Treatment Modalities

Individual Therapy
Family Therapy
Behavior Therapy
Milieu Therapy
Cognitive therapy
Psychopharmacology
Individual Therapy
Primary focus is to develop trust
Provide logic and rational explanation to increase the awareness and
understanding about anxiety

Provide information about the nature of disease

Medication information

Stress management

Develop daily structural plan

 Family Therapy
Is method of treatment in which all family members gain insight
into problems, improve communication and improve functioning
of individual members as well as the family as a whole .

Understanding how family dynamics contribute to the client

psychopathology
Mobilizing the family inherent strength and functional recourses ,

Restructuring maladaptive family behaviors

 Major concepts of Family therapy
Differentiation of self: ability to define oneself as a separate being.
Triangles : refers to a three person emotional configuration that is considered as the basic building block of
the family system.
Nuclear family emotional process: emotional functioning in a single generation
Family projection process: parents projecting anxiety to the children.
Multigenerational transmission process: values, beliefs, behaviors are transmitted from one generation to
other
Sibling position: it influences development of personality characteristics.
Emotional cut off: it is the result of dysfunction within the family of origin, which promotes same type of
dysfunction in the new family.
Societal emotional process: societys response to the stress.
 Behavior Therapy

A form of psychotherapy that modify the maladaptive behavior pattern by

reinforcing more adaptive behaviors
It is based on principles of classical conditioning and operant conditioning
Techniques of behavior therapy
Shaping

Reinforcement are given for response closer to the desired ones

Eg: Give reward to watch teacher
Give reward for making sound like teacher
Give reward to form like teacher
Modeling

Learning new behaviors by

imitating the behaviors of other
Premack Principle

the occurrence of one event can serve as reinforcement of the desired

behavior

If a child misuse the telephone and neglect his school performance

Then you can allow use of mobile as reinforcement of completing his work
Extinction

A gradual decrease in frequency of a response, when the positive

reinforcement is withheld

Ignore the inappropriate behavior like temper tantrums in children

Contingency Contracting

The behavior change that is desired is stated explicitly in writing

 Token Economy
Token are awarded when desired
behaviors are performed and
may be exchange for designated
behavior

Client can buy something for 2

token, trip by 5 token, coffee by 3
token
Time out

Punishment during which the client removed from the environment where
the unacceptable behavior is being exhibited
Overt Sensitization

It is a type of aversion therapy

Produce unpleasant consequence for undesirable behavior

Example Antabuse : Disulfiram given to alcoholics

Covert Sensitization

The individual learn through their mind to visualize nauseating scene and
even to induce a feeling of nausea

The person dose not have to perform the undesired behaviors but simply
imagines them
 Systematic Desensitization
Relaxation technique
Hierarchy construction
Desensitization from lower to higher
Systematic process in which the person overcome their fear of phobia in a
hierarchy progresses
Each step is paired with relaxation
 Flooding
It is also called implosive therapy
Desensitize individual to phobic stimuli by flooding them with a
continues presentation of the phobic stimulus until the anxiety no
longer present
Milieu therapy

Manipulate the environment so

that all aspect of client hospital
environment are consider
therapeutic

Structure the environment in order

to effect behavioral changes and
improve individual function
 Milieu Therapy

Condition that promote therapeutic community

Basic need should be fulfilled
Personal space and privacy should be maintained
Autonomy and democratic form of self government should be exist
Structured program should exist
Community and family should be included
Type of Milieu Therapy

Art Therapy Music Therapy Psychodrama

Occupational Therapy Recreational Therapy

 Type Goal Example

Recreational Therapy Redirect client activity to rechannel Bowling, exercise, jogging,

destructive energy in appropriate picnics
manner

Music Therapy Express emotion through music Singing, playing instrument,

dancing
Art Therapy Art Therapy is the use of art drawing, painting, sculpture,
materials for self-expression and
reection in the presence of a trained
art therapist
Psychodrama Create drama that portray real life Playing role of significant other
situation

Occupational Therapy Help client to be more productive and activities of daily living
enhance self-esteem Creative activities and
therapeutic relationship skills
are used
 Cognitive Therapy-Aaron Beck

Cognitive Therapy: based on the concept of pathological mental

processing. The focus of treatment is on the modification of
distorted cognition and maladaptive behaviors
According to this model Anxiety is experienced when the
patient is unable to cope with stress

Altering in cognitive function

Increase the aware about thoughts, evaluate them, develop new

technique over 5- 20 session
Strategies used

Recognizing automatic thoughts

SOCRATIC QUESTIONING:
Ask the client to describe the feeling about the specific situation
ROLEPLAY AND IMAGERY: to elicit the automatic thoughts
Three column thought recording:
Situation Automatic thoughts Emotional response
Girl friend broke up I am stupid no one Sad, depresssion
likes me
Modifying the automatic thoughts:
Generating alternatives.
Examining evidence
Decatastrophizing: client is encouraged to review ways to cope adaptively
Reattribution: reversing the negative attribution from internal to external.
Daily record of dysfunctional thoughts

Situation Automatic Emotional Rational response Outcome/emotional

thoughts response response

Girl friend I am stupid Sad, I am not stupid. Sadness, depression 50%

broke up no one depression Just because one
likes me 90% do not like me ,
that does not
mean no one
likes me
 Behavioral interventions
Activity scheduling: rate each activity of daily
living for mastery and pleasure
Graded task assignments : break down the
main task into small tasks
Behavior rehearsal: role play
Distraction: by activity or introducing another
topic
Miscellaneous: relaxation, assertive training,
role modeling, social skill training.
Group therapy

A number of clients meet together with a therapist for the purpose of

sharing, gaining personal insight, and improving intrapersonal coping
strategies.
Seating: circle of chairs
Size: 5-10 members
Membership: open or closed
Phases of group: orientation phase, working phase and termination phase