1. Introduction to Psychology
Treatment of Psychological Disorders

2. Psychological Therapies
Whereas the biological therapies view mental disorders through the medical model, psychological therapies view the roots of abnormal behavior in mental states
Each therapy has its own view as to the cause of mental disorder
Each therapy has its own approach to the treatment of mental disorder
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3. Insight-Oriented Therapy
E.g. psychoanalysis, humanistic, gestalt
Help person understand the basis of their thinking, behavior, emotions and perceptions
Insight into the cause will lead to change
Emotion focused therapy or process experiential

4. Action-Oriented Therapy
E.g. Cognitive-Behavioral therapy, Rational-Emotive therapy
Encourages individuals to change behavior or thinking
Multifaceted and individually tailored
Strong therapeutic relationship
Behavioral techniques and cognitive restructuring

5. Varieties of Psychological Treatment
Psychodynamic
Humanistic
Cognitive-behavioral
Biological/Biomedical
Group therapy
Family and marital therapy
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6. Psychodynamic Approach
The psychodynamic approach was created by S. Freud
Mental symptoms reflect unconscious conflicts that induce anxiety
Insight refers to the situation in a person comes to understand their unconscious conflicts
Therapeutic change requires an alliance (relationship) between the patient and therapist
© John Wiley & Sons, Inc.

7. Psychodynamic Techniques
The goal of psychodynamic therapy is to achieve insight into unconscious conflicts
Free Association refers to a technique in which the patient is encouraged to say whatever comes to mind to reveal the unconscious processes of the patient
Interpretation: Therapist interprets the thoughts, and feelings of the patient in order to reveal the hidden conflicts and motivations
Analysis of transference: Patients bring into therapy their past troubled relationships; these are transferred to the therapist
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8. Humanistic Therapy Roger’s Client-centered therapy Therapeutic Climate
Genuineness
Unconditional Positive Regard
Empathy
TherapeuticProcess
Guidance, clarification, become more comfortable with genuine self

9. Cognitive-Behavioral Therapies
Cognitive-behavioral therapies focus on the current behaviors of a person
Emphasis is on the present rather than the past
Cognitive-Behavioral therapists are very directive
Therapy duration is short-term rather than years long
Initial focus is on a detailed behavioral analysis: focus is on the problem behavior and the stimuli associated with it
© John Wiley & Sons, Inc.

10. Behavior Therapies
Classical conditioning techniques can alter emotional responses
Systematic desensitization: Patient is encouraged to confront a feared stimulus (snake) while in a relaxed state
Therapist trains relaxation
Patient constructs an image hierarchy
While relaxing, patient imagines the least fearful of the images in their hierarchy (e.g. being on the planet as a snake)
Exposure: Patient is exposed to the stimulus that they fear (locked in a room full of snakes)
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11. Cognitive Therapies
Focus of cognitive therapies is on changing dysfunctional thought patterns
Rational Emotive Therapy focuses on the hurtful thought patterns of the patient
Ellis’s theory suggests that pathology results when persons adopt illogic in response to life situations
Therapist notes illogical and self-defeating thoughts and teaches alternative thinking that promotes rational thought

12. Cognitive Restructuring
Beck or Ellis
Irrational beliefs
Extreme emotional reactions
ABC’s or Rational Emotive Therapy
A – activating event
B – belief
C – consequences (emotional)
D – disputing beliefs

13. Recent research indicates:
Receiving psychotherapy is considerably more effective than no treatment
CBT shows a slight but consistent advantage with regards to effectiveness compared to insight-oriented therapy
People who do best in therapy are those who have the least problems
personality disorders show less benefit

14. The Medical Model
The Medical Model views abnormal behavior as reflecting a biological disorder
Usually localized within the brain
Involving either brain damage or a disruption of the neurotransmitter processes of the brain
Person is viewed as a patient, treated by doctors in a mental hospital
Therapies tend to be physical in nature
Drugs (Pharmacotherapy)
Surgical alteration of brain (Psychosurgery)

