Myers’ Psychology for AP* David G. Myers PowerPoint Presentation Slides by Kent Korek Germantown High School Additions by Loretta Merlino Worth Publishers, © 2010 *AP is a trademark registered and/or owned by the College Board, which was not involved in the production of, and does not endorse, this product.

Unit 13: Treatment of Psychological Disorders

Objective I will be able to identify and apply the theories of treatment methods for psychological disorders on tests and on individual and group assignments

Essential Questions 1. What are the different treatments for psychological disorders? 2. How do these treatment methods differ by perspective? 3. How do we evaluate the effectiveness of treatment?

Family Therapies Family therapy

Unit Overview The Psychological Therapies Evaluating Psychotherapies The Biomedical Therapies Click on the any of the above hyperlinks to go to that section in the presentation.

Introduction-copy * History of treatment-reformers: Philippe Pinel Dorothea Dix *Psychotherapy (talk therapies)= Trained therapist uses psychological techniques to assist one seeking to overcome, or to achieve personal growth

Types of Therapy (copy all) 1. individual (therapist and client) 2. group (therapist and clients with similar issues; cheaper; helps one realizes others have same problem) 3. family (therapist and all family members; modify individual habits and family patterns) 4. support group (moderator/leader and people that share same problem-AA, bereavement, medical, etc..)

Psychological Therapies =Talk Therapies (called Psychotherapy) Based on the Perspectives

Psychotherapy are Talk Therapies based on Perspectives (goals): Psychoanalysis-(insight therapy) Freud: Insight into unconscious motives and feelings 1. Psychodynamic Therapy influenced by Freud: same as above-by identifying themes across important relationships, including childhood and therapist’s 2. Humanistic Therapy -self acceptance and self fulfillment Both 1 and 2 are Insight Therapy=Helps people reduce inner conflict and increase self-understanding; assume that psychological problems lessen as self-awareness grows 3. Behavior Therapy: uses behavior modification to change learned behaviors-least likely to explore underlying causes 4. Cognitive Therapy: identifying and changing faulty beliefs that affect feelings, thoughts and actions 5. Cognitive -Behavior Therapy : changing both the way we think and act since our irrational, negative thinking affects our behavior Eclectic Approach-using a blend of therapies

Psychoanalysis (copy all) Psychoanalysis (Freud) Aims of therapy: bring repressed feelings to conscious awareness to gain insight into origins of one’s issues/problems

Psychoanalysis Methods (copy all) Methods-takes several times a week for several years 1. Free association saying whatever comes to mind 2. Resistance (you pause, change subject, you omit what seems Irrelevant, your mind goes blank, you joke-these blocks are called resistance and Lead to Interpretation ( of resistance) the meaning 3. Dream analysis (manifest verses latent content) 4. Transference (strong positive or Neg. feelings towards therapist that represent important relationships)

Psychoanalysis Psychodynamic Therapy (copy) Psychodynamic therapy influenced by Freud Differences with psychoanalysis: once a week for a few weeks or months, no couch

1. Review Materials-Have by 3/1/14 Barron’s AP Psychology soft cover- (6th edition, 2014-one without CD) REA Crash Course AP Psychology (2nd edition) Barron’s AP Psychology flash cards (2nd edition) bn.com, amazon.com or Barnes and Noble store 2. The ONLY WAY TO GET AP scores: Register with apcentral.collegeboard.com (by 1/30/15)

Humanistic Therapies (copy all) Humanistic treatment aim= to boost one’s inborn potential for self-fulfillment by helping with self-awareness and self-acceptance Humanistic focus more on: -conscious (not unconscious) taking responsibility for one’s feelings/actions promoting growth instead of curing As a result use client not patient

Humanistic Therapies (copy) Client-centered therapy (Carl Rogers) Nondirective therapy (listen’s to client without judging, interpreting, or directing towards insights) therapists show: 1. Genuineness 1. 1.genuineness (no 2. acceptance (no judging) 3. empathy (understand clients feelings) RESULT: clients deepens self-understanding and self-acceptance and changes to dysfunctional behaviors result

