Modes of Psychotherapy

Number of people that your working with: Depends on their issues

There are clinical, cultural or economic issues that makes us choose different
modes

Some of those issues or reasons to choose are:

o Patient problem or diagnosis

o Problem demonstration

o Mediating goals of treatment

o Patient preference

o Efficiency of treatment

Individual Psychotherapy:

o A very important part is the treatment plan:

It is not static, because everything is in constant change

The written treatment plan helps the patient and the therapist
remain aware of the reason of PT

You dont have to write down your treatment plan but you have to
remember your main goal

Also new goals and treatment plans can appear

Overview of what the therapist hopes to accomplish with the

patient

They depend on the theoretical model

o Child Psychotherapy:

Before starting PT is necessary to asses the child, the parent and the
parent - child interaction

Play therapy is a safe setting for resolving conflict in the child's life
 Play is a safe place for kids, thats the way they express their
thoughts and feelings

The child structures the hour by choosing both the topics and the
types of play

Children get different feedback during the therapy, making him see
that there are other contexts

Kids feel very guilty when they get mad with your parents

We have to asses problems related to behavioural, emotional or

intelectual functioning

Therapy: Working with children and their families to bring

meaningful improvement to their lives

Research or training: You need to understand meanings and how to

work with them

Common Problems:

Attention deficit/hyperactivity disorder

Conduct disorder

Oppositional defiant disorder

Separation anxiety disorder

Externalising disorders: Child acts out often become

disruptors for parents, teachers or other children

Internalising disorders: Maladaptive thoughts and

feelings (the most difficult to notice)

Every problem a kid has is related to his parents, it is the adults fault

The kid doesnt have the ability to know what is wrong and make
decisions of their own

Kids dont ask for therapy, someone always brings them

Abilities:
 Competence: Ability to handle expected developmental tasks
(normal development activities)

Resilience: Ability to demonstrate competence when you

have been faced with significant adversity

Assessment of the child:

Developmental perspective: What moment (not stage) of the

development he or she is

Comprehensive perspective: You cannot apply a test and

thats it

You need to know what the problem is and when did

it arise

What`s the child current state (physical, cognitive,

linguistic and social development)

What are the characteristics of their parents and their

parenting use

What is the childs larger environment outside the

family, recent major events (e.g.futbol school)

Multi source approach: Dont just keep what the

parent says (school, other family members, etc.)

Multi method approach: Observation, test, interview,

etc. Not just one

Multi setting approach: Look for all the contexts the

kid lives in

Assessment methods:

Interview

Behavioural Observation

Behaviour Rating Scales (how many times)

Self-report Scales (mostly for parents)

 Projective/Expressive Techniques (e.g. drawing
family)

Intelectual Tests

Psychotherapy: You HAVE to get special training (how)

Self-instructional training

Parent training

Play therapy training

Change process in children:

Catharsis and labelling feelings (teach them)

Corrective emotional experience (I can understand

this and live in another way)

Insight and working through (I have this issue so lets

work with it)

Learning alternative problem-solving techniques

(maintaining variables)

Non-specific variables

Video: Sand Therapy

Video:

While working with children we have to assume that

the more useful medium to talk will be play

You can just put generic toys there, you have to

carefully choose which toys are adequate

The important thing is not the toy but what it does

and what it represents

You have to know the child and his/her

developmental state
 Drawing and painting is another good way for kids to
express their experiences and feelings

The drawings and paintings can yield a great mount

of information, but it is difficult to interpret it

It is simpler and more natural for them to express

what happened

Provides opportunity for reparations

Therapist is passive but and active observer

You take mental notes to detect patterns

Some things that show up with sexual abuse is:

Avoidance or explicit expression of sexual

topics

Broken things (sense of not being whole)

Violent, disorganised or frightening

environments

You have to be very careful not to read too much and

very open to what the child is saying

The right interpretations are guided by your patient,

you have to listen

The interpretations are hypothesis that the patient

confirms

o Couple therapy:

Recommended when the issue is basically in the couple unit rather

than on the individuals

They help the couple have a more satisfying relationship

Helps the couple to terminate the relationship if it is necessary for

them
 That decision must be taken by the couple not by the
therapist

The final decision is never yours is the couples

Approaches:

Integrative couple therapy:

Founded in behavioral therapy

Control variables in the relationship (things that can

be changed)

Emphasis is placed on determining what are the

controlling variables in marital interactions

Based in two components:

