1 / 36

Treating mental illness - Outline

Treating mental illness - Outline. History and careers Psychological treatment = therapy Does therapy work? Psychological testing Bio-medical treatment. History. Grim Bedlam Rosenhan 1973 Pseudopatients in mental wards Less than 7 min/day with trained staff

josephhart
Download Presentation

Treating mental illness - Outline

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Treating mental illness - Outline • History and careers • Psychological treatment = therapy • Does therapy work? • Psychological testing • Bio-medical treatment

  2. History • Grim • Bedlam • Rosenhan • 1973 • Pseudopatients in mental wards • Less than 7 min/day with trained staff • Dehumanizing contact with staff

  3. Careers in psychology as atreatment provider • Psychiatrist - MD • Nurse - BS, MS • Clinical / counseling psychologist - PhD • Counselors - MS in Psychology • Social workers - MS in Social Work

  4. Treatment: Two general kinds Psychological Structured interaction between a trained professional and a patient Bio-medical Drugs, allopathic intervention, directly acting on the nervous system

  5. Different approaches to therapy and assessment • Cognitive - habitual patterns of expression and thinking • Behavioral - behaviors and settings • Humanistic - conscious perceptions and beliefs • Psychoanalytic - repressed thoughts as important as expressed thoughts

  6. Cognitive therapy Focus on habitual patterns of expression and thinking

  7. Cognitive Therapy • Central assumption: • Neurosis derived from cognitive failure, e.g. irrational thinking, overgeneralization of pessimism etc. • The patient is not acting rationally • Therapy • Teaching instructive ways of thinking • Many different styles of therapist-patient interaction

  8. Cognitive Therapy Example • You are depressed. • The therapist asks you to: • Take an issue that you’re depressed about • Think about other explanations for why the event is happening • E.g., Not your fault

  9. Behavioral therapy Focus on behaviors and the settings that elicit them

  10. Behavior Therapy • Central assumption: • Condition is learned • The product of Classical or Operant Conditioning • Therapy • Systematic desensitization • Undoing the link between the conditioned stimulus and the conditioned response • Aversive conditioning • Transform a positive conditioned response into a negative conditioned response • Positive reinforcement • Token economies

  11. Behavioral Therapy Example • You are depressed. • The therapist • Isolates what making you depressed • Exposes you to it incrementally • More customarily used for anxiety • Phobias

  12. Humanistic = person-centered therapy Focus on the patient’s conscious perceptions and beliefs

  13. Person-Centered Therapy • Central assumption: • The person is a client, not a patient, with potential for self-actualization • Client’s self-perceptions are accurate • Conversation is fruitful • Therapy • Active Listening = echoing, restating, seeking clarification.

  14. Person-Centered Example • You are depressed. • The therapist listens what you have to say: • Conversation without judgment, interpretation, or direction. • Therapist looks for an opportunity for the client’s growth • Most group therapy is person-centered • AA is person-centered

  15. Psychoanalytic therapy Repressed thoughts as important as expressed thoughts

  16. Psychoanalysis • Central assumption: • Possible and desirable to discovering what hidden feelings/memories underlie the problem • There is tension between the ID and SUPEREGO that therapy can resolve • Therapy • Free association • Say whatever comes to mind • Dream interpretation • A window to the subconscious

  17. Psychoanalysis Example • You are depressed. • The therapist asks you to: • Freely associate about e.g. your family • Would not ask about a specific event because you (by assumption) don’t know what you are depressed about

  18. Does therapy work?Client’s Perceptions • 89% of therapy consumers were at least “fairly well satisfied” with the results (Consumer Reports) • 9 of 10 who recalled feeling “fair” or “very poor” at beginning reported feeling “very good” “good” or at least “so-so” at end.

  19. Skepticism about therapy • Placebo effect • Regression to the mean • People often enter therapy in crisis. • Clients may need to believe that therapy was worth it. • Clients generally like their therapists.

  20. Clinician’s Perceptions • Resounding “yes” • case studies, feedback from clients, etc. • However, they know of “failures” by other clinicians. • Not particularly reliable.

  21. Outcome Research • Controlled research has looked at how well therapy works • People who are NOT in therapy get better • People in therapy get more better

  22. Commonalities • Hope for demoralized people • A new perspective • An empathic, trusting, caring relationship

  23. Psychological testing MMPI-2 Projective tests Behavioral monitoring Neuroimaging

  24. MMPI-2 • Minnesota Multiphasic Personality Inventory • 567 true / false questions • Scored on 27 different scales • Clinical • Content • Validity: lying and faking

  25. MMPI examples • Q: The world seems hopeless to me • A: True • Score a point to the scale for Depression • Q: I never get angry • A: True • Score a point to the scale for Lying

  26. Other • Projective tests • Rorschach inkblots • Thematic apperception (TAT) • Behavioral monitoring • Ward staff counts positive and negative interactions with other patients and staff • Self-monitoring

  27. Bio-medical treatment == Drugs • Used to treat Neurosis AND Psychosis • Drugs • Anti-psychotic • Anti-anxiety • Anti-depressant • Other • Electroconvulsive Therapy • Psychosurgery

  28. Anti-psychotic drugs • Their effects: • Dampen responsiveness to irrelevant stimuli • Help decrease the positive symptoms of schizophrenia (e.g., hallucinations, paranoia) • These work by: • blocking dopamine receptors • Examples: Thorazine, Clozaril

  29. ± Anti-psychotics drugs • + Reduce positive symptoms • Fewer hallucinations and delusions • Able to live at home • - Fail to touch negative symptoms • Patients still lack motivation • A zest-less life • Yucky side-effects • Parkinson’s disease • Tardive dyskinesia

  30. Anti-anxiety drugs • Tranquilizers: • Reduce tension and anxiety • These work by • Depressing central nervous system activity (by augmenting the action of the neurotransmitter GABA) • Examples: Valium, Librium

  31. ± Anti- tranquilizers • Habit forming! • Serious addiction problems • Interact with alcohol to make a lethal tonic

  32. Anti-Depressant Drugs • Their effects: • Help to elevate arousal and mood • These work by • Increasing the availability of serotonin and norepinephrine

  33. Tricyclic anti-depressants • Examples: Tofranil, Elavil • Block the reuptake of serotonin and norepinephrine into the presynaptic neuron • Prolong the effects of the neurotransmitters • Side-effects • Dry mouth, fatigue

  34. SSRI anti-depressants • Selective serotonin reuptake inhibitors • Example: Prozac • Alter personality, mood becomes more elevated • Few side-effects but not as effective as tricyclics for severe depression

  35. Electroconvulsive Therapy (ECT) • Its effects: • Decreases disabling depression • Used only: • in rare cases for severe depression • in patients not responding to drug treatments • It works by: • Sending a brief electric current through the brain of the anesthetized patient

  36. ECT Continued • How does it work? • We don’t know for sure; • Maybe it releases neurotransmitters, • Maybe causes seizures that calm neural centers • Are there any problems? • Causes memory loss for the duration of the treatment • Otherwise, there appears to be no resulting brain trauma

More Related