Psychotherapy ppt.

psychotherapy

1. WELCOME

2. Seminar on introduction to psychotherapy Submitted to: Mr. Ratheesh kumar Asst.prof .(psychiatry) LJM college of nursing Submitted by : Santa Srujanika Priyadarshinee M.Sc 1 st year

3. Introduction: In 1853 , Walter Cooper Dendy introduced the term “ psychotherapeia ” regarding how physician might influence the mental states of sufferers and thus their bodily ailments.

4. Cont.... In the late 1800s , Sigmund Freud (now known as the father of psychotherapy) developed psychoanalysis, an early form of psychotherapy.

5. Cont.... The term psychotherapy is derived from ancient Greek word psyche (meaning – breath ,spirit, soul) and therapeia (healing, medical treatment). The oxford English dictionary defines it now as “the treatment of disorders of the mind or personality by psychological methods.”

6. Definition of psychotherapy: Psychotherapy defined as , “ the informed and planful application of techniques derived from established psychological principles by pesons qualified through training and experience to understand these principles and to apply these techniques with the intention of assisting individuals to modify such personal characteristics as feelings, values, attitudes, and behaviours which are judged by the therapist to be maladaptive.” - [ meltzoff and kornreich,1970 ]

7. Cont.... Psychotherapy as “ the treatment by psychological means, of problem with emotional nature, in which a trained person (therapist) deliberately establishes a professional relationship with the patient to remove, modify or retard existing symptoms, mediate disturbed patterns of behaviour , and promote positive personality development.” [ Wolberg ]

8. Common features : Common goals Common factors Shared functions of psychotherapeutic rationales or procedures

9. Goals of psychotherapy : To achieve remission of symptoms To mediate disturbed pattern of behaviours To strengthen the ego To improve growth and development of client To protect self esteem of client To produce deeper insight To modify deviated personality To develop positive attitude To correct psychopathology

10. STAGES OF PSYCHOTHERAPY: Psychotherapy can be defined as , “a purposeful and willing relationship between at least two people, one who is supposed to know what he is doing, and other who wants help to change his life for the better . The psychotherapeutic relationship is considered to proceed in 4 main stages: Early stage Middle stage Late stage Termination phase

11. Techniques of psychotherapy: Ventilation Abreaction Reassurance Explanation Suggestion Persuasion Reinforcement Recreation Relaxation

12. Types of psychotherapy: Psychotherapies are classified into 3 types- According to depth of probing in the unconscious mind Superficial or short term Deep or long term Educative According to number of patients Individual psychotherapy Group psychotherapy family psychotherapy

13. Cont.... According to purpose Supportive psychotherapy Re-educative psychotherapy Reconstructing psychotherapy

14. Indications of psychotherapy: Neurotic illness Psychosomatic illness Schizophrenia Depression Mania Psychotic states Alcoholism Drug addiction Sexual deviation Personality disorder Marital disharmony

15. Contraindication: Severe psychotic illness Excitement Assaultive and destructive behaviour Negativism

16. Limitations of psychotherapy: It is not possible to administer for uncooperative patient. Difficult in cases of clients with low intellectual capacities, as to develop insight into the situation adequate intellectual capacities are essential.

17. Requirements of a psychotherapist- Therapist possess post graduate qualification and training in psychiatry. Medical graduates, medico social worker, clinical psychologists with orientation and experience in psychotherapy can give superficial psychotherapy under guidance of psychiatrist. The psychiatry team members are reasonably free from psychological conflicts and possess empathy healthy , personality, art of listening power, capable of understanding life situations and problems. Psychiatrist will be able to inspire confidence of the client.

18. Adverse effects: Patient may become excessively dependent on therapy or therapist. Ineffective psychotherapy wastes time and money and damages patient role.

19. Definition: Individual psychotherapy some times called as counselling is a process through which clients work one-on-one with a trained therapist ,in a safe, caring , and confidential environment, to explore their feelings, beliefs and behaviours ,work through challenging or influential memories , identify aspects of their lives that they would like to change , set personal goals, and work toward desired change . Individual psychotherapy

20. AIMS OF INDIVIDUAL PSYCHOTHERAPY : The therapist has to make the client to understand his/her feeling To modify maladaptive behaviour To improve IPR and establishing therapeutic relationship To make personal changes Provide consistent emotional support Assisting the client in gaining insight about the problem.

