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OUTLINE History
∙ Ancient Greeks where it all started
I. Biological Therapies
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∙ Middle Ages: Paracelsus
II. Psychotherapy
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∙ Walter Cooper Dendy coined “psycho-therapeia” (1853)
a. Psychoanalytic Psychotherapy
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∙ Sigmund Freud → Psychoanalysis Father of Psychiatry
b. Cognitive Therapy ∙ Behavior Therapy/Cognitive Therapy “classically trained”
c. Behavior Therapy ∙ Interpersonal Therapy by Carl Rogers
d. Group Therapy ∙ Brief Therapy
e. Family and Couples Therapy
III. Psychosocial Treatment and Rehabilitation Indications and Recommendations
a. Social Skills Training ∙ Indications:
b. Milieu Therapy
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o All the disorders you find in Kaplan
c. Psychosocial Rehabilitation
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Psychotherapy can be psychoanalytic and supportive tx
IV. Guidelines for Patient Referral Kaplan & Sadock's Synopsis of Psychiatry: Behavioral
📣 SPEAKER NOTES 📝 TRANSCRIBER NOTES
Sciences/Clinical Psychiatry 11th Edition
∙ Recommended when:
BIOLOGICAL THERAPIES o A person is grappling with any life, relationship, or
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∙ Pharmacological agents work issue
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∙ Electroconvulsive agents we do use ECT in Psychiatry o A specific mental health concern causing the
∙ Transcranial Magnetic Stimulation (TMS) newer modality
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individual a great deal of pain lasting more than a few days
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of the somatic treatment; already used in some areas abroad It’s okay to be sad, angry or frustrated when something
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∙ Light therapy for Seasonal Affective Disorders unpleasant happened but we should be able to bounce back
Seasonal Affective Disorder (SAD): in DSM-5 is identified as
Major Depressive Disorder with Seasonal Pattern; symptoms usually
Psychotherapy
occur during the fall and winter months when there is less sunlight
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∙ Problem-solving
📣 ∙ Goal-oriented don’t just say, “Doc, I wanna be better”,
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∙ Sleep deprivation for Insomnia
you need to define what “better” means for you
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∙ Melatonin an over-the-counter (OTC) agent for sleep
∙ Develop awareness of how behavior contributes to the
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∙ Drug-assisted interviewing done a few decades ago
problem and coping skills to address these
∙ Psychosurgery for brain stimulation; implant something
∙ It is most successful when an individual enters therapy on
in the patient’s brain to affect the electrical activity
their own and strongly motivated to change
∙ Placebos
📣 Alternative Therapies would include: 1.
Different Types of Psychotherapy
Psychoanalytic Psychotherapy
∙ Acupuncture and Acupressure
2. Cognitive Therapy
∙ Orthomolecular Therapy
3. Behavior Therapy
∙ Plant extracts
4. Group Therapy and Stress Debriefing
5. Family and Couples Therapy
PSYCHOTHERAPY
∙ Also known as “Talk Therapy” or the “Talking Cure”
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PSYCHOANALYTIC PSYCHOTHERAPY
∙ A treatment of psychic problems through talking to a
∙ It has other names: “Psychodynamic”, “Insight-oriented”,
Psychotherapist
“Intensive”, “Exploratory”, “Uncovering”
o This is a person who has special education for
giving help this way
∙ Two (2) subtypes:
o Expressive Subtype
∙ A process focused on helping people learn more constructive
▪ Interpreting unconscious conflicts and
ways to deal with the problems or issues in life
gaining insight
PSYCHIATRY 3 | Quinivista, R
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📣 We use the term “Psychological First Aid” instead
o Supportive Subtype it’s more of a counseling STRESS DEBRIEFING
∙ Crisis intervention 📣 applied to something bad happened
▪ Strengthening a patient’s defenses,
directing them toward adaptive and
healthy ways of problem solving
∙ Immediate response to a crisis and the long term
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COGNITIVE THERAPY development of psychological adaptation aimed at preventing
Help px connect with their thoughts, emotions & behavior future problems