Humanistic Therapy Client-centered therapy (copy all) (Carl Rogers) Therapist Demonstrates: 1. Active /Reflective listening Paraphrase clarify Reflect feelings 2. Unconditional positive regard (nonjudgmental acceptance of client –the most important therapist’s role) The result-client accept even his/her worst traits and feels valued, then can change/heal

Behavior Therapies-based on learning/behavioral perspective Behavior Therapy (assumes Abnormal behaviors are learned) Operant conditioning techniques (changing behaviors through rewards, punishments, ignoring behaviors) Includes: Behavior Modification(reinforce desired behaviors and withholding reinforcement for, or punishing, undesired behaviors) such as Token Economies

Joseph Wolpe 1915-1997 Systematic Desensitization

FEAR What are you afraid of? Arachnophobia

Exposure therapies-expose one to fears Behavior Therapies Classical Conditioning Therapies-Classical conditioning techniques for everyday issues Exposure therapies-expose one to fears Uses Counterconditioning: Counterconditioning= pairing the unpleasant event/stimulus (snake, spider, elevator, clown, flying, public speaking, etc…) with something incompatible with fear (something relaxing) 1.Systematic desensitization-Joseph Wolpe 1. Anxiety Hierarchy (come up with an 8 to10 item hierarchy) 2. Learn Relaxation 3. The person thinks about or experiences each step in the hierarchy, one at a time, from lowest to highest, while relaxation 2. Virtual reality exposure therapy (ex=flight simulator) 3. Aversive conditioning (opposite of # 1) Substitute a negative (aversive)response for a positive response to a harmful stimulus (ex=snap rubber band when curse)

Behavior Therapies Aversion Therapy

Other Counterconditiong Techniques (copy and leave one space) Flooding (with snakes, for example)=extreme exposure to the feared item without any special techniques-results in the realization that harm did not result Modeling (being assertive, or petting a dog, to demonstrate that harm does not result)

Cognitive Therapy (copy) The Goal: Using Thoughts to Change Emotions and behaviors by teaching new ways of thinking 1. How might your thoughts affect your emotions? 2. How might your thoughts affect your behavior?

What is Wrong with Each Thought and How Might it Affect Behavior?: Everything I do must be approved and loved by all. I have to be competent and successful at everything I do. It is a disaster when things do not go the way I want them to. My unhappiness is not my fault. It is because of what other people do. The people in my life need to change the way they are. My boyfriend wouldn’t cheat on me if I were different

What might I say to myself instead? Everything I do must be approved and loved by all. I have to be competent and successful at everything I do. It is a disaster when things do not go the way I want them to. My unhappiness is not my fault. It is because of what other people do. The people in my life need to change the way they are. My boyfriend wouldn’t cheat on me if I were different

The Premise of Cognitive Therapy We have Faulty Cognitions (thinking): irrational beliefs and expectations that distort our behaviors, attitudes and emotions

Cognitive Therapies Share One or More of these Goals(leave space for examples) Disconfirmation=Client confronted with evidence that contradicts existing beliefs (give example) Reconceptualization=Client forms alternative beliefs to explain their experiences (give example)

Aaron Beck- Cognitive Therapy

Cognitive Therapies Beck’s therapy for depression: felt that cognitive therapy could change Catastrophizing beliefs

Beck’s Focus Illogical, Maladaptive Thoughts Client’s told to test thoughts for accuracy Example: I never have a good time -Client comes up with times that were good. -Clients get homework to test/assess their thoughts and behaviors (ex=be assertive-see what happens).

Beck’s Type of Maladaptive Thoughts Overgeneralization- blanket judgments (I am a failure) Polarized Thinking- putting information into two categories (people like me-people hate me) Selective Attention-focusing on only one detail of many (my friends always criticize me) Write down Examples for each (you have three minutes)

Beck’s/ Cognitive Therapy for depression:

Cognitive Therapies-p. 615

Cognitive Therapies-p. 615

Cognitive Behavioral Therapy Goal=alter the way we think and act since our irrational negative thinking affects our behavior (ex. Telling self, “I will not die if I leave the house,” Next, taking actions to leave the house) Rational Emotive Therapy or Rational Emotive Behavioral Therapy(RET or REBT)- by Albert Ellis

