Transcript Biomedical therapies

How do we help people with
mental health issues?
The treatment of psychological disorders:
An overview of modern techniques
Treatment approaches
 Learning or adjustment-related disorders (like phobias):
psychotherapy with a trained, compassionate therapist
 Biologically-influenced disorders (like schizophrenia):
biomedical therapy
 Bio-psycho-social approach: draw from a variety of
techniques (drugs and psychotherapy in combination)
Eclectic approach: using techniques from different
forms of therapy
Psychologists/clinical social workers supply the
therapy; psychiatrists prescribe and monitor
medicines
Part 1: Psychotherapy
#1: Psychoanalysis
 Freud
 Psychological problems caused by childhood’s
residue of repressed impulses and conflicts
 Work through buried feelings and take responsibility
for own growth
 Healthier, less anxious living becomes possible
when people release the energy they had previously
devoted to id-ego-superego conflicts
#1: Psychoanalysis (cont.)
 Free association; therapist sits out of view
 Resistance: blocking from consciousness of anxiety-producing
material; in the flow of your free associations; when you
change the subject, joke, or omit things
 Interpretation and insight: underlying wishes, feelings,
conflicts
 Transference: the patient’s transfer to the analyst of
emotions linked with other relationships
 Several years, several sessions a week, $$$$$$
 Psychodynamic therapies: based on Freud’s ideas; face to
face therapy that helps people learn to understand their
current symptoms by focusing on important themes in their
lives across important relationships.
#2: Humanistic Therapy
 Client-Centered Therapy
 Developed by Carl Rogers (1902-1987)
 Non-directive: listens without judgment,
interpretation, or directing the client toward
certain insights
 Belief that people already possess the resources
for growth
 Therapist uses techniques such as active listening
within a genuine, accepting, empathic
environment to facilitate clients’ growth
#2: Humanistic Therapy
 Boost peoples’ capacity for self-fulfillment by
helping them grow in self-awareness and selfacceptance.
 Focus on the present, not the past.
 Conscious, rather than unconscious thoughts.
 Taking immediate responsibility for one’s feelings
and actions.
 Promoting growth instead of curing illness (clients,
not patients).
#2: Humanistic Therapy (cont.)
 Active Listening: empathic listening in which the
listener echoes, restates, and clarifies; “hearing”
 http://www.youtube.com/watch?v=DjTpEL8acfo
#3: Behavior Therapy
 Behavior Therapy
 therapy that applies learning principles to the
elimination of unwanted behaviors (behavior
modification)
 Counterconditioning
 procedure that conditions new responses to
stimuli that trigger unwanted behaviors
 based on classical conditioning
 includes systematic desensitization and aversive
conditioning
#3: Behavior Therapy (cont.)
 Exposure Therapy
 treat anxieties by exposing people (in imagination
or reality) to the things they fear and avoid
#3: Behavior Therapy (cont.)
 Systematic Desensitization
 type of counterconditioning
 associates a pleasant, relaxed state with
gradually increasing anxiety-triggering stimuli
 commonly used to treat phobias
 Aversive Conditioning
 type of counterconditioning that associates an
unpleasant state with an unwanted behavior
 nausea ---> alcohol
#3: Behavior Therapy (cont.)
 Systematic Desensitization
#3: Behavior Therapy (cont.)
 Aversion
therapy
for
alcoholics
#3: Behavior Therapy (cont.)
 Token Economy
 an operant conditioning procedure
that rewards desired behavior
 patient exchanges a token of some
sort, earned for exhibiting the
desired behavior, for various
privileges or treats
#4: Cognitive Therapy
 Cognitive Therapy
 teaches people new, more adaptive
ways of thinking and acting; new habits
of mind that are healthier and more
productive
 based on the assumption that thoughts
intervene between events and our
emotional reactions
Aaron Beck’s Treatment for
Depression
 Cognitive therapy can reverse peoples’
catastrophizing beliefs about themselves, their
situations, and their futures.
 Gentle questioning to reveal irrational thinking;
persuade people to “remove the dark glasses”
through which they view life.
 Change “self talk;” stress inoculation training;
dispute negative thoughts
#4: Cognitive Therapy (cont.)
 The Cognitive
Revolution:
the most
widely used
and popular
form of
therapy!
#4: Cognitive Therapy (cont.)
 A cognitive
perspective
on
psychological
disorders
#4: Cognitive Therapy (cont.)
 Cognitive
therapy for
depression:
effective,
gets results
#5: Cognitive-Behavioral Therapy
 A popular integrated therapy that combines
cognitive therapy (changing self-defeating
thinking) with behavior therapy (changing
behavior); changing how people think and
how they act; replace negative ways of
thinking and acting with positive ones
 Very useful for anxiety and depression;
learning how to re-label impulses and feelings
to “unstick” the brain and change bad habits
#6: Group and Family Therapies
 Family Therapy
 treats the family as a system
 views an individual’s unwanted
behaviors as influenced by or directed
at other family members
 attempts to guide family members
toward positive relationships and
improved communication
Evaluating Psychotherapies
 To whom do
people turn
for help for
psychological
difficulties?
Evaluating Psychotherapies
Number of
persons
Average
untreated
person
Poor outcome
80% of untreated people have poorer
outcomes than average treated person
Average
psychotherapy
client
Good outcome
Evaluating Psychotherapies
89% of people said that they were at
least “fairly well satisfied” with their
treatment!
Part 2: Biomedical therapies
Biomedical Therapies
 The emptying of U.S. mental hospitals
Biomedical Therapies
Biomedical Therapies
Common drugs
Antipsychotic drugs: Thorazine, Clozapine,
Risperdal, Zyprexa, Seroquel, Abilify
Antianxiety drugs: Xanax, Ativan
In the final 12 years of the 20th Century, the
rate of outpatient treatment for anxiety
disorders doubled.
Antidepressant drugs: Prozac, Zoloft, Paxil
Mood stabilizers: Lithium
Other Biomedical Therapies
 Electroconvulsive Therapy (ECT)
 therapy for severely depressed patients in
which a brief electric current is sent through
the brain of an anesthetized patient
 Deep brain stimulation, magnetic
stimulation
 Psychosurgery
 surgery that removes or destroys brain tissue
in an effort to change behavior (extremely
rare)
Electroconvulsive Therapy