Psychodynamic:-

psychodynamic was founded by Sigmund Freud (1856-1939). Freud believed that people could be cured
by making conscious their unconscious thoughts and motivations, thus gaining insight.The aim of this
therapy is to release repressed emotions and experiences, i.e., make the unconscious conscious. It is
only having a cathartic (i.e., healing) experience can the person be helped and "cured."

This form of therapy is commonly used with clients suffering from depression or anxiety diagnoses, and
there is some evidence suggesting that psychodynamic therapy may be as effective in treating
depression as other forms of therapy

Assumptions

1.psychologists see psychological problems as rooted in the unconscious mind.

2.Manifest symptoms are caused by latent (hidden) disturbances.

3.Typical causes include unresolved issues during development or repressed trauma.

4.Treatment focuses on bringing the repressed conflict to consciousness, where the client can deal with
it.

Therapy contains many different therapeutic techniques. These techniques are intended to increase
awareness and foster insight into the client's behavior.some of them are given below:

1.Free Association:

Free association involves exploring a person's unconscious through spontaneous word association.
Clients are encouraged to say whatever comes to mind when the therapist presents them with a word,
no matter how trivial, illogical, or irrelevant the response may seem. It is the therapist's job to interpret
the responses as patterns in the associations that are identified.

A simple technique of psychodynamic therapy, is free association, in which a patient talks of whatever
comes into their mind. This technique involves a therapist reading a list of words (e.g.. mother,
childhood, etc.) and the patient immediately responds with the first word that comes to mind. It is
hoped that fragments of repressed memories will emerge in the course of free association.

Free association may not prove useful if the client shows resistance, and is reluctant to say what he or
she is thinking. On the other hand, the presence of resistance (e.g., an excessively long pause) often
provides a strong clue that the client is getting close to some important repressed idea in his or her
thinking, and that further probing by the therapist is called for.

Freud reported that his free associating patients occasionally experienced such an emotionally intense
and vivid memory that they almost relived the experience. This is like a "flashback" from a war or a rape
experience. Such a stressful memory, so real it feels like it is happening again, is called an abreaction. If
such a disturbing memory occurred in therapy or with a supportive friend and one felt better--relieved
or cleansed--later, it would be called a catharsis.

Frequently, these intense emotional experiences provided Freud a valuable insight into the patient's
problem

2.Dream Analysis

According to Freud the analysis of dreams is "the royal road to the unconscious." He argued that the
conscious mind is like a censor, but it is less vigilant when we are asleep. As a result, repressed ideas
come to the surface - though what we remember may well have been altered during the dream process.

Dream analysis is the investigation of repressed feelings that can be expressed in our dreams. This
theory believes repressed feelings often manifest themselves in our dreams. This happens because our
defenses are lowered when we sleep. Dream analysis helps uncover this unconscious material.

Dreams have two levels of content:

a)Latent content, or hidden motives, wishes, or fears

b)Manifest content: This refers to the dream as it actually appears

3.Freudian Slip

A “Freudian slip” is also known as a slip of the tongue or, more formally, parapraxes. These slips refer to
instances when we mean to say one thing but accidentally let “slip” another, specifically when deeper
meaning can be attributed to this slip.

For example, you might call it a Freudian slip when someone intends to say “That is your best idea yet!”
but accidentally says “That is your worst idea yet!”. Another example is where a person may call a
friend's new partner by the name of a previous one, whom they liked better.

Freud (and some subsequent psychodynamic theorists) believed that these “accidental” slips of the
tongue are not truly accidental, but actually reveal something meaningful about you. Freudian theory
holds that no behavior is accidental or random; rather, every move you make and every word you say
are determined by your mind (conscious, subconscious, or unconscious) and your circumstances.

A psychodynamic therapist may pay special attention to any such slips, whether they occur in session or
are simply related by the client during a session, and find meaning in the word substitution. They may
conclude that a slip is actually a little piece of your unconscious finding its way to the surface, indicating
an unmet desire or unknown association between two concepts.

