Transcript kassinsec17
Psychology in Modules by Saul Kassin Section 17: Treatment Treatment Psychological Therapies Perspectives on Psychotherapy Medical Interventions ©2006 Prentice Hall Psychological Therapies Professionals Involved in Therapy • Clinical Psychologists • Ph.D. in psychology, conducts testing, diagnosis, treatment, and research • Counseling Psychologists • Ph.D. in counseling, help people with marital, family, and minor adjustment problems • Psychiatrists • M.D., does a residency in psychiatry and can prescribe medications • Psychiatric Social Workers • Master’s degree in social work with special training in counseling ©2006 Prentice Hall Psychological Therapies Psychoanalytic Therapies • Uncovering, resolving unconscious conflicts • Orthodox Psychoanalysis • • • • Free association Dream Analysis Resistance Transference • Brief Psychoanalytic Therapy ©2006 Prentice Hall Psychological Therapies Psychoanalytic Therapies • Free association • A basic technique of psychoanalysis in which the patient says whatever comes to mindfreely and without censorship • Resistance • The tendency for patients to actively block, or “resist,” psychologically painful insights • Transference • The tendency of patients to displace intense feelings for others©2006 onto the therapist Prentice Hall Psychological Therapies Behavioral Therapies • Behavioral-therapy or Cognitive-behavioral Therapy • Techniques used to modify disordered thoughts, feelings, and behaviors through the principles of learning • Classical Conditioning Techniques • Flooding, Systematic Desensitization, Aversion Therapy • Operant-Conditioning Techniques • Reward and Punishment, Token Economy, Biofeedback, Social Skills Training ©2006 Prentice Hall Psychological Therapies Behavioral Therapies • Classical-Conditioning Techniques • Flooding • Technique in which the patient is saturated with a fear-provoking stimulus until the anxiety is extinguished • Systematic Desensitization • Technique used to treat anxiety disorders by pairing gradual exposure to an anxiety-provoking situation with relaxation • Aversion Therapy • Technique for classically conditioned people to react ©2006 Prentice Hall with aversion to alcohol and other harmful substances Psychological Therapies BehavioralTherapeutic Therapies Effects of Exposure & Response Prevention • These are BaselineInstruction-Response Prevention (RP) cycles from a woman with a hand-washing compulsion. • After a few cycles, the woman was washing less often and getting fewer urges to wash. Hand Washing Urges ©2006 Prentice Hall Psychological Therapies Behavioral Therapies Aversion Therapy to Treat Alcoholism • Alcohol is paired with a chemical that causes nausea and vomiting. Prentice Hall • Person should learn©2006 to associate alcohol with nausea. Psychological Therapies Behavioral Therapies • Operant-Conditioning Techniques • Reward and Punishment • Token Economy • Biofeedback • Procedure in which people learn to control physiological responses with the help of “feedback” about their internal states • Social Skills Training • Used to teach interpersonal skills through modeling, rehearsal, and reinforcement (e.g., assertiveness ©2006 Prentice Hall training) Psychological Therapies Behavioral Therapies Biofeedback and the Tension • Sensors on the head Headache detect muscle activity. • System converts signal to visual display. • Patient watches the display, learns to relax forehead muscles. ©2006 Prentice Hall Psychological Therapies Cognitive Therapies • Cognitive Therapy • A form of psychotherapy in which people are taught to think in more adaptive ways • Rational-Emotive Behavior Therapy • A form of cognitive therapy in which people are confronted with their irrational, maladaptive beliefs • Beck’s Cognitive Therapy • Uses a gentler, more collaborative approach to cognitive therapy ©2006 Prentice Hall Psychological Therapies Cognitive Therapies Ellis’ A-B-C Theory of Emotional Distress • Emotional distress is caused by irrational thoughts and self-defeating beliefs. • Activating Event - Beliefs - Consequences • Emotional consequences then help sustain the ©2006 Prentice Hall irrational beliefs. Psychological Therapies Humanistic Therapies • Removing impediments to personal growth • Person-Centered Therapy • Involves a warm and accepting environment to foster self-insight and acceptance • Founded