WEEK 6 - Treatment Flashcards
Explain the term psychotherapy?
Involves techniques that attempt to improve psychological and emotional wellbeing.
Who, apart from psychologists, can use psychotherapy?
Social workers Counsellors Nurses GPs Psychiatrists
Name some characteristics that make a good therapist.
Warmth Therapeutic alliance Key issues Align treatment with patient Willing to get feedback from client, supervisor and colleagues Keep up-to-date with research Ethics
What model are therapeutic practices based around?
The science-practitioner model
Research-orientated practice
Name some psychotherapeutic perspectives
Psychodynamic Humanistic-existential Behavioural Cognitive behavioural Biological
What are psychodynamic therapies?
Founded by Freud.
Psychopathy is developed when people remain unaware of their true motivations and fears.
Health is restored when they become aware of their subconscious.
What is insight in relation to psychodynamic therapy?
Capacity to understand their own psychological processes
What is the therapist-client alliance and why is it important to psychodynamic therapy?
Relationship with therapist is crucial in changing psychological processes.
What are the 5 core beliefs of psychodynamic therapies?
- Most behaviour is driven by unconscious wishes, impulses, drives and conflicts
- There is meaningful explanation/cause for abnormal behaviour, which can be discovered by the therapist
- Current issues are due to childhood experience
- TO overcome problem, emotional expression and reliving of the past experiences is crucial
- Once the client understands and has emotional insight into the unconscious drives/material, the symptoms are understood and therefore, often resolve themselves
What are the stages of psychoanalysis?
- Free association
- Interpretation
- Dream analysis
- Resistance
- Transference (Counter transference)
- Working through
What is the psychodynamic stage of free association?
- Free reign to express thoughts/feelings and whatever comes to mind
- It is assumed that with enough practice, free association will facilitate the uncovering of the unconscious material
What is the psychodynamic stage of interpretation?
- Comes into play as presumably unconscious material begins to surface
- At the right time, the therapist will explain defences and underlying meaning of behaviours, thoughts, desires or dreams
- Interpretations should reflect insights that the patient os making themselves
- then interpretations can be claimed as patients idea rather than therapists
What is the psychodynamic stage of dream analysis?
- Therapist interprets dreams in the context of what is occurring in life for the person
- Looks at dreams manifest (Actual dreamt events) and tries to determine the latent (hidden) meaning
What is the psychodynamic stage of resistance?
- Resistance or blockages to free association are thought to arise from unconscious control over sensitive areas
- These are targeted by therapist
What is the psychodynamic stage of transference?
When people experience similar thoughts, feelings, fear, wishes and conflicts in new relationships as they did in previous ones
- Person may transfer feelings from prior relationship onto therapist as it is a highly intimate and disclosing relationship
What is counter transference in relation to the stages of psychodynamic theory?
Where therapist transfers their own emotional vulnerabilities onto the client
- Negative effect
What is the 6th stage of the psychodynamic theory, ‘working through’?
Therapist assists person in processing the information and insights gained during therapy. Also involves continued identification of arising conflicts and resistance
What are some criticisms of the psychodynamic approach?
- Sample bias: Frued based approach on rich, intelligent, successful individuals
- Confirmation bias: selecting pieces of information that supports claims and disregards info that doesn’t
- Long term = expensive
- Do we really need insight to solve problems?
- Lack of scientific rigour in some situations - circular arguments
What is humanistic-existential psychotherapy?
- Considered as 1 of 3 main approaches (behaviourism/psychoanalysis)
- Concerned with how a person experiences self, relationships with others and the world
- Person-centred therapy
- Gestalt therapy
What is maslows hierarchy of needs?
- Self actualisation
- Esteem need
- social needs
- safety needs
- Physiological needs
What are 2 common misconceptions about Maslow’s hierarchy of needs?
- You have to satisfy more basic need before progressing up the hierarchy towards self-actualisation
- Self-actualisation is the peak of hierarchy of needs
What is person-centred therapy?
- Rejects the notion of a disease-model
- People do therapy to help solve problems and not to be cured of their disorder
Who devised person-centred therapy?
Carl Rogers who rejects the notion of a disease model
What are the core traits of a therapist in the person-centred therapy model of humanistic existential psychotherapy?
- Therapists must be authentic and genuine
- The therapist must express unconditional positive regard (acceptance of client’s feelings)
- Must relate to client with empathetic understanding
What are the Rogerian assumptions of person-centred therapy in the huanistic-existential model of psychotherapy?
- People can be understood only from the vantage point of their own perceptions and feelings
- Healthy people are aware of their own behaviour
- People are innately good and effective, the become ineffective and disturbed only when faulty learning intervenes
- Behaviour is purposive and goal-directed
- Therapists should not attempt to manipulate events for the individual - rather they should create conditions which will facilitate independent decision making by the client
In the humanistic-existential theory of psychotherapy, what is gestalt therapy?
