Transcript Unit 13 PowerPoint

Unit 13:
Treatment for Psychological
Disorders
Essential Question
Which type of therapy is the best way to treat
psychological disorders?
Day 1
Psychoanalysis and Humanistic Therapies
Do Now:
Write down, in your journal, something from
your childhood that you think affects you
today.
What is Psychoanalysis?: Video
Psychoanalysis
Sigmund Freud’s theory of personality and
therapeutic technique that attributes thoughts and
actions to unconscious motives and conflicts.
Freud believed the patient’s free associations,
resistances, dreams and transferences- and the
therapists’ interpretations of them-released
previously repressed feelings, allowing the patient to
gain self-insight.
Psychoanalysis
Resistance- the blocking from consciousness of anxietyladen material
Interpretation- the analyst’s thoughts on dream
meanings, resistances, and other significant behaviors in
order to promote insight
Transference- the transfer of emotions from other
relationships to the analyst
Psychoanalysis of Jay Gatsby: Video
Humanistic Therapies
Carl Rogers developed the humanistic technique of
client-centered therapy, in which the therapist uses
techniques such as active listening within a genuine,
accepting, empathetic environment to facilitate client’s
growth.
The humanistic perspective focuses on people’s potential
for self-fulfillment. Humanistic therapists attempt to
help clients grow in self-awareness and self-acceptance.
There is more of an emphasis on the present and future
more than the past.
Carl Rogers cont..
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Carl Rogers was an American psychologist.
He is also one of the founding fathers of psychotherapy research. Rogers is considered to be
one of the founding fathers of psychotherapy and was honored for his research with the Award
for Distinguished Scientific Contributions by the APA in 1956.
He also created the person-centered approach where clients have an opportunity to develop a
sense of self where they can realize how their attitudes, feelings and behavior are being
negatively affected. Although it was proven to be effective, this was criticized by many other
behavior psychologists because it lacked structure.
Humanistic Therapies
Active Listening- empathetic listening in which the listener
echoes, restates, and clarifies. A feature of Rogers’ clientcentered therapy
Unconditional Positive Regard- a caring, accepting, nonjudgemental attitude, which Carl Rogers believed to be
conductive to developing self-awareness
Carl Rogers: Video
Day 2
Group/Family Therapies and Cognitive Therapies
Do Now:
See handout...
Cognitive Therapies
Aaron Beck is an American Psychiatrist and
professor. He is known as the father of cognitive
therapy. His techniques are widely used to treat
depression.
Cognitive therapists believe that thoughts,
feelings, and behaviors are all connected. By
modifying how one thinks, they can feel better
and be cured or treated for their mental illness.
Cognitive Therapies
Cognitive Therapies
Cognitive Therapy- therapy that teaches people new and
more adaptive ways of thinking and acting, based on the
assumption that thoughts intervene between events and
our emotional reactions
Cognitive-Behavioral Therapy- a popular integrated
therapy that combines cognitive therapy (changing how
you think) with behavioral therapy (changing how you
Family Therapy
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Family therapy is a type of psychotherapy that treats the family as a system. It views an individual's unwanted
behaviors as influenced by, or directed at other family members.
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Assumes no one person is an island.
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We need to connect to our families emotionally.
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Some problem behaviors arise from people trying to differentiate themselves from their families and becoming
their own person, and emotionally connecting with them as a group and a whole.
Family therapists work with family members to mend broken relationships.
Group Therapy
There are several types of self-help groups. Some are even online. Most groups focus on taboo illnesses like AIDS,
anorexia, alcoholism, etc. There are also groups for people with hearing loss, vision loss, any handicap. One of the
most widely known and most common groups is Alcoholics Anonymous (AA). These sessions help alcoholics
abstain and/or decrease their usage of alcohol.
Group therapy has proven to be very effective, wether it was just "motivational therapy," or a 12 step program. Over
100million Americans belong to a religious, interest or self-help group. 9/10 say that group members "support
each other emotionally." (Gallup, 1994)
Day 3
Behavior Therapies and Drug Therapies
Do Now:
What is behavior therapy? What is drug
therapy? Do you think either of these
therapies are effective? Why or why not?
Behavior Therapies
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Mary Cover Jones is the pioneer of behavior therapy. She
graduated Vassar College in 1919.
She worked a lot with behavior psychologist John B. Watson
during the 1920s.
She also developed a technique called desensitization to acute
phobias. During desensitization, a person is introduced to a series
of stimuli related to their phobia. In 1968, Jones received the
prestigious G. Stanley Hall Award from the APA.
Behavioral therapists believe that problem behaviors are the
problem, not the lack of awareness of them. They believe that
learned behaviors can be replaced by constructive behaviors.
Joseph Wolpe
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Joseph Wolpe was a South African psychiatrist. He is also one
of the most influential figures in Behavior Therapy.
While enlisted in the South African army as a medical doctor,
Wolpe get the opportunity to work with soldiers diagnosed
with "war neurosis," widely known today as post traumatic
stress disorder (PTSD). At the time, PTSD was treated by
drug therapy.
