Psychotherapy is the generic name for formal psychological treatment.

The particular techniques used by a therapist depend on their training. However, all involve
interactions between a practitioner and a client. And, all are aimed at changing patterns of
thought, emotion, or behavior to improve mental health and well-being. It is estimated that there
are more than 400 approaches to psychotherapy. As a result, many therapists follow an eclectic
approach
and use a variety of techniques tailored to the needs of their clients.

There are different types of therapists who receive training and certification through different
types
of professional programs. All require at least master’s level training after graduating with a
Bachelor’s degree.

• To work as a clinical or psychiatric social worker or nurse requires a master’s degree.

• To work as a clinical psychologist, a doctoral degree is required. This can be a PhD, which
involves training in both clinical work and research, or a PsyD that involves mostly training
in clinical work.
• To be a counsellor or counselling psychologist, a master’s degree like a master’s of
education or PhD is required.
• To become a psychiatrist, one must complete medical school and receive an MD.
• Art therapy training typically requires the completion of a post-graduate certificate or a
Master’s degree.
• People with training in other allied health fields often work in clinical roles as well. These
include occupational therapists, recreation therapists, and speech-language therapists, all
of which also require MA-level training

Psychoanalysis is a therapeutic approach, based on Freudian personality theory. The goal of

psychoanalysis is to help clients gain insight into their unconscious and understand how these
processes affect daily functioning. Doing so is thought to free them from unconscious influence
of the personality. The focus of psychoanalysis is on emotions, defense mechanisms, wishes,
dreams, fantasies, past experiences, and interpersonal experiences.

One of the techniques used in psychoanalysis is free association, where the patient is
encouraged to talk freely about everything that comes to mind. The analyst then uncovers the
underlying or unconscious meaning of what has been said.

Dream analysis is also used to reveal unconscious processes. Dreams are considered symbolic
and the analyst uncovers their true meaning for the patient. Psychoanalysis is not practiced with
much frequency any more, in part because it is viewed as inefficient and expensive and based on
a theoretical approach to understanding the causes of behavior that is no longer accepted by
mainstream psychology.

Humanistic approaches to psychotherapy arose in opposition to psychoanalysis. They are not

reconstructive or paternalistic like psychoanalysis. Rather, the focus is on supporting the client
through a journey of self-discovery as they acquire self-knowledge and realize their actualization
potential. These therapies relate to Maslow’s and self-determination theory notions of
selfactualization that you learned about in earlier units.
Carl Rogers founded the form of humanistic therapy, called client-centered therapy. The
approach focuses on the thoughts, desires, and abilities that represent the client’s understanding
of the self.The therapist uses reflective responses to restate the client’s view, reflecting the
underlying emotion of the client, which communicates to the client that the therapist
understands. The client is also encouraged to elaborate to foster growth. Overall, the goal of the
therapist is to convey unconditional positive regard, empathy, genuineness to support the client’s
self-actualization goals.

Cognitive therapies are based on the theory that distorted thought patterns produce maladaptive
behaviors and emotions.

Aaron Beck was a pioneer in developing cognitive therapies for depression. His approach
involved identifying and altering the dysfunctional schemes of the self, situations, and the future
that produce automatic thoughts. The technique involves having the client monitor their
automatic thoughts and connecting them to events, emotions, and behavior. The therapist and
client work together to examine evidence for and against the automatic thoughts. The client is
tasked with testing their negative predictions and substituting adaptive reality based predictions.
For example, rather than interpreting a negative interaction with their boss to mean that they are
a worthless person, cognitive therapy would aim to have the client interpret the bosses behavior
as meaning that their boss was having a bad day.