- Dysfunction caused by individuals suppressing experiences and traits that are anxiety inducing
- Need to recognise and accept those to be integrated as a whole
- Socialisation has lead people to become overly self-controlling of thoughts, behaviours and feelings in order to conform
- Lose touch with inner self and causes dysfunction
- Emphasis of therapy is accepting feelings and focussing on here and now
What are the two gestalt techniques used?
Empty chair technique: Provides opportunity to talk to another without risk
Two-chair technique: outline both sides of the story
What are some criticisms of the humanistic-existential theory?
- Lack of scientific rigour in some situations - difficult to measure self awareness
- Positive regard and empathy may not be necessary for effective counselling
- Efficacy is variable - some evidence suggests not more beneficial than simply talking to a non professional about problems
- Cultural bias? some argue that humanistic approach is based on Western individualistic values
What are behavioural and cognitive behavioural therapies?
Psychodynamic and humanist perspective focus on isight and emotion as the pathway to improvement
- Behavioural therapy and CBT evolved as a result of the development of behaviourism and cognitive psych from 1940s. Both have their basis in scientific explorations rather than clinical practice
What are the basic principles to behavioural and CBT?
- Short-Term
- Therapeutic focus is the current behaviour/cognitions, not on past experiences or inferred motives
- Therapy commences with behavioural analysis
- Therapy targets problematic behaviours, cognitions and emotional responses
What are Exposure behavioural therapies?
- Used to treat phobias and anxiety-triggered responses
- Involves confronting the client with the fear.
- The way in which this confrontation occurs determines the type of exposure used.
- Techniques include:
- Systematic desensitisation
- Flooding techniques
- Virtual reality exposure
- The crucial element in all exposure is to expose the client so they are prevented from escaping the stimulus until anxiety subsides
Anxiety reaction _______ over time due to the ______ _______ for maintenance.
- Decay
- Energy requirements
B preventing the capacity to _______ or ________, the person experiences ______ ______ and is therefore _________.
- flee or fight
- anxiety decay
- Reconditioned
What is systematic desensitisation in relation to exposure techniques in behavioural therapy?
- Aimed at specifically the alleviation of maladaptive anxiety, particularly phobias
- Involves pairing relaxation with imagery of anxiety provoking scenes or stimuli - a counterconditioning process
What is flooding in relation to exposure techniques in behavioural therapies?
- Client is exposed immediately to feared experience
Response prevention: The therapist stops the person from engaging in their typical avoidance responses - both behavioural and cognitive
What is virtual reality and how can it assist exposure techniques of behavioural therapies?
- The client views computer generated images of the feared experience
What is modelling and skills training in relation to behavioural therapies?
- Learning theory (Bandura) 1960s
- Influences heavily how clinical psychologists explain how disorders develop as well as develop through new therapeutic approaches to treatment
What is modelling in relation to behavioural therapies?
- Children and adults model the behaviour of others, often subconsciously
- Can learn maladaptive and adaptive behaviours
- Client modelling the behaviour of therapist can be used implicitly or explicitly
In relation to modelling in behavioural therapies, what is social skills training?
- Assisting clients with interpersonal/scial problems
- Direct skills training from therapist, followed by role playing with self-examination of behaviour and rehearsal
- VR is also used for social interactional problems
- Can be used to improve social interactions in people with schizophrenia, depression, autism. However, when used in this manner cannot be considered to cure the disorder
What is assertion training and behavioural rehearsal in relation to modelling in behavioural therapies?
Teaching people to respond to requests in an appropriate manner - eg. not excessively submissive or aggressive
Behavioural rehearsal: Therapist uses role-play to demonstrate and allow practice of behaviours
What is operant conditioning?
The use of reward based systems to counteract maladaptive behaviours, emotions or cognitions
Pippa is given a smack for chewing up your steel-cap boots. What kind of operant conditioning is this?
Postive punishment
Reward: smack
Behaviour: do not eat steel caps again
What are conditioning techniques in relation to behavioural therapies?
- Widely used in dealing with anxiety disorders, especially in children or in high-needs environments
Token economy: use star chart or similar to promote desired behaviour or discourage unwanted behaviour.Often used in children but can be used in an adult setting
What are aversion therapies in relation to conditioning techniques?
Pairing of unpleasant stimuli with unwanted behaviour
- Not commonly used, however, still useful
What are some criticisms of behavioural therapies?
- Some therapies require a moderate-high level of motivation
- Negative thoughts can be realistic
- Insufficient consideration of personal relationships
What are the advantages to group therapy?
- Cost/time efficient
- Allows peer support
- Helps to normalise experience
- Better opportunities to practice skills
- Can be done online or in person
What are the disadvantages to group therapy?
- People may be reluctant to share/fell comfortable
- May learn new maladaptive behaviours from others
- Lack of personalised treatment
What is family therapy?
Group therapy but the family members are the group group
- Therapy is focussed on all members
- Strategic
- Structural
What is strategic and structural family therapy?
Strategic: Designed to improve communication between family members, help them work together to solve problems etc
Structural: The therapist interacts with and observes the family and helps to change the way they interact
