Who Provides Psychotherapy?

1. Clinical psychologist
2. Psychiatrist
3. Counseling psychologist
4. Licensed professional
counselor
5. Psychoanalyst
6. Clinical social worker
How Do I Choose
the Right Therapist?
 Many people and agencies can serve as
good resources
 Check with your family physician, clergy
person, local mental health center,
college counseling center, psychology
instructor, family and friends
 Give the therapist at least three to four
sessions to see if working together will
be effective
 If you do not feel that you are benefiting
from therapy, discuss this with the
therapist and be prepared to change if
necessary
Psychoanalytic Techniques
 Psychoanalysis – based on
several assumptions involving
conflict and the unconscious
mind

Freud’s Couch
 Psychoanalytic Therapy
Psychoanalytic Therapy

Freud saw many things as having sexual overtones

Psychoanalytic Techniques
 techniques that move issues from the
unconscious to the conscious level for
resolution
 therapy assumes that some issues may
relate to childhood experiences
 The ego serves to keep these issues below
the level of consciousness (defense
mechanisms)
 Catharsis is an emotional energy that is
released when early conflicts are relived
Psychoanalytic Techniques
 Moving issues from the unconscious
to the conscious can be achieved
through
 Free association: patient says
whatever comes to mind
 Dream analysis : Dreams
(hyperlink)

express unconscious issues

 Manifest content: the actual content of
a dream
 Latent content: symbols that are
disguised unconscious issues or motives
Psychoanalytic Techniques
 Resistance: Therapist looks for
evidence that the patient is avoiding an
issue
 Transference: Does the patient treat
the therapist in ways that are similar to
their parents?
 Interpretation: Therapist provides
analysis of the meaning of the thoughts,
behaviors, and dreams of the patient
 Interpretationleads to understanding and
resolution of unconscious issues
Post-Freudian Psychoanalysis
 Most significant change
is the concern for
shortening the length of
analysis
 Today’s analyst will take
a more active role in
therapy
 Focus on present,
rather than childhood
experiences
Humanistic Techniques –
(also looking for insight)
 The 3 necessary elements of
humanistic therapy:
 Unconditional Positive Regard
 Genuineness
 Non-Directive Guidance
Humanistic Techniques
 Client-centered therapy – goal is to help
the individual self-actualize (Carl Rogers)
 Focus is on the present
 Focuses on one’s feelings or affect

 Therapist attempts to mirror the feelings of the

person
Humanistic Techniques (hyperlink)

 How Does One Mirror?

 Therapist must be an active listener.

 Therapist needs to be empathetic –

able to understand and share the
essence of another’s feelings

 Therapist will try to express

unconditional positive regard
Active listening
 Paraphrase
 You DON’T say “I know how you feel” but you
summarize the person’s words in your own
words
 Invite clarification
 What is an example of that?
 Reflect feelings
 ‘It sounds frustrating’ could mirror what you’re
sensing from the body language, tone, etc.
Behavioral Therapy
 Therapy that applies learning principles (e.g.
conditioning) to the elimination of unwanted
behaviors.
Counterconditioning
 Classical conditioning used to
evoke a new response to the
trigger stimulus

 Example: relaxation paired with an

enclosed space like an elevator –
fear and relaxation are
incompatible

 Exposure therapies and aversive

conditioning
Behavioral Therapy
Systematic Desensitization
(an exposure therapy)
Behavioral Therapy
Flooding
 Behavioral Therapy – counter
conditioning – pairs trigger stimulus
with a new response
Aversion Therapy

Can happen naturally -

drinking at a party paired with Or artificially
throwing up. Just the smell Ipecac +
can make you sick. Alcohol =
Does it work? Short term yes! Nausea
 Exposure Therapy:
Virtual Reality Exposure Therapy
Like you are an avatar

Help with PTSD?

CNN Virtual Reality Battles PTSD 9 2011
http://www.youtube.com/watch?v=hjyRu1e-Jmo
 Behavioral Therapy
Modeling – client observes and imitates appropriate
behaviors
- Works well for children with phobias and with
assertiveness training
Operant Conditioning Therapy
-Shaping new behaviors
Token Economy: reward wanted behaviour
Punishment: making an aversive stimulus contingent on
the unwanted behavior
 Found to not be an effective tool to reduce unwanted behavior
 Unwanted behaviors should be ignored entirely

Extinction: removing all rewards for the target behavior

 Cognitive Therapy

Constant
repetition of
negative
thoughts leads
to abnormality
Cognitive Therapy
Assumes that problem behaviors and
emotions result from faulty thought
processes and beliefs

Analyzes a person’s thought processes

Attempts to restructure thought

processes
 Changing thought patterns will in turn
alter problem behaviors and emotions
Cognitive Therapy –
change your self-talk
Nobody likes me 

I’m a moron 

I’m worthless 

My jokes are bad 

 Cognitive Therapy

Nobody likes me  Sue likes me – she is just

angry at me now.
I’m a moron  I’m smart. I just made a
mistake.
I’m worthless  I’m a good person.
My jokes are bad  It’s not my fault the class
has no sense of humour.
 Albert Ellis: Rational Emotive
Behavioral Therapy REBT
A confrontational cognitive therapy that
vigorously challenges people’s illogical
self-defeating attitudes and assumptions.
Cognitive-Behavioral Therapy
 Addresses self harming
thoughts and behaviors
 Replaces harmful
thoughts with more
positive ones
 Creates more positive
approaches to everyday
settings
Group Approaches
 Group therapy – label applied
to a variety of situations in
which a number of people are
involved in a therapeutic setting
at the same time
Group Approaches
 Benefits of group therapy:
 Economy: group therapy is less
expensive
 Group support: there is comfort in
knowing that others have similar
problems
 Feedback: group members learn from
each other
 Behavioral rehearsal: group members
can role-play the activities of the key
persons in a member’s life
Group Approaches
 Family Therapy – the roles,
interdependence, and communication skills
of family members are addressed
 Part of a system; all impact one another
 Improper family communication = problems
Evaluating Psychotherapy
 Difficult task
 Sometimes spontaneous remission of symptoms
 Difficult to agree on what is meant by recovery
or care
 The large, meta-analysis studies showed
positive results for psychotherapy
Evaluating Psychotherapy
 No evidence that any one type of
therapy is universally better than
others – an eclectic approach is
probably best
 Some types of therapy are better
suited for some problems than others
 Which therapy is best for what
disorder is one of the most active
areas of research
 Some therapists are more effective
than others
Evaluating Psychotherapy
 Behavioral Conditioning
 Bed-Wetting

 Phobias

 Compulsions

 Sexual disfunction
 Psychodynamic
 Depression and Anxiety
 Cognitive & Cognitive Behavioral
 Anxiety

 PTSD

 Depression