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Psychotherapy (Chapter 19)

Psychotherapy (Chapter 19). First Lecture Outline : History of psychotherapy Psychotherapy approaches Foundations of counselling Video 101: Psychodynnamics. Monday’s midterm. Results will not be finalized until Monday Many did well!! Keep it up!!

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Psychotherapy (Chapter 19)

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  1. Psychotherapy (Chapter 19) First Lecture Outline: History of psychotherapy Psychotherapy approaches Foundations of counselling Video 101: Psychodynnamics

  2. Monday’s midterm • Results will not be finalized until Monday • Many did well!! Keep it up!! • Multiple choice (out of 40) were done well • Average around 27 or 28/40 • Score is out of 30 for both quizzes

  3. History • Mental illness = demonic possession • Exorcism, flogging, torture, bleeding, enemas • Braveheart: “purification of spirit” • Middle ages: Asylum • St. Mary of Bethlehem: Bedlem, uproar, confusion • “over-crowded prison for social outcasts” • 1800s: Mesmer, Charcot, Breuer, Freud • origins of hypnosis and cathartic methods

  4. Other interventions from the 1900’s • Psychosurgery 1930s to 1950s: Prefrontal lobotomy • left patients vegetative, replaced by very specific microsurgery for lesions

  5. Electroconvulsive therapy (ECT) in 1940s: • 150 volts run through the head for 1-2 seconds • leads to memory loss, broken bones, still used as “last resort” for depression • Today the patient is usually placed under general anesthesia, paralysed with drugs, monitored and assisted with breathing. • Antipsychotic medications in the 1950s

  6. What is a clinical interview? • Psychotherapy involves talking to people • Structured and unstructured interviews • Model of psychotherapy directs attention of interview • Psychodynamic: Focus on early experiences • Behavioral: Focus on symptoms, ABC’s • Cognitive: Questions about specific thought patterns • Humanistic: Unconditional positive regard

  7. Interviewing in an assessment • Focus depends on what you are assessing, diagnosis • Background includes medical, school/work, family, hobbies, description of symptoms, and “other sources of information” • Tests then augment interview • Intelligence, neuropsychological, memory tests • Personality and behavioral measures • Psychophysiological and computer tasks

  8. Who can conduct “therapy” • Anyone can offer themselves to the public as a “therapist” or “counsellor” • These are not protected titles or services: watch out! • Only a psychologist can say they offer “Psychological intervention” or “Psychological assessment” • Title and services of a “psychologist” governed by provincial statute

  9. Psychodynamic therapy approaches • Patients improve once they become conscious of ego-threatening material • Free association: Client says whatever comes to mind; Dream analyysis • Resistance is an impediment to progress • Transference of feelings from significant others to therapist; Countertransference • Website listing psychotherapy approaches for personality disorder

  10. Evolution of psychoanalysis • Originally it could take years at 3-5 sessions per week • Unstructured and relaxed approach necessitated comfortable seating, surroundings • Change to become more task-oriented and time limited • “Contracting” with clients for a specific number of sessions to reach a goal

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