While most modern psychologists agree that Freudian slips are generally just “slips,” it’s hard to argue
that occasionally a slip of the tongue can reveal an interesting connection in the speaker’s mind.

Critical Evaluation
- Therapy is very time-consuming and is unlikely to provide answers quickly.

- People must be prepared to invest a lot of time and money into the therapy; they must be motivated.

- They might discover some painful and unpleasant memories that had been repressed, which causes
them more distress.

- This type of therapy does not work for all people and all types of disorders.

- The nature of Psychoanalysis creates a power imbalance between therapist and client that could raise
ethical issues.

Humanistic therapies:-
it evolved in the USA during the 1950s. Carl Rogers proposed that therapy could be simpler, warmer
and more optimistic..Rogers strongly believed that in order for a client's condition to improve therapists
should be warm, genuine and understanding.

Rogers rejected the deterministic nature of both psychoanalysis and behaviorism and maintained that
we behave as we do because of the way we perceive our situation. "As no one else can know how we
perceive, we are the best experts on ourselves." (Gross, 1992)

Person centered therapy is also called client centered therapy. notable characteristic of person- or
client centered therapy is the use of the term “client” rather than “patient.

GOALS OF THERAPY

The goals of person-centred therapy are (Seligman, 2006):

1. To facilitate client’s trust and ability to be in the present moment. This allows the client to

be honest in the process without feeling judged by the therapist.

2. To promote client’s self-awareness and self-esteem.

3. To empower the client to change.

4. To encourage congruence in the client’s behaviour and feelings.

5. To help people to gain the ability to manage their lives and become self-actualised.

Core Conditions

Client-centered therapy operates according to three basic principles that reflect the attitude of the
therapist to the client:

1.The therapist is congruent with the client.

2.The therapist provides the client with unconditional positive regard.

3.The therapist shows empathetic understanding to the client.

Techniques

The following techniques will be discussed in relation to the person-centred approach: congruence,
unconditional positive regard and acceptance, empathy, and reflection of feelings.

1.Unconditional Positive Regard

The next Rogerian core condition is unconditional positive regard. Rogers believed that for people to
grow and fulfill their potential it is important that they are valued as themselves.

This refers to the therapist's deep and genuine caring for the client. The therapist may not approve of
some of the client's actions, but the therapist does approve of the client. In short, the therapist needs an
attitude of "I'll accept you as you are." The person-centered counselor is thus careful to always maintain
a positive attitude to the client, even when disgusted by the client's actions.

2.Empathy

Empathy is the ability to understand what the client is feeling. This refers to the therapist's ability to
understand sensitively and accurately [but not sympathetically] the client's experience and feelings in
the here-and-now.

An important part of the task of the person-centered counselor is to follow precisely what the client is
feeling and to communicate to them that the therapist understands what they are feeling.

3.Genuineness or Congruence:

A client centered therapist needs to feel comfortable sharing his or her feelings with the client. Not only
will this contribute to a healthy and open relationship between the therapist and client, it provides the
client with a model of good communication and shows the client that it’s okay to be vulnerable.

4.Nondirectiveness:

The person-centred approach utilises nondirectiveness as a technique by its therapists.Nondirectiveness

refers to allowing clients to be the focus of the therapy session without the therapist giving advice or
implementing strategies or activities.

5.Reflection of Feelings:

repeating what the client has shared about his or her feelings; this lets the client know the therapist is
listening actively and understanding what the client is saying, as well as giving them an opportunity to
further explore their feelings.
 The person-centred approach has been successful in treating problems including anxiety disorders,
alcoholism, psychosomatic problems, agoraphobia, interpersonal difficulties, depression, and
personality disorders.It could also be used in counselling people with unwanted pregnancy, illness or
loss of a loved one. When compared with other therapies such as goal-focused therapies, person-
centred therapy has been shown to be as effective as them.

