chapter 7: psychoanalysis, psychotherapy, and behavioral therapies

what approaches should be used to address mental health issues

psychoanalysis

psychotherapy

behavioral therapy

classical psychoanalysis

Sigmund Freud

assess unconscious thought and feelings, and resolve conflict by talking to a psychoanalyst

- attend many sessions over the course of months-years

- resolve internal conflict - which usually occurs from early childhood experiences

- past relationships are a focus for therapy

therapeutic tools

Free association.

Dream analysis and Interpretation.

Transference.

Use of defense mechanisms.

free association

spontaneous, uncensored verbalization of whatever comes to a clients mind

dream analysis and interpretation

urges and impulses of the unconscious mind that played out through the dreams of clients

transference

feelings that the client has developed toward the therapist in relation to similar feelings toward significant person in the clients early childhood

psychotherapy

involves verbal therapeutic-to-client interaction

- develop a trusting relationship

psychodynamic psychotherapy

same as psychoanalysis but

- focuses on pts present state

interpersonal psychotherapy (IPT)

pts. address specific problems

- improves: interpersonal relationship, communication, role-relationship, bereavement

cognitive therapy

focus on individuals thoughts and behaviors to solve current problems

- based on cognitive model

- treats: depression, anxiety, eating disorders

-- other issues that can improve by changing a clients attitude toward life experiences

behavioral therapy

changing behavior is key to treating problems:

anxiety and depressive disorder

- it's learned and has consequences

- teach client ways to decrease anxiety or avoidant behavior and give clients the opportunity to practice techniques,

- help reduce anxiety and avoidant behavior

- successfully treat: phobias, substance use or addictive disorders. other issues

cognitive behavioral therapy

cognitive + behavioral approach

- personality disorder

- self injurious behavior

focus: gradual behavior changes and provides acceptance and validation for these pts

cognitive reframing

assists clients to identify negative thoughts that produce anxiety, examine the cause, and develop supportive ideas that replace negative self talk

goal: decrease anxiety

- pt. can change thought of self throughout therapy

concepts of cognitive reframing

priority restructuring

journal keeping

assertiveness training

monitoring thoughts

priority restructuring

assists clients to identify what requires priority, such as devoting energy to pleasurable activities

journal keeping

helps clients write down stressful thoughts and has a positive effect on well-being

assertiveness training

teaches clients to express feelings, and solve problems in a nonaggressive manner

monitoring thoughts

helps clients to be aware of negative thinking

modeling

therapist or other serves as role model for clients

- in acute care milieu

- helps improve interpersonal skills

goal: have client imitate behavior

operant conditioning

client receives positive rewards for positive behavior

- positive reinforcement

- token exchange

systematic desensitization

planned, progressive, graduated exposure to anxiety-proving stimuli in real life situations

--> client uses relaxation to suppress the anxiety response

aversion therapy

treatment that uses punishment to decrease the frequency of undesirable behaviors

meditation, guided imagery, diaphragmatic breathing, muscle relaxation, and biofeedback

control: pain, tension, anxiety

flooding

exposing a client to a great deal of an undesirable stimulus in an attempt to turn off the anxiety response

- while in the company of a therapist

response prevention

preventing a client from performing a compulsive behavior with the intent that anxiety will diminish

thought stopping

negative thoughts or compulsive behavior arise? = say or shout "STOP" and substitute with a positive thought.

- goal: command should be come silent