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Treatment of Psychological Disorders Unit 12. Topics In treatment of Psychological Disorders History of TreatmentHistory of Treatment Types of TherapyTypes.

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Presentation on theme: "Treatment of Psychological Disorders Unit 12. Topics In treatment of Psychological Disorders History of TreatmentHistory of Treatment Types of TherapyTypes."— Presentation transcript:

1 Treatment of Psychological Disorders Unit 12

2 Topics In treatment of Psychological Disorders History of TreatmentHistory of Treatment Types of TherapyTypes of Therapy PsychoanalyticPsychoanalytic HumanisticHumanistic BehavioralBehavioral CognitiveCognitive EclecticEclectic Kinds of Therapists

3 History of treatment Psychological problems have always existed. How they have been handled has greatly differedPsychological problems have always existed. How they have been handled has greatly differed In Ancient, as well as Medieval societies, mental illness equated with possession of an evil spirit. Patients were persecuted, not treatedIn Ancient, as well as Medieval societies, mental illness equated with possession of an evil spirit. Patients were persecuted, not treated Remains of humans with holes in their heads have been found. Trephining is the drilling of a hole into a human head to release evil sprits.Remains of humans with holes in their heads have been found. Trephining is the drilling of a hole into a human head to release evil sprits.

4 History of treatment Hippocrates(Ancient Greece) and Galen(Ancient Rome) both believed that mental illness was biological and could be treated.Hippocrates(Ancient Greece) and Galen(Ancient Rome) both believed that mental illness was biological and could be treated. Around the time of the Enlightenment, treatment began to take a more modern form.Around the time of the Enlightenment, treatment began to take a more modern form. In the 19 th century, Philippe Pinel and Dorothy Dix began rallying for more humane treatment of patientsIn the 19 th century, Philippe Pinel and Dorothy Dix began rallying for more humane treatment of patients Instead of caging and beating patients, Pinel and Dix helped create separate institutions for the mentally illInstead of caging and beating patients, Pinel and Dix helped create separate institutions for the mentally ill

5 Deinstitutionalization In the 1950s, once medication for mental illnesses became more readily available, there was a movement to Deinstitutionalize (release from hospital) patientsIn the 1950s, once medication for mental illnesses became more readily available, there was a movement to Deinstitutionalize (release from hospital) patients This was a way to save money as well as mainstream patients back into regular society and be treated as outpatientsThis was a way to save money as well as mainstream patients back into regular society and be treated as outpatients It was not very successful. Patients could not take care of themselves. Many Schizophrenics ended up homeless and delusional.It was not very successful. Patients could not take care of themselves. Many Schizophrenics ended up homeless and delusional.

6 Preventative Efforts More recently in the United States, a greater emphasis has been placed on preventative care.More recently in the United States, a greater emphasis has been placed on preventative care. The logic is that if a Psychological disorder can be treated proactively, it will become less severe.The logic is that if a Psychological disorder can be treated proactively, it will become less severe. There are 3 levels of Preventative careThere are 3 levels of Preventative care Primary PreventionPrimary Prevention Secondary PreventionSecondary Prevention Tertiary PreventionTertiary Prevention

7 Preventative Efforts Primary prevention is the aim to avoid the occurrence of a Mental illness by targeting societal or domestic issues that may lead to disorders. (D.A.R.E., counseling for children of divorce, homeless shelters) Primary prevention is the aim to avoid the occurrence of a Mental illness by targeting societal or domestic issues that may lead to disorders. (D.A.R.E., counseling for children of divorce, homeless shelters) Secondary Prevention is the treatment of disorders in their infancy stages and people at risk. Could include therapy for rape victims or early PTSD support groups Secondary Prevention is the treatment of disorders in their infancy stages and people at risk. Could include therapy for rape victims or early PTSD support groups Tertiary Prevention is aimed at keeping existing mental illness from becoming more severe. A.A., N.A., rehabilitation centers Tertiary Prevention is aimed at keeping existing mental illness from becoming more severe. A.A., N.A., rehabilitation centers

8 Types of Therapy Depending on a Psychologist’s perspective on the causes of mental illness, their view on how to treat disorders will varyDepending on a Psychologist’s perspective on the causes of mental illness, their view on how to treat disorders will vary Psychoanalytic, Humanist, Behavioral and Cognitive theorists believe in the value of Psychotherapy, mainly by talking to a Psychologist.Psychoanalytic, Humanist, Behavioral and Cognitive theorists believe in the value of Psychotherapy, mainly by talking to a Psychologist. Psychologists with a Biomedical approach rely heavily on the use of drugs.Psychologists with a Biomedical approach rely heavily on the use of drugs. Note: Most Psychologists refer to people seeking help as patients. Humanists refer to them as clientsNote: Most Psychologists refer to people seeking help as patients. Humanists refer to them as clients

