+ Treatment of Psychological Disorders Chapter 13
Feb 24, 2016
+
Treatment of Psychological DisordersChapter 13
+Types of Mental Health Therapy
Psychotherapy – trained therapist uses psychological techniques to assist someone seeking to overcome difficulties or achieve personal growth Often used for learning-related disorders (like phobias)
Biomedical therapy – prescribed medication or medical procedure that acts directly on a patient’s nervous system Used for biologically influenced disorders (like schizophrenia)
Eclectic approach – uses techniques from various forms of therapy
+Psychotherapies
Psychoanalysis – not used very often Goals – bring repressed feelings into conscious awareness Methods:
Free association – saying whatever comes to your mind which indicates resistance – blocking from consciousness of anxiety-laden material
Interpretation – analyst notes supposed dream meanings, resistances and other significant behaviors and events in order to promote insight
Use of dream analysis Transference – patient's transfer to the analyst of emotions
linked with other relationships Involves several years of several sessions a week with therapist
traditionally out of view of the patient
+Psychotherapies -cont-
Psychodynamic therapists – views individuals as responding to unconscious forces and childhood experiences and seeks to enhance self-insight Therapists talks to clients face to face and weekly
for a few months Interpersonal psychotherapy – variation to
psychodynamic therapy Goal: help people gain insight into the roots of
their difficulties and works for symptom relief rather than overall personality change
+Psychotherapies -cont-
Humanistic Therapies Differences with psychoanalysis
Focus on present and future more than past Focus on conscious rather than unconscious feelings Take immediate responsibility for one’s feelings and actions rather
than uncovering hidden determinants Promote growth instead of cure illness
Use of client-centered therapy – therapists uses active listening within a genuine, accepting, empathic environment to facilitate clients’ growth Uses active listening – echoing, restating and seeking clarification of
what the person expresses and acknowledging expressed feelings Developed by Carl Rogers
+Psychotherapies -cont-
Humanistic therapies -cont- Use of unconditional positive regard – caring,
accepting, nonjudgmental attitude to help clients develop self-awareness and self-acceptance
Tips for active listening: Paraphrase Invite clarification Reflect feelings
+Psychotherapies -cont-
Behavior therapies – applies learning principles to the elimination of unwanted behaviors Counterconditioning – uses classical conditioning to evoke
new responses to stimuli that are triggering unwanted behaviors Exposure therapy – expose people to what they normally
avoid Systematic desensitization – associates a pleasant relaxed
state with gradually increasing anxiety-triggering stimuli Virtual reality exposure therapy – progressively exposes
people to simulations of their greatest fears Aversive conditioning – associates an unpleasant state with
an unwanted behavior
+Psychotherapies -cont-
Behavior therapies -cont- Operant conditioning
Behavior modification – reinforcing desired behaviors and withholding reinforcement or enacting punishment for undesired behaviors
Token economy – people earn a token for displaying an appropriate behavior which can later be exchanged for privileges or treats
Criticisms: Are the conditioned behaviors durable? Is it ethical for one human to control another’s
behavior?
+Psychotherapies -cont-
Cognitive therapies – teaches people new, more adaptive ways of thinking and acting based on the assumption that thoughts intervene between events and our emotional reactions Beck’s therapy for depression – uses gentle
questioning to reveal irrational thinking in clients and persuades people to change the lens through which they see life
Cognitive-behavioral therapy – aims to change self-defeating thinking and change behavior
+Psychotherapies -cont-
Group and family therapies Family therapy – treats the family as a
system and views an individual’s unwanted behaviors as influenced by or directed at other family members
+Psychotherapies -cont-
Evaluating Psychotherapies Effectiveness
Approximately 90% of clients report feeling better – but keep in mind that clients Enter therapy in crisis May need to believe therapy was worth the effort Generally speak kindly of their therapists
Meta-analysis – a procedure for statistically combining the results of many different research studies Has shown that the average therapy clients ends up better off than
80% of untreated individuals on waiting lists Therapy is most effective when the problem is clear-cut APA encourages evidence-based practices – clinical decision-making
that integrates the best available research with clinical expertise and patient characteristics and preferences
+Treatment vs. No Treatment
+Psychotherapies -cont-
Commonalities Among Psychotherapies Offer hope for demoralized people Offer people a plausible explanation for their
symptoms and an alternative way of looking at themselves or responding to the world
Provide an empathic, caring and trusting relationship
+Biomedical Therapies
Biomedical therapy – physically changing the brain’s functioning by altering its chemistry with drugs or affecting its circuitry with electroconvulsive shock, magnetic impulses or psychosurgery In most cases can only be offered by psychiatrists
Drug Therapies Antipsychotic drugs – used to treat schizophrenia and other
forms of severe thought disorder Long-term use can promote tardive dyskinesia –
involuntary movement of the facial muscles, tongue and limbs
+Biomedical Therapies -cont-
Drug Therapies -cont- Antianxiety drugs – used to control anxiety and
agitation Depress central nervous system activity Can result in psychosocial dependence or
withdrawal Antidepressants - used to treat depression
Increase norepinephrine or serotonin Research shows that placebos account for about
75% of the effectiveness of antidepressants Mood-stabilizing drugs
+Biomedical Therapies -cont-
Brain Stimulation Electroconvulsive therapy (ECT) – biomedical therapy for
severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient 80%+ of people show marked improvement after 3
sessions a week for 2-4 weeks Can result in some memory loss
Repetitive transcranial magnetic stimulation (rTMS) – application of repeated pulses of magnetic energy to the brain to stimulate or suppress brain activity Only stimulates the brain’s surface and results in no memory
loss
+Biomedical Therapies -cont-
Psychosurgery – surgery that removes or destroys brain tissue in an effort to change behavior Least used Lobotomy – rarely used psychosurgical procedure that cut the nerves
connecting the frontal lobes to the emotion-controlling centers of the inner brain Often caused lethargy and reduced creativity
Therapeutic Life-Style Change Exercise Sleep Light exposure Social connection Anti-rumination – identifying and redirecting negative thoughts Nutritional supplements
+Therapists and Their Training