PSYCHOLOGY

CLASS 12th

Chapter 5
( Therapeutic Approaches And
Counselling )
 Topics :
⚫ Psychotherapy is a voluntary relationship between
the one seeking treatment or the client and the one
who treats or the therapist.
⚫ It aims at changing maladaptive behaviour, to solve
their problems etc.
⚫ There are several characteristics of
psychotherapeutic approaches:
Systematic application of principles
Only trained person can practice therapy
It involves a therapist and a client who seeks and receives
help.
 Therapeutic relationship
⚫ Interaction between client and therapist form
therapeutic relationship
⚫ Special relationship between client and therapist is
known as therapeutic relationship. It has two
components :
- Contractual nature of relationship

- Limited duration of therapy

Unique properties of relationships :

⚫ Trusting & confiding relation

⚫ Unconditional positive regard
⚫ Empathy
⚫ Strict & confidential
⚫ Professional relationship
Types of therapies :
⚫ PSYCHODYNAMIC THERAPY
⚫ BEHAVIOUR THERAPY
⚫ COGNITIVE THERAPY
⚫ Humanistic-Existential Therapy
⚫ BIOMEDICAL THERAPY
⚫ ALTERNATIVE THERAPIES
 Psychodynamic therapy
⚫ It is pioneered by Sigmund Freud. It is oldest form of
psychotherapy.
⚫ It has conceptualized the structure of psyche, dynamics
between different components of psyche and source of
psychological distress.
⚫ Intrapsychic conflicts leads to disorder.
⚫ First step is to elicit this Intrapsychic conflict by the
method of free association & dream analysis invented
by psychoanalysis.
⚫ Modality of Treatment:
⚫ (a) Transference: The client starts identifying the
therapist with the authority figures of the past, usually
childhood.
⚫ (i) The therapist maintains a non-judgmental and
permissive attitude and allows the client to continue with
this process of emotional identification.
⚫ (ii) Transference Neurosis
⚫ • Positive Transference
⚫ • Negative Transference
⚫ (b) Resistance
⚫ (i) Conscious Resistance.
⚫ (ii) Unconscious Resistance.
⚫ (c) Interpretation
⚫ (i) Subtle process, the pinnacle of psychoanalysis.
⚫ (ii) Two analytical techniques:
⚫ Confrontation
⚫ Clarification
⚫ Working Through: confrontation, clarification and
interpretation.
⚫ Insight
⚫ (i) End-point of psychoanalysis
⚫ (ii) Intellectual Insight
⚫ (iii) Emotional Insight
Intense treatment, three phases.
⚫ (i) Initial Phase: Client becomes familiar with the
routines, establishes a therapeutic relationship, and
recollects the superficial material from the
consciousness about the past and present.
⚫ (ii) Middle Phase: Characterised by transference,
resistance on the part of the client, and confrontation,
clarification and working through on the therapist’s
part; all these processes finally lead to insight.
⚫ (iii) Third Phase: Termination; the relationship with
the analyst is dissolved and the client prepares to leave
the therapy.
Behaviour therapy :
⚫ Behaviourists believes that distress arises due to faulty
learning.
⚫ The clint unlearn the faulty behaviour and relearn a
new one by various techniques.
⚫ Mode of treatment :
⚫ - clint is interviewed and analysed
⚫ - identification of malfunctioning behaviour
antecedent factors and maintaining factors.
⚫ -antecedent operation and consequent operations
are used.
⚫ Behavioral Techniques :