NOTES: Variations of Cognitive Therapy

• Rational-emotive therapy: The therapist acts as a teacher, explaining the client’s errors in
thinking and demonstrating more adaptive ways to think and behave.
• Mindfulness-based cognitive therapy: People who recover from depression may
continue to be vulnerable to faulty thinking when they experience negative moods; teach
mindfulness techniques to manage negative moods.
• Cognitive-behavioral therapy (CBT): Incorporates techniques from cognitive therapy
and behavior therapy to correct faulty thinking and change maladaptive behaviors
• Dialectical Behavior Therapy: Combines CBT and mindfulness but with an emphasis on
self-awareness and acceptance; effective for some personality disorders because for these
clients some aspects of personality are difficult to change
Group therapy rose in popularity after World War II. There were many different stressors related
to the war, with more people needing therapy than there were therapists available to treat them.
Delivering a therapeutic technique, like mindfulness, or cognitive, or behavioral techniques to a
group rather than a single individual has several advantages.
In general, group therapy builds social support among the members, in addition to establishing
support from the therapist leading the group. The group setting also provides an opportunity for
members to improve their social skills and to learn from one another’s experiences. And group
therapy is often significantly less expensive than individual treatment.
Family therapies focus on particular groups of individuals, those in the same family. The focus
of family therapy is on relationship quality as the cause of problems. The therapist works with
the members of the family to foster an understanding of and to change negative patterns of
relating and interacting with others in the family.

The therapist may focus on attachment styles, attribution styles, communication and conflict
resolution styles, and expressed emotion in the family, which is a pattern of critical and negative
communication.

Many classes of psychological disorders can be treated with psychotropic medications. Review
the effects of each class of drug presented here: antianxiety, antipsychotic, antidepressants, and
stimulant medication, then click on each to learn more.
Many classes of psychological disorders can be treated with psychotropic medications. Review
the effects of each class of drug presented here: antianxiety, antipsychotic, antidepressants, and
stimulant medication, then click on each to learn more.

NOTES:
Antianxiety Drugs
• Commonly known as tranquilizers
• Example: Benzodiazepines
o Increase the activity of GABA
o Induce drowsiness and are highly addictive
• For an animation of how these drugs affect GABA and neural transmission, click
Benzodiazepines

Antipsychotics Drugs
• Treatment of schizophrenia and other disorders that involve psychosis
• Block dopamine receptors to reduce activity
• Older generation of drugs had negative side effects like involuntary twitching of muscles,
especially in the neck and face.
• Newer medications are more effective and have fewer side effects, such as Clozapine.
Antidepressants Drugs
• Often used for disorders other than depression, like anxiety disorders
• Monoamine oxidase (MAO) inhibitors
o Elevate the levels of norepinephrine, serotonin, and dopamine by inhibiting enzyme
monoamine oxidase that removes these neurotransmitters
• Tricyclic antidepressants
o Block reuptake of norepinephrine, serotonin
• Selective serotonin reuptake inhibitors (SSRI)
o Generally preferred, effective, fewer side effects
o Prozac
Stimulants Drugs
• Used to treat ADHD
• Examples: Ritalin, Concerta, Adderall
• Inhibit norepinephrine and dopamine reuptake
• Stimulate the prefrontal cortex of the brain to increase behavioral and emotional control

When a disorder does not respond to traditional psychotherapy or psychotropic medication

treatment, alternative treatments that affect neurological functioning may be used.

Electroconvulsive Therapy
• Administer a strong electrical current to the patient's brain to produce a seizure
• Effective for severe depression
• ECT now generally occurs under anesthesia, with powerful muscle relaxants to eliminate
motor convulsions, confine the seizure to the brain
Electroconvulsive Therapy
A woman being prepared for ECT has a soft object placed between her teeth to prevent her from
swallowing her tongue. ECT is most commonly used to treat severe depression that has not been
responsive to medication or psychotherapy.

Deep Brain Stimulation

Electrodes surgically implanted deep within the brain
Mild electricity stimulates the brain at an optimal frequency and intensity
Successful in treating Parkinson's disease, OCD, depression

Tanscranial Magnetic Simulation

• A powerful electrical current produces a magnetic field
 • When rapidly switched on and off, the magnetic field induces an electrical current in the
brain region directly below the coil, interrupting neural function in that region
• TMS is used mainly to treat severe depression

Phototherapy
Definition: The person sits in front of strong lighting for several hours each day
Effective for seasonal affective disorder
Depression associated with low exposure to natural light
Greater incidence at higher latitudes where daylight exposure is reduced during winter

Incidence of Seasonal
Affective Disorder
As shown by this map, incidence of SAD varies by latitude.