1. Therapies for Psychological Disorders
Chapter 13
Therapies for Psychological Disorders

2. What is Therapy?
Therapy for psychological disorders takes a variety of forms, but all involve some relationship focused on improving a person’s mental, behavioral, or social functioning

3. What is Therapy? Therapy: General term for any treatment process
In psychology and psychiatry - a variety of psychological and biomedical techniques aimed at dealing with mental disorders or coping with problems of living

4. The Components of Therapy
Relationship between the therapist and the patient/client and some or all of the following processes:
Identifying the problem
Identifying the cause of the problem or the conditions that maintain the problem
Deciding on and carrying out some form of treatment

5. Contemporary Approaches to Therapy
Psychological therapies: Based on psycho-logical principles (rather than biomedical approach)
Often collectively called psychotherapy

6. Contemporary Approaches to Therapy
Biomedical therapies: Focus on altering the brain
Drugs
Psychosurgery
Electroconvulsive therapy

7. Types of Mental Health Care Professionals
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor 29

8. Counseling psychologist
Professional Title
Specialty:
Problems of normal living
Work setting:
Schools, clinics, other institutions
Credentials:
Master’s in counseling, PhD, EdD, or PsyD
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor 29

9. Clinical psychologist
Professional Title
Specialty:
Those with severe disorders
Work setting:
Private practice, mental health agencies, hospitals
Credentials:
PhD or PsyD
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor 29

10. Professional Title
Specialty:
Severe mental disorders (often by means of drug therapies)
Work setting:
Private practice, clinics, hospitals
Credentials: MD
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor 29

11. Professional Title Freudian therapy Private practice MD
Counseling psychologist
Specialty:
Freudian therapy
Work setting:
Private practice
Credentials: MD
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor 29

12. Psychiatric nurse practitioner
Specialty:
Nursing specialty; licensed to prescribe drugs
Work setting:
Private practice, clinics, hospitals
Credentials:
RN – plus special training in treating mental disorders and prescribing drugs
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor 29

13. Clinical social worker
Professional Title
Counseling psychologist
Specialty:
Social worker with specialty in dealing with mental disorders
Work setting:
Often employed by government
Credentials:
MSW
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor 29

14. Professional Title
Specialty:
Combines spiritual guidance with practical counseling
Work setting:
Religious order or ministry
Credentials:
Varies
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor 29

15. Insight Therapies: Psychodynamic Therapies
Psychoanalysis: Form of psychodynamic therapy developed by Sigmund Freud
Analysis of transference: Analyzing and interpreting the patient’s relationship with the therapist
Dream interpretation, free association
Neo-Freudian psychodynamic therapies: Developed by psychodynamic theorists who embraced some of Freud’s ideas, but disagreed with others (sex, childhood)

16. How Do Psychologists Treat Mental Disorders?
Psychologists employ two main forms of treatment: the insight therapies and the behavioral therapies

17. Insight Therapies: Humanistic Therapies
Humanistic therapies: tendency for positive growth and self actualization (may be blocked by unhealthy environment)
Client-centered therapy: Emphasizes healthy psychological growth through self-actualization (Rogers)
Reflection of feeling: Paraphrasing client’s words to capture the emotional tone expressed
Unconditional positive regard: nonjudgmental and respect for client

18. Insight Therapies: Cognitive Therapies
Cognitive therapy: Emphasizes rational thinking as the key to treating mental disorder
Cognitive therapy for depression (Aaron Beck)
Confront destructive thoughts that support it
Can be at least as effective as medication

19. Insight Therapies
Insight therapies: Psychotherapies in which the therapist helps others understand (gain insight) their problems (emotions, thoughts)
AKA – talk therapies
Psychodynamic – unconscious conflicts
Humanistic – positive growth & self-actualization
Cognitive – emphasizes rational thinking (ex. Beck – depression; confront thoughts that support it)

20. Systematic desensitization Contingency management
Behavior Therapies
Behavior therapy: based on the principles of behavioral learning, especially operant and classical conditioning
Systematic desensitization
Aversion therapy
Contingency management
Token economies