Behavioral exchange

Involve attempts to increase the ratio

of positive to negative behaviors
exchanged by the couple at home

Communication/Problem-solving training

Teach the couple to be their own

therapists

Psychodynamic:

Gain an understanding of the use of such ego defense

mechanism as projection to place expectations on
their partner

Ego analyst: People develop dysfunctional

relationships with their partners because they do not
feel they observe their own feelings

Sometimes one person can push the other to do

things to prove to him/herself one damaging
hypothesis

Humanistic:
 Relationship enhancement (Guerney)

Based on client centered approach

It includes being empathic, concentrating in

the partners internal world, and learning to
listn intently

Emotionally focused couples therapy:

Based on the attachment theory

You have a bond and this means that you can

express yourself without the other judging

Sex therapy:

It does not ignore that sexual problems could be the

result of relationship issues

Not all CP are trained to do sex therapy, you need to

get specialized in that

It has to be determined the root of the sexual

problem before deciding wether or not sex therapy is
necessary

It includes basic education about normal sexual

functioning and series of exercises practiced by the
couples in the privacy of their home

You need to make them confront their issues, even the

hiddenones

o Family Therapy:

Ackerman Approach: (Family)

The therapist normally is very active in Psychotherapy

(confronting the family about its defenses)

Use of traditional forms of interpretation (so the family can

understand why those issues are happening)
 The therapist is seen as a parental figure, because hes the
one whos leading the session

Family system theorist:(Family)

When you have a system it works because all its parts work
correctly

If one of the parts is damaged it will affect the whole system

(the family)

Even if the problem is not that bad, it can alter and damage
the whole system

It focuses on the inter-relationships (not the individual but all

the posible relations between them)

Conjoint Family Therapy:

Families go trough three stages:

Contact: Where they realise they have an issue (only

explaining the problem)

Chaos: When one member shows the issue (the

therapist can see what is affecting the family)

Integration: The family integrates the techniques

learned during therapy in their everyday life

Therapist as a teacher

Techniques:

Family life chronology (make them all talk about their

experiences with their meanings chronologically)

Role reversal (act as the other one) it helps them to

understand the other, it has to be discussed later

Family sculpting: The family makes a sculpture of an

specific moment (you can do it with materials,
drawings, but is better with people (themselves))

Bowens Approach:
 Core concepts:

Differentiation of the self:

Crisis the kids at home have when they

discover they are different from their parents
or family

Understand yourself as an individual and not

as group (family)

That they are individuals

Normally it creates resistance from their

parents

Triangulation:

Include a third person (extra) to their

relationship problems

It can be use to be more objective

It can be used to create alliances to prove you

are write

It is wrong because you bring a person who

has nothing to do with the problem

Nuclear Family Emotional System:

There are systems created during problems

Some members feel more identified with

others emotionally

Family Projection Process:

They go because of one person, but they

dont see that there is a system

Someone doesnt recognise their

responsibility on the problems

Emotional Cutoff:
 Someone withdraws emotionally from their
family

When kids grow up they leave their home fast

Lock themselves up, putting on headphones,

leaving early and arriving late, etc.

Multigenerational Transmission Process:

Problems you carry generation to generation

It comes from family and the family itself

teaches it

Sometimes is related to the way you raise

your kids

You have to see what is repetitive in the family

dynamics

Sibling Position:

If you are the youngest or the oldest makes a

difference

The order in which you were born and the

number of siblings

Societal Believes:

What the family thinks a family should be

Disequilibrium between what they are and

what they should be

Minchins approach:

Structural family therapy:

Boundaries among family members:

Pay attention to the boundaries and how

strong and permeable they are
 Changing the type and intensity of relationships

Relationships are always changing

Analyse how they have change trough time

Family structure

It plays a big role in the dynamic of the family

Family Subsystems

Find family subsystems

It can be parents and kids, father and first

child, etc.

Boundary Permeability

How mandatory or rigid are the boundaries

Can someone from one system get

information or pass to another easily?

