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Unit 13: Treatment for Psychological Disorders. Essential Question . Which type of therapy is the best way to treat psychological disorders?. Day 1. Psychoanalysis and Humanistic Therapies. Do Now:.
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Essential Question Which type of therapy is the best way to treat psychological disorders?
Day 1 Psychoanalysis and Humanistic Therapies
Do Now: Write down, in your journal, something from your childhood that you think affects you today.
Psychoanalysis Sigmund Freud’s theory of personality and therapeutic technique that attributes thoughts and actions to unconscious motives and conflicts. Freud believed the patient’s free associations, resistances, dreams and transferences- and the therapists’ interpretations of them-released previously repressed feelings, allowing the patient to gain self-insight.
Psychoanalysis Resistance- the blocking from consciousness of anxiety-laden material Interpretation- the analyst’s thoughts on dream meanings, resistances, and other significant behaviors in order to promote insight Transference- the transfer of emotions from other relationships to the analyst
Humanistic Therapies Carl Rogers developed the humanistic technique of client-centered therapy, in which the therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to facilitate client’s growth. The humanistic perspective focuses on people’s potential for self-fulfillment. Humanistic therapists attempt to help clients grow in self-awareness and self-acceptance. There is more of an emphasis on the present and future more than the past.
Carl Rogers cont.. • Carl Rogers was an American psychologist. • He is also one of the founding fathers of psychotherapy research. Rogers is considered to be one of the founding fathers of psychotherapy and was honored for his research with the Award for Distinguished Scientific Contributions by the APA in 1956. • He also created the person-centered approach where clients have an opportunity to develop a sense of self where they can realize how their attitudes, feelings and behavior are being negatively affected. Although it was proven to be effective, this was criticized by many other behavior psychologists because it lacked structure.
Humanistic Therapies Active Listening- empathetic listening in which the listener echoes, restates, and clarifies. A feature of Rogers’ client-centered therapy Unconditional Positive Regard- a caring, accepting, non-judgemental attitude, which Carl Rogers believed to be conductive to developing self-awareness
Day 2 Group/Family Therapies and Cognitive Therapies
Do Now: See handout...
Cognitive Therapies Aaron Beck is an American Psychiatrist and professor. He is known as the father of cognitive therapy. His techniques are widely used to treat depression. Cognitive therapists believe that thoughts, feelings, and behaviors are all connected. By modifying how one thinks, they can feel better and be cured or treated for their mental illness.
Cognitive Therapies Cognitive Therapy- therapy that teaches people new and 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 integrated therapy that combines cognitive therapy (changing how you think) with behavioral therapy (changing how you act)
Family Therapy • Family therapy is a type of psychotherapy that treats the family as a system. It views an individual's unwanted behaviors as influenced by, or directed at other family members. • Assumes no one person is an island. • We need to connect to our families emotionally. • Some problem behaviors arise from people trying to differentiate themselves from their families and becoming their own person, and emotionally connecting with them as a group and a whole. • Family therapists work with family members to mend broken relationships.
Group Therapy There are several types of self-help groups. Some are even online. Most groups focus on taboo illnesses like AIDS, anorexia, alcoholism, etc. There are also groups for people with hearing loss, vision loss, any handicap. One of the most widely known and most common groups is Alcoholics Anonymous (AA). These sessions help alcoholics abstain and/or decrease their usage of alcohol. Group therapy has proven to be very effective, wether it was just "motivational therapy," or a 12 step program. Over 100million Americans belong to a religious, interest or self-help group. 9/10 say that group members "support each other emotionally." (Gallup, 1994)
Day 3 Behavior Therapies and Drug Therapies
Do Now: What is behavior therapy? What is drug therapy? Do you think either of these therapies are effective? Why or why not?
Behavior Therapies • Mary Cover Jones is the pioneer of behavior therapy. She graduated Vassar College in 1919. • She worked a lot with behavior psychologist John B. Watson during the 1920s. • She also developed a technique called desensitization to acute phobias. During desensitization, a person is introduced to a series of stimuli related to their phobia. In 1968, Jones received the prestigious G. Stanley Hall Award from the APA. • Behavioral therapists believe that problem behaviors are the problem, not the lack of awareness of them. They believe that learned behaviors can be replaced by constructive behaviors.
