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Treatment of Psychological Disorders Unit 3 (Chapter 15)

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1 Treatment of Psychological Disorders Unit 3 (Chapter 15)

2 Types of Treatment ▪ Types of therapies – Insight therapies ▪ “talk therapy”

3 Types of Treatment ▪ Types of therapies – Behavior therapies ▪ Changing overt behavior through use of conditioning

4 Types of Treatment ▪ Types of therapies – Biomedical therapies ▪ Alter the biological functioning using drugs or mild electric shocks

5 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

6 Who Seeks Treatment? ▪ Utilization rates ▪ Women more than men ▪ Medical insurance ▪ Education level ▪ Psychological Disorders and professional treatment

7 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

8 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

9 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

10 The Early Days of Therapy ▪ 1793 real efforts made to treat the mentally ill with kindness and guidance – Philippe Pinel (France)

11 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

12 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

13 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

14 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

15 Transference ▪ Therapist becomes a symbol of parental authority – At first the patients would transfer positive feelings and then over time transfer negative feelings

16 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

17 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

18 Humanistic Therapy ▪ Focuses on the importance of choices made by individuals and the potential to change one’s own behavior ▪ Dominant type is Client- Centered Therapy founded by Carl Rogers

19 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

20 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

21 Evaluation ▪ Clients must be intelligent and verbal ▪ Wide range of applications ▪ Very little chance of misunderstanding ▪ One flaw is that it lacks scientific backing

22 Group Therapy ▪ Expanded use after the introduction of Client- Centered Therapy – Group size: 6-8 – Major advantage is that it adds a social component (support groups)

23 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

24 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

25 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

26 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

27 Flooding – For phobias – Exposure to fearful items in a rapid manner, also removing the avoidance response

28 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

29 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

30 Cognitive Therapies ▪ Developed by Aaron Beck ▪ Focused on helping people change their ways of thinking – Distorted thinking and unrealistic beliefs lead to maladaptive behavior

31 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

32 Rational-Emotive Behavior Therapy (REBT) ▪ Created by Albert Ellis ▪ Version of CBT ▪ Very directive and challenging ▪ Same goals as CBT

33 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

34 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

35 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

36 Psychopharmacology ▪ Antidepressant drugs – Treat depression by inhibiting the reuptake of serotonin – Prozac ▪ Mood stabilizers – Treat manic and depressive episodes (bipolar) – Lithium

37 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

38 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

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