Family Power

Decision making and family movilization

Alignments and coalitions

There are some family members who grow up

together against some activity

In coalition they grow up together against

some other member of the family

Family mapping

Help the therapist and the family understand

the dynamics

You put everything mentioned above

You also include people with great influence

on the family
 Genogram:

Virtual tool for assessment of family patterns

and context

Also a therapeutic intervention or assessment

They allow clinicians to quickly conceptualise

the individuals context within the growing
diversity of family forms

It involves stories to contextualise the

therapist

o Group Therapy:

Multiple therapist being seen in the same session

This patients have no relation with each other (not filial)

It uses co-therapists (it is very hard for one therapist to be aware of

all the members)

Homogeneous (same age group, problem, etc.) or heterogeneous

(everyone can be there, they are united through one variable)

Open (anybody can come at any moment, it doesnt matter when

you arrive or leave) or closed (you plan it ahead with the group you
have)

Ten curative factors (Yalom), it can be useful for:

Impairing of information (It is easier to impart information to

many people at once)

Installation of hope (let them know they can overcome their

problem)

Universality (you are not the only one with that problem)

Altruism (everyone looks out for each other)

Corrective recapitulation (people in the group can give you

feedback on what is wrong, not judging)
 Socialising techniques (Give advices of techniques that have
been useful for them)

Imitative behaviour (Do what other member has done to see

if it works for me)

Interpersonal learning (learning from each other)

Group cohesiveness (trusting and believing in the other

members of the group)

Catharsis (Express everything you have to say without

judgement)

A major therapeutic factor is how we learn from each other (life,

experiences, feelings, etc.)

The thing you obtain is feedback from the group members and the
psychologist

It is a social microcosm (everything that happens outside of the

group can happen inside)

It is important to be working in their here and now (Focus on

recapitulated relationships)

Task of the therapist:

He must actively assist patient in translating their complaints

into interpersonal issues

The therapist must find ways to help the group reflect back
on its own process

Help the group continuously attend to the interpersonal

dynamics that occur within the group

It is very complex because youll have to deal with various individual

with their own thoughts and issues

There are many different techniques to approach children, each directed to some
condition. You need a lot of strategies, talking sometimes is not enough

Psychological treatments (Psychodynamic)

