1. SUMMARY of Psych Therapy designs Refer to chapter 16 to accompany these notes!

2. History of treatment Attitudes towards and treatment of the mentally ill have changed significantly over time Anciently – believed mentally ill were possessed by demons – trephining – drilled holes in their skull to release spirits Imprisonment Progressive era – call for more humane treatment – counseling and institutions –Dorothea Dix in US –Philippe Pinel in France

3. Post 1950s Pharmacology MEDS – drugs De-institutionalization Seek to treat mentally with meds and with out- patient counseling Get away from lifetime institutionalization Side effect – increase mentally ill population in prison or homeless - struggle to function

4. 60 Minutes Clip Jan 2014 – Cree Deeds son’s suicide – danger of de- institutionalization http://www.cbsnews.com/news/mentally-ill-youth-in- crisis/http://www.cbsnews.com/news/mentally-ill-youth-in- crisis/

5. Today Continue trend in medication and out- patient therapy Increased emphasis on PREVENTION – how……? – de- stressors –Stable families –Emphasize better nutrition, exercise, sleep, etc.

7. Summary of different treatment perspectives

8. Psychoanalysis Issue - Person’s symptoms are outward manifestation of deeply repressed problems, possibly from childhood Freud Role of Uncon Developmental fixation Emphasis on childhood, trauma, repression Projective tests – free association, hypnosis, dream analysis, ink blot, TAT

9. Humanism Summary Issue – boost patients self-esteem by helping him realize his potential, possibilities for growth, and self-actualization Maslow and Rogers Therapy techniques – unconditional positive regard, client centered therapy, active listening, show genuine concern for patient People are innately good NOT deterministic – you can use your agency to choose your course in life Key terms – hierarchy of needs, free will, self-actualization

10. Behaviorism Summary Issue – abnormal behavior is caused by a dysfunctional environment. Change the environment – fix the behavior 100% nurture – ALL behaviors are learned Skinner and operant conditioning (alter reinforcements or punishments) Bandura and social modeling – model healthy behaviors Classical Conditioning – Counter Condition – replace association of anxiety/fear with calm – hierarchy of fears –Systematic desensitization – proceed step by step by imagining –In vivo desensitization – proceed step by step live –Implosive Therapy – imagine most frightening scenario (top of hierarchy) –Flooding – actually do most frightening scenario – live –(ultimate goal is always to do it live – but you may do imagination first)

11. Cognitive - Summary Issue – dysfunctional behaviors are caused by dysfunctional thoughts. Confront the patient’s irrational thoughts Albert Ellis – Rational Emotive Therapy – expose irrational thoughts Locus of Control – (internal V. external) be realistic in what you take credit for or what you take blame for Seligman’s – Learned helplessness – do you have control of your situation – do you take action? Aaron Beck’s Cognitive Triad – dysfunctional thoughts about your 1.) self, 2.) your world, and 3.) your future

12. Cognitive Summary Aaron Beck’s Cognitive Triad – dysfunctional thoughts about your 1.) self, 2.) your world, and 3.) your future

13. Cognitive Summary Dysfunctional Attribution Style Failures Internal – I am a loser Global – I suck at everything Stable – I will always suck at everything Successes External – I got lucky/the test was easy Specific – I only got a good grade on this one test Unstable – this success won’t last

15. Pharmacology – MEDS Emphasis on biomedical causes – Chemical imbalances Brain abnormalities Genetic Predispositions (NATURE)

16. MEDS Anti-Psychotic (Schizophrenia) –Too much dopamine –Drugs block receptor sites for dopamine - diminish + symptoms (hallucinations and delusions) –Haldol, Thorazine –Side effect – tardive dyskinesia Anti-Depressants -Unipolar depression - Too little serotonin – Prozac and Zoloft block serotonin reuptake -Bipolar – lithium Anti-Anxiety - Barbiturates – valium, Xanax – depress activity of central nervous system

17. MEDS Risks of all meds – Finding right med at the right dosage – often process of trial and error –ALL meds have some kind of undesirable side effect

18. Other Medical Interventions Electroconvulsive Therapy (ECT) – induced medical seizure – used historically to treat multiple mental illnesses –used today as last resort treatment of depression –Risk = possible memory loss

19. Other Medical Interventions Psychosurgery – historical prefrontal lobotomies 1950s/60s (JFK’s sister, “One Flew Over the Cuckoo's Nest”)

20. 60 Minute Clips on Treatment Sept 2013 – Untreated Mental illness and connection to mass shootings:Sept 2013 – Untreated Mental illness and connection to mass shootings: http://www.cbsnews.com/video/watch/?id=50156091n