Psychological Interventions Lecture 1

Complex psychological problems are

• Impactful

• Comorbid

• Chronic

• Characterized by:

  • Interpersonal difficulties

  • Personality patterns

  • Trauma history

Common mental health disorders

• MDD (single or episodic)

• Anxiety disorders

• Mild to moderate OCD

• Insomnia

• Mild eating disorders

Complex mental health disorders

• Chronic/persistent depression

• Personality disorders

• Psychosis

• (Complex) PTSD

• Suicidality

• Severe eating disorders

• Dissociative Identity Disorder

• BipolarDisorder

Two major paradigms of treatments for complex problems

• Psychoanalytic psychotherapy (Sigmund Freud)

• Cognitive Behavior Therapy (Anton Beck)

Psychoanalytic Psychotherapy

• Developed in the late 19th century/early 20th century

• Goal: bring unconscious or deeply buried thoughts and feelings to the conscious mind

• Focus:

  • Past and present integrated

  • Internal conflicts and unconscious processes

  • Relational patterns

  • Early developmental experiences

Psychoanalytic Psychotherapy: How?

• Intensive, in-depth talk therapy

• Originally:

  • Long-lasting (open-ended)

  • Low structure

Psychoanalytic Techniques

• Dream analysis

• Free association

• Transference (projection of feelings of the client for the therapist) / countertransference (projection of the feelings of the therapist for the client)

Cognitive Behavioural Therapy

• First stage: Behavior Therapy: “Neurotic symptoms are learned patterns of behaviour which for some reason or another are unadaptive,”

• Second stage: Cognitive Therapy: “depression and other psychological disorders arise from faulty cognitions and/or faulty cognitive processing, and the remedy is to correct the mis- appraisals”

• Third stage: Cognitive behavior therapy

• Goal: changing cognitions and behavior to bring about change in how one feels in daily life

• Focus:

  • Present

  • Symptoms

  • Teaching skills

Cognitive Behavioural Therapy: How?

• Structured, goal-oriented treatment sessions

• Practical and active participation

Cognitive Behavioural Therapy: Techniques

• Cognitive restructuring

• Exposure therapy

• Behavioral experiments

• Behavior activation

• Problem solving skills

• Relaxation

Factors of Psychotherapy

• Specific factors: Shape how change occurs (e.g. techniques)

• Common factors of psychotherapy:

  • Therapeutic alliance

  • Attention and time investment

  • Hope and expectation

  • Credible rationale

Psychological interventions for complex problems

• Complex problems are highly debilitating, long-lasting, highly comorbid and often include interpersonal patterns/trauma history.

• Interventions for complex problems stem from psychoanalysis and CBT.

  • Longer and more flexible than CBT

  • Shorter and more focused than psychoanalysis