Understanding Different Types of Therapy and their Effectiveness

1. Warm Up • Explain the difference between psychological and biomedical therapy? • How would a psychoanalytic therapist treat someone? • How would a Humanistic therapist treat someone? • How would a behaviorist therapist treat someone? • What is the difference between systematic desensitization and flooding? • List 2 difference between the psychoanalytic perspective and behavioral 7. How could a token economy help someone with an anxiety disorder?

2. Warm Up • Pick up both sheets off of the overhead

3. Chapter 17 pt. 2: Cognitive and Biomedical Therapy

4. The Most Dominant Therapy is the Cognitive Approach

5. Assumption and Goal of Cognitive Therapy • Cognitive Therapy assumes that thoughts exist between events and responses. A person’s response depends on how they interpret the situation. • Goal of Cognitive therapy is to teach people new and more realistic, helpful, and adaptive patterns of thinking and acting. • Want to See glass half-full instead of half-empty!!

6. Lost job Internal beliefs: I’m worthless. It’s hopeless. Depression Lost job Internal beliefs: My boss is a jerk. I deserve something better. No depression Negative Thought Patterns (Cognition) Leads to Depression

7. Aaron Beck’s Views on Depression (NOT IN BOOK) • Beck believed the key to understanding depression was in an individual’s thought patterns. • Argued depressed people’s negative thought patterns and creation of negative schemas caused them to misinterpret the world which often caused them to feel worthless and incompetent. • Depressed people tend to view world with “dark sunglasses.”

8. Beck’s Examples of Negative Schemas (NOT IN BOOK) • Arbitrary Interference: drawing negative conclusions from an event without any evidence. • Ex: After an argument thinking “that person hates me.” • Dichotomous Thinking: irrational all or nothing thinking. • Ex: “I can’t be happy unless everyone likes me.”

9. Albert Ellis’s Rational Emotive Therapy (NOT IN BOOK) • Albert Ellis also believed that people’s maladaptive thoughts led to maladaptive emotional responses. • He promoted a form of treatment known as Rational Emotive Therapy: involves getting patients to recognize the irrationalities within their thought patterns and helping them create healthier forms of thinking and behaving.

10. Rational Emotive Therapy is a Form of Cognitive-Behavior Therapy • Cognitive-Behavior Therapy: aims to alter the way people think (ex: irrational thought patterns) and act (ex: compulsions).

11. Effectiveness of Cognitive Therapy

12. Nearly all Psychotherapies can be Conducted as Group Therapies • Less costly and time consuming therapy is often effective b/c it helps people see that they are not alone in their problem. • Family Therapy: assumes no person is an island and that we grow in relation to our families but we also seek to differentiate from them which leads to friction. • Therapy focuses on maintaining healthy relationships.

13. Effectiveness of Psychotherapy? How do We Evaluate? • Is it therapy that helps people get better or would it occur naturally? • Regression towards the Mean: the tendency for unusual emotions (depression/sadness) or events to return (regress) toward their average state with time.

14. Effectiveness of Psychotherapy? How do We Evaluate? • In order to test impact of treated vs. untreated, studies using meta-analysis must be used. • Meta-analysis: procedure for statistically combining the results of many different research studies.

15. Meta-analysis Illustrates Success of Psychotherapy

16. Which Therapies work for which problems • There is no “best” therapy • No difference between group and ind. • Cognitive and behavior therapy- depression • Cognitive, exposure- Anxiety • Cognitive and behavior- Bulimia • Behavior modification- bed wetting • Behavior- phobias, OCD

17. Alternative Therapy • 1. Therapeutic Touch • No human energy field • 2. Eye Movement Desensitization and Reprocessing • Maybe • But… probably…. • 1. Placebo and reliving trauma • 3. Light Exposure • Good for SAD

18. Who Conducts Therapy?

19. Who Conducts Therapy? • Clinical psychologists • Most are psychologists with a Ph.D. and expertise in research, assessment, and therapy, supplemented by a supervised internship. • About half work in agencies and institutions, half in private practice.

20. Who Conducts Therapy? • Clinical or Psychiatric social worker • A two-year Master of Social Work graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems. • About half have earned the National Association of Social Workers’ designation of clinical social worker.

21. Who Conducts Therapy? • Counselors • Marriage and family counselors specialize in problems arising from family relations. • Pastoral counselors provide counseling to countless people. • Abuse counselors work with substance abusers and with spouse and child abusers and their victims.

22. Who Conducts Therapy? • Psychiatrists • Physicians who specialize in the treatment of psychological disorders. • Not all psychiatrists have had extensive training in psychotherapy, but as M.D.s they can prescribe medications. Thus, they tend to see those with the most serious problems. • Many have a private practice.

23. Therapies outside of Psychotherapy Are Often Biomedical • The biomedical perspective focuses on altering body chemistry. • Biomedical perspective is rooted in discoveries of psychopharmacology: study of the effect of drugs on the mind and behavior.

24. State and county mental hospital residents, in thousands 700 600 500 400 300 200 100 0 Introduction of antipsychotic drugs Rapid decline in the mental hospital population 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 Year Social Effects of Drug Treatments

25. Drug Treatments: Antipsychotics • Antipsychotics are used to treat psychotic disorders like schizophrenia. • Antipsychotics helps those experiencing both positive and negative symptoms. • Most Common Examples: • Thorazine: alleviates delusions/hallucinations. • Clozaril: alleviates negative symptoms and social withdrawal.

26. Drug Treatments: Anxiolytics (Anti-Anxiety) • Anti-Anxiety drugs depress nervous system activity. • Often most heavily abused prescription drug. • Most common examples are: • Valium • Librium • Xanax

27. Drug Treatments: Anti-depressants • Most anti-depressants increase the availability of norepinephrine and serotonin which elevates arousal and mood. • Most common examples are: • Prozac • Zoloft • Paxil

28. Drug Treatments:Bipolar Disorder • The salt lithium is most frequently used to treat the mood swings of bipolar disorder. • Decreases adrenaline and increases serotonin.

29. Electroconvulsive Therapy (ECT) • Electroconvulsive Therapy: used to treat the severely depressed after other treatments have failed. • Success rate is high. • Side effects can include some memory loss.

30. Psychosurgery is Most Drastic Intervention • Psychosurgery involves removing or destroying brain tissue in an effort to change behavior. • Best known procedure is a lobotomy: Ice pick like instrument is put through the eye sockets cutting the links between the frontal lobes and the emotional control centers. Used to be used to “cure” uncontrollably violent patients but now very rare.

31. Lobotomy