Advise about Treatments

Cognitive-Behavioral Psychotherapy

If I was going to give advice to anyone seeking any kind of treatment I would first want to lay both options out on the table. First we will discuss what cognitive-behavioral psychotherapy is and what it consists of or who it may be beneficial to. We do not know what our friend is suffering from but certain dysfunctions and disorders may have more of an impact than other types of treatment. This type of therapy has proven itself in the long run good for people who suffer from panic disorders and depression. More research must be done to pin point what it is exactly about this approach that works but something about it is being done right. By using the cognitive-behavioral approach you are restructuring the whole outlook of what that client has grown up to believe in. This approach is teaching them a whole new belief system and new ways of looking at certain situations. One specific approach is called rational emotive behavior therapy (REBT) created by Albert Ellis. Maybe our friend has a maladaptive thought process that is slowing destroying the relationships in his life and his life in general. The REBT approach is going to help you relearn the "shoulds", "musts", and "oughts" in different situations in your life; it takes a clear stand on human values and human worth. It will help a person have a more positive outlook on these areas. Another major approach in this area is Beck's cognitive therapy; this was originally designed to be used on patients or clients that experience depression but now is also used for anxiety disorders. One form of this approach is also used for more conditions including eating disorders, obesity, personality disorders, substance abuse, and schizophrenia. According Beck people make bad decisions because of their dysfunctional beliefs; and because of their dysfunctional belief they also have a dysfunctional way of processing information (Butcher, Mineka, & Hooley, 2013, p.574-576).
In the first phase of reconstructing persons dysfunctional beliefs the clients will become aware of what patterns of thinking may be the cause of the dysfunctions. They need to understand what are the "abnormal" patterns of thinking and what are the "normal" patterns of thinking. They will need to be able to identify the wrong patterns of thinking and even record these thoughts as homework for their next therapy session. With the help of medical health professionals they will be able to identify why their patterns of thinking are abnormal and how it is causing distress with the rest of their life. They may also be asked to test new ways and new patterns of thinking to be able to have a comparison as to why they think the things they do (Butcher, Mineka, & Hooley, 2013, p.574-576). To be able to accomplish this whole process successfully I would think the client (my friend) should find a clinical therapist that they will be able to have an open trusting relationship with. When you explore a person's beliefs system and have to teach them from right and wrong, you would have to have a trusting relationship. If I am the client and I do not believe in what you are trying to help me correct within my patterns or thoughts then the treatment will not be as effective. This type of therapy is going to be good for a person who likes to see things mapped out. For example a person who suffers panic attacks they may use a form of cognitive therapy by mapping out the first initial cause of there attacks, so lets say one cause is worrying about being in a distressful situation and having a panic attack, the next step along the lines of this disorder is identifying the initial psychical symptoms of the panic attack. Cognitive therapy has helped lay this out in a cycle, the threat, then the thoughts of the situation to come, the body sensations that will follow in psychical forms, and then lastly the outcome of the whole situations which is usually catastrophic (Butcher, Mineka, & Hooley, 2013, p.192). This type of therapy might be beneficial if they believe the thinking patterns they carry are astray from what is considered to be "normal" and nondestructive to yourself or others.
Psychodynamic Therapist

