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Major approaches to Psychotherapy Cognitive therapy Cognitive behavioral therapy Behavior therapy Psychoanalytic/psychodynamic Interpersonal psychotherapy Humanistic/experiential approach

proach o Emotion focused apporch o Focus is on enhancing the individuals emotional experience in order to understand the individuadls psychopathology Lecture is most focused on cog and cog behavioral Cognitive Therapy for Depression Based on the cognitive model of depression o Becks Negative Cognitive Triad People have negative thoughts about themselves, worlds, and their future These negative thoughts bring about their depression Stressor brings about depression as well Ex: Stressor is failed exam Self: I failed the exam, because I am stupid World: I am a failure at everything I do Future: I am never going to get into medical school. Key assumption is that cognitions/interpretations are distortred nad must be changed o Person is being too hard on themselves o To ameliorate depression, just adjust their negative thoughts Characteristics o Short term Typically about 10-12 sessions o Focused on the here and now Whats going on right now in the persons life; not focused on past/childhood experiences o Collaborative Patiet and therapist are working together for as shared goal Both patient and therapist want to alleviate the patients depression o Regular feedback Therapist provides regular feedback to the client about the progress the client is making towards the goal Initial focus: Symptom reduction Primary intervention strategy: Cognitive restructuring o B/c clients negative thoughts are bringing on the depression, we have to change the thoughts Modifying automatic thoughts Thought record Situation: Failed exam

Automatic thoughts: I am a failure at everything I do Evidence supporting the AT: I failed this exam. I have failed on other exam in my life. Evidence not supporting AT: I have passed most of the exams in my life. Alternative thoughts: I failed this exam, but I pass most of the exams I take.

Ex: Judith Beck o Can be paired w/ or w/o medication o cant stop these thoughts but once you start to feel bad, you can figure out what youre thinking and modify these thoughts. o Therapy is short term and collaborative Client generated many of the ideas Clienat has homework outside of therapy Cognitive-Behavior Therapy (CBT) Most well reasearched therapy with the most empirical evidence across all disorders discussed in lecture Cognitions, emotions, and behaviors all influence each other Ex: Anxiety Therapy o Intervention strategies 1. Cognitive restructuring: identify anxiety provoking thoughts; assess evidence through exposure 2. Behavioral techniques: exposure, gradually face the experiences that you fear the most Case Study: Snake phobias o How exposure challenges her anxiety provoking thoughts o Exposure hierarchy o Need a strong therapeutic relationship- needs to trust the therapist How do we know if therapies work? Efficacy/Outcome studies: Randomized Controlled Trials (RCTs) o RCT elements Random assignment to treatment or control group Control: typically wait for 12-16 weeks while other group receives treatment but eventually will get treatment Fixed treatment length (time-limited): everyone gets the same number of treatments/sessions Focused only on one diagnosis/problem Manualized treatment Outlines what is to occur at each session, what are the goals, what clients should do b/w sessions Helps standardize treatment across participants

Efficacy: whether a particular treatment shows improvement in a controlled study using random assignment What have we learned from RCTs? o Treatment works for about 50% of individuals o All treatments work about equally well Why? Common factors/non-specifics Hope/placebo effect Therapy relationship Exposure/emotional experiencing Reinforcement Remaining questions 1. How do therapies work? o Process studies to examine the mechanisms of change in our therapies 2. How well do therapies work in the real world? o Only tells us how it works in a controlled environment o Effectiveness: whether a particular treatment works in the real world Do the findings from RCTs generalize to the real world? o

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