RET REBT Albert Ellis

Premise of RET Ellis’s ABCs of Beliefs: Emotional problems arise when one’s assumptions are unrealistic. Example: I will fall apart if I am rejected. As a result, I do. Ellis’s ABCs of Beliefs: Problems are due to our belief about a situation, not necessarily due to the situation Activating Event (say being criticized) Belief (I must be loved by everyone to be happy) Consequent Emotions (unhappiness) The goal of RET is to change B=FALSE, SELF-DEFEATING BELIEFS

**Techniques of RET/REBT Role Playing to see how your beliefs affect relationships Modeling to demonstrate other ways of thinking and acting Humor to show the absurdity of the belief Persuasion The therapist gives hw – ask a girl out who will reject you, so you can learn that you can cope

Comparison of Psychotherapies

Evaluating Psychotherapies

Is Psychotherapy Effective? Who do you think should decide this? Regression toward the mean when in crisis, we tend to return to a stable state-may not be due to treatment (621-green box) Client’s perceptions (very positive)

Why Clients Remain Positive enter tx. In crisis and may mis-attribute improvement to tx. have “stake” in believing therapy was worth it speak highly of their therapist even if symptoms remain

Is Psychotherapy Effective? Clinician’s perceptions same as client’s Research=2/3 of those treated for non-psychotic disorders improved markedly *Meta-analysis=statistically combine results of many different research studies. Show that one who gets therapy end up better off than 80% of those who do not get treatment *Placebo Effect=the power of our belief in treatment influences our improvement

The Relative Effectiveness of Different Therapies Evidence-based practice basing treatment methods (what tx. to use for what) on:

Evaluating Alternative Therapies Eye movement desensitization and reprocessing (EMDR)p. 624 *Light exposure therapy helps with Seasonal affective disorder (SAD)

Commonalities Among Psychotherapies Hope for demoralized people A new perspective An empathic, trusting, caring relationship

Culture and Values in Psychotherapy (p. 511) Similarities between cultures Differences between cultures

Types of Therapists

The Biomedical Therapies

Biological Approach/Perspective (copy all) The Biomedical Therapies performed by psychiatrist/medical doctor -changing brain’s functioning with: 1.Drugs method called psychopharmacology 2. Electroconvulsive therapy (ECT-shocking brain) 3. Magnetic impulses to brain 4. Psychosurgery prefrontal lobotomy; separating corpus callosum

Drug Therapies Psychopharmacology-using medication to treat disorders Factors to consider with drug therapy: *Normal recovery rate of untreated patients And recovery due to *Placebo Effect tested with: *Double blind procedure

Drug Therapies

Drug Therapies Antipsychotic Drugs (copy all) *Psychoses (some loss of reality contact with delusions and hallucinations) *Chlorpromazine (sold as Thorazine or Haldol)- lowers responsiveness to irrelevant Stimuli: positive symptoms of schizophrenia *Antipsychotic meds. impact neurotransmitter Dopamine –they are antagonists: similar to molecules of neurotransmitter dopamine and it occupies receptor sites and blocks activity Schizophrenia results from too much dopamine Tardive dyskinesia (similar to Parkinson’s symptoms) involuntary movements of facial muscles, tongue, and limbs from anti-psychotic drugs)

(copy all)Drug Therapies Antipsychotic Drugs Atypical antipsychotics –Clozaril- used to lessen negative symptoms of schizophrenia and cause “awakenings” Overall, antipsychotic drugs are effective

Drug Therapies Antianxiety Drugs (copy all) Xanax, Ativan, D-cycloserine Draw back: 1.Physiological Dependence 2. Worsening symptoms When stopped

Drug Therapies Antidepressant Drugs (copy all) Antidepressant drugs-increase activity of serotonin Use with mood and anxiety disorders increase levels of norepinephrine or serotonin, neurotransmitters that elevate mood Prozac, Zoloft and Paxil block removal of serotonin from synapses and are called: Selective-serotonin-reuptake Inhibitors (SSRIs) May be just as effective as therapy or exercise-should use for severe depression Drugs lead to Neurogenesis=creation of new brain cells-maybe y take 3-4 wks to work

Drug Therapies Antidepressant Drugs

Drug Therapies (copy all) Mood-Stabilizing Medications *Lithium carbonate for the highs and lows of bipolar unsure why this drug is effective

(copy all) Brain Stimulation Electroconvulsive Therapy *Electroconvulsive therapy (ECT) P. 633- used for sever depression that has not responded to meds.