21. MODES OF INDIVIDUAL PSYCHOTHERAPY: Brief cognitive therapy: Behaviour therapy Brief interpersonal psychotherapy Split – treatment psychotherapy

22. 1.Brief cognitive therapy: This therapy uses a time – limited, goal -oriented, problem solving approach. Candidates for this mode of therapy are described as educated, verbal and psychologically minded.

23. 2. Behaviour therapy: This therapy focus on modifying overt symptoms without regard to the client’s private experience or inner conflicts. The role of the therapist include limit setting, promoting adaptive behaviours, discourage the use of maladaptive behaviours, promoting assertiveness and assisting the client in exploring new ways of adjusting to the environment.

24. 3. Brief interpersonal psychotherapy It is a semi-structured, time limited model of psychotherapy. The therapist reinforces the client’s self esteem, employs a conversational, goal focused approach, supports the positive use of defence mechanisms or coping skills, and avoid the use of transference and counter transference.

25. Cont... Four problem areas commonly associated with depression and anxiety respond to BPIT. Grief Loss Internal conflict Isolation

26. 4. split-treatment psychotherapy: It is referred to as dual treatment,triangulated treatment. It involves a protocol between nurse-therapist and a psychiatrist. Client with the diagnosis of a mood disorder, psychotic disorder, MR are often seen in split treatment psychotherapy.

27. Types of individual psychotherapy: Counselling psychoanalytical

28. Counselling: The term is used in a specific sense to refer to methods developed by Carl Rogers. The term counselling also applies less specifically to the other kind of brief therapy with limited objectives, in which the therapist takes a more active role.

29. Psychoanalytical therapy Psychoanalytical is the most time consuming form of psychotherapy. Its practitioners receive lengthy training which involves personal analysis as well as supervised experience in treating patients .

30. Techniques of individual psychotherapy: When the client comes first time for OPD, Observe the client Provides conducive environment with comfortable sitting Assess the physical status Establish psychotherapeutic relationship Gain confidence of client Explain the theoretical information Encourage client to express the feelings

31. Cont... Therapist plays an active listener Give valuable situation Modify the therapeutic procedures and ways of handling the problems Frequency of therapeutic sessions are decided upon client needs

32. Indications of individual psychotherapy: Stress related disorder Alcohol and drug dependence Sexual and marital disorder

33. Benefits of individual psychotherapy: Develop a new perspectives and life skills Help to deal with addictive behaviours Help to learn to take responsibility Improve the quality relationships Reduce stess Learn new behaviours Feel better and understand own thoughts feeling

34. Disadvantages: Leakage of privacy Lead to more negative impact Takes long time to cure Initial hitch

35. Approaches: Psychodynamic therapy Humanistic therapy Behaviour therapy Cognitive therapy

36. Definition: Group therapy is a form of treatment in which carefully selected emotionally ill persons are placed into group, guides by a trained therapist for the purpose of changing the mal adaptive behaviour of individual member.

37. Cont... Group therapy the meeting is with whole group and one or two therapists.

38. Selection of client: Homogenous groups , adolescents and patient with personality disorder, families and couples where the system needs change. Group size: Optimal size for group therapy is 8-10 members. Duration and frequency of group session: Once in a week for 45 min to 1 hour.

39. Types of group therapy: According to size of group: Small group (3peoples) Large group (10 – 15 peoples) According to the duration: Short term Long term According to diagnosis of client: Homogenous Heterogeneous

40. Models of group therapy Support groups Re-education and re motivation group Problem solving therapy groups Insight without reconstruction group Personality reconstruction groups

41. Therapeutic factors: Sharing experience Support to and from group members Socialization Imitation Inter personal learning

42. TECHNIQUES : Reflecting or rewarding comments of group members Asking for group reaction Asking for individual reaction Pointing out any shared feelings Summarizing various points at the end of sessions.

43. ADVANTAGES Cost effective Members profit by hearing other members discussing their problems Opportunity to explore specific styles of communication Learn multiple ways of solving problems Learn socialization skills