Prevalence of Psychological Disorders in U.S.
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Transcript Prevalence of Psychological Disorders in U.S.
Treating Psychological
Disorders
Chapter 15
Who Seeks Treatment?
15% of U.S. population in a
given year
Most common presenting
problems
Anxiety and Depression
Demographics
4.5 million people
Women more than men
Education level
Barriers to Treatment
Medical insurance
Who Provides Treatment?
Clinical psychologists
Counseling psychologists
Psychiatrists
Clinical social workers
Psychiatric nurses
Counselors
Types of Treatment
Psychotherapy
Insight therapies
Psychodynamic
24%
Behavior therapies
“talk therapy”
Cognitive
8%
Changing overt behavior
Clientcentered
6%
Biomedical therapies
Biological functioning
interventions
Behavioral
11%
Eclectic
35%
Other
16%
Psychoanalysis
Focuses on uncovering unconscious conflicts resulting from fixations at early
developmental stages
Uses techniques such as...
To minimize
Resistance
and facilitate
Free association
Dream analysis
Interpretation
Transference
Goal is to rebuild personality
Client-Centered Treatment
Believes disorders result from incongruence between self-concept and
reality or dependence on acceptance from others.
Uses techniques such as
Unconditional positive regard
Empathy
Genuineness
Reflection
Goal is to increase client self-acceptance (minimize incongruence)
Behavioral Therapies
Believe disorders are maladaptive patterns of behavior that have
been learned.
Use techniques such as
Conditioning (Classical & Operant)
Aversion
Systematic Desensitization
Social Skills Training
Biofeedback
To eliminate maladaptive behavior and replace with adaptive
behavior.
Behavior Therapies
B.F. Skinner and colleagues
Goal: unlearning maladaptive behavior and
learning adaptive ones
Systematic Desensitization – Joseph Wolpe
Classical
conditioning
Anxiety hierarchy
Aversion therapy
Alcoholism,
sexual deviance, smoking, etc.
Figure 15.7 The logic underlying systematic desensitization
Behavior Therapy
B.F. Skinner and colleagues
Social skills training
Modeling
Behavioral
rehearsal
Cognitive-Behavioral Therapy
Aaron Beck
Cognitive therapy
Use techniques such as
Believe disorders result from
irrational assumptions and
negative, self-defeating
thoughts.
Thought stopping
Recording automatic thoughts
Refuting negative thinking
Reality testing
Homework
Goal is to detect negative,
irrational thinking and replace
with realistic thinking
Cognitive-Behavioral Therapy
Martin Seligman
Learned helplessness
and depression
Difficult to establish
helplessness-depression
link
Cognitive-Behavioral Therapy
Martin Seligman
Explanatory style
a person’s habitual way
of explaining events,
typically assessed along
three dimensions:
internal/external,
stable/unstable, and
global/specific
% Remaining after 1 year
70
60
50
40
30
20
10
0
Bottom Bottom
25%
50%
Top
50%
ASQ
Top
25%
Biomedical Therapies
Type
Example
Positive Effects
Adverse Effects
Antianxiety Drugs
Valium,
Xanax
Quick acting
Reduces anxiety
Nausea,
drowsiness,
confusion
Decrease psychotic
symptoms
Tardive dyskinesia
Reduce depressive
symptoms
Dry mouth,
Blurred vision,
Constipation,
Drowsiness
Prevents mood
swings
Reduces depressive
symptoms
Kidney and
Thyroid damage
Memory loss,
Impaired attention
Thorazine,
Haldol
Elavil,
Nardil,
Antidepressant Drugs Prozac,
Paxil,
Zoloft
Antipsychotic Drugs
Bipolar Treatment
ECT
Lithium
Biomedical Therapies
Psychopharmacotherapy
Antianxiety - Valium, Xanax, Buspar
Antipsychotic - Thorazine, Mellaril, Haldol
Tardive
dyskinesia
Clozapine
Antidepressant:
– Elavil, Tofranil
Mao inhibitors (MAOIs) - Nardil
Selective serotonin reuptake inhibitors (SSRIs) –
Prozac, Paxil, Zoloft
Tricyclics
Figure 15.12 Antidepressant drugs’ mechanisms of action
Biomedical Therapies
Psychopharmacotherapy
Mood stabilizers
Lithium
Valproic
acid
Electroconvulsive therapy (ECT)
Current Trends and Issues in Treatment
Managed care
Empirically validated
treatments
Blending Approaches to
treatment
Multicultural sensitivity
Deinstitutionalization
Revolving door problem
Homelessness