1 / 31

Treatment of Disorders

Treatment of Disorders. History of Treatment. Ethical Issues in Treatment. Deinstitutionalization occurred during the mental health movement of the 1960s Don’t exclude mentally ill from society, but help them function within society

sol
Download Presentation

Treatment of Disorders

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. Treatment of Disorders

  2. History of Treatment

  3. Ethical Issues in Treatment • Deinstitutionalization occurred during the mental health movement of the 1960s • Don’t exclude mentally ill from society, but help them function within society • Shorten in-patient treatment (only keep in hospital if necessary) • More out-patient care • APA guidelines 

  4. Who Provides Treatment? • Psychiatrists – Medical doctors, MD • Psychologists – PhD, PsyD, some MA • Clinical Social Workers, MA • Marriage/Family Therapists, MA • Licensed Professional Counselors, MA • Psychiatric Nurses, RN • Substance Abuse Counselors, CADC • Pastoral Counselors

  5. Psychotherapy – trained therapist uses psychological techniques to help someone to overcome problems or difficulties • Biomedical therapy – prescribed medication that acts on nervous system • Eclectic approach – use a blend of therapies and approaches

  6. Psychoanalysis • Free association • Say whatever comes to mind, no censoring of thoughts • Overcome resistance (blocking of anxiety-laden material) • Transference • Patient transfers unconscious feelings towards someone else onto the therapist • i.e. patient w/Electra complex has attraction to Freud (transfers attraction to father onto therapist)

  7. Psychodynamic • Childhood experiences • Enhance self-insight • Interpersonal therapy – brief (12-16 session) treatment, effective for depression

  8. Psychoanalysis v. Humanistic • Humanistic therapies differ from psychoanalysts in focusing on… 1) Present & future (not past) 2) Conscious rather than unconscious 3) Immediate responsibility 4) Promoting growth instead of curing illness

  9. Client-Centered Therapy (Carl Rogers) • Nondirective  Active listening • Clarification or “reflect” what has been said back to patient • Genuineness, acceptance, empathy • Unconditional positive regard  no judgment

  10. Behavior Therapies – Classical Conditioning • Counterconditioning • Pair feared stimulus w/good outcome • Exposure therapy – expose patient to feared stimulus • Learn relaxation techniques • Systematic desensitization hierarchy • Aversive conditioning • Pair the undesirable behavior with bad outcome

  11. Behavior Therapy • Systematic Desensitization

  12. Behavior Therapy • Aversion therapy for alcoholics

  13. Behavior Therapies – Operant Behavior Modification – use reinforcement to increase desired behaviors Token Economy – provide “tokens” each time desired behavior is performed that can be redeemed later for a bigger reward

  14. Cognitive Therapies • Cause = irrational thinking patterns • Aim = correct habitual thinking errors • Aaron Beck’s Cognitive(-Behavioral) Therapy  Cognitive Triad 1) Negative feelings about self “I am a failure” 2) Negative feelings about world “The world is unfair” 3) Negative feelings about future “The future is hopeless, it will never get better”

  15. Beck’s Cognitive Therapy for Depression • Over-generalization  drawing general conclusions from a single (usually negative) event. E.g. thinking that failing to be promoted at work means a promotion will never come. • Minimalization and Maximization  Getting things out of perspective: e.g. either grossly underestimating own performance or overestimating the importance of a negative event. • Dichotomous thinking  Thinking that everything is either very good or very bad so that there are no gray areas. In reality, of course, life is one big gray area.

  16. Cognitive-Behavioral Therapies Albert Ellis’s Rational Emotive Behavior Therapy (REBT) The A-B-C model A= Adversity (anticipating event) B = Belief about “A” C = Consequences (behavioral, emotional)

  17. Stress Inoculation Training • SIT is a form of cognitive restructuring as it is a method of changing an individual’s thinking patterns about themselves and their lives. The aim is to change their emotional responses and their behavior ideally before the individual becomes very anxious or depressed as a result of stress.

  18. Nontraditional Psychotherapies • Eye movement desensitization and reprocessing (EMDR) • Often used for PTSD • Uses patients’ rhythmic eye movements • Therapist moves finger from left to right while patient recalls disturbing event or issue

  19. Evaluating Psychotherapies • To whom do people turn for help for psychological difficulties?

  20. Is Psychotherapy Effective? • Overestimation • Clients enter in crisis (temporary) • Want to believe it was worth the effort • Placebo effect (expect to get better) • Regression toward the mean (the usual state is better than rock bottom, which is where most patients start)

  21. Is Psychotherapy Effective? • Those not treated often improve, but those undergoing therapy are more likely to improve • No one therapy is best in all cases • Evidence-based practice – clinical decision making that integrates best available research w/clinical expertise and patient characteristics

  22. Three Benefits of Psychotherapies • Offer expectation that things can and will get better • Offers plausible explanation for symptoms and alternative way of thinking • Effective therapists are empathetic and seek to understand  builds trust

  23. Number of persons Average untreated person Average psychotherapy client Poor outcome Good outcome 80% of untreated people have poorer outcomes than average treated person Evaluating Psychotherapies

  24. Biomedical Therapies • Psychopharmacology – study of drugs and their effects on mind and behavior

  25. Antipsychotic Drugs • Treats schizophrenia • Decrease receptiveness to irrelevant stimuli • Block dopamine • Thorazine, Haldol, neuroleptics • Atypical antipsychotics (Clozapine) • Tardivedyskinesia – involuntary movements of face, tongue, limbs

  26. Antianxiety Drugs • Depress CNS activity (tranquilizers – benzodiazepines) • Boost GABA • Xanax, Ativan, D-cycloserine • Can lead to psychological and physiological dependence • Treats anxiety disorders (PTSD, OCD)

  27. Antidepressant Drugs • Increase serotonin & norepinephrine • Selective Serotonin Reuptake Inhibitors (SSRIs) • Prozac, Zoloft, Paxil • Block reabsorption of serotonin from synapse • Treat depression, some anxiety disorders (OCD) • Tricyclics are more effective (serotonin & norepinephrine)

  28. Lithium • Mood stabilizer • Treats bipolar disorder • Lowers risk of suicide

  29. Brain Stimulation Techniques • Electroconvulsive Therapy (ECT) • Side effects (memory loss) • Repetitive transcranial magnetic stimulation (rTMS) • Less side effects

  30. Psychosurgery • Removes or destroys brain tissue to change behavior • Lobotomy • ONLY USED IN EXTREME CASES

More Related