Psychological disorders are treated through the use of 2 basic practices:

Biomedical Psychotherapy

There are many approaches to psychotherapy; however, each category contains 4 characteristics that are indispensable:

1. Organized interpersonal communication between therapist and client.

2. Therapy is rooted in psychological research and theory. 3. Therapy is provided with the goal to better adjust to

problems and stressors, treat disorders, and encourage personal growth and insight.

4. Therapy is intended to positively influence the feelings, thought patterns, and behaviors of the client.

There is no one type of therapy that is right or will work for everyone; each individual must be evaluated to determine which approach will appropriately meet the client's needs.

Biomedical • Though not psychological in nature,

biomedical therapies are thought to be more successful when combined with psychological therapies. Biomedical therapies include psychotropic or psychotherapeutic drug therapy, electroconvulsive therapy (ECT), and psychosurgery.

• Psychotropic drug therapy, the most frequency used of the biomedical therapies, uses anti-anxiety drugs, antipsychotic drugs, and antidepressant drugs, as well as lithium.

• ECT and Psychosurgery are very controversial methods of biomedical therapy. ECT, also known as electric shock therapy, is very rarely used and clients are generally put to sleep through the procedure.

• Psychosurgery is extinct, because of the severe side effects such as impaired ability to learn, seizures, and death, and there is very little evidence that it has been successful.

• ECT is usually only considered after all other treatments have been tried and have failed.

Psychodynamic

• Psychodynamic therapy assumes that unresolved and unconscious conflict is the root of mental problems, frequently arising from childhood; the goal is to provoke self-insight.

• Traditional psychodynamic therapy focused on the id, client directed, and used 3 methods: interpretation of transference, free association, and dream analysis.

Though some analysts hold fast to traditional Freudian psychodynamic therapy, most psychodynamic therapy focuses more on the ego, is more structured, therapist directed and is much shorter in duration.

Criticisms of Psychodynamic• Freud’s theories overemphasized the

unconscious mind, sex, aggression and childhood experiences.

• Many of the concepts proposed by psychodynamic theorists are difficult to measure and quantify.

• Most of Freud’s ideas were based on the case studies and clinical observations rather than empirical, scientific research.

Strong Points of Psychodynamic• The methods and theories of

psychodynamic thinking contribute to experimental psychology.

• Many of the theories of personality developed by psychodynamic thinkers are still influential today.

• Psychodynamic opened up a new view on mental illness, suggesting that talking about problems could help relieve symptoms of psychological distress.

Humanistic

Humanistic therapies follow the philosophy that one has freedom of choice. It focuses on the quality of the individual present.

Humanistic is client centered therapy (client directed) and looks at the client’s self-awareness and self-acceptance

Strong Points of Humanistic Psychology• One of the major strengths of humanistic psychology is that it

emphasizes the role of the individual; this school of psychology gives more credit to the individual in controlling and determining their state of mental health.

• It also takes environmental influences into account; rather than focusing solely on our internal thoughts and desires, humanistic psychology also credits the environment's influence on our experiences.

• Humanistic psychology continues to influence therapy, education, healthcare and other areas.

• Humanistic psychology helped remove some of the stigma attached to therapy and made it more acceptable for normal, healthy individuals to explore their abilities and potential through therapy

Criticisms of Humanistic Psychology Humanistic psychology is often seen as

too subjective; the importance of individual experience makes it difficult to objectively study and measure humanistic phenomena.

Another major criticism is that observations are unverifiable; there is no accurate way to measure or quantify these qualities.

Behavior

• Behavior therapy is use of learned response to teach or effect behavioral changes.

• Behavioral psychology, also known as behaviorism, is a theory of learning based upon the idea that all behaviors are acquired through conditioning.

• Conditioning occurs through interaction with the environment. According to behaviorism, behavior can be studied in a systematic and observable manner with no consideration of internal mental states.

Criticisms of Behaviorism

• Many critics argue that behaviorism is a one-dimensional approach to behavior and that behavioral theories do not account for free will and internal influences such as moods, thoughts, and feelings.

• Behaviorism does not account for other types of learning, especially learning that occurs without the use of reinforcements or punishments.

• People and animals are able to adapt their behavior when new information is introduced, even if a previous behavior pattern has been established through reinforcement.

Strong Points of Behaviorism • Behaviorism is based upon observable

behaviors, so it is easier to quantify and collect data and information when conducting research.

• Effective therapeutic techniques such as intensive behavioral intervention and token economies are all rooted in behaviorism.

• These approaches are often very useful in changing maladaptive or harmful behaviors in both children and

Cognitive

Cognitive therapy works on the premise that beliefs and thoughts affect behaviors.

Cognitive therapy is basically replacing negative self talk with positive self talk.

Strong Points of Cognitive• Cognitive behavior therapy has been used to treat people

suffering from a wide range of disorders, including anxiety, phobias, depression, addiction and a variety of maladaptive behaviors. CBT is one of the most researched types of therapy, in part because treatment is focused on a highly specific goal and results can be measured relatively easily.

