Therapies for Psychological Disorders

1. Therapies for Psychological Disorders Chapter 13

2. What is Therapy? • Core Concept: • Therapy for psychological disorders takes a variety of forms, but all involve some relationship focused on improving a person’s mental, behavioral, or social functioning

3. What is Therapy? • Therapy – General term for any treatment process; in psychology and psychiatry, therapy refers to a variety of psychological and biomedical techniques aimed at dealing with mental disorders or coping with problems of living.

4. Components of Therapy • In addition to the relationship between the therapist and the patient/client, the therapeutic process typically involves some or all of the following processes: • Identifying the problem • Identifying the cause of the problem or the conditions that maintain the problem • Deciding on and carrying out some form of treatment

5. Contemporary Approaches • There are 2 main contemporary approaches to therapy. • 1.Psychological Therapies • 2.Biomedical Therapies

6. Contemporary Approaches: Psychological • The psychological therapies are often collectively called: psychotherapy. • They are based on psychological principles: • “Couch Talks”

7. Contemporary Approaches: Biomedical • Treatments that focus on altering the brain, especially with drugs, psychosurgery, or electroconvulsive therapy.

8. Types of Mental Health Care Professionals

16. How do Psychologist Treat Mental Disorders? • Core Concept: • Psychologists employ two main forms of treatment: • Insight Therapies • Behavioral Therpaies

17. Insight Therapies • Insight therapies –Psychotherapies in which the therapist helps patients/clients understand (gain insight into) their problems. • This can be done in many different ways and many different approaches are used.

18. Types of Insight Therapies

19. Insight Therapies • Talk therapies –Psychotherapies that focus on communicating and verbalizing emotions and motives to understand their behavior. • Psychodynamic therapies –Insight therapies based on the assumption that mental disorder is caused by powerful (dynamic) mental forces and conflicts.

20. Insight Therapies: Psychodynamic • Freudian Psychoanalysis- • The form of psychodynamic therapy developed by Sigmund Freud • Analysis of transference –Analyzing and interpreting the patient’s relationship with the therapist, based on the assumption that this relationship mirrors unresolved conflicts in the patient’s past.

21. Insight Therapies: Neo-Freudian • Neo-Freudian psychodynamic therapies –Therapies developed by psychodynamic theorists who embraced some of Freud’s ideas, but disagreed with others.

22. Insight Therapies: Humanistic • Humanistic therapies –Techniques based on the assumption that people have a tendency for positive growth and self actualization, which may be blocked by an unhealthy environment • Client-centered therapy –Emphasizes healthy psychological growth through self-actualization • Reflection of feeling – Paraphrasing client’s words to capture the emotional tone expressed

23. Insight Therapies: Cognitive • Cognitive therapy –Emphasizes rational thinking as the key to treating mental disorder. • Cognitive therapy for depression involves: • Evaluating evidence • Situational factors • Alternative solutions

24. Insight Therapies: Group Therapy • Group therapy – Psychotherapy with more than one client. • Self-help support groups – Groups that provide social support and an opportunity for sharing ideas about dealing with common problems; typically organized/run by laypersons (not professional therapists). • AA

25. Group Therapies • For many issues, couples counseling or family therapy can often be more effective than individual therapy with one individual at a time.

26. Behavior Therapies • Behavior therapy – Any form of psychotherapy based on the principles of behavioral learning, especially operant conditioning and classical conditioning.

27. Behavior Therapy

28. Behavioral Therapies: Classical Conditioning • Systematic desensitization – Technique in which anxiety is extinguished by exposing the patient to an anxiety-provoking stimulus. • Exposure therapy – Desensitization therapy in which patient directly confronts the anxiety-provoking stimulus (as opposed to imagining it).

29. UCS (foul odor) UCR (nausea) CR CS (cigarette smoke) Classical Conditioning Therapies • Aversion therapy – Involves presenting individuals with an attractive stimulus paired with unpleasant stimulation in order to condition a repulsive reaction.

