Transcript Unit 3 Therapy - Springdale High School

Treatment of Psychological
Disorders
Unit 3 (Chapter 15)
Types of Treatment
▪ Types of therapies
– Insight therapies
▪ “talk therapy”
Types of Treatment
▪ Types of therapies
– Behavior therapies
▪ Changing overt behavior
through use of
conditioning
Types of Treatment
▪ Types of therapies
– Biomedical therapies
▪ Alter the biological
functioning using
drugs or mild electric
shocks
Who Seeks Treatment?
▪ 15% of U.S population in a given year
▪ Most common presenting problems
– Anxiety and Depression
– Treatment seeking for various
disorders –
▪ Mood disorders
Who Seeks Treatment?
▪ Utilization rates
▪ Women more than men
▪ Medical insurance
▪ Education level
▪ Psychological Disorders and
professional treatment
Who Provides Treatment?
▪ Clinical psychologists – PhD in psychology
▪ Counseling psychologists – PhD in psychology
▪ Psychiatrists – medical doctors (only ones that can give
medication)
▪ Clinical social workers
▪ Psychiatric nurses
▪ Counselors
The Early Days of Therapy
▪ Historically, people with severe
mental illnesses were often
thought to be possessed by
demons
– “treatment” was severe and often
deadly
The Early Days of Therapy
▪ First reform took place in
England
– Bethlehem Hospital “Bedlam” was
converted into an asylum
– Little more than prisons
– Beatings, ice baths
The Early Days of Therapy
▪ 1793 real efforts made to treat
the mentally ill with kindness
and guidance
– Philippe Pinel (France)
Psychoanalysis
▪ Sigmund Freud and followers
▪ Goal is to discover unresolved
unconscious conflicts, urges and
desires that are assumed to cause
disorders
▪ Used techniques such as dream
interpretation and free
association
Dream Interpretation
▪ Freud believed that repressed
material surfaced in dreams in
symbolic form
– Manifest content – actual
dream/events
– Latent content – hidden,
symbolic meaning
▪ If correctly interpreted this
would reveal conflicts creating
the nervous disorder
Free Association
▪ Devised by Josef Breuer
and adopted by Freud
▪ Freely say whatever comes
into your mind
– As patients talked they reveal
things that were loosely
associated with their flow of
ideas
Resistance
▪ Point in which the patient
becomes unwilling to talk
about certain topics
▪ Freud believed that
resistance meant he was
getting close to repressed
material
Transference
▪ Therapist becomes a symbol of parental authority
– At first the patients would transfer positive feelings and
then over time transfer negative feelings
Evaluation of Psychoanalysis
▪ People who are withdrawn or have severe issues are not
good candidates, best for those who are fairly intelligent
and verbally expressive
▪ Flaws are:
– Lack of scientific research to support claims
– Unwillingness to believe things that did not fit into
Freud’s world view
– Obsessed with linking everything back to sex
Psychoanalysis Today
▪ The couch is gone
▪ Now known as clients instead of
patients
▪ Psychologist is far more
directive (asking questions, etc.)
