Chapter 16
Psychotherapy
Major Types of Psychotherapy
> Psychoanalysis/Psychodynamic Therapy > Humanistic Therapy > Cognitive and Behavioral Therapy
Psychoanalysis
Is the first formal psychotherapy to emerge, developed by Sigmund Freud The patient lies on a couch and speaks about whatever comes to his or her mind Techniques: free association, interpretation, transference of feelings
Goals of Psychoanalysis
o Release of energy devotes to id/ego/superego conflicts Help patients fully know themselves Bring patients' repressed feelings into conscious awareness o Give patients insight to their thoughts, feelings, and disorders
Psychodynamic Therapy Modern adaptation of psychoanalysis Focus on themes across important relationships o Childhood experiences o Therapist-patient relationship Patients explore and gain perspective into their thoughts and feelings Reveal past patterns and interpret behavior Elicit in-session emotions Humanistic Therapy
Humanistic therapists aim to boost self-fulfillment by helping people grow in self- awareness and self-acceptance Client-centered therapy o Developed by Carl Rogers o Listen to client in an accepting and non-judgmental way o Building Non-directive Unconditional positive regard Focus on paraphrasing and reflecting feels
Cognitive and Behavioral Therapy (CBT)
Psychological symptoms are the result of an interaction between thoughts and behaviors Aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy) Focus on behavior and learning mechanisms Broadly applicable and evidence-based
CBT Treatment for Anxiety Disorders
Exposure Therapy (Phobia, PTSD, GAD) Interoceptive Exposure (Panis Disorder) . Exposure and Ritual Prevention (OCD)
Exposure Therapy
> Treats anxiety disorders -- Expose patients to stimuli they fear and avoid > Over time, habituation to the feared stimulus occurs > Imaginal, in vivo, virtual reality
Interoceptive Exposure
Expose patients to different physical sensations that might mimic panic attack symptoms Rate how anxious it makes them feel Examples: o Breathe through a straw o Shake head back and forth Stair climbing Chair spinning o Hyperventilation
Exposure and Response Prevention
> Used to treat OCD > Expose patient to stimulus, then prohibit him/her from performing any rituals or safety behaviors
CBT Treatment for Depression
o Cognitive Restructuring Behavioral Activation o Acceptance and Commitment Therapy
Teaches people adaptive ways of thinking and acting based on the assumption that thoughts intervene between events and our emotional reactions "Just because you have a thought, doesn't mean it's true"
CBT Treatment for Depression (Continued)
Recognizing and labeling cognitive distortions Changing maladaptive behaviors Emotional regulation and distress tolerance Cognitive defusion Mindfulness Acceptance of negative internal experiences Living in accordance with goals and values, not according to symptoms
Psychotherapy Outcomes
> Meta-analysis of a number of studies suggests that thousands of patients benefit more from therapy than those who did access therapy
> Different types of therapies work better for different disorders/symptoms and different people
> Some medications are as effective as therapy, while some are not o For some disorders, medication + therapy may be an ideal combinat