15. Pharmacotherapy
Psychotropic medications are drugs that act on the brain to alter mental function
Prior to 1956, schizophrenia was virtually untreatable with many patients confined for life in mental hospitals
Chlorpromazine (Thorazine) was found to reduce severity of psychotic thought, allowing people to live outside of mental institutions
Reduced size of institutions
The psychotropic actions of many drugs are often accidentally discoveries

16. Antipsychotic Medications
Schizophrenia can be viewed as composed of:
Positive Symptoms: Presence of hallucinations
Negative Symptoms: Absence of affect
Antipsychotic medications refer to drugs that alleviate schizophrenia
Antipsychotic medications are more effective for the positive symptoms than for negative symptoms of schizophrenia

17. Dopamine and Schizophrenia
The positive symptoms of schizophrenia reflect too much brain dopamine activity
Antipsychotic drugs are effective antagonists of dopamine receptors (block the action of dopamine)
Drugs such as amphetamine release dopamine from terminals; too much amphetamine exposure can induce a psychotic state in humans
Negative schizophrenic symptoms may reflect brain damage enlarged ventricles)

18. Antidepressant Medications
Depression reflects a disturbance of mood, sleep, and appetite
Psychotropic antidepressant drugs can lift depression (require 3-4 weeks for effect)
Tricylic antidepressants: Act by blocking the reuptake of norepinephrine and serotonin
Monoamine oxidase (MAO) inhibitors: MAO degrades transmitters; drugs that inhibit MAO allow the transmitter to work for longer periods
Selective serotonin reuptake inhibitors: Prozac blocks the reuptake of serotonin

19. Antianxiety Medications
Anxiety reflects an intense emotional state of dread and apprehension
Drugs such as Valium increase the activity of the transmitter GABA to dampen the neural activity of the brain
Valium is useful in the short-term treatment of anxiety
Antianxiety medications can result in drug dependence
© John Wiley & Sons, Inc.

20. Electroconvulsive Therapy
Antidepressant drugs require 3-4 weeks to take action on mood; the person may be at risk for suicide or is not responding to drug treatment
Electroconvulsive shock therapy (ECT) refers to the intentional induction of a brain seizure by shock administered to either or both hemispheres
ECT produces immediate improvement in mood (explanation is unknown)
Side effects of ECT include memory loss

21. Common Factors in Psychotherapy
Development of a therapeutic alliance
Providing a rationale
Opportunity for catharsis or venting
Acquisition and practice of new behaviors
Beneficial therapist qualities (objective, confidential, professional)
Patient positive expectations and hope

22. Eclecticism
Involves using different treatments for different clients with different problems
Using a reasonable combination of various treatments for the same client (technical eclecticism)
- all populations can receive different types of group therapy

23. Advantages to groups Efficiency 2. Universality Empathy 4. Interaction
5. Acceptance 6. Altruism
Modeling 8. Pressure
9. Practice 10. Reality testing
11. Transference

24. Suicide Risk Factors Diathesis psychological disorder (90%)
substance use and abuse (25-50%)
family history of suicide
family breakdown
societal breakdown
past suicide attempts

25. Suicide Risk Factors Stress
changes in relationships, academic/work, or financial situation
life event that is shameful or humiliating
significant loss
homosexuality
recent suicide

26. Suicide Warning Signs withdrawal change in eating, sleeping, friends
writing and talking about death
telling statements
agitation followed by calm resignation
giving away valued possessions

27. What to do as a friend Take suicide threats seriously
Don’t be afraid to discuss suicide
Recognize the warning signs and the risk factors
Don’t leave the person alone
Get help

28. What to do as a therapist
Ask directly about suicide
Find out if they have a plan
Do they feel like they are in control of their behaviour?
Develop a safety plan
Make a contract
Treat the psychological disorder
Crisis situation – break confidentiality
Grief after suicide...