 Youdecideanapproachbecauseitconnectswithyouandyourideaofwhathumansare
Psychodynamicpsychotherapy:
SigmundFreudwasthefatherofpsychoanalysisandapsychiatrist
Rationale:
Basedonthepremisethatassatisfyingandusefullifecomesfrombeing
honestwithoneself
Noteasy,weburiedourundesirablesattributesandmotives
Theyremainuncionsionsexceptinamodifiedformorwhentheconscious
mindisweakened
ContemporaryPDreferslesstoprimitiveimpulsesandmoreto
unconsciousrepresentationsofrelationshipswithpeoplewho
influencedouryounglife
Goals:
Obtainintelectualandemotionalinsightintowhythisissueishappening
(inouryoungestyears)
Workingthroughthoseinsights,sonowthepersoncandothings
differently
Maintainabalancebetweentheid,theegoandthesuperego
Strengtheningoursenseofselfthroughlogical,rationalself
understanding
Troughitweachieveabroadeningofourorganisationofexperienceso
wecanmakemorerealisticlifechoicesandleadtomoresatisfying
andsocialresponsiblelives
Putmemoriesonthetable,analysethemandworkthroughthem
Process:
Opiningface:Positivetransference(puttinginyoueverythinghecannot
dealwith)
Workingthrough:
Negativetransference(putnegativethings)
Uncoveringunconsciousmaterial(askaboutmeaningofthings,
theyshowtheunconscious)
Examininghowunconsciousconflictsaffectcurrentbehaviour
Intellectualandemotionalinsight(achievedthroughmaking
connectionsbetweenseeminglyunconnectedaspectsofones
experiences)
Thisiswhytheymightbeinterestedindetailsthatyoumaynot
considerimportant
Ourunconsciousexpressesthroughthingsthatthingsthatarenot
obvioustous
Youwanttransferencetohappensothatthepatientisabletosee
whatsgoingonwithhim
Traditional:
50minutesessions
5timesperweek(theresamomentwhenyoudontknowwhat
elsetosaysoyoustarttalkingaboutdeeperthings)
 Durationofseveralyears(theywantyoutounderstandwhats
goingonwiththeinsights)
Freudsdivanwasmadetobesimilartoamothersuterus,which
isthesafestplaceyouhave
Techniques:
Transference
Processinwhichthepatientprojectsontotheanalyst
emotionalhistory
Interpretationtheclientsthoughtsandfeelingstowardsthe
therapist
Thisfacilitatestheclientinachievinginsightinto
unconsciousinterpersonalmotives,etc.
Identifyingresistance
Identifyingthebehaviourthatpreventsinsightor
unconsciousmaterialfromreachingconsciousness
Itpreventsyouasatherapisttogetclosertoyourpatient
Ithappensmostlywhenyoustarttalkingaboutacertain
topic
Itisknownunconsciously,thepatientisnotawarethathe
isdoingit
Freeassociations:
Atherapeutictechniqueinwhichapersonsaysanything
thatcomestomind
Itisnotusedeverytime,onlywhenthetherapists
thinksit'snecessary
Thegoalistouncoverunconsciousmaterial
ForFreuditwasveryimportantthetimebetweenwords
(unconsciousresistance)
Dreaminterpretation:
Atherapeutictechniqueusedtouncoverunconscious
process
Manifestcontent(consciousmind'sefforttodisguisethe
hidden)
Latentcontent(thesymbolsrepresentingthetruecontent)
Theinterpretationisnotsubjective,itsdeeplyconnected
tothestoryofthepatient
Psychopathologyofeverydaylife:
Analysisofeverydaybehaviortouncoverunconscious
processes
Therapeuticrelationship:
Analyticneutrality:
Essentialsotheclientsexperienceisnotcontaminatedby
thetherapist
Thisdoesntmeanthattheyarenotempathetic
Countertransference:
 Isthetherapists(undesirable)transferencetowardthe
client(interferes)
Youstartworkingthatwithyourpatientintherapy
PsychoanalysisPostFreud:
AlfredAdler
FirstdisciplineofFreudtodisagreewiththemaster
Developedinindividualpsychology