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∙ Help patients with the following:
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o Identify negative cognitions unhealthy thinking ∙ Therapeutic and preventive
o Develop alternate schemas teach how to think
o Rehearse new cognitive responses FAMILY AND COUPLES THERAPY
📣 This therapy is initiated by Dr. Aaron Beck and applied to: 📣
∙ Work towards improving group interactions and help each
member function better this is the usual goal of therapy
∙ Depressive Disorders
∙ Panic Disorder ∙ Aims to bring:
∙ Obsessive Compulsive Disorder (OCD) o Light the often hidden patterns that maintain a
∙ Somatoform Disorder group’s balance, and
∙ Paranoid Personality Disorder o Help the group understand the purpose of patterns
PSYCHOSOCIAL TREATMENT AND REHABILITATION
∙ Methods to enable people who are severely mentally ill to
develop social and vocational skills for independent living
📣 This includes the following:
1. Social Skills Training
2. Milieu Therapy
3. Psychosocial Rehabilitation
SOCIAL SKILLS TRAINING
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∙ Interpersonal behaviors required for community survival
📝 Aaron T. Beck: an American psychologist who is widely regarded
as the Father of Cognitive Therapy; died peacefully on Nov. 1, 2021
∙ Method: role playing taught how to manage themselves
∙ Trained to improve social skills in specific situations
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BEHAVIOR THERAPY o Report decreased social anxiety after training
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∙ Ameliorating people’s maladaptive behavior without because the px will have an idea on what to do in real life
theorizing about their inner conflicts
would do with Psychoanalytic Psychotherapy
unlike what you
∙ Problem-solving, information-processing skills 📣 practical
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∙ All behavior that is learned → can be unlearned
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∙ Operant and Classical Conditioning founded by these MILIEU THERAPY
o This is applied to: Phobias, compulsions, sexual ∙ Focus: living, learning, and working environment
dysfunctions, psychophysiological reactions ∙ Emphasize group and social interaction
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GROUP THERAPY ∙ Rules and expectations mediated by peer pressure
∙ Carefully selected people meet in a group guided by trained When a px is disturbed or doing something unacceptable
therapists and help one another effect personality change → peers catch their attention before the staff will intervene
∙ Strengths:
o Immediate feedback from peers ∙ This stresses a patient’s:
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▪ The chance for both patient and o Rights to goals
therapist to observe a patient’s o Freedom of movement in a open ward
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response to a variety of people o Informal relationship with the staff
📣 This is practiced and applied to:
Call them by their first names
∙ Adolescents, Personality Disorder, families, couples ∙ There should be clear communication
PSYCHIATRY 3 | Quinivista, R
📣 A very good example is: Fountain House
PSYCHOSOCIAL REHABILITATION
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Social Practice is pioneered by Fountain House; a specialized
form of therapy that uses the setting of an intentional community to
assist people in their mental health recovery; helps px learn new
skills, hone their talents, build dignity, develop a sense of belonging,
and make progress towards their goals
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∙ Patients created their own social support network
They help each other out with the basic activities
∙ Activities:
o Chores
o Assisting each other in banking or budgeting
o Manning thrift shops
o Visiting hospitalized friends
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o Refurbishing apartments
The Philippine Mental Health Association (PMHA) have a
Day Center where the patient can go to rehab and be trained
∙ Vocational training 📣 for px with severe mental illness
📣 This is when patients are referred to Psychiatry
GUIDELINES FOR PATIENT REFERRAL
∙ Be confident and enthusiastic
∙ Always present the referral as part of ongoing medical care
∙ Have the name and phone number of referral source ready
∙ Inform the psychiatrist of the referral
∙ Make appointments for evaluation while patient is in clinic
∙ Schedule a follow-up appointment
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PSYCHIATRY 3 | Quinivista, R