Soldiers were given a drug to make them open up about their
problems and experiences. People thought that if they talked
enough about what they experience, they would be cured,
which was not the case. The lack of success with this
treatment led Wolpe to question psychotherapy, seeing as he
Albert Ellis
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Albert Ellis was an American psychologist. He developed Rational
Emotive Behavior Therapy in 1955 which is is a comprehensive,
empirically based psychotherapy. It focuses on resolving emotional
and behavioral problems to enable people to have a more happy and
fulfilling life.
He received several awards for his work, including the 2003 award
from the Association for Rational Emotive Behaviour Therapy (UK),
Association for Behavioral and Cognitive Therapies 2005 Lifetime
Achievement Award and the Association for Behavioral and Cognitive
Therapies 1996 Outstanding Clinician Award.
Behavior Therapies
Counterconditioning- a behavior therapy procedure that uses classical
conditioning to evoke new responses to stimuli that are triggering unwanted
behaviors
Exposure Therapies- behavioral techniques that treat anxieties by exposing
people (in imagination or actuality) to the things they fear and avoid
Systematic Desensitization- a type of exposure therapy that associates a
pleasant relaxed state with gradually increasing anxiety-triggering stimuli
(commonly used to treat phobias)
Behavior Therapies
Virtual Reality Exposure Therapy- an anxiety treatment that progressively
exposes people to stimulations of their greatest fears, such as airplane
flying, spiders, or public speaking
Token Economy- an operant conditioning technique where people earn a
token of some sort for exhibiting a desired behavior, these tokens can later
be exchanged for privileges or treats
Behavior Therapies
Aversive Conditioning- a type of
counterconditioning that
associates an unpleasant state
(such as nausea) with an
unwanted behavior (such as
drinking alcohol)
Behavior Therapies
Does psychotherapy really work?
cont...
Client’s Perceptions
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Readers of Consumer Reports (1995; Kotkin et al., 1996 Seligman,
1995) related their experiences with mental health professionals,
89% sad they were "fairly well satisfied." Although we should keep
clients opinions in mind, they are not always reliable on whether
something works or not:
People often go to therapy in a time of crisis: With a normal flow of
events, crisis usually passes on its own. People might attribute their
progress to a therapy.
Clients may need to believe that the therapy was worth the effort:
Patients do not want to admit they wasted their time and money on
something that did not work.
Clinician’s Perceptions
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Most clinicians, even though not having cured a problem,
see a client leaving as a success. Clients come in during a
period of unhappiness and decide to leave when they
remotely feel better, even if eventually they end up seeing
another therapist about the same exact problem that wasn't
fully cured in the first place.
Research
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The original challenge of how effective psychotherapy is was challenged by Hans Eysenck (1952).
He summarized studies showing that two-thirds of people receiving psychotherapy for nonpsychotic disorders
improved a lot. To this day, no one really opposes that statement.
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Later, is was revealed that Esyneck's results could have been a bit skewed because he used a small sample.
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Today, hundreds of studies are available, including randomized clinical trials.
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After randomly assigning people on a waiting list to therapy or no therapy, the results are digested by metaanalysis, a procedure for statistically combining results of many different research studies. Depending on the
results, sometimes they exhibit regression towards the mean, a tendency for extremes of unusual scores to fall
The Purpose of Different Therapies
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Energy Therapies: Propose to manipulate people's invisible energy fields.
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Recovered-Memory Therapies: Aim to unearth "repressed memories" of early child abuse.
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Rebirthing Therapies: Engage people in teen reenacting the supposed trauma of their birth.
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Facilitated Communication: Has an assistant touch the typing hand of a child.
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Crisis Debriefing: Forces people to rehearse and "process" their traumatic experiences.
Alternative Therapies
EMDR (Eye Movement
Desensitization and
Reprocessing)
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Light Exposure Therapy
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Seasonal Affective Disorder (SAD): a type of seasonal
depression (usually wintertime when there is a lack of
light)
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People who had SAD reportedly felt better after
getting a timed daily dose of intense light.
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Brain scans have proven this therapy sparks activity in
the brain that influences arousal and hormones.
(Ishida et al., 2005)
Adored by thousands but also considered a sham
by others.
Francine Shapiro developed EMDR one day while
going for a walk in a park and observing anxiety
treatment. She had people imagine traumatic
scenes while she triggered eye movements by
waving her finger in from of their eyes. This
supposedly enabled them to unlock and reproved
previously frozen memories.
Almost all people reported reductions in their
distress after one therapeutic session.
Three Elements of Psychotherapy
Hope for Demoralized People
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People who seek therapy are usually unhappy, depressed, anxious, and incapable of turning
things around positively.
A New Perspective
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Every therapy offers people an explanation for their symptoms in a different way of looking at
themselves or responding the world.