Joseph Wolpe • Joseph Wolpe was a South African psychiatrist. He is also one of the most influential figures in Behavior Therapy. • While enlisted in the South African army as a medical doctor, Wolpe get the opportunity to work with soldiers diagnosed with "war neurosis," widely known today as post traumatic stress disorder (PTSD). At the time, PTSD was treated by drug therapy. • Soldiers were given a drug to make them open up about their problems and experiences. People thought that if they talked enough about what they experience, they would be cured, which was not the case. The lack of success with this treatment led Wolpe to question psychotherapy, seeing as he was a dedicated supporter of Freud.
Albert Ellis • Albert Ellis was an American psychologist. He developed Rational Emotive Behavior Therapy in 1955 which is is a comprehensive, empirically based psychotherapy. It focuses on resolving emotional and behavioral problems to enable people to have a more happy and fulfilling life. • He received several awards for his work, including the 2003 award from the Association for Rational Emotive Behaviour Therapy (UK), Association for Behavioral and Cognitive Therapies 2005 Lifetime Achievement Award and the Association for Behavioral and Cognitive Therapies 1996 Outstanding Clinician Award.
Behavior Therapies Counterconditioning- a behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors Exposure Therapies- behavioral techniques 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)
Behavior Therapies Virtual Reality Exposure Therapy- an anxiety treatment that progressively exposes people to stimulations of their greatest fears, such as airplane flying, spiders, or public speaking Token Economy- an operant conditioning technique where people earn a token of some sort for exhibiting a desired behavior, these tokens can later be exchanged for privileges or treats
Behavior Therapies Aversive Conditioning- a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol)
cont... Client’s Perceptions • Readers of Consumer Reports (1995; Kotkin et al., 1996 Seligman, 1995) related their experiences with mental health professionals, 89% sad they were "fairly well satisfied." Although we should keep clients opinions in mind, they are not always reliable on whether something works or not: • People often go to therapy in a time of crisis: With a normal flow of events, crisis usually passes on its own. People might attribute their progress to a therapy. • Clients may need to believe that the therapy was worth the effort: Patients do not want to admit they wasted their time and money on something that did not work. • Clients typically speak kindly of their therapists: Even if their problem has not been solved, therapists do their job by listening and offering positive advice. Although the problem has not been solved, clients still try to think positively about other things they got out of therapy. • Clinician’s Perceptions • Most clinicians, even though not having cured a problem, see a client leaving as a success. Clients come in during a period of unhappiness and decide to leave when they remotely feel better, even if eventually they end up seeing another therapist about the same exact problem that wasn't fully cured in the first place.
Research • The original challenge of how effective psychotherapy is was challenged by Hans Eysenck (1952). • He summarized studies showing that two-thirds of people receiving psychotherapy for nonpsychotic disorders improved a lot. To this day, no one really opposes that statement. • Later, is was revealed that Esyneck's results could have been a bit skewed because he used a small sample. • Today, hundreds of studies are available, including randomized clinical trials. • After randomly assigning people on a waiting list to therapy or no therapy, the results are digested by meta-analysis, a procedure for statistically combining results of many different research studies. Depending on the results, sometimes they exhibit regression towards the mean, a tendency for extremes of unusual scores to fall back toward the average.
The Purpose of Different Therapies • Energy Therapies: Propose to manipulate people's invisible energy fields. • Recovered-Memory Therapies: Aim to unearth "repressed memories" of early child abuse. • Rebirthing Therapies: Engage people in teen reenacting the supposed trauma of their birth. • Facilitated Communication: Has an assistant touch the typing hand of a child. • Crisis Debriefing: Forces people to rehearse and "process" their traumatic experiences. • Evidence-Based Practice: Clinical decision-making that integrates the best available research with clinical expertise and patient characteristics and preferences.
Alternative Therapies EMDR (Eye Movement Desensitization and Reprocessing) • Adored by thousands but also considered a sham by others. • Francine Shapiro developed EMDR one day while going for a walk in a park and observing anxiety treatment. She had people imagine traumatic scenes while she triggered eye movements by waving her finger in from of their eyes. This supposedly enabled them to unlock and reproved previously frozen memories. • Almost all people reported reductions in their distress after one therapeutic session. • 84/100 percent of trauma victims participating in four different studies said this method worked. (Shapiro 1999, 2002) • Light Exposure Therapy • Seasonal Affective Disorder (SAD): a type of seasonal depression (usually wintertime when there is a lack of light) • People who had SAD reportedly felt better after getting a timed daily dose of intense light. • Brain scans have proven this therapy sparks activity in the brain that influences arousal and hormones. (Ishida et al., 2005)
Three Elements of Psychotherapy Hope for Demoralized People • People who seek therapy are usually unhappy, depressed, anxious, and incapable of turning things around positively. A New Perspective • Every therapy offers people an explanation for their symptoms in a different way of looking at themselves or responding the world. An Empathetic, Trusting, Caring • Therapists are great listeners and are Relationship empathetic, giving advice and creating a bonding relationship with their clients, making them feel safe and secure.
