Goals
- Be able to differentiate between
- Psychiatry
- Psychology
- Social Work
- Counseling
- Describe how to find a mental health provider
- Describe the three major theoretical orientations of psychotherapy and the scientific support behind them
- Name biomedical additions that can support psychotheraputic efforts
- Discuss factors that treatment outcome researchers consider in their work
What do we mean by "going to therapy?"
Psychotherapy
Use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems.
Psychotherapist
An umbrella term meaning a person who is trained and licensed to help people with a wide range of psychological concerns.
Who am I talking to?
Does therapy
- Psychology
- Clinical Psychologist
- Licensed Psychological Associate
- Psychiatry
- Psychiatrists
- Nursing
- Nurse practitioner specializing in psychiatry
- Social Work
- Licensed social workers
- Counseling
- Licensed Personal Counselors
- Family and Marriage Therapy
I know to "look for the helpers," but that's a lot of helpers...
| Who? | Undergrad? | Grad? | Really good at? | Years of psychotherapy training? |
|---|---|---|---|---|
| Clinical Psychologists | Psychological science (STEM) | PhD | Psychotherapy (exploratory and prescribed) and the science behind it, complex assessment, treating severe mental illness | Minimum of 6 years, often at least 2-3 full time |
| Psychiatrists | Biomedical sciences | MD/DO | Psychoactive medications, some psychotherapy (if at a residency that values it) | Varies, up to 4 years part time |
| Counseling | Counseling (Education) | MS or PhD | Psychotherapy that focuses on adjusting to life circumstances | MS – 1-2 | PhD - 6 |
| Social work | Social work | Typically MSW | Psychotherapy that emphasizes socio- cultural aspect | Usually 1-2 |
They should have certain ethical guidelines
- Beneficence and nonmaleficence.
- Psychotherapists work to benefit their clients while trying to do no harm.
- Fidelity and responsibility.
- Psychotherapists establish trust with their clients and maintain standards of professionalism.
- Integrity.
- Psychotherapists communicate honestly and truthfully with their clients.
- Justice.
- Psychotherapists engage in fair and equitable practices.
- Rights and dignity.
- Psychotherapists recognize that each individual has a right to autonomy.
What am I looking for?
Exploratory/Supportive therapy
- Adjusting to life change
- Pregancy
- Work/school issues
- Grief work Focused/Action oriented therapy
- Symptoms needing resolution
- Mental illness
Where do I find them?
- Exploratory
- Private practices
- https://www.psychologytoday.com/us
- Focused
- Academic medical centers
- Behavioral health centers
- https://www.abct.org/
Psychoanalysis/Psychodynamic
- What is it
- The therapist helps the client explore the unconscious, conflictual dynamics of personality
- Based on
- Freudian theories--relationships with parents.
- Techniques
- Psychoanalyst listens while the client talks about whatever comes to mind, without any censorship or filtering, and provides their opinion on its significance.
- Length of treatment
- Can be years, critiqued for vague goals and no defined endpoint.
- Scientific consensus
- Weak; Not patent-centered care.
Humanistic
- What is it
- Therapist is warm, empathetic, and accepting.
- Promotes growth and responsibility by having the client consider their own situations and the world around them to achieve life goals.
- Based on
- The idea that people are burdened by limits and expectations placed by themselves and others.
- Techniques
- Helps people unburden from societal limits and expectations.
- Showing unconditional positive regard, being empathetic, genuine, and warm with person.
- Length of treatment
- Varies, critiqued for vague goals and no defined endpoint.
- Scientific consensus
- Necessary, but insufficient to change behavior.
Cognitive-Behavioral
- What is it
- Combination of cognitive and behavioral science principles to bring about change.
- Based on
- The premise that changing thoughts can bring about change.
- The theory that thoughts, emotions, and behaviors are interrelated.
- Techniques
- Broad, but based on learning and cognitive theory
- Dependent on individual conceptualization
- Length of treatment
- Shorter term, dependent on client
- There's a defined endpoint and goal.
- Scientific consensus
- "Evidence-based" psychotherapy often comes out of this orientation. Effective for 60-80% of the population.
Better together (some of the time...)
- Medications
- Decently effective by itself, but not curative
- Most effective in combination with psychotherapy
- Include
- Psychostimulants
- Antidepressants
- Mood stabilizers
- Anti-anxiety (goes against CBT however)
- Exposure therapy is the CBT solution.
- Antipsychotics
- Brain stimulation
- Decently effective by itself, but not curative
- Most effective in combination with psychotherapy
- Include
- Electroconvulsive therapy
- Transcranial magnetic stimulation
- Transcranial direct stimulation
How do you study psychotherapy?
- Type of treatment in question
-
Independent variable
-
- Client characteristics
-
Control variables
-
- Outcomes
-
Dependent variable
-
What keeps outcome researchers up at night?
What therapies do you compare your treatment against?
- Waitlist (therapy vs. control group not in therapy)
- Another treatment (therapy vs. drugs/exercise/therapy...)
- Supportive counseling/Placebo (therapy vs. placebo)
Nonspecific factors
- That patient and provider just clicked.
What is an ethical placebo?