Humanisticapproachbecausehesaidourmotivesarealways
basedonimprovement
Considersthedynamicforces
Focusongoalsandchangenegativeperspectives
Adlerusedearlyrecollectionsasawaytolookforpatterns
(unconscious)
Hestillseestheunconsciousasaveryimportantpartofthehuman
being
CarlJung
ViewedasaheirtoFreud
Agreedwiththeimportanceoftheunconscious
Collectiveunconscious(things,symbolsthatwehaveashumans
thatmoveus,containsallhumanexperienceandpotencial)
FeltFreudoverlookedthecollectiveunconscious
Shadowself(partsofthepsycheuncomfortablefortheself)
Anima(femmininewithinallmales)
Animus(Masculinewithinallfemales)
Dreamimagestoembracetheshadowselfandrelateitwiththe
publicself
KarenHorny
Shedisagreedwiththeconceptofpenisenvy"
Shefeltthatmenweretheoneswhoenviedwomen
Basicanxiety:Resultofdisturbancesinparentchildrelationship
Inattemptingtodealwithbasicanxietyindividualsdevelopsocial
orientation:
Dependant
Submissive
Avoidant
Inflatedselfconceptandothers
AnnaFreud:
Egopsychology
Roleofchildhoodindevelopment:
Continuosefforttoadapttothedemandsofreality
Playingagreaterroleintheirfunctioning
ErikErikson:
AgreedwithFreudthatdevelopmentoccurredinstages
Whathedidntagreeonwasonthestageshehad
Heemphasizedsocialasopposedtosexualdevelopment
 Yougothroughstagesdependingonyourinteractions
Developmentoccursthroughthelifespan
Ego:
Relativelypowerfulpartofpersonality
Functionstoestablishandmaintainasenseofidentity
Egopsychology
Thefightyouhavetomaintainyouridentity
HeinzKohut
Selfpsychology
Importanceofhowrealrelationshipsinfluencesdevelopment
Morehumanisticunderstandingoftheself:
Humansstrivingtobecomeacoherentfunctional
individual
Abletoachieveitsfullpotential
Hisapsychoanalysisbecausehestillbelievesintheconceptsof
unconscious
BriefpsychodynamicTherapy:
Interpersonalpsychotherapy
Theoryfocusedonaspectsofpsychodynamictheoryconsideredto
bewellstablished
Ratherthanwritingformaterialtoemergefromtheclientsfree
associationovermonths
Itisconsideredbriefforpsychodynamics
Video:
Everytherapist,nomatterhis/herapproach,shouldbehumane
Psychodynamicapproach:
Psychoanalysis
Behaviorunconsciouslydriven
Advantagesinuncoveringunconscious
Accessingrepressedmaterialfromthepast
Jungiananalysis
Adleriananalysis
Humanisticapproach:
Existential
PersonCentered
Other
Cognitivebehavioral:
Cognitivetherapy
Behavioraltherapy
Realitytherapy
Postmodern:
Solution
Narrative
HumanisticApproach
Gestalt:
Objetivo:Empedraralapersonaconelterapeutacomogua
Sehablamsacercadelprocesoquedelcontenidodelaterapia
Tratadeconcentrarseenelaquyenelahora
Itdoesnthaveanspecificstandardisedtechnique
Makehimresponsibleaboutwhathefeelsandwhathethinks
Gamesareusedinsteadoftechniques
Emptychairtherapy
ClientCenteredTherapy:
Referredtoasnondirectivecounselingandpersoncenteredtherapy
ThekeyfigureinthistherapyisCarlRogers:
Uncomfortablewiththeideaoftherapistasauthoritiesinsearchof
unconsciousmaterial
Discoveredtherapistguidesindividualtoselfuniderstanding
Bigbrakefrompsychodynamic
Basichumantendencyistowardmaintainingandenhancingtheexperiencingself
orselfactualization
Assumedthecauseofdisorderisblockedselfactualization
Goal:
Gapbetweenperceivedselfandidealself(tohelpselfactualization)
Increaseselfacceptance
Innerdirection(findingandunderstandingsense)
Supportpersonalgrowth
Releasinganalreadyexistingcapacityinapotentiallycompetent
individual
Thepatientchoosesweretogotoachievehis/herpotential
Thismeansthepatientisnotpassiveatall
