Psych 100 Lesson 16 Treatment (1)

  1. Elements of Treatment
    1. History
      1. No systematic treatments before 1880's
      2. Bruener and the talking cure for Anna O
      3. Freud steals Bruener's discovery
      4. Psychanalysis is born
    2. Classes of Treatment
      1. Insight Therapies - talking cures
      2. Behavior Therapies - classical and operant conditioning
      3. Biomedical Therapies - medical intervention, mostly chemical, but others
    3. Clients
      1. Insured, divorced/separated, educated, middle aged, females
      2. Disjunction between diagnosis and treatment
    4. Therapists
      1. Psychologists
      2. Psychiatrists
      3. Other health professionals: clinical social workers, psychiatric nurses, counselors
  2. Insight Therapies
    1. Psychoanalysis-Freud, Jung, Adler,-emphasizes the recovery of unconscious conflicts, motives, and defenses through techniques of free association, transference
      1. Anxiety dominated disturbances (phobia, panic, obsessive-compulsive, conversion) are neuroses
        1. Caused by unconscious conflicts left over from childhood
        2. Evoke defense mechanisms which lead to self defeating behaviors
          1. Repression, projection, displacement, reaction formation, regression, rationalization, identification (Weiten, pg 491)
        3. Defenses rarely fully successful
      2. Personality theory postulates layers of onion
        1. Conscious, Preconscious, Unconscious
        2. Tapped by free association, spontaneous expression of thoughts and feelings, uninhibited
        3. Dream analysis, direct expression of unconscious, symbolic interpretation
      3. Interpretation, explains inner feelings at root of problem
      4. Resistance, defensive maneuvers intended to hinder progress
      5. Transference, relating to therapist in ways that mimic critical relationships in their lives
      6. Jung's variation, collective unconsciousness, common memory
    2. Client-Centered Therapy- Rogers, reaction to psychoanalysis, emphasizes providing supportive emotional climate for clients, who determine pace and direction of therapy
      1. Cause of neurosis incongruence between self concept and reality
      2. Creating proper therapeutic climate
        1. Genuineness
        2. Unconditional positive regard
        3. Empathy
      3. Peer relationship, clarification, mirroring, build toward insights and congruence
    3. Cognitive Therapy, Beck & Ellis, emphasizes recognizing and changing negative thoughts and maladaptive beliefs
      1. Depression is caused by errors
        1. Blame selves when inappropriate
        2. Focus on negative, ignore positive
        3. Pessimistic about the future, self fulfilling prophesy
        4. Negative conclusions about self worth based on insignificant events
      2. Therapist resets standards for evaluation, underlying reasoning
      3. Borrow from behavior therapies, mixed with talk therapy
    4. Group Therapy - simultaneous treatment of several clients in a group
      1. Employ socialization as a tool for changing attitudes and behavior
      2. Therapist is setting goals, initating and maintaining theraputic process, protect clients
      3. Facilitates and promotes healthy client
      4. Takes into account the social context of behavior
      5. More cost effective than 1 on 1 therapies
    5. Evaluating Insight Therapies
      1. Limited primarily to neuroses
      2. Eysenck identifies spontaneous remissions, about the same recovery as those treated
        1. Problems tend to be self correcting
      3. Subjective benefit
      4. Doing something