Brain Stimulation Electroconvulsive Therapy

Brain Stimulation (copy all) Alternative Neurostimulation Therapies Magnetic Stimulation (p. 634) Repetitive transcranial magnetic stimulations (rTMS) Deep-Brain Stimulation

Brain Stimulation Alternative Neurostimulation Therapies

Psychosurgery =surgery that removes or destroys brain tissue-2 kinds (copy bold, italicized words) 1. Lobotomy History (Portuguese MD, Monitz, developed in1930s-earned Nobel Peace Prize Procedure-cut nerves connecting frontal lobe with emotion centers-used for uncontrollably emotional and violent patients; shock pt. into coma, ice pic like instrument in both eye sockets, took 10 minutes; 10s of thousands lobotomized between 1936 and 1954, 35,000 in US) Side effects: lethargic, immature, uncreative-Permanent Lobotomy abandoned when antipsychotic drugs became available in 1950s 2. Severing Corpus Calossum to separate brain hemispheres to treat severe epilepsy

The End

Eclectic Approach = an approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy.

Psychotherapy = treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth.

Psychoanalysis = Sigmund Freud’s therapeutic technique. Freud believed the patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight.

Resistance = in psychoanalysis, the blocking from consciousness of anxiety-laden material.

Interpretation = in psychoanalysis, the analyst’s noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight.

Transference = in psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent).

Psychodynamic Therapy = therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight.

Insight Therapies = a variety of therapies that aim to improve psychological functioning by increasing the client’s awareness of underlying motives and defenses.

Client-centered Therapy = a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate client’s growth. (Also called person-centered therapy.)

Active Listening = empathic listening in which the listener echoes, restates, and clarifies. A feature of Roger’s client-centered therapy.

Unconditional Positive Regard = a caring, accepting, nonjudgmental attitude, which Carl Rogers believed would help clients to develop self-awareness and self-acceptance.

Behavior Therapy = therapy that applies learning principles to the elimination of unwanted behaviors.

Counterconditioning = a behavior therapy procedure that used classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; includes exposure therapies and aversive conditioning.

Exposure Therapies = behavioral techniques, such as systematic desensitization, that treat anxieties by exposing people (in imagination or actuality) to the things they fear and avoid.

Systematic Desensitization = a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias.

Virtual Reality Exposure Therapy = an anxiety treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders, or public speaking.

Aversive Conditioning = a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol).

Token Economy = an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats.

Cognitive Therapy = therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions.

Cognitive-behavioral Therapy = a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior).

Family Therapy = therapy that treats the family as a system. Views an individual’s unwanted behaviors as influenced by, or directed at, other family members.

Regression Toward the Mean = the tendency for extreme or unusual scores to fall back (regress) toward their average.

Meta-analysis = a procedure for statistically combining the results of many different research studies.

Evidence-based Practice = clinical decision-making that integrates the best available research with clinical expertise and patient characteristics and preferences.

Biomedical Therapy = prescribed medications or medical procedures that act directly on the patient’s nervous system.

Psychopharmacology = the study of the effects of drugs on mind and behavior.

Antipsychotic Drugs = drugs used to treat schizophrenia and other forms of severe thought disorder.

Tardive Dyskinesia = involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors.

Antianxiety Drugs = drugs used to control anxiety and agitation.

Antidepressant Drugs = drugs used to treat depression; also increasingly prescribed for anxiety. Different types work by altering the availability of various neurotransmitters.

Electroconvulsive Therapy (ECT) = a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient.

Repetitive Transcranial Magnetic Stimulation (rTMS) = the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity.

Psychosurgery = surgery that removes or destroys brain tissue in an effort to change behavior.

Lobotomy = a now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain.

Resilience = the personal strength that helps most people cope with stress and recover from adversity and even trauma.