▪ Less focus on id, more on ego
Humanistic Therapy
▪ Focuses on the importance
of choices made by
individuals and the
potential to change one’s
own behavior
▪ Dominant type is ClientCentered Therapy founded
by Carl Rogers
Client Centered Therapy
▪ Therapist provides unconditional positive regard that has
been missing and helps the person recognize
discrepancies between their real and ideal selves
▪ Very nondirective, meaning the client does all the work
and the therapist is a sounding board
Client Centered Therapy
▪ 4 basic elements
1. Reflection – therapist just restates what the client says
2. Unconditional positive regard – creates a warm, accepting
atmosphere
3. Empathy – listens closely and carefully and try to feel what
they feel
4. Authenticity – must be genuine and not hide behind the
role of therapist
Evaluation
▪ Clients must be intelligent and verbal
▪ Wide range of applications
▪ Very little chance of misunderstanding
▪ One flaw is that it lacks scientific backing
Group Therapy
▪ Expanded use after the
introduction of ClientCentered Therapy
– Group size: 6-8
– Major advantage is that it
adds a social component
(support groups)
Behavior Therapies
▪ B.F. Skinner and colleagues
– Goal: unlearning maladaptive
behavior and learning adaptive ones
▪ Action based
▪ Change behavior because it is not a
symptom of anything else, it is the
problem
Behavior Therapies
▪ Classical Conditioning Therapies
– Stimulus causes response
– Pair neutral item with stimulus to get the
response
– Remove stimulus and then the neutral
item causes the response
Systematic Desensitization
– Series of steps to reduce fear
1. Relax through deep muscle relaxation training
2. List of fears made (from least to greatest)
3. Along with the therapist, the client begins to
confront fears by starting with the least fearful on the
list
Aversion therapy
–Uses classical conditioning to create
anxiety
–Pairs unpleasant stimulus with a
unwanted behavior
–Example is overeating
▪ Pair bad smells with eating fast food
▪ You begin to associate the two and
eventually do not eat fast food
because of this
Flooding
– For phobias
– Exposure to fearful items in a rapid manner, also
removing the avoidance response
Operant conditioning Therapies
– Modeling – learning through observing others and
imitating behaviors
– Reinforcement – strengthening a response by
following with something pleasant (positive
reinforcement) or removing an unpleasant stimulus
(negative reinforcement)
– Extinction – removing the reinforcer to remove the
behavior
Evaluation
▪ Not good for extreme cases such as severe depression or
schizophrenia, geared more toward mild behaviors
▪ Effective in quickly reducing or eliminating unwanted
behaviors so an individual can function better in society
Cognitive Therapies
▪ Developed by Aaron Beck
▪ Focused on helping people
change their ways of thinking
– Distorted thinking and
unrealistic beliefs lead to
maladaptive behavior
Cognitive-Behavioral Therapy (CBT)
▪ Focuses on present, not past
▪ Assumes disorders come from illogical, irrational
thoughts
▪ Aim is to change thinking patterns
▪ Uses behavioral techniques (positive reinforcement)
▪ People need to come to grips with negative beliefs
Rational-Emotive Behavior Therapy (REBT)
▪ Created by Albert Ellis
▪ Version of CBT
▪ Very directive and challenging
▪ Same goals as CBT
Evaluation
▪ Less expensive because these therapies take less time
– Deal with short term behaviors instead of long term,
underlying issues
▪ Success in treating many types of disorders
▪ Scientifically backed
Biomedical Therapies
▪ Directly affecting the biological functioning of the
body and/or brain
1. Drug therapy (psychopharmacology)
2. Shock therapy (electroconvulsive therapy)
3. Surgical treatments
Psychopharmacology
▪ Antianxiety drugs
– Reduce anxiety and produce relaxation by lowering
sympathetic activity of the brain
– Valium, Xanax
▪ Antipsychotic drugs
– Diminish or eliminate symptoms of schizophrenia by
decreasing dopamine activity
– Neuroleptics, major tranquilizers
– Tardive dyskinesia can develop long term
Psychopharmacology
▪ Antidepressant drugs
– Treat depression by inhibiting the reuptake of
serotonin
– Prozac
▪ Mood stabilizers
– Treat manic and depressive episodes (bipolar)
– Lithium
Electroconvulsive therapy (ECT)
▪ Electrodes placed on the
outside of your head and a
mild current is passed
through the brain
▪ Used to treat serious cases
of depression
▪ Fast, so used for suicidal
patients
Psychosurgery
▪ Involves cutting into the brain to
remove or destroy brain tissue for
the purpose of relieving symptoms
of mental disorders
▪ Bilateral cingulotomy used today
– Electrode used to destroy brain
cells in the cingulate gyrus