Transcript Treatment of Psychological Disorders

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Treatment of
Psychological Disorders
Chapter 13
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Types of Mental Health Therapy
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Psychotherapy – trained therapist uses psychological
techniques to assist someone seeking to overcome
difficulties or achieve personal growth
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Biomedical therapy – prescribed medication or
medical procedure that acts directly on a patient’s
nervous system
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Often used for learning-related disorders (like phobias)
Used for biologically influenced disorders (like
schizophrenia)
Eclectic approach – uses techniques from various forms
of therapy
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Psychotherapies
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Psychoanalysis – not used very often
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Goals – bring repressed feelings into conscious awareness
Methods:
 Free association – saying whatever comes to your mind
which indicates resistance – blocking from consciousness of
anxiety-laden material
 Interpretation – analyst notes supposed dream meanings,
resistances and other significant behaviors and events in
order to promote insight
 Use of dream analysis
 Transference – patient's transfer to the analyst of emotions
linked with other relationships
 Involves several years of several sessions a week with
therapist traditionally out of view of the patient
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Psychotherapies -cont Psychodynamic
therapists – views individuals
as responding to unconscious forces and
childhood experiences and seeks to enhance
self-insight
Therapists talks to clients face to face and weekly for
a few months
 Interpersonal psychotherapy – variation to
psychodynamic therapy
 Goal: help people gain insight into the roots of their
difficulties and works for symptom relief rather than
overall personality change
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Psychotherapies -cont
Humanistic Therapies
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Differences with psychoanalysis
 Focus on present and future more than past
 Focus on conscious rather than unconscious feelings
 Take immediate responsibility for one’s feelings and actions rather
than uncovering hidden determinants
 Promote growth instead of cure illness
Use of client-centered therapy – therapists uses active listening
within a genuine, accepting, empathic environment to facilitate
clients’ growth
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Uses active listening – echoing, restating and seeking clarification of
what the person expresses and acknowledging expressed feelings
Developed by Carl Rogers
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Psychotherapies -cont Humanistic
 Use
therapies -cont-
of unconditional positive regard – caring,
accepting, nonjudgmental attitude to help clients
develop self-awareness and self-acceptance
 Tips for active listening:
 Paraphrase
 Invite clarification
 Reflect feelings
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Psychotherapies -cont
Behavior therapies – applies learning principles to the
elimination of unwanted behaviors
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Counterconditioning – uses classical conditioning to evoke
new responses to stimuli that are triggering unwanted
behaviors
 Exposure therapy – expose people to what they normally
avoid
 Systematic desensitization – associates a pleasant relaxed
state with gradually increasing anxiety-triggering stimuli
 Virtual reality exposure therapy – progressively exposes
people to simulations of their greatest fears
Aversive conditioning – associates an unpleasant state with an
unwanted behavior
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Psychotherapies -cont Behavior
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therapies -cont-
Operant conditioning
 Behavior modification – reinforcing desired behaviors
and withholding reinforcement or enacting punishment
for undesired behaviors
 Token economy – people earn a token for displaying
an appropriate behavior which can later be exchanged
for privileges or treats
 Criticisms:
 Are the conditioned behaviors durable?
 Is it ethical for one human to control another’s
behavior?
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Psychotherapies -cont Cognitive
therapies – teaches people new,
more adaptive ways of thinking and acting
based on the assumption that thoughts
intervene between events and our
emotional reactions
 Beck’s
therapy for depression – uses gentle
questioning to reveal irrational thinking in clients
and persuades people to change the lens
through which they see life
 Cognitive-behavioral therapy – aims to change
self-defeating thinking and change behavior
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Psychotherapies -cont Group
and family therapies
 Family
therapy – treats the family as a system and
views an individual’s unwanted behaviors as
influenced by or directed at other family
members
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Psychotherapies -cont
Evaluating Psychotherapies
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Effectiveness
 Approximately 90% of clients report feeling better – but keep in
mind that clients
 Enter therapy in crisis
 May need to believe therapy was worth the effort
 Generally speak kindly of their therapists
 Meta-analysis – a procedure for statistically combining the results
of many different research studies
 Has shown that the average therapy clients ends up better off
than 80% of untreated individuals on waiting lists
 Therapy is most effective when the problem is clear-cut
 APA encourages evidence-based practices – clinical decisionmaking that integrates the best available research with clinical
expertise and patient characteristics and preferences
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Treatment vs. No Treatment
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Psychotherapies -cont Commonalities
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Among Psychotherapies
hope for demoralized people
 Offer people a plausible explanation for their
symptoms and an alternative way of looking at
themselves or responding to the world
 Provide an empathic, caring and trusting
relationship
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Biomedical Therapies
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Biomedical therapy – physically changing the brain’s
functioning by altering its chemistry with drugs or
affecting its circuitry with electroconvulsive shock,
magnetic impulses or psychosurgery
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In most cases can only be offered by psychiatrists
Drug Therapies
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Antipsychotic drugs – used to treat schizophrenia and other
forms of severe thought disorder
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Long-term use can promote tardive dyskinesia – involuntary
movement of the facial muscles, tongue and limbs
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Biomedical Therapies -cont Drug Therapies
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Antianxiety drugs – used to control anxiety and
agitation
 Depress central nervous system activity
 Can result in psychosocial dependence or
withdrawal
 Antidepressants - used to treat depression
 Increase norepinephrine or serotonin
 Research shows that placebos account for about
75% of the effectiveness of antidepressants
 Mood-stabilizing drugs
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Biomedical Therapies -cont Brain
Stimulation
Electroconvulsive therapy (ECT) – biomedical
therapy for severely depressed patients in which a
brief electric current is sent through the brain of an
anesthetized patient
 80%+ of people show marked improvement after 3
sessions a week for 2-4 weeks
 Can result in some memory loss
 Repetitive transcranial magnetic stimulation (rTMS) –
application of repeated pulses of magnetic energy to
the brain to stimulate or suppress brain activity
 Only stimulates the brain’s surface and results in no
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memory loss
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Biomedical Therapies -cont
Psychosurgery – surgery that removes or destroys brain tissue in
an effort to change behavior
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Least used
Lobotomy – rarely used psychosurgical procedure that cut the nerves
connecting the frontal lobes to the emotion-controlling centers of the
inner brain
 Often caused lethargy and reduced creativity
Therapeutic Life-Style Change
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Exercise
Sleep
Light exposure
Social connection
Anti-rumination – identifying and redirecting negative thoughts
Nutritional supplements
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Therapists and Their Training