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1、Chapter 15Treatment of Psychological Disorders(心理错乱/障碍的治疗),psychotherapy or Treatment 心理治疗,在这个过程中，一个人希望消除症状，或解决生活中出现的问题，或寻求个人发展而进入的一种含蓄的或明确的契约关系，以一种规定的方式与心理治疗家相互作用； 以消除、缓解、纠正现有症状，调节异常行为、促进积极人格发展为目的； 治疗师与患者建立良好的人际关系； 治疗师应接受专业的训练，得到社会认可，拥有相应的理论指导，可以解释心理障碍的原因并为解决障碍提供有效措施；,心理咨询counseling,咨询内容包括：职业指导、教育辅
2、导、心理健康咨询、婚姻家庭咨询等； 在咨询师与来访者之间建立良好的人际关系，帮助来访者学会更有效地认识自己、对待自己、对待他人以及生活中的难题； 例如：心理援助、心理干预； 咨询的最核心条件：共情、理解和尊重； 咨询能力：咨询者专业技能，对待来访者的态度或关心人的能力； 通过一种由专业人员引导的人际关系而实现的帮助过程、教育过程、增长过程。,关于心理治疗的主要问题,治疗师在心理治疗过程中要做些什么?他们是如何进行治疗的? 不同理论 不同技术- 针对不同的问题-寻求治疗的是一些什么样的人? 或什么人需要心理治疗？ 如何评估治疗效果?,十八世纪时心理治疗所使用的“镇静椅”,Original poi
3、nt:psychoanalysis by Sigmund Freud (1856-1939) Psychoanalysis (精神分析); “Talk therapy” （谈话疗法）; To solve unconscious conflicts; Psychotherapists: who provide psychotherapy (心理治疗师) Client(来访者); who seeks therapy;,The Elements of the Treatment Process,Treatments: How many types are there? Discussion (讨论)
4、 Psychological testing(心理测验) Advice （建议） Emotional support (情绪支持) Persuasion (劝告) Conditioning procedures (条件反射训练) Relaxation training (松弛训练) Role playing (角色扮演) Drug therapy (药物治疗) Biofeedback (生物反馈) Group therapy (群体治疗),The Elements of the Treatment Process,Types Insight therapies (省悟疗法)：通过复杂的言语交流
5、来洞悉当事人内心的困苦并找出解决之道（“Talk therapy”-谈话疗法） Individual therapy(个别治疗） Family therapy (家庭治疗) Marital therapy (婚姻治疗) Group therapy(群体治疗） Behavior therapies (行为疗法)the principles of learning (学习原则)：改变外显行为改变反应和不良习惯而不是分析内心世界 Biomedical therapies (生物医学疗法) 干预当事人的生物机能 Drug therapy (药物治疗) Electroconvulsive therapy
6、 (电休克疗法) The right to prescribe medication (处方权),The Elements of the Treatment Process,Clients: Who seeks therapy? 15% of U.S population in a given year Most common presenting problems Anxiety and Depression Unsatisfactory interpersonal relations Troublesome habits(强迫动作思维) Poor self control Low self
7、-esteem（自尊低落） Marital conflicts（婚姻冲突） Self doubt（自我怀疑） Sense of emptiness（空虚感） Feelings of personal stagnation(个人发展停滞）,The Elements of the Treatment Process,Figure 15.2 Therapy utilization rates,Figure 15.3 Psychological disorders and professional treatment,Therapists: who provides professional trea
8、tment? Psychologists (PhD, PsyD, EdD) Clinical psychologist (临床心理学家) full-fledged disorders Counseling psychologist (咨询心理学家) Everyday adjustment problem Behavioral techniques other than psychoanalysis,Psychiatrists (精神病学家) with an MD More severe disorders Drug therapy More likely to use psychoanalys
9、is and less likely to use behavioral & group therapy,Others Clinical social worker (临床社工) Psychiatric nurse (精神科护士) Counselor (咨询师),Figure 15.3 Who people see for therapy. Based on a national survey by Olfson and Pincus (1994), this pie chart shows how therapy visits were distributed among psycholog
10、ists, psychiatrists, other mental health professionals (social workers, counselors, and such) and general medical professionals (typically physicians specializing in family practice and internal medicine). As you can see, psychologists and psychiatrists account for about 62% of outpatient门诊病人 treatm
11、ent.,Insight therapy 通过言语交流来增进自我了解并进而促成人格以及行为上积极改变。 Psychoanalysis, Related psychodynamic approaches, Client-centered therapy Cognitive therapy,Insight Therapies,Treatment of anxiety-dominated disorders Neurosis (神经症): Phobic恐惧症, Panic恐慌症, obsessive-compulsive强迫症, conversion disorders Goal: to disco
12、ver unresolved unconscious conflicts, motive and defense,Insight Therapies: Psychoanalysis心理分析,Insight Therapies: Psychoanalysis,Sigmund Freud and followers Goal: discover unresolved unconscious conflicts Free association Dream analysis Interpretation Resistance and transference,为什么源自弗洛伊德研究的精神分析疗法通常
13、被称为“谈话疗法”?,Figure 15.4 Freuds view of the roots of disorders,procedures Probing the unconscious Free association Dream analysis Interpretation ( 解释) Inch by inch Oedipal complex (伊底普斯情结)恋母情结 Resistance (抵抗) Late Pretend to engage in the therapy Hostile Transference (移情),Insight Therapies: Psychoanal
14、ysis,Other psychodynamic therapies (心理动力学疗法) Carl Jung 集体无意识与外界（社会、文化、人际等）压力的冲突是心理异常的主要原因。 Alfred Adler 自卑“情结” 精神分析学派治疗思想共同点 无意识 早期经验 差异： Jung：集体无意识/顺应天性; Freud：性与攻击/征服无意识; Adler:自卑/克服自卑; 精神分析法就是通过谈话，帮助病人了解自己，尤其是无意识里的问题，然后解决问题。 主治：各类神经症（焦虑症）,Insight Therapies: Psychoanalysis,Carl Rogers（1902-1987） H
15、umanistic perspective (人本主义观点)：human potential movement (发掘人类潜能运动) Maslow的治疗观点：实现自我潜能； 当事人在决定治疗的进度和方向上起到主要作用。 原因:Incongruence不一致 or inconsistency between self-concept and reality Over-dependence on others for approval and acceptance Anxious-defense mechanism distorted reality or stifled 窒息personal d
16、evelopment,Insight Therapies: Client Centered Therapy (当事人中心疗法),Goal: restructure self-concept to better correspond to reality Therapeutic Climate治疗氛围 Genuineness真诚 Unconditional positive regard无条件地尊重 Empathy同感/神入/同情 Respect ones own feelings and values Therapeutic process治疗进程 Provide feedback: clarification澄清 Little guidance and advice; Human mirror;,Insight Therapies: Client Centered Therapy (当事人中心疗法),准确的感知觉,歪曲事实,否认事实,歪曲,否认,适应程度低的个体,适应程度高的个体,Figure 15.5 Rogerss view of the roots of disorders,