⚫ - Positive reinforcement
⚫ - Token economy
⚫ - Negative reinforcement
⚫ - Aversion conditioning
⚫ - Systematic desensitisation (fears)
⚫ - Principle of reciprocal inhibition
⚫ - Modelling
⚫ Cognitive therapy
1). Rational Emotive Therapy (RET) (Albert Ellis)
• Irrational beliefs mediate between the antecedent
events and their consequences.
• The first step in RET is the
antecedent-belief-consequence (ABC) analysis.
• Antecedent events, which caused the psychological
distress, are noted.
• Client is interviewed to find irraltional believes which
distorting the reality.
• Unconditional positive regard
• Non-directive questioning ( gentle, make the client
think deeper, change philosophy, rational belief system
replaces the irrational belief system.)
2. Aaron Beck’s Cognitive Therapy:
⚫ As per him, childhood experience create core
schemas which include beliefs and action patterns.
⚫ They create negative thoughts which are characterized
by cognitive distortions.
⚫ These patterns of thoughts are called dysfunctional
cognitive structures. Repeated occurrence can cause
anxiety & Depression.
⚫ The aim is to achieve cognitive restructuring.
COGNITIVE BEHAVIOUR THERAPY (CBT)
⚫ Short & efficacious treatment
⚫ Adopts bio psychosocial approach.
⚫ Combines cognitive and behavioural techniques.
⚫ Origins in biological, psychological and social realms.
⚫ Comprehensive technique
HUMANISTIC THERAPY
⚫ Distress arises due to inability to find meaning of life.
⚫ Motivation by desires of self actualization
⚫ Healing occurs at a stage
⚫ It requires free emotional expression which is curbed
and leads to destructive behaviour etc.
⚫ Therapy creates permissive and non judgmental
atmosphere
⚫ Therapist is facilitator & guide
⚫ Aim is to expand the client’s awareness.
EXISTENTIAL THERAPY
⚫ Victor frankl gave logo therapy i.e treatment for the
soul.
⚫ Neurotic anxiety arises
⚫ Frankl emphasised to the role of spiritual anxieties
leading to meaninglessness and hence may be called
existential anxiety.
⚫ The goal is to facilitate the client to find the meaning
of his/her being.
CLIENT CENTRED THERAPY
⚫ Given by Carl Rogers.
⚫ He brought into psychotherapy the concept of self.
⚫ It provides warm relationship.
⚫ Empathy, unconditional positive regard, non
judgmental
⚫ The reflection us achieved by rephrasing client’s
statements.
⚫ Personal relationships improves with increase in
adjustments.
GESTALT THERAPY
⚫ Given by Freiderick perls with his wife Laura perls.
⚫ Goal is to increase self awareness and acceptance
⚫ Can be done in group settings
⚫ Therapist encourages client.
BIOMEDICAL THERAPY
⚫ Medicines can be prescribed given by psychiatrist.
⚫ Nature of medicine depends on disorder
⚫ Anti psychotic drugs, milder drugs
⚫ Medication should be under supervision
⚫ Electro convulsive therapy (ECT)
⚫ Mild shocks given via electrodes
⚫ Not a routine treatment
Factors Contributing to Healing:
⚫ Techniques adopted by the therapist and the
implementation of the same with the client.
⚫ The therapeutic alliance.
⚫ Catharsis: A process of emotional unburdening by a
client.
⚫ 4. Non-specific Factors:
⚫ (i) Patient Variables (motivation for change,
expectation of improvement).
⚫ (ii) Therapist Variables (positive nature, good mental
health, absence of unresolved emotional conflicts).
Ethics in Psychotherapy:
⚫ Informed consent needs to be taken.
⚫ Confidentiality of the client should be maintained.
⚫ Alleviating personal distress should be the goal of all
attempts of the therapist.
⚫ Integrity of the practitioner-client relationship is
important.
⚫ Respect for human rights and dignity.
⚫ Professional competence and skills are essential.
ALTERNATIVE THERAPIES Yoga:
⚫ A. Sudarshana Kriya Yoga (SKY)
( Rapid breathing, PTSD, Reduces stress)
⚫ B. Kundalini Yoga
(breathing techniques, OCD)
⚫ C. Vipasana Meditation
(Mindfulness-based meditation)
Rehabilitation of the Mentally :
⚫ In rehabilitation, the patients are given:
(i) Occupational Therapy: teaches skills such as candle
making, paper bag making and weaving to help them to
form a work discipline
(ii) Social Skills Training: Develops interpersonal skills
through role play, imitation and instruction; objective is
to teach the patient to function in a social group.
(iii) Cognitive Retraining: Improves the basic cognitive
functions of attention, memory and executive function.
(iv) Vocational Therapy: Once the patient improves
sufficiently, gains skills necessary to undertake
productive employment.
Topics Covered :
⚫ Psychotherapy meaning.
⚫ Therapeutic relationship.
⚫ Classification of therapies.
⚫ PSYCHODYNAMIC THERAPY.
⚫ Behaviour therapy.
⚫ Cognitive therapies.
⚫ Humanistic-Existential therapy.
⚫ Biomedical therapy.
⚫ Factors contributing to healing.
⚫ Alternative therapies.
⚫ Rehabilitation of mentally ill.