9 Psychoanalytic Therapy Psychoanalysis is a technique that was developed by, you guessed it, Sigmund Freud in which the patient frequently lies on a couch, talking to a therapist out of their sight line. Psychoanalysis is a technique that was developed by, you guessed it, Sigmund Freud in which the patient frequently lies on a couch, talking to a therapist out of their sight line. Remember, Psychoanalysts view disorders as an unconscious conflict. They focus on unearthing the underlying problemRemember, Psychoanalysts view disorders as an unconscious conflict. They focus on unearthing the underlying problem They believe other methods of therapy may help, but don’t always address the problem.They believe other methods of therapy may help, but don’t always address the problem. Symptom Substitution -when one symptom is treated, another arises Symptom Substitution -when one symptom is treated, another arises

10 Psychoanalysis Freud used techniques such as Hypnosis, dream analysis and free association.(Hypnosis & dream analysis were covered in Unit 4:States of Consciousness)Freud used techniques such as Hypnosis, dream analysis and free association.(Hypnosis & dream analysis were covered in Unit 4:States of Consciousness) Free association is when a patient is asked to say whatever comes to mind without thinking. Freud would have patients just talk in a sort of stream of consciousness.Free association is when a patient is asked to say whatever comes to mind without thinking. Freud would have patients just talk in a sort of stream of consciousness. Generally, it is believed that we censor what we say to hide unconscious feelings, but through free association we have no time to censor, so true meanings emergeGenerally, it is believed that we censor what we say to hide unconscious feelings, but through free association we have no time to censor, so true meanings emerge

11 Psychoanalysis One of the main problems with Free association and dream analysis is it is heavily reliant on the Psychologist’s interpretation.One of the main problems with Free association and dream analysis is it is heavily reliant on the Psychologist’s interpretation. With dream analysis, there is the Latent and Manifest content of dreams.With dream analysis, there is the Latent and Manifest content of dreams. Psychologists are more interested in the Latent content. (Manifest content=actual content of dream. Latent content=Hidden meaning behind dream)Psychologists are more interested in the Latent content. (Manifest content=actual content of dream. Latent content=Hidden meaning behind dream)

12 Psychoanalysis Often, patients disagree with the therapists interpretation or get defensive. This is believed by Psychoanalysts to be a sign of resistance.Often, patients disagree with the therapists interpretation or get defensive. This is believed by Psychoanalysts to be a sign of resistance. Psychoanalysts believe this to be a way of blocking their conscious from coming to terms with deeply repressed thoughts or feelings.Psychoanalysts believe this to be a way of blocking their conscious from coming to terms with deeply repressed thoughts or feelings. Many times, the stronger the resistance, the closer the psychologist believes they are getting to the root of the problemMany times, the stronger the resistance, the closer the psychologist believes they are getting to the root of the problem

13 Psychoanalysis Another aspect of psychoanalysis is the issue of Transference. Many times, patients begin to develop deep feelings for their therapist.Another aspect of psychoanalysis is the issue of Transference. Many times, patients begin to develop deep feelings for their therapist. Patients may think they are in love with their therapist, or look at them as a parental figure.Patients may think they are in love with their therapist, or look at them as a parental figure. It may not always be positive. Patients may redirect troubling or hateful thoughts about someone or something onto their therapist.It may not always be positive. Patients may redirect troubling or hateful thoughts about someone or something onto their therapist.

14 Psychoanalysis Remember,Remember, Psychoanalytic=Freud or strict adherence to Freudian methods or teachingsPsychoanalytic=Freud or strict adherence to Freudian methods or teachings Psychodynamic=Offshoots of Freudian theories. Recognize importance of unconscious, but have tweaked theoriesPsychodynamic=Offshoots of Freudian theories. Recognize importance of unconscious, but have tweaked theories Psychoanalysis is known as an Insight therapy. The goal is to have patients gain an insight or understanding of their problems.Psychoanalysis is known as an Insight therapy. The goal is to have patients gain an insight or understanding of their problems.