by Carl Rogers • Therapists show empathy, unconditional positive regard, and use reflection • Gestalt Therapy • Therapy in which clients are aggressively prompted to express their feelings • Founded by Fritz Perls ©2006 Prentice Hall Psychological Therapies Humanistic Therapies Group-Therapy Approaches • Group Therapy • The simultaneous treatment of several clients in a group setting • Each approach to psychotherapy has a form of group therapy, e.g., transactional analysis is used by psychoanalysts. • Family Therapy • Form of psychotherapy that treats the members of a family as an interactive system ©2006 Prentice Hall Perspectives on Psychotherapy The Bottom Line: Does Psychotherapy The Benefits of Psychotherapy Work? • Based on the results of 475 studies (Smith et al., 1980), the average psychotherapy client shows more improvement than 80% ©2006 of those in the no-treatment Prentice Hall control group. Perspectives on Psychotherapy Improvement in Psychotherapy: The More The Better? • With additional therapy sessions, the percentage of people who improve increases up to 26 sessions. • Rate of improvement then levels off. • At one session per week, six months appears to be the ideal of amount of ©2006 Prentice Hall time. Perspectives on Psychotherapy Are Some Therapies Better Than Others? • All approaches are equally effective. • However for some disorders, certain types of therapy tend to be more successful. • Examples: behavioral therapy for phobias, person-centered therapy for raising self-esteem, and cognitive therapy for depression • There is no universal “best” type of therapy. ©2006 Prentice Hall Perspectives on Psychotherapy What are the Active Ingredients? • Three common, nonspecific factors are apparent in all types of psychotherapy. • Supportive Relationship • A Ray of Hope • Placebo Effect (the curative effect of an inactive treatment that results simply from the patient’s belief in its therapeutic value) operates but it is not as effective as real psychotherapy. • Opportunity to Open Up ©2006 Prentice Hall Perspectives on Psychotherapy What is the Future of Psychotherapy? Orientations of Psychotherapists Eclectic: Borrowing ideas and techniques from different ©2006 Prentice Hall approaches Medical Interventions Drug Therapies • Psychopharmacology • The study of the effects of drugs on psychological processes and disorders Medical Interventions Drug Therapies Antipsychotic Drugs & Hospitalization Trends ©2006 Prentice Hall Medical Interventions Types of Drug Treatments I • Antianxiety Drugs • Tranquilizing medications used in the treatment of anxiety • Trade names: Librium, Valium, Xanax, BuSpar • Antidepressants • Drugs that relieve depression by increasing the supply of norepinephrine, serotonin, or dopamine • Trade names: Tofranil, Prozac ©2006 Prentice Hall Medical Interventions Types of Drug Treatments II • Mood Stabilizer • Calms mania; may reduce bipolar mood swings • Trade Name: Lithium Carbonate • A drug used to control mania and mood swings in people with bipolar disorder • Antipsychotic Drugs • Drugs used to control the positive symptoms of schizophrenia and other psychotic disorders • Trade names: Thorazine, Clozaril, Risperdal ©2006 Prentice Hall Medical Interventions Perspectives on Drug Therapies • Drugs have helped numerous people who once lived in psychiatric institutions. • People may not respond well to psychotherapy. • However, some drugs produce unpleasant or dangerous side effects and may lead to a physical and/or psychological addiction. • Thus, patients become passive in the healing process. • Neither psychotherapy nor drug therapy has been found to be generally more effective. ©2006 Prentice Hall Medical Interventions • Electroconvulsive Therapy (ECT) • Electric-shock treatments that often relieve severe depression by triggering seizures in the brain • Psychosurgery • The surgical removal of portions of the brain for the purpose of treating psychological disorders ©2006 Prentice Hall How To: Beating the Winter Blues Seasonal Differences in SAD • Seasonal Affective Disorder (SAD) is depression linked to certain times of year. • Symptoms are lethargy, withdrawal, increases in sleeping and eating • People with SAD feel even worse than most people do in the winter. • Light therapy can ease ©2006 Prentice Hall their suffering. Where People Turn for Help ©2006 Prentice Hall