• Cognitive behavior therapy is often best suited for clients who are comfortable with introspection. In order for CBT to be effective, the individual must be ready and willing to spend time and effort analyzing his or her thoughts and feelings. Such self-analysis can be difficult, but it is a great way to learn more about how internal states impact outward behavior.

• Cognitive behavior therapy is also well-suited for people looking for a short-term treatment options that does not necessarily involve pharmacological medication. One of the greatest benefits of CBT is that it helps clients develop coping skills that can be useful both now and in the future.

Criticisms of Cognitive Behavior Therapy

• Initially, some patients suggest that while they recognize that certain thoughts are not rational or healthy, simple becoming aware of these thoughts does not make it easy to stop having them.

• It is important to note that CBT does not just involve identifying these thought patterns; it is focused on using a wide range of strategies to help clients overcome these thoughts. Such strategies may include journaling, role-playing, relaxation techniques and mental distractions.

The Doctor Is In…(scenario)

• Bernice is a 47 year old woman who recently lost her job in an auto factory. She is depressed and very concerned about how she is going to make ends meet when her unemployment insurance runs out. She married right out of high school and supported her husband through school by working in factory. Her husband was killed in an auto accident seven years ago. She has 2 children, 22 and 15 years old. Bernice tells you that she is concerned about her drinking. Because her father was an alcoholic and her mother was always sad and withdrawn. She also still feels like a bad mother because she can’t give her children all the things she sees other kids have, even though the children don’t care.

• After reading the above scenario, pretend you are a therapist and decide what aspects of the scenario would be important for each of the following approaches.

• Biomedical Treatment• Behavioral Treatment• Cognitive Treatment

• Humanistic Treatment• Psychodynamic Treatment

Discuss one aspect of treatment from each approach you would use with Bernice.

Biomedical Treatment Behavioral Treatment Cognitive Treatment

Humanistic Treatment Psychodynamic Treatment

Question????

P.440 In what ways are psychoanalysis

and cognitive therapy similar, and how do they differ? How would you choose between the two to get treatment for a psychological problem you may be experiencing?

Why do people seek therapy?

Stressful current life circumstancesThese people often feel vulnerable and tend

to be open to psychological treatment because they are motivated to alter their present state.

In such situations, clients may gain considerably, and in a brief time, from the perspective provided by their therapist.

Reluctant clientsSome people enter therapy by more indirect

route. Motivation to enter treatment differs widely

among psychotherapy clients. Men are reported as being more reluctant to

seek therapy than women.

Question???

Men are reported as being more reluctant to seek therapy than women. What factors may explain these differences?

• People with long standing problems– People entering therapy have experienced

long-term psychological distress and have lengthy histories of maladjustment.

– These people seek psychological assistance out of dissatisfaction and despair.

– They may enter treatment with a high degree of motivation, but as therapy proceeds, their persistent patterns of maladaptive behavior may generate resistance with the therapist.

People who seek personal growthPeople that feel like they have not lived up

to their own expectations and realized their own potential.

These people, partly because their problems are more manageable than the problems of others, may make substantial gains in personal growth.

• There is no “typical client "or “model” therapy.

• All standard therapies can document some success.

• Client motivation to change and the severity of symptoms are important to the outcome of therapy.

• Various therapies have greater success when a therapist takes the characteristics of a particular client into account in determining treatment approaches.

The Therapeutic Alliance The outcome of psychotherapy normally

depends on whether the client and therapist are successful in achieving a productive working alliance.

The client’s major contribution is their motivation.

Client’s who are pessimistic about their chances of recovery or who are ambivalent about dealing with their problems and symptoms respond less well to treatment.

Medication or Psychotherapy Depending upon the severity of your symptoms,

therapy alone, medication alone, or therapy combined with medications may be recommended by your doctor.

In some circumstances, a combination of medication and therapy will be most effective. Antidepressants are usually used to treat more severe symptoms and help correct the chemical imbalance within the brain that contributes to symptoms of depression.

Psychotherapy can help in a variety of ways, including altering negative thought patterns which lead to depression, and helping you understand and cope more effectively with the conflicts and stressors in your life.

Drugs tend to alleviate the symptoms by inducing biochemical changes.

It does not help the individual understand and change the personal or situational factors that may be creating or reinforcing maladaptive behaviors.

When drugs are discontinued, clients may be at risk of relapsing.

The use of medications in the course of treatment may not be ideal for some disorders, because drugs themselves generally do not cure disorders.

Psychotherapy produces more long-lasting benefits than medications alone, unless the medications are continued indefinitely.

Combined Treatments

Medications can be combined with a broad range of psychological approaches.

They can help clients benefit more fully from psychotherapy.

Question???

P.459 One of the main criticisms of

biological therapies is that they treat the symptoms of mental disorder without uncovering and treating the underlying problems from which people are suffering. Do you agree with this criticism? Why?

Questions???

Imagine that you’re working in a high stress office and you’re having difficulty managing your anxiety. A colleague suggests that you see the staff nurse to get a prescription for an antianxiety drug. Would this action be advisable? Why or why not?