Transcript Psychological Therapies

History of Insane Treatment
Maltreatment of the insane throughout the ages
was the result of irrational views. Many patients
were subjected to strange, debilitating, and
downright dangerous treatments.
The Granger Collection
The Granger Collection
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History of Insane Treatment
Philippe Pinel in France and Dorthea Dix in America founded humane
movements to care for the mentally sick.
Culver Pictures
http://wwwihm.nlm.nih.gov
Philippe Pinel (1745-1826)
Dorthea Dix (1745-1826)
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Therapy
• It used to be that if
someone exhibited
abnormal behavior,
they were
institutionalized.
• Because of new drugs
and better therapy,
the U.S. went to a
policy of
deinstitutionalization.
Emptying of Mental Hospitals
Psychotherapy
• An interaction between a trained
therapist and someone suffering from
psychological difficulties.
Eclectic Approach
• The most popular form of therapyit is basically a smorgasbord where
the therapist combines techniques
from different schools of
psychology.
Psychoanalytic Therapy
• Psychoanalysis
(manifest and latent
content through….
hypnosis free
association, dream,
interpretation).
• Think Freud
• Unconscious
• Resistance
• Transference
Transference
• In psychoanalysis, the patient’s transfer to the
analyst of emotions linked with other
relationships.
Criticism of Psychoanalysis
• Psychoanalysis is hard to refute because it
cannot be proven or disproven.
• Psychoanalysis takes a long time and is
very expensive.
Humanistic Therapy
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Client-Centered Therapy by Carl
Rogers
These are non-directive therapies and
use active listening.
Active listening is where the listener
echoes, restates and clarifies what has
been said.
Focus on: present and future (not the
past), conscious thoughts (not
unconscious ones).
Take responsibility for you actionsinstead of blaming childhood anxieties.
Self-actualization, free-will and
unconditional positive regard.
Therapist use genuineness, acceptance
and empathy to show unconditional
positive regard towards their clients.
Gestalt Therapy by Fritz Perls
encourage clients to get in touch with
whole self.
Behavior Therapies
• Therapy that applies learning
principles to the elimination of
unwanted behaviors.
•The behaviors are the problems- so
we must change the behaviors.
Behavioral Therapies
Counterconditioning
• Classical Conditioning
1. Aversive Conditioning
2. Systematic
desensitization
3. Flooding
Operant Conditioning
• Token Economy
Classical Conditioning Techniques
Counterconditioning:
• A behavioral therapy that conditions
new responses to stimuli that trigger
unwanted behaviors.
Systematic Desensitization
• A type of counterconditioning that
associates a pleasant relaxed state
with gradually increasing anxietytriggering stimuli.
How would I use
systematic
desensitization to reduce
my fear of snakes?
Systematic Desensitization
Progressive Relaxation
Exposure Therapy
Flooding
Virtual Technology Exposure Therapy
Aversive Conditioning
• A type of counterconditioning that
associates an unpleasant state with an
unwanted behavior.
How would putting poop on the fingernails
of a nail biter effect their behavior?
Operant Conditioning
Token Economy: an operant
conditioning procedure that rewards a
desired behavior.
A patient exchanges a token of some sort,
earned for exhibiting the desired behavior,
for various privileges or treats.
Cognitive Therapy
• Change the way we
view the world
(change our
schemas)
• Aaron Beck
• Albert Ellis and
Rational Emotive
Therapy
• Teaches new
adaptive ways of
thinking and acting
Cognitive Therapy
Cognitive Therapy
Aaron Beck and his view of
Depression
• Noticed that
depressed people were
similar in the way they
viewed the world.
• Used cognitive therapy
get people to take off
the “dark sunglasses” in
which they view their
surroundings
Albert Ellis and RET
Ellis says that it is generally irrational and self-defeating to get all worked up about someone else's
behavior.
Your feelings don't control your thoughts -- your thoughts control your feelings.
Negative emotions are not inevitable, but occur as the result of patterns of thinking people have as
they get older. If we can learn to rethink the situations, we can learn to control negative emotions.
Example:
(Activating event) Drunk worthless loser neighbors are outside, making noise during a
week night making my dog go all crazy.
(irrational thought) They MUST SHUT UP!.
(Consequences of having those thought) When noisy drunk people are outside late
being loud they wake me up, make my dog bark and I get mad, I lie awake feeling angry
and mad and don't get back to sleep for a long time.
(Dispute the irrational Beliefs) THERAPIST: WHY shouldn't they make noise? Who made
the rule that people have to go to bed early? Maybe you too should be up partying! Who
made you Supreme Ruler of the Universe dictating how people Should or Must act?
What the hell is wrong with you? Maybe you are the loser? Who are you to judge?
(Effective new thinking- substitute something rational instead) Drunk people are often
noisy, but it's no BIG deal. I don’t like it, but I can deal with it. Maybe I will talk with them
in the morning (when they are sober and I am calmer). Maybe I should not be so quick
to judge.
Group Therapies
Group Therapy
Group therapy normally consists of 6-9 people attending a 90-minute
session that can help more people and costs less. Clients benefit from
knowing others have similar problems.
© Mary Kate Denny/ PhotoEdit, Inc.
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Family Therapy
Family therapy treats the family as a system. Therapy guides family
members toward positive relationships and improved communication.
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The Biomedical Therapies
Therapies aimed at the altering
the body chemistry.