21. Classical Conditioning Therapies
Systematic desensitization: Anxiety is extinguished by gradually exposing the patient to an anxiety-provoking stimulus
Exposure therapy: patient directly confronts the anxiety-provoking stimulus (as opposed to imagining it)
Aversion therapy: Present an attractive stimulus with unpleasant stimulation in order to condition a repulsive reaction

22. Operant Conditioning Therapies
Contingency management: Changing behavior by altering the consequences (rewards and punishments) of behavior
Token economies: Applied to groups involving distribution of “tokens” contingent on desired behaviors

23. Cognitive-Behavioral Therapy: A Synthesis
Modify irrational thoughts
Set attainable behavioral goals
Develop realistic strategies to attain goals
Evaluate results
Rational-emotive behavior therapy: irrational thoughts and behaviors are the cause of mental disorders (REBT)
Albert Ellis – strong approach, no acceptance of irrational thoughts, may be a heated interaction

24. How Is the Biomedical Approach Used to Treat Mental Disorders?
Biomedical therapies seek to treat mental disorders by changing the brain’s chemistry with drugs, its circuitry with surgery, or its patterns of activity with pulses of electricity or powerful magnetic fields

25. It’s your last day of notes! 

26. Drug Therapy
Psychopharmacology: The prescribed use of drugs to help treat symptoms of mental illness ostensibly to ensure that individuals are more receptive to talk therapies

27. Drug Therapy Antipsychotic drugs
Include chlorpromazine, haloperidol, and clozapine
Usually affect dopamine pathways (reduce it)
May have side effects
Tardive dyskinesia: Incurable disorder of motor control resulting from long-term use of antipsychotic drugs

28. Drug Therapy Antidepressants and mood stabilizers
Usually affect serotonin/norepinephrine (increase)
(MAO) inhibitors – increase norepinephrine
Tryicyclics – inhibit reuptake
SSRIs – inhibit reuptake of serotonin (Prozac)
Lithium carbonate – treats bipolar (can be toxic)
Highly controversial – suicide, using just when uneasy

29. Drug Therapy Antianxiety drugs
Barbiturates – relax central nervous system
Benzodiazepines – decrease activity in anxiety regions of brain
Do not
Use to relieve ordinary anxieties of everyday life
Take for more than a few days at a time
Combine with alcohol

30. ONLY TWO MORE SLIDES OF NOTES FOR THE YEAR!!! 

31. Psychosurgery
Psychosurgery: The general term for surgical intervention in the brain to treat psychological disorders
The infamous prefrontal lobotomy is no longer performed
Severing the corpus callosum, however, can reduce life-threatening seizures

32. Brain-Stimulation Therapies
Electroconvulsive (ECT) therapy - used for treatment of severe depression
Side effect – memory disruption
Transcranial magnetic stimulation (TMS): a possible alternative to ECT- treatment of depression, schizophrenia, and bipolar disorder

33. Hospitalization and the Alternatives
Therapeutic community: Program of treating mental disorder by making the institutional environment supportive and humane for patients
Deinstitutionalization: Policy of removing patients, whenever possible, from mental hospitals
Community mental health movement: Effort to deinstitutionalize mental patients and to provide therapy from outpatient clinics

34. Drug Therapy
Stimulants: suppress activity level in persons with attention-deficit/hyperactivity disorder (ADHD)
Causes and boundaries of ADHD are vague and the potential exists for over-diagnosis
Side effects – growth, sleep, later use

35. Insight Therapies: Group therapies
Group therapy: Psychotherapy with more than one client
Self-help support groups: Groups that provide social support and an opportunity for sharing ideas about dealing with common problems
typically run by laypersons (not professional therapists)
Couples and family therapy

36. Participant Modeling: An Observational-Learning Therapy
Participant modeling: Therapist demonstrates and encourages a client to imitate a desired behavior

37. Evaluating the Psychological Therapies
Eysenck proposed that people with non-psychotic problems recover just as well with or without therapy
Reviews of evidence have shown:
That therapy is better than no therapy
It appears advantageous to match specific therapies with specific conditions

38. Mental “First Aid”
If someone asks you for help, keep in mind that serious problems (especially those involving suicide or threats) require immediate professional treatment
Otherwise, your best tools may involve
Listening
Acceptance
Exploring alternatives