Culture and Therapy • People from different countries and different cultures might have a different way of dealing with their problems. • Not everyone is open to displaying their feelings. People who have therapists with the same culture as them have a stronger bond. • Some religious people do not see the need of a therapist. They feel as though it is more beneficial to turn to God and only God.
Sheldon’s psychotherapy session https://www.youtube.com/watch?v=uZq_U2hbnvs EMDR https://www.youtube.com/watch?v=gZ5MLn1Cc94
Alfred Adler • Alfred Adler was an Austrian doctor and psychotherapist. • He is the founder of individual psychology and put emphasis on feelings of inferiority and the inferiority complex. The inferiority complex is a lack of self-worth and feelings of not being up to society's standards. • Adler considered humans as a whole, an individual. So, he called his psychology "Individual Psychology." Along with Sigmund Freud, he was a co-founder for the psychoanalytic movement and was a member of the Vienna Psychoanalytic Society.
Dorothea Dix • Dorothea Dix was an American advocate for the mentally insane. She lobbied for state legislatures and the U.S. Congress to establish the first mental asylum. • During the Civil War she was appointed Superintendent of Army Nurses for the Union Army. She was extremely strict and had guidelines saying that army nurses needed to be between the ages of 35 and 50, had to be plain looking and restricted the clothing they wore to avoid the exploitation of nurses by male doctors and patients. • During her career in the Civil war, she tended to any wounded person, regardless of whether they were a part of the Union Army or the Confederate Army. She believed anyone who was suffering could get help. She advocated for the ill both during her career as a nurse and afterwards.
Day 4 Brain Stimulation and Psychosurgeries
Do Now: What are some ways in which patients with mental disorders are treated without drugs? With drugs?
Biomedical Therapy • Biomedical therapy- prescribed medications or medical procedures that act directly on the patient’s nervous system • altering brain chemistry with drugs, or affecting its circuitry with electroconvulsive shock, magnetic impulses or psycho surgery • any prescribed medicines can only come from psychiatrists
Psychopharmacology • Prior to modern biomedical treatments and discoveries in psychopharmacology people with severe mental illnesses were often subjected to hospital confinement • psychopharmacology- the study of the effects of drugs on mind and behavior • drug testing in psychopharmacology almost always occurs under the confines of a double-blind study
Antipsychotic Drugs • antipsychotic drugs- drugs used to treat schizophrenia and other forms of severe thought disorder • antipsychotic drugs came as a huge revolution in drug therapy and actually happened because of an accident. Physicians discovered that drugs used for other medical purposes calmed patients with psychoses (disorders in which hallucinations or delusions indicate some loss of contact with reality)
cont... • Consider chlorpromazine: it was first used to lessen responsiveness to irrelevant stimuli and was then used to treat patients with schizophrenia • drugs like this are antagonists because they block dopamine receptor sites to help stop hallucinations
Dangers of Antipsychotic Drugs these are very powerful and long term use of them can bring about 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 • Antianxiety drugs- drugs used to control anxiety and agitation • xanax and ativan • often used in combination with psychological therapy • kinda cool: D-cycloserine acts upon a receptor that facilitates the extinction of learned fears
Criticisms • A common criticism: antianxiety drugs and behavior therapies reduce symptoms without resolving underlying problems. For example if someone just takes a xanax as soon as they begin to feel anxious a psychological dependence can quickly be formed • Along with psychological dependence there can be a physiological dependence where when use stops there can be increased anxiety, insomnia, and withdrawal
Antidepressant Drugs • Antidepressant drugs- drugs used to treat depression; also increasingly prescribed for anxiety. Different types work by altering the availability of various neurotransmitters. • they are not solely used for treating depressed patients and were named that for their initial use however they are now used to successfully treat anxiety disorders such as obsessive-compulsive disorder
Alternatives to Medication • Aerobic exercise can help calm people who are anxious and energize people who feel depressed • the effects of antidepressant drugs are relatively small as researchers have found that placebos account for nearly 75% of the active drug’s effect