Cognitive Behavioral Therapy:

Cognitive behavioral therapy (CBT) can be used to treat people with a wide range of mental health
problems.CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we
act (behavior) all interact together. Specifically, our thoughts determine our feelings and our behavior.

Therefore, negative and unrealistic thoughts can cause us distress and result in problems. When a
person suffers with psychological distress, the way in which they interpret situations becomes skewed,
which in turn has a negative impact on the actions they take.

CBT aims to help people become aware of when they make negative interpretations, and of behavioral
patterns which reinforce the distorted thinking. Cognitive therapy helps people to develop alternative
ways of thinking and behaving which aims to reduce their psychological distress.

Cognitive behavioral therapy is, in fact, an umbrella term for many different therapies that share some
common elements. Two of the earliest forms of Cognitive behavioral Therapy were Rational Emotive
Behavior Therapy (REBT), developed by Albert Ellis in the 1950s, and Cognitive Therapy, developed by
Aaron T. Beck in the 1960s.

CBT Assumptions:

• The cognitive approach believes that abnormality stems from faulty cognitions about others, our world
and us. This faulty thinking may be through cognitive deficiencies (lack of planning) or cognitive
distortions (processing information inaccurately).

• These cognitions cause distortions in the way we see things; Ellis suggested it is through irrational
thinking, while Beck proposed the cognitive triad.

• We interact with the world through our mental representation of it. If our mental representations are
inaccurate or our ways of reasoning are inadequate then our emotions and behavior may become
disordered.

Therapists use several different techniques in the course of cognitive therapy to help patients examine
thoughts and behaviors. These include:

Validity testing. The therapist asks the patient to defend his or her thoughts and beliefs. If the patient
cannot produce objective evidence supporting his or her assumptions, the invalidity, or faulty nature, is
exposed.
Cognitive rehearsal. The patient is asked to imagine a difficult situation he or she has encountered in
the past, and then works with the therapist to practice how to successfully cope with the problem.
When the patient is confronted with a similar situation again, the rehearsed behavior will be drawn on
to deal with it.

Guided discovery. The therapist asks the patient a series of questions designed to guide the patient
towards the discovery of his or her cognitive distortions.

Journaling. Patients keep a detailed written diary of situations that arise in everyday life, the thoughts
and emotions surrounding them, and the behavior that accompany them. The therapist and patient
then review the journal together to discover maladaptive thought patterns and how these thoughts
impact behavior.

Homework. In order to encourage self-discovery and reinforce insights made in therapy, the therapist
may ask the patient to do homework assignments. These may include note-taking during the session,
journaling (see above), review of an audiotape of the patient session, or reading books or articles
appropriate to the therapy. They may also be more behaviorally focused, applying a newly learned
strategy or coping mechanism to a situation, and then recording the results for the next therapy session.

Modeling. Role-playing exercises allow the therapist to act out appropriate reactions to different
situations. The patient can then model this behavior.

Strengths of CBT:

1. Model has great appeal because it focuses on human thought. Human cognitive abilities has been
responsible for our many accomplishments so may also be responsible for our problems.

2. Cognitive theories lend themselves to testing. When experimental subjects are manipulated into
adopting unpleasant assumptions or thought they became more anxious and depressed (Rimm & Litvak,
1969).

3. Many people with psychological disorders, particularly depressive , anxiety , and sexual disorders
have been found to display maladaptive assumptions and thoughts (Beck et al., 1983).

4. Cognitive therapy has been very effective for treating depression (Hollon & Beck, 1994), and
moderately effective for anxiety problems (Beck, 1993).

Limitations of CBT:

1. The precise role of cognitive processes is yet to be determined. It is not clear whether faulty
cognitions are a cause of the psychopathology or a consequence of it.

Lewinsohn (1981) studied a group of participants before any of them became depressed, and found that
those who later became depressed were no more likely to have negative thoughts than those who did
not develop depression. This suggests that hopeless and negative thinking may be the result of
depression, rather than the cause of it.

