Psychological Disorders

1. Psychological Disorders • Some statistics: • 1 in 6 Americans suffers clinically significant mental disorders • The incidences of mental disorders doubles for those below the poverty line • Over 75% of all sufferers experience their first symptoms by the age of 24

2. Psychological Therapies

3. With the development of drugs in the 1950’s, the major push was to localize therapy and to deinstitutionalize patients

4. There are over 250 identifiable types of psychotherapy, though the most influential are: • Psychodynamic Therapies • Humanistic Therapies • Behavior Therapies • Cognitive Therapies • Group and Family Therapies • Bio-Medical Therapies Any therapist who uses a combination of therapies is said to be using an “eclectic” approach to therapy

5. Psychoanalysis

6. Aims: • Psychoanalysis assumes that many psychological problems are fueled by the childhood repression of impulses and conflicts

7. It is the job of a psychoanalyst to: • bring repressed feelings into conscious awareness • have the patient “work through” the feelings • release the negative, repressed energy

8. Methods: • Free Association • Dream Interpretation

9. Resistance: • Resistance hints at anxiety and the repression of sensitive material. A psychotherapist wants to first make a patient aware of these areas, and then explore their underlying meanings further.

10. Methods: • While revealing their secrets, patients may begin to experience strong feelings towards their therapists. This is called transference.

11. Methods: • interpersonal psychotherapy. • Helps people gain insight into the roots of their difficulties by focusing on current relationships, rather than past or repressed feelings. • especially effective with those patients suffering from depression.

12. Humanistic Therapies

13. Aims: • The humanistic therapist’s goal is to boost self-fulfillmentby helping people grow in self-awareness and self-acceptance.

14. Methods: • Humanists hope to accomplish their goals by: • Focusing on the present and the future, rather than the past • Exploring feelings as they occur • Dealing with conscious thoughts

15. Methods: • Humanists hope to accomplish their goals by: • Having patients take immediate responsibility for their thoughts and actions, rather than hiding them • Promoting growth, rather than dwelling on a “cure” for an illness

16. Methods: • Re-enforce the idea of free will, or that people are capable of controlling their own destiny

17. HI! Remember Me? • Methods: • Carl Rogers’ “Client-Centered Therapy” is a widely used humanistic technique. • Focuses on a therapist’s ability to exhibit genuineness, acceptance, and empathy for their clients. • The deeper understanding a therapist portrays, the more open a client will be (this empathy is also called unconditional positive regard).

18. Methods: • A key aspect of a client-centered therapy session is what Rogers called “active listening” • a technique of listening intently, echoing, restarting and seeking clarification, and acknowledgement of a clients expressed verbal and non-verbal emotions

19. Behavior Therapies

20. Aims: • Behaviorists believe that problem behaviorsare the problem, and the goal is not to figure out the meanings behind them, but instead to simply eliminate or unlearnthe problem behavior

21. Methods: • We learn behaviors and emotions through classical and operant conditioning , so maladaptive behaviors (disorders) are learned behaviors as well. • If so, behaviorists believe that disorders can be unlearned.

22. a young child has a bedwetting problem. • A behaviorist would have the child sleep on a moisture-sensitive mattress hooked up to an alarm. • Every time the child wet the bed, an alarm would go off. • Eventually the child will learn to awaken themselves at the onset of a full-bladder feeling.

23. If a claustrophobic fear of elevators is a learned aversion to confined spaces, then a behaviorist would put something relaxing in the elevator to alleviate the fear response (soothing, classical music?). Associating the trigger (enclosed spaces) with a new, less fearful response (relaxation) is called counter conditioning.

24. Methods: • For example, if a young child cries hysterically as soon as he enters the doctors office, his mother may bring along some of his favorite toys when they go to the office. Associating the trigger with a new, less fearful response is called counter-conditioning.

25. Methods: • There are three types of classical counter conditioning. • Systematic Desensitization • Implosive Therapy • Aversive Conditioning

26. Systematic Desensitization: • IE. Billy is afraid of rabbits and other furry creatures. Rabbits = Fear. • Billy enjoys eating. Eating = Happy. • Billy’s therapist wants to eliminate Billy’s fear of rabbits. His therapist will attempt to associate the fear-inducing rabbits with something that makes Billy happy, like dinner time.

