Methods of Therapy

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therapies for abnormal behaviors
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  TOPIC:METHODS OF THERAPYPsychotherapy is a   systematic interaction between a therapist and a client that appliespsychological principles to affect the client’s thoughts, feelings, or behavior in an effortto help the client overcome psychological disorders, adjust to problems in living, or developas an individual. HISTORY Historically speaking, “treatments” of psychological disorders often reflected theassumption that people who behaved in strange ways were possessed by demons . Becauseof this belief, treatment tended to involve cruel practices such as exorcism andexecution. Some people who could not meet the demands of everyday life were tossed intoprisons. Others begged in the streets, stole food, or became prostitutes. A few foundtheir way to monasteries or other retreats that offered a kind word and some support.Generally speaking, they died early. ã Asylums. They originated from monasteries. They were the firstinstitutions meant primarily for people with psychological disorders. Buttheir function was warehousing, not treatment. Their inmate populationsmushroomed until the stresses created by noise, overcrowding, and diseaseaggravated the problems they were meant to ease. Inmates were frequentlychained and beaten. ã Mental Hospitals. In the US mental hospitals gradually replaced asylums.The mental hospital’s function is treatment, not warehousing. Still, becauseof high patient populations and understaffing, many patients received littleattention. Even today, with somewhat improved conditions, one psychiatristmay be responsible for the welfare of several hundred residents on theweekend when other staffs are absent. ã The Community Mental Health Movement. Community mental healthcenters attempt to maintain new patients as outpatients and to servepatients who have been released from mental hospitals. Today most peoplewith chronic psychological disorders live in the community, not in thehospital. PSYCHOANALYTIC THERAPIES This type of therapy is based upon the theories and work of Sigmund Freud , who foundedthe school of thought known as psychoanalysis . Psychoanalytic therapy looks at how theunconscious mindinfluences thoughts and behaviors . Psychoanalysis frequently involves looking at early childhood experiences in order to discover how these events mighthave shaped the individual and how they contribute to current actions . Peopleundergoing psychoanalytic therapy often meet with their therapist at least once a weekand may remain in therapy for a number of weeks, months, or years.Psychoanalytic therapists generally spend time listening to patients talk about theirlives, which is why this method is often referred to as the talking cure. The therapyprovider will look for patterns or significant events that may play a role in the client'scurrent difficulties. Psychoanalysts believe that childhood events and unconsciousfeelings, thoughts, and motivations play a role in mental illness and maladaptivebehaviors . Psychoanalytic therapy also makes use of other techniques including freeassociation, role play, anddream interpretation.  HUMANISTIC THERAPIES Psychoanalytic therapies focus on internal conflicts and unconscious processes.Humanistic therapies focus on the quality of the client’s subjective, consciousexperience. Traditional psychoanalysis focuses on early childhood experiences. Humanistictherapies are more likely to focus on what clients are experiencing here and now.I.Client-Centered Therapy Client-centered therapy, also known as person-centered therapy , is a non-directiveform oftalk therapythat was developed byhumanistpsychologist Carl Rogers duringthe 1940s and 1950s. He was a humanist thinker and believed that people arefundamentally good . He also believed that people have an actualizing tendency, or adesire to fulfill their potential and become the best people they can be. Rogers initially started out calling his technique non-directive therapy. While his goalwas to be as non-directive as possible, he eventually realized that therapists guideclients even in subtle ways. He also found that clients often do look to their therapistsfor some type of guidance or direction. Eventually, the technique came to be known asclient-centered therapy.Mental health professionals who utilize this approach strive to create a therapeuticenvironment that is conformable, non-judgmental and empathetic. Two of the keyelements of client-centered therapy are that it: ã Is non-directive. Therapists allow clients to lead the discussion and do not try to steerthe client in a particular direction. ã Emphasizesunconditional positive regard. Therapists show complete acceptance andsupport for their clients.According to Carl Rogers, a client-centered therapist needs three key qualities:Genuineness: The therapist needs to share his or her feelings honestly. By modeling this behavior,the therapist can help teach the client to also develop this important skill. Unconditional Positive Regard: The therapist must accept the client for who they are and display support and care nomatter what the client is facing or experiencing. Rogers believed that people oftendevelop problems because they are used to only receiving conditional support;acceptance that is only offered if the person conforms to certain expectations. Bycreating a climate of unconditional positive regard, the client feels able to express hisor her emotions without fear of rejection. Empathetic Understanding: The therapist