The second approach should also have a good explanation and background as to why my friend should or should not choose this method. This therapeutic approach began with Sigmund Freud and is practiced in two different forms being classical psychoanalysis and psychoanalytically oriented psychotherapy. Both forms deal with trying to dig emotionally deep within the patient to find suppressed memories, thoughts, or actions that may have lead to the current situations at hand. Some say this type of approach in therapy is neglecting the patient's current needs and wants; the sole purpose of this therapy is to find something deep within that person's history to pinpoint why they are being affected today with this disorder or dysfunction. Through a rigorous schedule of therapy that includes meeting with a therapist three times a week, together the clinical specialist and the client will work in determining if there are any issues in the patients past that even they may not be connecting with their current situation. Some of Freud's original treatment analysis comes from a therapy called psychoanalysis. This type of therapy has four basic techniques including free association, analysis of dreams, analysis of resistance, and analysis of transference. The first technique free association is when the therapist has the client say whatever comes to mind and not associating it with a particular subject. In the long run this is to study what the unconscious mind may be directing towards. Although the patient may think these words are random they may have a deeper meaning to them in the long run but that is for the therapist to determine. Another technique that is used to try to find clues within the unconscious mind is the analysis of dreams. It is said that a person's desires and feelings let themselves out through the ways of our dreams. By distinguishing the symbols within the dreams we may be able to uncover the connections they have with the dysfunctions occurring in that person present state of mind (Butcher, Mineka, & Hooley, 2013, p.574-576).
The third technique following more of the original theories of Freud is the analysis of resistance. This is when the therapist finds areas within the client's life or past life that they are very unwilling to talk about. It is the therapists task to uncover these areas of things or experiences that their client does not want to talk about and it is also the therapists task to figure out if any of these uncovered secrets have anything to do with the dysfunctions that person is currently experiencing. The last technique is the analysis of transference, this is when the relationship of the client and therapist is studied because it has been determined that the way a person may treat their therapist will reflect the relationship they may have had with their own parents or caregivers, this process is called transference. If there is a type of connection between the therapist and client that reflects issues in the clients past then there could be a start to the path of being able to cure the client of their dysfunctions. The therapist would have to get the client to understand the transference relationship to be able to start the client on the road to recovery. The original version of psychodynamic theories are rarely practiced today, it may take several years to be able to pin point what in the patients past is affecting their lifestyles of today. Several years is also a long time to hope for a solution to your current dysfunctions your are dealing with, another way to think of it though, is several years is a small price to pay for a lifetime of symptom free living if the condition is pinpointed and cured (Butcher, Mineka, & Hooley, 2013, p.580-581).This approach of therapy is going to work well on someone who does has a distraught past that may have an unsettling closure to it. Although, many people do not even know they have this type of past because the thoughts or memories have been deeply suppressed within that person mind. I think this type of approach in therapy can also be used with other types of therapy. It is not going to hurt anyone to talk about random thoughts and feelings or to talk about what we dream about. If anything it is more information and background for the clinical therapist who is treating the client.
Conclusion

The advice I would present to my friend is the summaries written above on both different types of therapies. No matter what a patient or client should remember that not all therapies work on everyone, and it may take trial and error to find something that will be effective for your own situation. Psychotherapy should not be about ethics and cultural diversity but this can be an issue and may be an issue for some people. Many minorities have the disadvantage is choosing they would like to be treated by. Whether it is for reasons concerning health insurance or monetary issues or it could be because there are not enough trained clinical therapist in their area but both issues could have an impact on what treatment my friend where to receive. After reading different topics throughout this unit I believe it is very important to make sure that my friend would feel comfortable with the therapist they choose. We all have natural instincts as far as first impressions go, the client should be able to tell from the first meeting with the therapist if they want to continue the treatment. This is also why they say the relationship that the therapist holds with the client is so important, because it is a factor in determining how successful the entire treatment plan will be. Goldfried and Davila made a great argument in their article that the relationship in the therapeutic technique that is used is as equally important as the therapeutic relationship that is built. A good relationship is needed for the beginning analysis in gathering information and background from the client to the end when the patient graduates from their treatment plan. If there is no good connection in all aspects of the relationship then how is the doctor going to keep the patient focused on what they are to be doing to cure themselves. We have also learned that by focusing on therapeutic technique only did not produce very positive or powerful results (Goldfried & Davila, 2005).
The key factors that my friend should keep in mind are first finding a therapist who has accurately diagnosed the dysfunctions of the patient. Most likely they already have an existing relationship with a clinical therapist, they should research how that therapist would like to proceed with treatment and also research the topic themselves through different resources about the different treatment options. As much as a psychotherapist would work in helping your situation the main issue is that you also know your body well and maybe the therapist needs to keep an open mind in what their client is suggesting as a treatment plan that would work best for themselves or their lifestyle.




References:

Butcher, J., Mineka, S., & Hooley, J. (2013) Abnormal psychology. (15th ed.) Upper
Saddle River, NJ.

Goldfried, M. R., & Davila, J. (2005). The role of relationship and technique in therapeutic change. Psychotherapy: Theory, Research, Practice, Training, 42(4), 421-430. doi:10.1037/0033-3204.42.4.421