An Empathetic, Trusting, Caring
Therapists are great listeners and are Relationship empathetic, giving advice and creating a
bonding relationship with their clients, making them feel safe and secure.
Culture and Therapy
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People from different countries and
different cultures might have a
different way of dealing with their
problems.
Not everyone is open to displaying their
feelings. People who have therapists
with the same culture as them have a
stronger bond.
Some religious people do not see the
need of a therapist. They feel as though
it is more beneficial to turn to God and
only God.
Sheldon’s psychotherapy session
https://www.youtube.com/watch?v=uZq_U2hbnvs
EMDR
https://www.youtube.com/watch?v=gZ5MLn1Cc94
Alfred Adler
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Alfred Adler was an Austrian doctor and
psychotherapist.
He is the founder of individual psychology and put
emphasis on feelings of inferiority and the inferiority
complex. The inferiority complex is a lack of selfworth and feelings of not being up to society's
standards.
Adler considered humans as a whole, an individual.
So, he called his psychology "Individual Psychology."
Along with Sigmund Freud, he was a co-founder for
the psychoanalytic movement and was a member of
the Vienna Psychoanalytic Society.
Dorothea Dix
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Dorothea Dix was an American advocate for the mentally insane.
She lobbied for state legislatures and the U.S. Congress to
establish the first mental asylum.
During the Civil War she was appointed Superintendent of
Army Nurses for the Union Army. She was extremely strict and
had guidelines saying that army nurses needed to be between the
ages of 35 and 50, had to be plain looking and restricted the
clothing they wore to avoid the exploitation of nurses by male
doctors and patients.
During her career in the Civil war, she tended to any wounded
person, regardless of whether they were a part of the Union
Army or the Confederate Army. She believed anyone who was
suffering could get help. She advocated for the ill both during her
career as a nurse and afterwards.
Day 4
Brain Stimulation and Psychosurgeries
Do Now:
What are some ways in which patients with
mental disorders are treated without drugs?
With drugs?
Biomedical Therapy
● Biomedical therapy- prescribed medications or
medical procedures that act directly on the patient’s
nervous system
○ altering brain chemistry with drugs, or affecting its
circuitry with electroconvulsive shock, magnetic
impulses or psycho surgery
○ any prescribed medicines can only come from
psychiatrists
Psychopharmacology
● Prior to modern biomedical treatments and discoveries
in psychopharmacology people with severe mental
illnesses were often subjected to hospital confinement
○ psychopharmacology- the study of the effects of
drugs on mind and behavior
○ drug testing in psychopharmacology almost always
occurs under the confines of a double-blind study
Antipsychotic Drugs
● antipsychotic drugs- drugs used to treat schizophrenia
and other forms of severe thought disorder
○ antipsychotic drugs came as a huge revolution in drug
therapy and actually happened because of an accident.
Physicians discovered that drugs used for other medical
purposes calmed patients with psychoses (disorders in
which hallucinations or delusions indicate some loss of
contact with reality)
cont...
○ Consider chlorpromazine: it was first used
to lessen responsiveness to irrelevant
stimuli and was then used to treat
patients with schizophrenia
○ drugs like this are antagonists because
they block dopamine receptor sites to help
stop hallucinations
Dangers of Antipsychotic Drugs
these are very powerful and long term use of
them can bring about tardive dyskinesiainvoluntary movements of the facial muscles,
tongue, and limbs; a possible neurotoxic side
effect of long-term use of antipsychotic drugs
that target certain dopamine receptors
Antianxiety Drugs
● Antianxiety drugs- drugs used to control anxiety and
agitation
○ xanax and ativan
○ often used in combination with psychological
therapy
○ kinda cool: D-cycloserine acts upon a receptor that
facilitates the extinction of learned fears
Criticisms
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A common criticism: antianxiety drugs and behavior
therapies reduce symptoms without resolving
underlying problems. For example if someone just
takes a xanax as soon as they begin to feel anxious a
psychological dependence can quickly be formed
Along with psychological dependence there can be a
physiological dependence where when use stops
there can be increased anxiety, insomnia, and
withdrawal
Antidepressant Drugs
● Antidepressant drugs- drugs used to treat
depression; also increasingly prescribed for anxiety.
Different types work by altering the availability of
various neurotransmitters.
○ they are not solely used for treating depressed
patients and were named that for their initial use
however they are now used to successfully treat
anxiety disorders such as obsessive-compulsive
disorder
Alternatives to Medication
○ Aerobic exercise can help calm people
who are anxious and energize people who
feel depressed
○ the effects of antidepressant drugs are
relatively small as researchers have found
that placebos account for nearly 75% of
the active drug’s effect
Mood-Stabilizing Medications
○ psychiatrists use mood-stabilizing
medications to treat patients with bipolar
disorder and mania
○ The salt lithium and a drug depakote are
used for this
Electroconvulsive Therapy
● Electroconvulsive Therapy (ECT)- a
biomedical therapy for severely depressed
patients in which a brief electric current is
sent through the brain of an anesthetized
patient