THERAPIESPertemuan 23

Matakuliah : L0014 / PSIKOLOGI UMUMTahun : 2007

Psychotherapy

• Specialized process where trained professional uses psychological methods

• Differing forms of psychotherapy have differing methods– Psychoanalytic: focuses on gaining insight– Humanistic: focuses on gaining insight– Social learning or behavior therapy: uses forms of

teaching

Therapies

Psychotherapy (2)

• Relationship involves power of therapist, emotional patient divulging personal data

• Ethical Standards– Goals of treatment understood/agreed to by client; in

best interest of client and society

– Careful consideration given to alternatives

– Therapist treats only within limits of expertise

Therapies

Psychotherapy (3)

• Ethical Standards

– Effectiveness of treatment must be evaluated

– Rules and laws of confidentiality followed

– No abuse of therapist-client relationship

– Therapist must treat all humans with dignity; respecting all genders, races, sexual orientation, and other sociocultural factors

Therapies

Therapies (1) • Psychoanalysis – founded by Freud

– Root of all problems is in unconscious conflicts– Imbalance in id, ego, and superego– Conscious insight can resolve conflicts– Special therapy techniques may be used

• Free association• Dream interpretation• Interpretation of resistance (from vague forms to

specific resistance)

Therapies

Therapies (2) • Psychoanalysis

– Transference – therapist-client relationship takes form of client’s relationships with own parents and other authority figures

– Catharsis – emotional experience or temporary relief from discomfort (some insight gained)

– Interpersonal psychotherapy for depression• Emerged from psychoanalytic tradition• Identifies sources of depression and goals for therapy

process; very successful outcomes

Therapies

Therapies (3) • Humanistic psychology – Carl Rogers

– People not born with unconscious mind– Client-centered therapy or person-centered

• Emphasis on client’s ability to help self – feels emotionally safe enough to explore own hidden emotions

• Therapist creates unconditional atmosphere (warmth, genuine positive regard, empathy)

– Reflection – therapist makes statements to clarify client’s feelings and emotions

Therapies

Therapies (4)• Gestalt therapy – founded by F. Perls

– Humanistic psychotherapy approach

– Meanings of sensations organized into whole perceptions

– Goal: create therapeutic experience helping client achieve greater self-awareness

– Emotional atmosphere: therapists often deal in confrontive, challenging manner necessary to loosen denied feelings

Therapies

Therapies (5)

• Cognitive-Behavior Therapy (CBT)– Abnormal behavior learned from inappropriate

experiences through

• Classical conditioning• Operant conditioning• Modeling

– Learning is central goal of therapy; therapist is teacher and client learns adaptive behaviors

– Cognitions less important

Therapies

• Cognitive-Behavior Therapy (CBT)

– Fear reduction methods using • Graded exposure - series of increasingly fearful situations

experienced for gradual mastery

• Use of modern technology - computer-generated virtual reality

• Treats obsessive-compulsive disorders when used with other methods

– Social skills training

• Shaping and positive reinforcement used in role playing

• Teach use of adaptive skills enough to handle real-life situations

• Focus on social skill problem of unassertiveness

Therapies

• Cognitive-Behavior Therapy (CBT)– Cognitive restructuring

• Assumes faulty cognitions – maladaptive beliefs, expectations, and thinking

• Effective for treating anxiety, depression

• Cannot modify clients’ existing behaviors because of inaccurate ways of thinking about themselves

• Patterns of cognition contributing to emotional distress

Therapies

– Selective abstraction

– Overgeneralization– Arbitrary

interference

–Magnification and minimization

–Personalization–Absolutistic thinking

Group and Family Therapy (1)• Group therapy

– Carried out with groups of 4 to 8 clients; sees experience more effective than individual therapy techniques

• Receives encouragement from others• Sees problem experienced by others• Learn from others’ advice• Learn new ways to interact with others • Format of group therapy varies widely

Therapies

Group and Family Therapy (2)

• Family therapy – Group composed of family members– Therapist trained in psychoanalytic, humanistic, and

behavioral approaches– Beliefs

• Family issues at root of problem• Dynamics of family system need analysis – function of each

need to be understood

– Therapists’ goals to resolve problems by improving functioning of family system

• Give family members insights and correct family dysfunctions

• Increase warmth and intimacy in family• Improve family member communication• Help members establish reasonable set of rules for family

regulation

Therapies

Human Diversity

• Ethnic, gender, and sexual issues in mental health

– U.S. has one of most advanced mental health system in world – does not cover all citizens

• Hispanics - less outpatient care than whites

• African Americans – more likely than whites to be committed to psychiatric hospitals (often involuntarily)

– U.S. mental health system

• Fewer women receive mental health services than men

• Gender of therapist does not appear to influence outcomes

– Feminist psychotherapy – radical approach

• Women treated as second-class citizens and Barbie dolls

Therapies

Human Diversity• Goals of Feminist Psychotherapy

– Advocates equal relationship in therapy– Encourage women to see how society limited them

to dependent roles– Encourage women to become aware of their anger;

find constructive ways of expressing– Have women define selves as independent– Women encouraged to consider own needs– Women should develop nontraditional skills

Therapies

• Drug therapy – Widely used to treat abnormal behavior– Commonly used psychiatric drugs

– Electroconvulsive therapy (ECT)– Transcranial stimulation

• Magnetic field used on frontal cortex

Therapies

• Effexor• Paxil • Prozac

• Zorloft • Xanax• Geodon

• Haldol• Navane• Risperdal

• Zyprexa• Depakote• Epilim

Medical Therapies

• Psychosurgery

– Trephining

– Prefrontal labotomy

– Modern names for labotomy surgeries conducted today

• Capuslotomy

• Cingulotomy

Therapies

Trephining operations were

apparently performed in

the Middle Ages to treat

abnormal behavior