Techniques:
Empatheticunderstanding(reflectandclarifyfeelings,activelistening)
Unconditionalpositiveregard
Congruence(genuine)
TherapistdoesNOT:
Askquestions
Makeinterpretations
Criticise
Reassure
Diagnoses
Assessment
Becauseitplacesyouinasuperiorrole
TherapistDOES:
Recognizeandclarifyclientsfeelings
Sothepatientcangrowthroughthatrecognition
Itdoesnthaveanspecificstandardisedtechnique
 Nondirectivetherapythatlooksforadeepconnectionwiththeclient
Ittriestoincreaseselfesteemandmaketheclientresponsive
Unconditionalpositiveregard,beempathicandcongruentandactivelistening
Thistherapycanworkforeveryone
Vs.Psuchodynamic:
Alternativefocusonselfdeterminationandinnerdirectness
Activeratherthanpassivepatient
Providedanalternativetotraditionalpsychoanalyticpsychotherapy
Ahistorical(theydonotfocusorcareabouttheprevioushistoryofthe
patient,butonthepresent)
ClientCentredTherapy(oldone):
Referredasnondirectivecounsellingandpersonenteredtherapy(Rogers)
Breakingwithpsychoanalysis:
Itisnotoktoseeatherapyasanauthority
Theclientshouldbehisownandonlyauthority
Therapistasahumanbeingistheremedynotthetechnicalskill
Imnotgonnaguideyou,Imgoingtobewithyou(OttoRank)
Understandingmyself(therapist)asahumanbeing
AsahumanIcanhelpyouunderstandandbewithyou
Theoreticalpropositions:
Wearealwayslookingforselfactualisation
Thegoalistomakethepersonawareaboutthegapbetweenthe
selfandtheidealself
Tomakehimknowwhatheneedstoachievethisidealself
Theybelieveinthebestpartoftheclient,theyseepotential
Andthegoalistofulfilthispotential
Empatheticunderstanding:
Reflectingfeelings
Activelistening
UPR
Congruence
Thetherapistwillnevercriticiseorjudgeormakeinterpretations
orreassure
Thetherapistrecogniseandclarifyclientsfeelings
Diagnoses
Theydontbelievetheresadiagnosisaboutthethingsthat
happentopeople
Assessmentplacestherapistinasuperiorrole
Thereareexpertsintheirownlives,youarenot
Itcanbeeffectiveforeveryone
Providedanalternativetopsychodynamictherapy
Itfocusedonselfdeterminationandinnerdirectness(not
biologicalurgesandinstinct)
Activeratherthanpassiveclient(lessauthorityfortherapies)
Itwasahistorical,soitwasshorter
 Logotherapy:
MaincontributorViktorFrankl
Paradoxicalintentionwheretheclientisinvitedtowishfortheverythingheis
tryingtoavoid
Dereflection:Theclientisencouragedtofocusonothers
Alltasksareusedwithinthesocraticdialoguesoclientsabandonineffectiveways
ofmakingmeaningandfindnew,moresatisfyingone
Askquestionstogodeeperanddeeper,eventuallyfindingnewmeanings
ExistentialTherapy:
Philosophicalapproachthatguidesthetherapistrationalefortherapy
WhatdoesitmeantobefullyaliveBasicquestion
Itisnotatherapyperse,itsaphilosophicalperspectiveoflife
KierkegaardandNietzschearetheauthorsthatinspiredit
RolloMaypopularisedthistypeoftherapy
Asumesthatexistenceprecedesessence
Soanindividualcannotbereducedtosomeessentialcomponen
IrvinYalom:(RolloMayinAmerica)
Rootofpsychologicalproblemsaretheexistentialrealitiesof:
Death
Freedom
Responsability
Isolation
Meaninglessness
Itisnotatechnique,itisaphilosophy
Everyhumanstrugglestoagreaterorlesserextentwithfourconcernsof
existence
Tohaveafullandsatisfyinglife,peoplemustlivewiththetensionbetweenthese
opposites
Freedom(responsibility)
Death(life)
Love(hate)
Wisdom(doubt)
Goals:
Embracethefundamentalnatureofhumanexistence
Manifestinourownlivesthatwemightfindsatisfactionandmeaningin
ourlives
Fullrecognitionoftheparadoxesthatareinevitableaspectoftheprocess
