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Approaches to Psychotherapy

Approaches to Psychotherapy

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Published by Hassan.shehri

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Published by: Hassan.shehri on Nov 22, 2007
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Approaches to psychotherapy
 APPROACHES TO PSYCHOTHERAPY 
Introduction
Treatment of psychological distress and disorders through verbal, cognitive and behavioral techniques;- many different schools of psychotherapy.-
listening
,
empathy
, interpretation, and action may all be involved.At the core of any psychotherapy is an
EMPATHIC RELATIONSHIP
, the
THERAPEUTIC ALLIANCE
.THREE MAJOR SCHOOLS:1.PSYCHOANALYTIC (PSYCHODYNAMIC)2.COGNITIVE-BEHAVIORAL (CBT)3.HUMANISTICBUT THE MOST FREQUENTLY USED AND EVIDENCE BASED IS (CBT)
 Psychodynamic Psychotherapy
Sigmund Freud
There have been a multitude of variations that have evolved and the term mostoften used to broadly encompass these approaches is "Psychodynamic."
Terms such as: neurosis, conflict, attachment, object relations, unconscious,defense mechanisms, id, ego, superego, drives, libido, transference,countertransference, and countless more have emerged from this approach.
A THEORY OF CONFLICTS
Psychodynamic therapies work to make the unconscious conscious so that we canhave greater insight into our needs and behavior and therefore more control overhow we allow these conflicts to affect us.
 PROCESS OF PSYCHODYNAMIC PSYCHOTHERAPY 
- Process more important than content.
 The symbolic meaning to a behavior or pattern of behavior. (E.G., exploring the process of RESISTANCE)
Symptom reduction seen as superficial. All behavior seen as symbolic: "nothinghappens by accident."
(example of being late).
TECHNIQUES OF THERAPY 
OPENING PHASE (FREE ASSOCIATION): The
analyst hardly ever says anythingexcept to make an “interpretation” (i.e., the unconscious motives behind youractions or thoughts are pointed out to you). There are no excuses for missing asession, and payment is required whether you attend the session or not.
. . . andthis goes on for several years.
 CATHARSISDREAM ANALYSISANALYSIS OF TRANSFERENCEANALYSIS OF RESISTANCEInterpretation
 Structural Model of Personality:(id, ego, superego)The Divisions of MIND: consiuoness, pre-conscious, and unconsciousness.
Cognitive Behavior Therapy:
 
The use of cognitions to modify behavior 
 
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Approaches to psychotherapy
Cognitive behavior therapy
is a clinically and research proven breakthrough inmental health care. Hundreds of studies by research psychologists and psychiatristsmake it clear why CBT has become the preferred treatment for conditions such as:Depression and mood swings, Shyness and social anxiety; Panic attacks and phobias;Obsessions and compulsions (OCD and related conditions); Chronic anxiety or worry;Post-traumatic stress symptoms (PTSD and related conditions); Eating disorders(anorexia and bulimia) and obesity; Insomnia and other sleep problems;Cognitive behavior therapy* combines two very effective kinds of psychotherapy — cognitive therapy and behavior therapy. Cognitive-Behavioral Therapy (CBT) is a practicalapproach that seeks to define concrete goals and uses active techniques to reach them. Thecognitive-behavioral therapist looks at patterns of thinking and behavior and how these patterns are reinforced and maintained by the person within his or her environment. Afunctional analysis of thinking and behavior is performed, often using log sheets and graphsto better understand thought and behavior patterns in the context of daily routines. Once anunderstanding of symptoms and behavior is achieved, the therapist and client together devisechanges in the patterns and continue tracking. This process is repeated until the originalgoals are met. Attention to irrational thinking patterns (e.g., automatic thoughts, catastrophicthinking) is central to the approach as well.Some of the techniques and programs that are usually associated with CBT are relaxationtraining, systematic desensitization, assertiveness training, and social skills training.Historically, Cognitive-Behavior Therapy (CBT) has its roots in the work of behaviouristssuch as Ivan Pavlov, John Watson, Joseph Wolpe, and B.F. Skinner. Skinner, in particular,developed theories of operant conditioning that were the basis of behavior therapy, whichviews the consequences of behavior as shaping future behavior. Associated with Skinner areterms such as stimulus-response, positive reinforcement, and contingencies of behavior.Skinner's emphasis was on observable behavior. It was theorists such as Albert Bandura(Social Learning Theory) and cognitive therapy and cognitive-behavioral therapy originatorssuch as Albert Ellis (Rational Emotive Behavior Therapy), Aaron Beck (Cognitive Therapy),William Glasser (Reality Therapy) and Donald Meichenbaum (Cognitive-BehavioralTherapy) that brought thought and emotion into this approach.
 How Cognitive Behavior Modification Works
Cognitions such as beliefs, attitudes and even emotions can cause behavior Much maladaptive behavior is caused by inappropriate or illogical cognitionsMany of our cognitions may not be accurate representations of realityBy changing these cognitions, the behaviors that they lead to will in turn be changedUsually employed with individuals who suffer from:dysfunctional automatic thoughts - involving content specific to an event.schemata - general rules about themselves or the world associated with anevent. (THE TRIANGLE).
Cognitive Distortions
These individuals often engage is self-statements that affect their behavior.All or Nothing” ThinkingSelective AbstractionOvergeneralization
 
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Approaches to psychotherapyMagnificationMinimizationPersonalizationLabeling
(Mislabeling)
CatastrophizingMind-readingNegative Predictions
 Methods of Cognitive Behavior Modification
1.Self-Instruction Training: (Overt-Covert),2.Thought-Stopping.3.Cognitive restructuring4.BEHAVIORAL RE-ATTRIBUTION5.COGNITIVE RE-ATTRIBUTION6.BEHAVIORAL EXPERIMENTATION7.SCHEMA ANALYSIS
 REIFROCEMENT 
Positive reinforcer:
A stimulus that when added to a situation, increases thelikelihood that a response will occur.
Positive reinforcement:
reward
Negative reinforcer:
A stimulus, that when removed from a situation, increases thelikelihood that a response will occur, relief.
Negative reinforcement:
relief Punishment – try to decrease the likelihood of a responsePositive punishment – something unpleasant occursNegative punishment – something pleasant is removed
TOKEN ECONOMY 
A behavior therapy procedure, based on operant conditioning principles, in whichinstitutionalized patients are given tokens, such as poker chips, for sociallyconstructive behavior, and are withheld when unwanted behaviors are exhibited. Thetokens themselves can be exchanged for desirable items and activities such as tea or coffee and extra time away from the ward.Token economy, in short term trials, waseffective at reducing the negative symptoms of schizophrenia. . For example, patientsin a mental hospital are given tokens they can exchange for food or coffee when theymake their beds, groom themselves, get up and go to sleep at the correct hours, and soon; they are fined (tokens are taken away) for assault or destruction of property.
Other Techniques
Time-out:
weaken undesired behavior by temporarily removing positivereinforcement.Example: Sending a student who frequently interrupts classroomroutine to sit in an empty room for 10 min. (Punishment II)
Response Cost
: tokens are withdrawn when child makes an undesired response
Extinction:
weaken undesired behavior by
ignoring
it.Example: A mother ignoring awhining child, or a teacher ignoring a student who speaks out of turn.
FLOODING:
 
This is the type of exposure therapy that starts with the most fearedrather than the least feared stimulus is called flooding; If conducted only in theimagination, it is sometimes called implosion. The therapist controls the timing andcontent of the scenes to be imagined or confronted, and instead of trying to relax, the
 
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