30. Behavioral Therapies: Operant Conditioning • Contingency management – Approach to changing behavior by altering the consequences, especially rewards and punishments, of behavior.

31. Operant Conditioning Therapies • Token economies – Applied to groups (e.g. classrooms, mental hospital wards) involving distribution of “tokens” contingent on desired behaviors; tokens can later be exchanged for privileges, food, or other reinforcers

32. Participant Modeling: An Observational-Learning Therapy • Participant modeling – Therapist demonstrates and encourages a client to imitate a desired behavior.

33. Cognitive-Behavioral Therapy: A Synthesis • Cognitive-behavioral therapy • Combines cognitive emphasis on thoughts with behavioral strategies that alter reinforcement contingencies • Assumes irrational self-statements cause maladaptive behavior • Seeks to help the the client develop a sense of self-efficacy

34. Cognitive-Behavioral Therapy: A Synthesis • Rational-emotive behavior therapy – Based on the idea that irrational thoughts and behaviors are the cause of mental disorders (REBT).

35. Evaluating the Psychological Therapies • Eysenck proposed that people with non-psychotic problems recover just as well with or without therapy • Reviews of evidence have shown: • That therapy is better than no therapy • It appears advantageous to match specific therapies with specific conditions

36. Mental “First Aid” • If someone asks you for help, keep in mind that serious problems (especially those involving suicide or threats) require immediate professional treatment. • Otherwise, your best tools may involve • Listening • Acceptance • Exploring alternatives

37. How is the Biomedical Approach used to Treat Mental Disorders • Biomedical therapies seek to treat mental disorders by changing the brain’s chemistry with drugs, its circuitry with surgery, or its patterns of activity with pulses of electricity or powerful magnetic fields.

38. Drug Therapy • Psychopharmacology – The prescribed use of drugs to help treat symptoms of mental illness ostensibly to ensure that individuals are more receptive to talk therapies.

39. Drug Therapy • Antipsychotic drugs • Include chlorpromazine, haloperidol, and clozapine • Usually affect dopamine pathways • May have side effects • Tardive dyskinesia – Incurable disorder of motor control resulting from long-term use of antipsychotic drugs

40. Drug Therapy • Antidepressants and mood stabilizers • Include Prozac, monoamine oxidase (MOA) inhibitors, and lithium carbonate (effective against bipolar disorder) • Treat depression and bipolar disorder • Usually affect serotonin and/or norepinephrine • The use of antidepressants to deal with general feelings of unease is highly controversial

41. Drug Therapy • Antianxiety drugs • Include barbiturates and benzodiazepines • May include some antidepressant drugs which work on certain anxiety disorders • Should not be used to relieve ordinary anxieties of everyday life • Should not be taken for more than a few days at a time • Should not be combined with alcohol

42. Drug Therapy • Stimulants suppress activity level in persons with attention-deficit/hyperactivity disorder (ADHD) • There is controversy from concern that the causes and boundaries of ADHD are vague and the potential exists for over-diagnosis

43. Psychosurgery • Psychosurgery –The general term for surgical intervention in the brain to treat psychological disorders. • The infamous prefrontal lobotomy is no longer performed. • Severing the corpus callosum, however, can reduce life-threatening seizures.

44. Brain-Stimulation Therapies • Electroconvulsive therapy is used for the treatment of severe depression • Transcranial magnetic stimulation, a possible alternative to ECT, can also be used for the treatment of depression,schizophrenia, and bipolar disorder

45. Hospitalization and the Alternatives • Therapeutic community –Program of treating mental disorder by making the institutional environment supportive and humane for patients • Deinstitutionalization – Policy of removing patients, whenever possible, from mental hospitals

46. Hospitalization and the Alternatives • Community mental health movement –Effort to deinstitutionalize mental patients and to provide therapy from outpatient clinics.