27. Systematic Desensitization: • IE. When Billy sits down for dinner, his therapist puts a rabbit in the room, in a far away corner. Billy hardly notices. • On succeeding days, his therapist gradually moves the rabbit closer and closer during dinner time. • Within two months, Billy is able to hold the rabbit in his lap during dinner time. His fear of rabbits has been countered.

28. Systematic Desensitization is also known as exposure therapy. A therapist is attempting to graduallysubstitute a positive response for a negative response to a harmless stimulus.

29. US = UR US = UR Rabbit = Fear Dinner = Relaxed A therapist wants to eliminate the fear response to rabbits.

30. Systematic Desensitization US + CS = UR Dinner + Rabbit = Relaxed After Counter-Conditioning: CS = CR Rabbit = Relaxed

31. Implosive Therapy floods patients with their worst fears first, in hopes that by confronting their worst fears, they’ll learn how to not back down

32. In aversive conditioning, a therapist tries to replace a positive response to a harmful stimulus with a negative response. • Aversive Conditioning:

33. Aversive Conditioning: • IE. Dave enjoys sucking his thumb at night. This is a bad habit. A therapist would cover Dave’s thumb with hot pepper before bed time. Dave does not like the taste of hot peppers, and therefore he will stop sucking his thumb.

34. US = UR Thumb Sucking = Enjoyment US = UR Hot Peppers = Sickness A therapist wants to eliminate the enjoyment derived from thumb sucking.

35. Aversive Conditioning US + CS = UR Hot Peppers + Thumb = Sickness After Reconditioning CS = CR Thumb Sucking = Sickness

36. Methods: • Behavior therapists who use operant counter conditioning: • Use positive reinforcers to shape behavior in a step-by-step manner • Withhold reinforcement, or punish, for undesired behaviors • Deter negative behaviors by simply ignoring them, and only acknowledging closer approximations of the desired behavior (shaping)

37. Methods: • The rewards used to modify behavior vary, from praise to food, depending on the individual, their disorder, and the therapist

38. Methods: • In some cases, a token economy is set up. A token economy is one in which a therapist rewards patients for displaying appropriate behaviors by giving them a token, such as a ticket or a plastic coin, that they can later exchange for prizes or gifts.

39. Cognitive Therapies

40. Aims: • Generally used for depression and anxiety disorders • Cognitive therapists attempt to teach people new, more adaptive ways of thinking and acting

41. Aims: • The belief is that our thinking and interpretation of external events is what causes depression and anxiety, notthe events themselves. A therapist wants to change the thought processes of patients from negative to positive to alleviate disorder symptoms.

42. IE. People with depression or anxiety disorders will interpret suggestions as criticism, disagreements as dislike, friendliness as pity. If a sufferer loses their job, they think “I’m worthless and it’s hopeless that I’ll find another job”. • A therapist wants to change these negative interpretations to positive thoughts and actions.

43. IE. A student has anxiety over a test. “I’m going to fail. I always fail. The test is hard, everyone is prepared, and I’ll probably forget everything anyway.” • A therapist may counter this with, “I didn’t do very well in that subject either, but I still passed and look where I am now. And you’re much brighter than I was at your age. The test will be difficult for everyone. Besides, you don’t need a perfect score to pass the exam.”

44. IE. In addition, have the student look at their past, good grades to prove to them that they are capable. • The goal is to dispute the negative thoughts, diffuse the stress, and enter positive thoughts and encouragement.

45. Methods: • cognitive-behavior therapy. This therapy aims to alter the way people act and the way they think.

46. IE. A client has an obsessive compulsive disorder, which included ritually washing their hands again and again. A cognitive-behavior therapist would show the client a PET scan that rationally explained the behavior as abnormal, not the fault of the client. • Next, through behavior therapy, a therapist would counter condition the disorder by having the client pick up their favorite instrument and play until the compulsion passed.

47. Group and Family Therapies

48. Aims: • Group therapy is generally for people experiencing family conflicts or those whose behavior is distressing to others. Benefits: • others have same disorder • share therapy ideas • receive feedback • you are not alone

49. Aims: • Provide a sense of community, safety, and connectedness • Support and friendship

50. Methods: • Usually groups of six to ten individuals • Averaging up to 90 minutes per week • Family Therapy promotes the idea that families are a unit that depends on each member to be positive and to communicate