TREATMENT OF ABNORMAL BEHAVIORS

1. TREATMENT OF ABNORMAL BEHAVIORS AP PSYCHOLOGY

2. Mental Health Practitioners • Psychiatrist: MD, an prescribe medication, perform surgery. • Generally take a biological approach to treating mental illness. • Do not take training in other methods of psychological treatment • Clinical Psychologists: Ph.D. or Psy.D., training emphasizes other therapeutic treatments of psychological disorders. • often work with psychiatrists to treat patients with supportive psychotherapy & medicine.

3. Mental Health Practioners(cont’d) • Counseling Psychologists: usually have advanced degrees & tend to deal with less severe mental health problems in college settings or in marital & family therapy practices. • Psychoanalysts: may or may not be psychiatrists, but follow the teaching of Freud & practice psychoanalysis or other psychodynamic theories. • Clinical or Psychiatric Social Workers: usually have a master’s degree in social work (MSW)

4. History of Therapy • Trephining: early humans thought that the mentally ill were possessed by evil spirit so they drilled holes in their heads to let the spirits out. • Hippocrates believed the root of psychological problems were physical & prescribed rest, controlled diets, & abstinence from sex & alcohol. • Galen (Greek physician) thought medication was needed to treat abnormal behavior, which was a result of an imbalance in the 4 bodily humors (similar to biomedical approach) • Middle Ages: mentally ill possessed by demons of Satan. Victims were punished with exorcisms or tested by drowning & burning. • Dorthea Dix(19th cent): humane treatment of mentally ill. Created separate institutions for them & pioneered more individualized & kinder treatment strategies.

5. Deinstitionalization • Resulted from overcrowding in mental institutions in the 1950s. • With the use of better psychotropic drugs, patients, not considered a threat to themselves or others were released from mental hospitals. • Goal was that patients would improve more rapidly in familiar community settings. • 1960s, Congress passed legislation to establish community mental health facilities • Negative consequence: homeless population, many of which are thought to be schizophrenic patients, mostly off their meds & in need of care.

6. Treatment Approaches • No one approach for treatment of mental disorders appears to be ideal. • Multiple approaches appear to be better than a single approach. • Meta-Analysis: Systematic statistical method for synthesizing the results of numerous research studies dealing with the same variables. • Such studies indicate that clients who receive psychotherapy are better off than most of those who receive no treatment.

7. Insight Therapies Psychoanalysis (Freud): believed that abnormal behavior was the result of unconscious conflicts from early childhood trauma experienced during the psychosexual stages of development. • Involves going back to discover the roots of problems by bringing the conflict into the conscious mind, helping the client gain insight & achieve personality change. • Traditional psychotherapy involves several sessions every week over 2-3 years • The therapist sits behind the patient & asks the patient to say whatever comes into his/her mind. Known as free association.

8. Insight Therapies (cont’d) • Dream interpretation: • Manifest Content: recalled dream’s surface content • Latent Content: hidden underlying meaning of dream • Freudian Slips “faulty actions” and hypnosis can also reveal hidden conflicts. • Resistance: blocking of anxiety-provoking feelings & experiences by talking about trivial issues or coming late for sessions is a sign that the patient has reached an important issue that needs to be discovered. • Transference: the patient may need to believe that the therapist is a significant person in the client’s emotional life so that he/she can replay previous experiences & reactions to gain insight about behaviors & current feelings.

9. Insight Therapies (cont’d) • Catharsis: release of emotional tension after remembering or reliving an emotionally charged experience from the past, which may ultimately result in relief of anxiety. • Traditional psychotherapy is too expensive & requires too much time for most people seeking psychological help. Psychodynamic Psychotherapy • Shorter in duration, less frequent, with the client sitting up & talking to the therapist. • Some therapists are more actively involved with patients, talking to them & pointing out associations to gain greater insights. • Believe that anxieties are rooted in past experiences, but do not necessarily assume problems stem from infancy or early childhood.