2. The cognitive model is narrow in scope - thinking is just one part of human functioning, broader issues
need to be addressed.

3. Ethical issues: RET is a directive therapy aimed at changing cognitions sometimes quite forcefully. For
some, this may be considered an unethical approach

Behavioral therapy
Behaviorism see psychological disorders as the result of maladaptive learning, as people are a blank
slate. Behaviorism assumes that all behavior is learnt from the environment and symptoms are acquired
through classical conditioning and operant conditioning.

Classical conditioning involves learning by association and is usually the cause of most phobias. Operant
conditioning involves learning by reinforcement (e.g. rewards) and punishment, and can explain
abnormal behavior should as eating disorders.

Consequently, if a behavior is learnt, it can also be unlearned.

a)Classical conditioning

Behavioural therapy that is based on classical conditioning uses a number of techniques to bring about
behaviour change. Originally this type of therapy was known as behaviour modification, but these days
it is usually referred to as applied behaviour analysis. The various methods of changing behaviour
include:

1.Flooding

Flooding is a process generally used for those with phobias and anxiety and involves exposing the
individual to objects/situations they are afraid of in an intense and fast manner. An example of this
would be exposing a person who is afraid of dogs to a dog for an extended period of time. The longer
this continues with nothing bad happening, the less fearful the person becomes.

The idea is that the person cannot escape the object/situation during the process and therefore must
confront their fear head on. Obviously this method can be disconcerting and may only be suitable for
certain situations.

2.Systematic desensitisation

This technique works on a similar premise to flooding, however it is more gradual. The therapist would
begin by asking the individual to write a list of fears they have. Once this list is written, the therapist will
teach relaxation techniques for the individual to use while thinking about the list of fears. Working their
way up from the least fear-inducing item to the most fear-inducing item - the therapist will help the
individual confront their fears in a relaxed state.
An example of this would be a person who is afraid of small spaces. They may start by thinking about a
small space or looking at an image of a small space while utilising relaxation techniques, and work their
way up to being in a small space. This pairing of the fear-inducing item and newly learned relaxation
behaviour aims to eliminate the phobia or anxiety.

3.Aversion therapy

This process pairs undesirable behaviour with some form of aversive stimulus with the aim of reducing
unwanted behaviour. An example of how this is commonly used is when an alcoholic is prescribed a
certain drug that induces nausea, anxiety and headaches when combined with alcohol. This means every
time the person drinks, they get negative side effects. This hopes to put off that person from drinking to
help them overcome their addiction.

b)Operant conditioning

Operant conditioning uses techniques such as positive reinforcement, punishment and modelling to
help alter behaviour. The following strategies may be used within this type of therapy:

1.Token economies

This strategy relies on positive reinforcement - offering individuals 'tokens' that can be exchanged for
privileges or desired items when positive behaviour is exhibited. This is a common tactic used by parents
and teachers to help improve the behaviour of children.

2.Contingency management

A more formal approach, contingency management involves a written contract between the therapist
and individual that outlines goals, rewards and penalties. For some, having this kind of clear agreement
helps to change behaviour and add a sense of accountability.

3.Modelling

Modelling involves learning through observation and imitation of others. Having a positive role model
can give individuals something to aim for, allowing them to change their behaviour to match their role
model's. This role model may be the therapist or someone the individual already knows.

4.Extinction

Extinction works by removing any type of reinforcement to behaviour. An example of this would be a
disruptive child who is given a time-out or told to sit on the 'naughty step'. By removing them from the
situation (and associated attention) the behaviour should stop. This premise can be carried across to
adults too - however the 'naughty step' will probably be given a different name.

Behavioural therapy for mental health issues

Behavioural therapy works best for mental health conditions that cause unwanted behaviour. Examples
of this would be addiction, anxiety, phobias and OCD. In some cases behavioural therapy works well
alone, however many find integrative therapies (like cognitive behavioural therapy) to be more
appropriate.