that we all have goals, driven goals
o While we have id, ego, etc they are a source of creativity
o Coined the term “inferiority complex”
o Talked about importance of self-esteem, self-esteem has important impact on mental health - Carl Jung:
o Emphasize collective unconscious: culturally determined symbols and myths that are shared among all people that could serve as a basis for interpretation beyond sex or aggression - Melanie Klein
o Primitive fantasises of loss and persecution like worrying about a parent dying or about being bullied, were important factors underlying mental illness
o Karen Jorney
Disagreed with Freud about inherent differences in the psychology of men and women – traced differences to society and culture instead of biology - All approaches: individual is part of a larger society, and conflicts can reflect the individual’s role in societ
Carl Jung?
- Emphasize collective unconscious: culturally determined symbols and myths that are shared among all people that could serve as a basis for interpretation beyond sex or aggression
Melanie Klein?
Karen Jorney?
- MK: Primitive fantasises of loss and persecution like worrying about a parent dying or about being bullied, were important factors underlying mental illness
- KJ: Disagreed with Freud about inherent differences in the psychology of men and women – traced differences to society and culture instead of biology
Psychodynamic these days - childhood/sex/unconsciousness/ego?
- Childhood and sex important, but not as much as Freud said it was
- Insight into unconsciousness: still as important
- Role of ego: can also be a positive force
- less interpretation of unconscious sexual or aggressive impulses
- Other concepts are still important: transference, fostering insight into unconscious processes
Psychodynamic these days - length? IPT?
- Interpersonal psychotherapy (IPT)
- Focuses on helping clients improve current relationships
- Treatment focused on person’s interpersonal behaviours and feelings
- particular attention to client’s grief, role disputes, role transitions or interpersonal deficits
- As interpersonal relations improve, assumed that symptoms will subside
- IPT vs classical psychoanalysis: face to face, less intensive, lasts shorter and less often sessions
Psychoanalysis - assumes humans are? encourages clients to? focuses on? session takes place? what happens during sessions?
a) More textbook notes on psychoanalysis
- Assumes humans are born with aggressive and sexual urges repressed during childhood development through use of defense mechanisms
- Encourage clients to bring repressed conflicts into consciousness to understand them and reduce unwanted influences
- Focus on early childhood events (where urges/conflicts were likely to be repressed)
- Take place over an average of 3 – 6 years, with 4 or 5 sessions a week
- Client reclines on couch and faces away from analyst
o Client expresses whatever thoughts/feelings come to mind
Analyst comments but doesn’t express his values/judgements
Free Association
- reporting every thought that enters the mind without censorship/filtering
- therapist looks for themes that recur
Dream Interpretation/Analysis - dreams are? interpretation?
- dreams are metaphors that symbolize unconscious conflicts/wishes that contain disguised clues
- mainfest = what dream was about, latent = underlying true meaning
- interpretation: therapist deciphers meaning (unconscious impulses/fantasies) underlying what the client says and does
Analysis of Resistance? Transference?
- resistance if reluctance to cooperate with treatment for fear of confronting unpleasant unconscious material
- could be interpreted that interpretation is correct
- aka as soon as you get to source of problem, patient feels distressed, tries to find way out
- Transference: analyst begins to assume major significance in clients life, client reacts to analyst based on unconscious childhood fantasies
- unconscious redirection or urge/anger/desireonto therapist
Cognitive-Behavioural Therapy: what? unlike psychodynamic? emphasizes? learning?
- In contrast to insight therapies, CBT argue that thinking and insight not enough – have to take action, do something
- either change thinking or behaviour or both
- Unlike psychodynamic, which emphasizes early developmental processes as source of problems, BCT emphasize current factors like maladaptive behaviours an dysfunctional thoughts
- Have to relearn system of rewards – wrongly rewarded for maladaptive behaviour, which causes problems