ofliving
Itscompletelynondirectiveandflexible,itsjustaphilosophicalconversation
Logotherapy:(Frankl)
Paradoxicalintentionwheretheclientisinvitedtowishforthethingheistrying
toavoid
Dereflection:Theclientinencouragedtofocusonothers
Alltasksareusedwithinthesocraticdialoguesoclientsabandonineffectiveways
 ofmakingmeaningG2
BehavioralandCognitive
Behavioural:
Until1950sbehaviouralprinciplesbegantobewidelyappliedtotreatinghuman
suffering
Eysenckstimulatedconsiderableinterestinbehaviourtherapy
Basically
Theyfocusonthecurrentbehaviourandwhatdeterminesit
Itisthedeterminantofthebehaviornotthebehaviorperse
Ashumanisticstheyarealsoahistorical
Emphasisespecific,overtbehaviourasthetargetoftreatment
Specifiestreatmentinobjectivetermstoenablereplicationandevaluation
Reliesonempiricalresearchasthesourceoftreatment,techniquesand
evaluations
Theywillneverasumethings,theydoresearch
Theyareveryclosetothescientificmethodineveryaspect
Behaviouralrationale:
Thoughtsandfeelingsareveryimportantbuttheyarenotmeasurable
Thereforeisbettertoavoidthemintheeffortstosolvepersonalproblems
Ifwechangeourbehaviourourthoughtsandbeliefswillalsochange
Behavioursaredevelopedthroughlearning,problematicandnon
problematic
Ourbehaviorisdevelopedbecausewelearneditfromourcontext
Goal:
Eliminateunwantedorproblematicbehaviours
Introducenewmoreadaptivebehaviors
Orstrengtheningalreadyexistingadaptivebehaviours
Treatseachchangeasahypothesis
Ifthetaskresultinthedesiredchangeinthetargetbehavioritis
consideredsuccessful
Behaviouralchangeprocess:
Bringschangethroughtwolearningprocesses:
StimulusControl(classicalconditioning)
Involveschangingthecuesorconditionsthatoccurbefore
behaviouroccurs
Reinforcement(operantconditioning)
Strengthenbehaviouristoincreaseitsfrequency
Promptsarethecuestoperformabehaviour
Settingeventsareenvironmentalconditionsthatelicitbehaviours
Basicallyyoureduceunwantedbehaviorsandincreaseadaptiveones
Interventionandtechniques:
Exposurebasedinterventions
Treatmentchoseforfearbasedproblems
Problemslikeanxietyandphobias
 Exposuretofearedstimuli:
Invivo
Imagineexposure
Computermediatedvirtualreality
Breakassociationoffearandanxietywithanstimuli
Relaxationbasedintervention
Addressingmuscletension,heartrate,bloodpressureand
hyperventilation
Clientslearntovoluntarilyinducerelaxation
Changefearoranxietyassociationtorelaxation
Responseprevention
Preventingobsessivecompulsiveritualsuntilthetendencyto
performthebehaviordeminishes
Untilhelearnsthatthecompulsionwontsolvetheobsession
Operantstrategies
Contingencymanagementprocedures
Theydresstheenvironmentalstimulithataremaintaining
undesiredbehavior
Techniqueslike:
Timeout
Succesiveapproximationorshaping
Tokeneconomies
SocialSkillTraining
Learningbehaviorsthatelicitdesiredbehaviorsfromothers:
Steps:
Identifyingproblematicinterpersonalsituations
Establishingspecificbehavioralgoals
Receivinginstructionsonandmodelingofadapting
behaviors
Reharsingthenewskillsandreceivingfeedback
Modeling
Demonstrationofdesiredbehaviorthattheclienthasneverdone
Heimitatesthemodel
Therapeuticrelationship
Opportunityformodellingdesiredadaptiveinterpersonalbehaviourand
sourceofsocialreinforcement
Therapistassumesadirectivestancethroughtreatmentbecauseitishis
responsibilitytoplanandstructurethesessions
Clientsareexpectedtobeactiveandhomeworkisregularlyassignedto
practice,strengthenandgeneralizetotheclientslifewhathasbeen
learnedinthesession