15 Humanistic Therapies The humanist therapies focus on helping people to achieve Self-actualization(realizing one’s unique personal potential)The humanist therapies focus on helping people to achieve Self-actualization(realizing one’s unique personal potential) Humanists see Self-actualization as a powerful motivational tool. Humanists also see people as innately good and possessing of Free will.Humanists see Self-actualization as a powerful motivational tool. Humanists also see people as innately good and possessing of Free will. Humanistic theory is the opposite of Determinism. Determinist theories argue we have no control over how we turn out.Humanistic theory is the opposite of Determinism. Determinist theories argue we have no control over how we turn out.

16 Humanism Client-centered therapy is one of the best known Humanistic therapy techniques. It was created by Carl Rogers. Client-centered therapy is one of the best known Humanistic therapy techniques. It was created by Carl Rogers. Client-centered therapy involves providing the client with Unconditional-positive regard(blanket acceptance)Client-centered therapy involves providing the client with Unconditional-positive regard(blanket acceptance) Rogers believed unconditional positive regard is essential to healthy development. People who have not experienced it may view themselves in a negative light. It also allows clients to take responsibility for themselves.Rogers believed unconditional positive regard is essential to healthy development. People who have not experienced it may view themselves in a negative light. It also allows clients to take responsibility for themselves.

17 Humanistic Therapy Humanistic therapy is also Non-directive. Rogers didn’t believe in telling his clients what to do.Humanistic therapy is also Non-directive. Rogers didn’t believe in telling his clients what to do. Rogers supported the belief that clients should choose a course of action for themselves.Rogers supported the belief that clients should choose a course of action for themselves. Humanists engage in what is called Active Listening. The therapist does very little talking and lets the client lead the session. They mirror what the client says to clarify meanings. They facilitate the session.Humanists engage in what is called Active Listening. The therapist does very little talking and lets the client lead the session. They mirror what the client says to clarify meanings. They facilitate the session.

18 Humanistic Therapy One subcategory of Humanism is Gestalt therapy which was developed by Fritz Perls. Remember Gestalt Psychologists believe the ‘whole is greater than the sum of its parts’One subcategory of Humanism is Gestalt therapy which was developed by Fritz Perls. Remember Gestalt Psychologists believe the ‘whole is greater than the sum of its parts’ Gestalt therapy emphasizes the importance of the clients getting in touch with their whole self.Gestalt therapy emphasizes the importance of the clients getting in touch with their whole self. They also focus on the importance of the present and have their clients appreciate every aspect of an event as it is occurring.They also focus on the importance of the present and have their clients appreciate every aspect of an event as it is occurring.

19 Humanism One final area in Humanistic therapy is the Existential therapies.One final area in Humanistic therapy is the Existential therapies. Existential therapies help clients achieve a meaningful perception of their lives.Existential therapies help clients achieve a meaningful perception of their lives. These therapies center around clients who have lost a sense of purpose in their lives.These therapies center around clients who have lost a sense of purpose in their lives. Therapists seek to have clients formulate a vision of their lives as worthwhile.Therapists seek to have clients formulate a vision of their lives as worthwhile.

20 Humanistic Aims Along with attempting to provide the client with Unconditional Positive regard, Humanists seek to offer additional areas of support.Along with attempting to provide the client with Unconditional Positive regard, Humanists seek to offer additional areas of support. Humanists seek to be genuinely empathetic and see the world through the client’s eyesHumanists seek to be genuinely empathetic and see the world through the client’s eyes Humanists seek to be authentic (genuine and honest)Humanists seek to be authentic (genuine and honest) Finally, Humanists seek not to offer advice, but to reflect on what the client says by rephrasing, repeating and summarizing. Through this, clients are able to see themselves more clearly.Finally, Humanists seek not to offer advice, but to reflect on what the client says by rephrasing, repeating and summarizing. Through this, clients are able to see themselves more clearly.

21 Behavioral Therapies Employ Operant and Classical conditioning methodsEmploy Operant and Classical conditioning methods Flooding, systematic desensitization, Aversion therapies, counterconditioning, etc.Flooding, systematic desensitization, Aversion therapies, counterconditioning, etc. Helpful in treating phobias, anxiety disorders, and OCDHelpful in treating phobias, anxiety disorders, and OCD

22 Cognitive Therapies Remember, a Cognitive therapist believes that Mental Illnesses stem from faulty and irrational cognitions.Remember, a Cognitive therapist believes that Mental Illnesses stem from faulty and irrational cognitions. Cognitive therapy sessions aim to get the patient to change their unhealthy patterns of thinkingCognitive therapy sessions aim to get the patient to change their unhealthy patterns of thinking A cognitive therapist aims to change a person’s attributional style. An unhealthy attributional style involves a person attributing their failures to their own inadequacies. (I suck at life or I’m stupid)A cognitive therapist aims to change a person’s attributional style. An unhealthy attributional style involves a person attributing their failures to their own inadequacies. (I suck at life or I’m stupid) Healthy attributional style is when people view failure more externally. (That challenge was hard. If I prepare better, next time I’ll succeed )Healthy attributional style is when people view failure more externally. (That challenge was hard. If I prepare better, next time I’ll succeed )

