Therapy Chapter 17 2006

Therapy Chapter 17 2006

Wed. Nov. 11,2006

1) attendance

2) return papers

3) Go over ch 16 page by page

4) Lecture

Overview

Most people seek therapy because there is the perception that they need some psychological help.

Most people who obtain therapy perceive that the therapy was of benefit to them.

People who attend more therapy sessions believe that therapy helped them more than people who attended fewer therapy sessions.

QUESTION?: While therapy is perceived as being helpful to the clients, does this mean it actually is helpful?

QUESTION?: Which therapy is the most effective?

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Regardless of the kind of therapy used, the evidence is that the type of therapy is not the critical factor. The type of therapy may be quite important in individual cases but there is no one clear winner in the “which therapy is best” category.

The attitude of the therapist IS important. A warm supportive, interested, therapist is more effective than one who is not. A therapist who develops good rapport with the client is more likely to be effective than one who does not.

Managed care --- Where the insurance provider limits the choice of therapist has been shown to be less helpful to patients than the situation where the therapist is selected by the patient.

Therapeutic Approaches

Psychoanalytic therapies

Psychoanalytic therapies are based on the concept that the patient needs to be healed by the skills of the therapist. Some of the techniques used are:

Free Association – where the therapist says a word and the patient responds with the first word that pops into their head. The therapist keeps track of the time it takes for the patient to respond and also keeps track of body language and other cues. --- Provide examples).

Typically, the patient shows resistance to therapeutic change due to internal conflicts.

Also typically the patient exhibits transference where the patient attributes their own feeling and conflicts onto the therapist.

(i.e., Patient says “ You really think I am disgusting don’t you.”)

Sometimes psychoanalysts tell the patients to keep track of their dreams and describe their dreams during therapeutic sessions. The therapist is trying to see what the dreams tell him about the patient’s various problems.

The big problem with psychoanalytic therapies is that treatment is generally prolonged and is very costly in terms of time and money.

Humanistic (client-centered) and Transactional Therapies

Humanistic and Transactional therapies are characterized by the view that the client is basically healthy and is able to cure themselves. The therapy tends to be non-directive and is based on the premise that self reflection on problems will yield positive solutions to those problems. The therapist may be a guide but the client’s insight is the real determiner of success.

Such therapies tend to rely on the verbal and cognitive skills of the client and work best with clients who are extroverts or at least speak frequently and openly with the therapist.

Behavior therapies

Behavior therapies are based on the concept that operant and classical conditioning are an efficient and effective means of changing peoples observable behaviors. Typically, the behaviors that need to be modified are quickly and clearly defined, the desired behaviors are determined along with the undesired behaviors. The baseline rates of the requisite behaviors are determined. The client/patient is reinforced for the desired behaviors and attempts are made to reduce the occurrence of undesired behaviors and positively reinforce the occurrence of desired behaviors.

Describe dining skills program at Mansfield State school (CT) and Token Economy at Spaulding Youth Center (Tilton, NH).

Also, describe de-conditioning fear of snakes.

Group Therapies

Group therapies involve selecting a number of clients who are in therapy sessions together. The advantages are especially great when there is a need for the client to have better social skills. Family therapy is a type of group therapy. (Describe some typical applications).

--- Go over ch 17 page by page.

Next chapter is Chapter 10 – Physical and Cognitive Development