10. Insight Therapies (cont’d) Interpersonal Psychotherapy: • Aimed to help people gain insight into the causes of their problems. • Focuses on current relations to relieve present symptoms. Humanistic Therapies • Believe that problems arise because the person’s ability to grow emotionally has been stifled by external psychosocial constraints • Client-Centered Therapy: • Unconditional Positive Regard:goal is to provide an atmosphere of acceptance, empathy, & sharing, permitting the client’s inner qualities to surface, leading the patient to self- actualization.

11. Insight Therapies (cont’d) • Person Centered Psychotherapy (Carl Rogers) • The greater the difference between the ideal and actual self, the greater the client’s problems. • Emphasizes developing positive self-concept through the therapist’s unconditional positive regard, active listening, sensitivity & genuineness. • Active Listening: therapist listens to client & echoes, restates, or clarifies to demonstrate empathy, showing the client that he/she was listening & understands what is being said. • This therapy allows the client to take the lead in determining the direction of the therapy.

12. Insight Therapies (cont’d) • Gestalt Therapy (Fritz Perls) • Push the client to decide if they will allow past conflicts to control their future or to take contorl of the his/her destiny. • Therapists are directive in their questioning & challenge clients to become aware of their feelings & emotions. • Use dream interpretation to help patient gain a better understanding of whole self & role play to get client to express true feelings. • Insight therapieshave been demonstrated to be effective for treating eating disorders, depression, and marital problems.

13. Behavioral Approaches • B.F. Skinner:abnormal behavior results from maladaptive behavior learned through faulty awards & punishments. • Goal: to extinguish unwanted behavior & replace it with more adaptive behavior. Classical Conditioning Therapies • Systemic Desensitization • Client is taught progressive relaxation techniques • With therapist, create an anxiety hierarchy from least to most feared stimulus. • Therapy starts with client being introduced to the least fearful stimulus. When he/she can relax with this fear, the process is repeated. Usually takes about 10 sessions to desensitize a person to a phobia.

14. Systematic Desensitization

15. Behavioral Approaches (cont’d) • Flooding is another exposure technique used to extinguish the conditioned response. • the client directly confronts the anxiety provoking stimulus, extinction is achieved. • CS: feared stimulus (ex: dog) • UCS: repeated presentation of the fear without the reason for being afraid (dog that is friendly) • CR: fear of dogs will be extinguished

16. Behavioral Approaches (cont’d) • Aversive Conditioning • Trains the client to associate physical or psychological discomfort with behaviors, thoughts, or situations he/she want to stop or avoid the client directly confronts the anxiety provoking stimulus, extinction is achieved. • Often used with the drug Antibuse (US) with alcohol (CS), which in combination causes extreme nausea (CR). • Within a few exposures, the patient learns to avoid alcohol • However, must be reinforced with an occasional pairing of the two to avoid extinguishing of CR.

17. Behavioral Approaches (cont’d) Operant Conditioning Therapies • Behavior Modification: the client choses a goal, & with each step toward that goal, he/she receives a small reward until the goal is reached. • Example – weight reducing programs such as Weight Watchers • Token Economies: positive behaviors are rewarded with secondary rein forcers such as tokens or points that can be exchanged for extrinsic rewards • often used in institutions to encourage acceptable behaviors or discourage unacceptable ones.

18. Behavioral Approaches (cont’d) Other Behavior Therapies • Social Skills Learning: based operant conditioning & Bandura’s social learning theory to improve interpersonal skills by using modeling, behavioral rehearsal, & shaping. • Using modeling, the client observes socially skilled people in order to learn appropriate social behaviors through role playing in structured situations. • Shaping reinforces increasingly more complex social situations • Helps people with social problems & former mental patients learn to cope in social situations.

19. Cognitive-Behavioral Approaches

20. Cognitive Behavioral Approaches