23 Cognitive therapies Aaron Beck, who created the Cognitive Triad was a pioneer in the field of Cognitive therapy.Aaron Beck, who created the Cognitive Triad was a pioneer in the field of Cognitive therapy. Cognitive therapy is often used to treat depression. Therapists attempt to get people to engage in tasks they know they can succeed in.Cognitive therapy is often used to treat depression. Therapists attempt to get people to engage in tasks they know they can succeed in. Beck uses his ideas from the Cognitive Triad to get people to view the world, themselves and their futures more positively.Beck uses his ideas from the Cognitive Triad to get people to view the world, themselves and their futures more positively.

24 Cognitive Behavioral Therapy Today, many Psychologists adopt a multi-tiered approach to therapy. One of the most common groupings is Cognitive and Behavioral methods.Today, many Psychologists adopt a multi-tiered approach to therapy. One of the most common groupings is Cognitive and Behavioral methods. One example of CBT is Rational Emotive Behavior Therapy or REBT which was developed by Albert EllisOne example of CBT is Rational Emotive Behavior Therapy or REBT which was developed by Albert Ellis Often times people have extremely irrational fears of what might happen to them in social or group settings such as giving a speech or pitching a new idea to a boss.Often times people have extremely irrational fears of what might happen to them in social or group settings such as giving a speech or pitching a new idea to a boss.

25 Cognitive behavior therapy A CBT therapist will look to alleviate these fears in people by challenging their beliefs on why they are so afraid in the first place.A CBT therapist will look to alleviate these fears in people by challenging their beliefs on why they are so afraid in the first place. Therapists will encourage the person to realize that their fear is most likely very irrational and can be overcome.Therapists will encourage the person to realize that their fear is most likely very irrational and can be overcome. A CBT therapist would have the person engage in the act they are afraid of or nervous about and realize that their fear was unwarranted.A CBT therapist would have the person engage in the act they are afraid of or nervous about and realize that their fear was unwarranted.

26 Group Therapy Group therapies can be from any of the fields of therapy we have discussed so far.Group therapies can be from any of the fields of therapy we have discussed so far. Often times group therapy sessions are eclectic in nature.Often times group therapy sessions are eclectic in nature. Treating families is one common area of group therapy (Family therapy ). Many times a patient’s problems stem from familial issues so treating the family as a whole can be effective.Treating families is one common area of group therapy (Family therapy ). Many times a patient’s problems stem from familial issues so treating the family as a whole can be effective.

27 Group Therapy Benefits of group therapy sessions are that they are less expensive and can simultaneously treat multiple people with similar disordersBenefits of group therapy sessions are that they are less expensive and can simultaneously treat multiple people with similar disorders It is also a way of getting patients to be able to relate to people who are experiencing similar issues in life.It is also a way of getting patients to be able to relate to people who are experiencing similar issues in life. Self-help groups such as NA and AA are good examples of this. Group therapy sessions for teens and couples support at churches is common.Self-help groups such as NA and AA are good examples of this. Group therapy sessions for teens and couples support at churches is common.

28 Psychodrama One last technique used in group therapy is Psychodrama. Psychodrama can include role-playing in which a person acts out a problem they are having with a group of people. Allows for insight on the problemOne last technique used in group therapy is Psychodrama. Psychodrama can include role-playing in which a person acts out a problem they are having with a group of people. Allows for insight on the problem Role-reversal is a way of a person seeing an issue from another person’s point of view to see how someone else might feel in a fight or disagreement Role-reversal is a way of a person seeing an issue from another person’s point of view to see how someone else might feel in a fight or disagreement Mirror technique is watching a group re-enact a situation you were originally a part of to judge your own behaviorsMirror technique is watching a group re-enact a situation you were originally a part of to judge your own behaviors

29 Somatic Therapies Somatic treatments, which aim to produce bodily changes, are used mostly by Psychologists with a Biomedical perspective on mental illnesses. Somatic treatments, which aim to produce bodily changes, are used mostly by Psychologists with a Biomedical perspective on mental illnesses. The most common type of Somatic therapy is drug therapy. This is known as PsychopharmacologyThe most common type of Somatic therapy is drug therapy. This is known as Psychopharmacology Drugs can be used to treat a wide array of psychological disorders such as anxiety, depression and even severe ones such as Schizophrenia.Drugs can be used to treat a wide array of psychological disorders such as anxiety, depression and even severe ones such as Schizophrenia.