The Biomedical Therapies
These include physical, medicinal, and other
forms of biological therapies.
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Drug Treatments
Surgery
Electric-shock therapy
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Psychopharmacology:
The study of the
effects of drugs on
mind and behavior.
Electroconvulsive Therapy
• Biomedical therapy
for severely
depressed patients in
which brief electric
current is sent
through the brain of
an anesthetized
patient.
Brain Stimulation
Electroconvulsive Therapy
(ECT)
ECT is used for severely
depressed patients who do
not respond to drugs. The
patient is anesthetized and
given a muscle relaxant.
Patients usually get a 100
volt shock that relieves
them of depression.
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Alternatives to ECT
Transcranial Magnetic
Stimulation (TMS)
In TMS, a pulsating
magnetic coil is placed
over prefrontal regions
of the brain to treat
depression with
minimal side effects.
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Psychosurgery
• Surgery that removes or destroys brain
tissue in an effort to change behavior.
Egas Moniz developed the
lobotomy in the 1930s.
Ice pick like instrument
through the eye sockets
cutting the links between the
frontal lobes and the
emotional control centers.
• Electroconvulsive
Therapy (ECT)- for
depression.
• Psychosurgury
1. Prefontal lobotomy
Eye Movement Desensitization and
Reprocessing (EMDR)
In EMDR therapy, the therapist attempts to
unlock and reprocess previous frozen traumatic
memories by waving a finger in front of the
eyes of the client.
EMDR has not held up under scientific testing.
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Light Exposure Therapy
Courtesy of Christine Brune
Seasonal Affective
Disorder (SAD), a
form of depression,
has been effectively
treated by light
exposure therapy. This
form of therapy has
been scientifically
validated.
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Drugs and Hospitalization
Testing New Drugs
• When a new drug is released there
is always too much enthusiasm.
•Must use a double-blind procedure
to combat placebo and experimental
effects.
These experiments better able use to
classify different types of drugs:
Antipsychotic Drugs
• Antipsychotic drugs are a class of
medicines used to treat psychosis and
other mental and emotional conditions.
These drugs help schizophrenics with
both positive and negative symptoms.
These drugs (Thorazine, Clozapine &
Haldol) often have powerful side effects
Antipsychotic Drugs
Classical antipsychotics [Chlorpromazine
(Thorazine)]: Remove a number of positive
symptoms associated with schizophrenia such
as agitation, delusions, and hallucinations.
Atypical antipsychotics [Clozapine (Clozaril)]: Remove negative symptoms
associated with schizophrenia such as apathy, jumbled thoughts,
concentration difficulties, and difficulties in interacting with others.
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Atypical Antipsychotic
Clozapine (Clozaril) blocks receptors for
dopamine and serotonin to remove the negative
symptoms of schizophrenia.
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Antianxiety Drugs
• Includes drugs like Valium, Xanax and Librium,
Ativan . Works on elevating the neurotransmitter
GABA.
•Like alcohol, they depress nervous system
activity.
•Most widely abused drugs.
Do they really solve the problem?
Antianxiety Drugs
Antianxiety drugs (Xanax and Ativan) depress the
central nervous system and reduce anxiety and tension
by elevating the levels of the Gamma-aminobutyric acid
(GABA) neurotransmitter.
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Antidepressant Drugs
• Prozac, Paxil, Zoloft,
• Lift you up out of depression.
• Monoamine oxidase
inhibitors (MAOIs), tricyclic
antidepressants (TCAs),
selective serotonin reuptake
inhibitors (SSRIs), and
serotonin-norepinephrine
reuptake inhibitors (SNRIs)
are most commonly
associated with
antidepressants.
Most increase the
neurotransmitters
Serotonin &
Norepinephrine.
Antidepressant Drugs
Antidepressant drugs like Prozac, Zoloft, and Paxil are
Selective Serotonin Reuptake Inhibitors (SSRIs) that
improve the mood by elevating levels of serotonin by
inhibiting reuptake.
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Prozac, Paxil Zoloft
• Work by blocking serotonin reuptake.
Mood-Stabilizing Medications
Lithium Carbonate, a common salt, has been used
to stabilize manic episodes in bipolar disorders. It
moderates the levels of norepinephrine and
glutamate neurotransmitters.
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The Relative Effectiveness of
Different Therapies
Which psychotherapy would be most effective
for treating a particular problem?
Disorder
Therapy
Depression
Behavior, Cognition, Interpersonal
Anxiety
Cognition, Exposure, Stress Inoculation
Bulimia
Cognitive-behavior
Phobia
Behavior
Bed Wetting
Behavior Modification
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Therapists & Their Training
Clinical psychologists: They have PhDs mostly.
They are experts in research, assessment, and
therapy, all of which is verified through a
supervised internship.
Clinical or Psychiatric Social Worker: They have a Masters of Social Work.
Postgraduate supervision prepares some social workers to offer
psychotherapy, mostly to people with everyday personal and family
problems.
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Therapists & Their Training
Counselors: Pastoral counselors or abuse
counselors work with problems arising from
family relations, spouse and child abusers and
their victims, and substance abusers.
Psychiatrists: They are physicians who specialize in the treatment of
psychological disorders. Not all psychiatrists have extensive training in
psychotherapy, but as MDs they can prescribe medications.
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Psychological Disorders are
Biopsychosocial in Nature
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