needs to be reflective, acting as a mirror of the client's feelings,thoughts. The goal of this is to allow the client to gain a clearer understanding of theirown inner thought, perceptions and emotions.By exhibiting these three characteristics, therapists can help clients growpsychologically, become more self-aware and change their behavior via self-  direction. In this type of environment, a client feels safe and free from judgment.Rogers believed that this type of atmosphere allows clients to develop a healthier viewof the world and a less distorted view of themselves. II.Gestalt Therapy Gestalt therapy was originated by Fritz Perls. Like client-centered therapy,Gestalt therapy assumes that people disown parts of themselves that mightmeet with social disapproval or rejection. People also don social masks, pretendingto be things that they are not. Therapy aims to help individuals integrateconflicting parts of their personality. The German word “gestalt” means “unifiedwhole”. This type of therapy focuses on the here and now. Perls also belieed,along with Rogers, that people are free to make choices and to direct theirpersonal growth. But the charismatic and forceful Perls was unlike the gentle andaccepting Rogers in temperament. Thus, unlike client-centered therapy, Gestalttherapy is directive. The therapist leads the client through plannedexperiences.BEHAVIOR THERAPY Psychoanalytic and humanistic forms of therapy tend to focus on what people think andfeel. Behavior therapists tend to focus on what people do. Behavior therapy – alsocalled behavior modification – applies principles of learning to directly promote desiredbehavioral changes. Behavior therapists rely heavily on principles of conditioning andobservational learning. They help clients discontinue self-defeating behavior patterns such as overeating, smoking, and phobic voidance of harmless stimuli. They help clients acquire adaptive behavior patterns such as the social skills required to start socialrelationships or say no to insistent salespeople.Behavior therapists may help clients gain “insight” into maladaptive behaviors such asfeelings of anxiety by helping the person become aware of the circumstances in which thebehaviors occur.Some frequently used behavior-therapy techniques: 1.Fear-Reduction Methods ã Flooding. The client is exposed to the fear-evoking stimulus until fear isextinguished. ã Systematic Desensitization. The client is gradually exposed to fear-evokingstimuli under circumstances in which he or she remains relaxed. ã Virtual Therapy. Using the technology we find in video games, programsmimic traumatic settings and events. The idea behind the treatment is tosystematically expose the patient to aspects of their experience in a gradedfashion so they can confront their fear of the trauma. ã Modeling. It relies on observational learning. In this method, clients observeand them imitate people who approach and cope with the objects orsituations that the clients fear.  2.Aversive Conditioning Many people also seek behavior therapy because they want to break bad habits suchas smoking, excessive drinking, nail-biting, and the like. Aversive conditioning is amethod in which a painful or aversive stimuli are paired with unwanted impulses, such as desire for a cigarette, in an effort to make the impulse less appealing. For example, to help people control alcohol intake, tastes of different alcoholicbeverages can be paired with drug-induced nausea and vomiting or with electricshock. 3.Operant Conditioning Procedures We tend to repeat behavior that is reinforced. Behavior that is not reinforcedtends to become extinguished. ã The Token Economy Many psychiatric wards and hospitals use token economies in which patientsneed tokens such as poker chips to purchase TV viewing time, extravisits to the canteen, or a private room. The tokens are dispensed asreinforcers for productive activities such as making beds, brushing teeth,and socializing. Token economies have not eliminated all symptoms ofschizophrenia but have increased patients’ activity and cooperation. Tokenshave also been used to modify the behavior of children with conductdisorders. ã Successive Approximations The operant conditioning method of successive approximations is often usedto help clients build good habits. For example, you want to study threehours each evening but can concentrate for only half an hour. Rather thanattempting to increase your study time all at once, you could do so graduallyby adding, say, five minutes each evening. After every hour or so ofstudying, you could reinforce yourself with five minutes of people-watchingin a busy section of the library. ã Biofeedback Training Through biofeedback training, therapists help clients become more awareof, and gain control over various bodily functions. Therapists attachclients to devices that measure bodily functions such as heart rate.Electronic signals are used to indicate (and thereby reinforce) changes(“operants”) in the desired direction – for example, a slower heart rate.Knowledge of results is a powerful reinforcer. ã Social Skills Training In social skills training, behavior therapists decrease social anxiety and buildsocial skills through operant conditioning procedures that employ self-monitoring, coaching, modeling, role-playing, behavior rehearsal, andfeedback. Social skills training has been used to help formerly hospitalizedmental patients maintain jobs and apartments in the community. Social skillstraining is effective in groups. Group members can role-play important
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