30 Antipsychotic Drugs Antipsychotic drugs are the main source of treatment for Schizophrenia. Antipsychotic drugs are the main source of treatment for Schizophrenia. Most Schizophrenics have scrambled thoughts/language so Psychotherapy is generally ineffectiveMost Schizophrenics have scrambled thoughts/language so Psychotherapy is generally ineffective Most common antipsychotic drugs are Thorazine and Haldol.Most common antipsychotic drugs are Thorazine and Haldol. These drugs work mainly to block receptor sites for Dopamine(remember, dopamine hypothesis). Side effects can be Tardive DyskinesiaThese drugs work mainly to block receptor sites for Dopamine(remember, dopamine hypothesis). Side effects can be Tardive Dyskinesia

31 Antidepressants Antidepressants are commonly used to treat mood disorders such as Major Depressive Disorder and Bipolar disorder. Antidepressants are commonly used to treat mood disorders such as Major Depressive Disorder and Bipolar disorder. Common drugs to treat unipolar depression are Tricyclic antidepressants, monoamine oxidase (MAO) inhibitors and Selective serotonin reuptake-inhibitors (SSRI) which increase serotonin activity( Prozac and Zoloft )Common drugs to treat unipolar depression are Tricyclic antidepressants, monoamine oxidase (MAO) inhibitors and Selective serotonin reuptake-inhibitors (SSRI) which increase serotonin activity( Prozac and Zoloft ) Lithium is also used to treat mania for people suffering from Bipolar disorder. Lithium is also used to treat mania for people suffering from Bipolar disorder.

32 Antianxiety Drugs Anxiety disorders are common are routinely treated with drugs.Anxiety disorders are common are routinely treated with drugs. These drugs act to depress the activity of the central nervous system making people feel more relaxed.These drugs act to depress the activity of the central nervous system making people feel more relaxed. Two main types of antianxiety drugs are Barbiturates such as Miltown and Benzodiazepines such as Xanax and Valium.Two main types of antianxiety drugs are Barbiturates such as Miltown and Benzodiazepines such as Xanax and Valium. Side affects include drowsiness, irritability, dizziness, memory and attention problems, and physical dependenceSide affects include drowsiness, irritability, dizziness, memory and attention problems, and physical dependence

33 Electroconvulsive Therapy Another, less common, form of somatic treatments is ECT. ECT involves the running of electrical currents through the brain.Another, less common, form of somatic treatments is ECT. ECT involves the running of electrical currents through the brain. Bilateral ECT involves the current passing through both hemispheres. Unilateral, only one hemisphere. Common side effects include memory loss Bilateral ECT involves the current passing through both hemispheres. Unilateral, only one hemisphere. Common side effects include memory loss Patients have a medically induced seizure followed by a loss of consciousness.Patients have a medically induced seizure followed by a loss of consciousness.

34 ECT ECT is used to treat severe cases of depression.ECT is used to treat severe cases of depression. Generally, to reduce the effects of the seizure, a patient is given muscle relaxers.Generally, to reduce the effects of the seizure, a patient is given muscle relaxers. The exact means by which ECT works is not fully understood. It is believed that benefits of ECT stem from changing the blood flow patterns in the brainThe exact means by which ECT works is not fully understood. It is believed that benefits of ECT stem from changing the blood flow patterns in the brain This treatment is roughly depicted in the film Eternal Sunshine of the Spotless Mind.This treatment is roughly depicted in the film Eternal Sunshine of the Spotless Mind.

35 Psychosurgery Psychosurgery is a relatively rare and intrusive treatment used often times as a last resort. Psychosurgery is a relatively rare and intrusive treatment used often times as a last resort. It is the purposeful destruction of part of the brain in an attempt to alter a behavior.It is the purposeful destruction of part of the brain in an attempt to alter a behavior. Most notable is the Prefrontal Lobotomy. This is the process of cutting off the neural connections from the frontal lobe to the rest of the brain.Most notable is the Prefrontal Lobotomy. This is the process of cutting off the neural connections from the frontal lobe to the rest of the brain. Many people lose the ability to think complexly and ability to solve detailed problems.Many people lose the ability to think complexly and ability to solve detailed problems.


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