CognitiveTherapy:
Theyuseametaphorwithcomputersbecausewhatsguideseverythingareour
thoughts
 Thesuccessandlimitationsofbehaviorism
Dissatisfactionwithpsychoanalisis
Therearesomemaladaptivethoughtsthatguidemaladaptivebehavior
Rationale:
Thewayhumanbeingsmakesenseofsituationsinfluenceshowwe
behaveemotionally
Misinterpretationsofsituationsandnemakeusunhappy
Ifwechangethewaywethinkabouttheworldourbehaviourwillchange
Weareabletoaccessallofourthoughts
Itiseasierfortheclienttoseetheconnectionsbetweenthoughts
Yourhistorydoesntdeterminesyourbehaviour,notallthoughtsareproducedby
history
Goals:
Helpidentifyunhelpfulthoughtprocesses
Itisbasedonaneducationalmodel

IntroductiontoHealthPsychology

Studyofsocial,behavioral,cognitiveandemotionalfactorsthatinfluencethe:
Maintenanceofhealth(positivethoughts,exercise,etc)
Developmentofillnessanddisease(drivingtoofast,alcohol,etc.)
Courseofillnessordisease(havinghope,copingstyles,etc.)
Patientsandfamilysrespondetoillnessanddisease
Trendsthatchangethefieldofhealthare
Changingpatternsofdiseaseandhealth
Chronicdiseasehavereplacedinfectiousdiseasesascausesofhealth
Manyofthemarepreventable,bychangingbehaviors,thoughts,etc.
Escalatingcostofmedicalcare
Changinginthedefinitionsofhealth
Healthintheearly1990s:Theabsenceofadisease
Buthealthismuchmorethanjustphysicalsymptoms
Cognitivepartthatdeterminesyourhealth
Emergenceofthebiopsychosocialmodelofhealth
Understandingthatwearemuchmorethanthebiologicalpart
ThefactthatIhaveanillnessdoesntmakemeunhealthy
Whatishealthanddisease?
Healthcanbeenhancedandimproved(always)
AnIllnessisthesymptomsofsomethingwronginyourbody
Diseaseistheunderlyingconditionthatcangiverisetoillness
Wecanactbeforesymptomsareevenpresent
Viewsofhealth:
Westernmedicine:
Viewsitastheabsenceofadisease
 Diseaseexclusivelyasabiologicalprocess
Exposuretopatogen
Focusonthedisease
Therewastheneedforamoreholisticmodel:
Considerssocial,psychological,andspiritualaspectsofapersons
health
Biopsychosocialmodel:
Includesbiological,psychologicalandsocialinfluence
Healthasapositivecondition
WorldHealthDefinitionofHealth:
Acompletestateofphysical,mental,andsocial,wellbeingandnot
merelytheabsenceofadisease
Estimatedcontributionsofdifferentfactorstohealthstatus:
Medicalcare:10%
Genetic:20%
Behaviour:40%
Otherfactors:30%(economical,environmental,etc.)
Healthpsychologists:
Scientiststhatresearchtheareasof:
Healthpromotion:
Interveneatthesocialorindividualleveltopromotehealthand
preventillnessanddisease
Clinicalhealthpsychology:
Interveneattheindividuallevestotreatillness,sloworprevent
diseaseprogressionandreducedisability
Healthpsychology:
Developmentorprogressionofillnessanddisease
Etiology
Individualsandfamilysresponsetoillnessanddisease
Outcomes
Theroleinmedicalsettingshasexpandedfrommentalhealthproblemsto:
Proceduresandprogramstohelppeoplestopsmoking
Eatahealthydiet
Exercisehabits
Adheretomedicaladvice(reducedropout)
Reducestress(important)
Controlpain
Livewithchronicdisease
Avoidunintentionalinjuries(prevention)
Relationofhealthpsychologytootherhealthrelatedfields:
BehavioralHealth(sociology,nutrition,exercise,etc.)
BehavioralMedicine(physiology)
HealthEducation
Medicine,psychosomatic,oncology,etc
HistoryofMedicine:Thewayyouunderstandsomethingisthewayyoutreatit
 Stoneage
Bodyandmindwereinfluencedbythespirit
Sorcerysourceodillness
Breachofsocialtaboo(punishment)
Objectintrusiondonebymagic
Supernaturalpossession
Losingonessoul
Treatments:
Confessionandappeasingofthegods
Magicalsuckingtoremovetheintrusiveobject
Driveoutevilspiritsusingpotions
Trephination
Ancientgreeks
Theebodyinfluencesdemind
Oneofthemajorcontributorsofwhathealthis
Originoftheviewthatdiseaseisanaturalprocess
Humoraltheory(illness:fourfluidsoffbalance)
Phlegmatic
Sanguine
Melancholic
Choleric
Thefirststosaythatdiseasecomesfrominside
Middleages
Bodyandmindwereinfluencedbythespirit
Anatomicalpathology:
Diseaselocalizedintheanatomy
Tissuepathology:
Specifictissuescouldbecomediseasedwhileothersremain
healthy
Cellularpathology:
Beliefthatliferesidedincellsandsocellsmustbetheplaceto
lookfordiseases
Germtheory:
Discoverythatparticlesintheairthatcouldnotbeseencould
causedisease
Magicbullet:
Aspecificcarecouldbefoundforeveryailmentthatrestorethe
persontoperfecthealth
Biopsychosocialmodel:
Mind,body,andenvironmentinteractincausingdisease
Contemporaryview
Bodyandmindwereinfluencedbysociobehavioral
Healthforthoseauthorsasacontributionstohealth
PsychosomaticMedicine:
Freud:
 Freudspatientshadmanyphysicalsymptomslike:headaches,muscular
pain,etc.
Confirmedthediagnosisofhysteriaandthatitwasproductofthepersons
lifestyle
Hispatientshadsymptomswithnophysicalbasis
Defensemechanisms
Thesuperego(values,cultureandmoral)repressedtheindividualandthis
makesthemphysicallyill
Heusedpsychoanalyticconceptstoclarifyhowphysiologicaland
endocrine
Eldestinodelalibidosirvecomocriterioparadistinguirlaenfermedad
Freudsaysthathappinessisrelatedtohealthanddisgracerelatedto
illness
Theneedofloveofanindividualissatisfiedbyarealobject
Mientraslanecesidaddeamordeunindividuasesatisfechaporunobjeto
realdelmundoexteriorconservasusalud
Influenceofgeneticandbiologicalfactors
Theirlivesaschildrenaffectstheirinthepresent
Canon:
Certainsituationshaveeffectsinourphysicalbody
Wereactalsoemotional,andthisdoesn'tmeanwearesick
Noteverythingcanbeexplainedbytheorganicdimension
Dunbar:
Feminist
Personalityprofilesareassociatedwithspecificdiseases
Considereddemotheroftheholistictherapy
Everypersonalcharacteristicwasrelatedtoanspecificissue
Shestronglybelievedintheconnectionbetweenmindandbody
Certainlifestylesandpersonalitiesarerelatedtoparticularissues
Alexander:
WorkedwithFreud
Whenapersonisinanstressfulsituation
Interviewingandinterventionarehismaintwomethods
Psychogenesis:Psychologicalprocessesareseenasideasordesires
Youcanusepsychologicalmethodstofindoutaboutreactions
Onespecificdisturbanceleadtoanspecificsomaticprocess
Geneticandchildhoodfactorsarecausesofdisease
Evenlaboralrelationshipscandeveloppsychosomaticillnesses
Connectionbetweenemotions,situations,etc.andtheorganicresponse