Chapter 13 Therapies for Psychological Disorders.
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Transcript of Chapter 13 Therapies for Psychological Disorders.
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Chapter 13
Therapies for Psychological Disorders
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Therapy for psychological disorders takes a variety of forms, but all involve some
relationship focused on improving a person’s mental,
behavioral, or social functioning
What is Therapy?
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What is Therapy?
Therapy: General term for any treatment process In psychology and psychiatry - a variety of
psychological and biomedical techniques aimed at dealing with mental disorders or coping with problems of living
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The Components of Therapy
Relationship between the therapist and the patient/client and some or all of the following processes: Identifying the problem Identifying the cause of the problem or the
conditions that maintain the problem Deciding on and carrying out some form of
treatment
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Contemporary Approaches to Therapy
Psychological therapies: Based on psycho-logical principles (rather than biomedical approach)
Often collectively called psychotherapy
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Contemporary Approaches to Therapy
Biomedical therapies: Focus on altering the brain Drugs Psychosurgery Electroconvulsive therapy
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Types of Mental Health Care Types of Mental Health Care ProfessionalsProfessionals
Counseling psychologistCounseling psychologist
Clinical psychologistClinical psychologist
PsychoanalystPsychoanalyst
Clinical social workerClinical social worker
PsychiatristPsychiatrist
Psychiatric nurse practitionerPsychiatric nurse practitioner
Pastoral counselorPastoral counselor
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Specialty:Specialty:
Problems of Problems of normal livingnormal living
Work setting:Work setting:
Schools, clinics, Schools, clinics, other institutionsother institutions
Credentials:Credentials:
Master’s in Master’s in counseling, PhD, counseling, PhD,
EdD, or PsyDEdD, or PsyD
Professional TitleProfessional Title
Counseling psychologistCounseling psychologist
Clinical psychologist
Psychoanalyst
Clinical social worker
Psychiatrist
Psychiatric nurse practitioner
Pastoral counselor
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Specialty:Specialty:
Those with severe Those with severe disordersdisorders
Work setting:Work setting:
Private practice, Private practice, mental health mental health
agencies, agencies, hospitalshospitals
Credentials:Credentials:
PhD or PsyDPhD or PsyD
Professional TitleProfessional Title
Counseling psychologist
Clinical psychologistClinical psychologist
Psychoanalyst
Clinical social worker
Psychiatrist
Psychiatric nurse practitioner
Pastoral counselor
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Specialty:Specialty:
Severe mental Severe mental disorders (often disorders (often
by means of drug by means of drug therapies)therapies)
Work setting:Work setting:
Private practice, Private practice, clinics, hospitalsclinics, hospitals
Credentials:Credentials:
MDMD
Professional TitleProfessional Title
Counseling psychologist
Clinical psychologist
Psychoanalyst
Clinical social worker
PsychiatristPsychiatrist
Psychiatric nurse practitioner
Pastoral counselor
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Specialty:Specialty:
Freudian therapyFreudian therapy
Work setting:Work setting:
Private practicePrivate practice
Credentials:Credentials:
MDMD
Professional TitleProfessional Title
Counseling psychologist
Clinical psychologist
PsychoanalystPsychoanalyst
Clinical social worker
Psychiatrist
Psychiatric nurse practitioner
Pastoral counselor
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Specialty:Specialty:
Nursing specialty; Nursing specialty; licensed to licensed to
prescribe drugsprescribe drugs
Work setting:Work setting:
Private practice, Private practice, clinics, hospitalsclinics, hospitals
Credentials:Credentials:
RN – plus special RN – plus special training in treating training in treating mental disorders mental disorders and prescribing and prescribing
drugsdrugs
Professional TitleProfessional Title
Counseling psychologist
Clinical psychologist
Psychoanalyst
Clinical social worker
Psychiatrist
Psychiatric nurse Psychiatric nurse practitionerpractitioner
Pastoral counselor
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Specialty:Specialty:
Social worker with Social worker with specialty in specialty in dealing with dealing with
mental disordersmental disorders
Work setting:Work setting:
Often employed Often employed by governmentby government
Credentials:Credentials:
MSWMSW
Professional TitleProfessional Title
Counseling psychologist
Clinical psychologist
Psychoanalyst
Clinical social workerClinical social worker
Psychiatrist
Psychiatric nurse practitioner
Pastoral counselor
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Specialty:Specialty:
Combines Combines spiritual guidance spiritual guidance
with practical with practical counselingcounseling
Work setting:Work setting:
Religious order or Religious order or ministryministry
Credentials:Credentials:
VariesVaries
Professional TitleProfessional Title
Counseling psychologist
Clinical psychologist
Psychoanalyst
Clinical social worker
Psychiatrist
Psychiatric nurse practitioner
Pastoral counselorPastoral counselor
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Insight Therapies: Psychodynamic Therapies
Psychoanalysis: Form of psychodynamic therapy developed by Sigmund Freud Analysis of transference: Analyzing and
interpreting the patient’s relationship with the therapist
Dream interpretation, free association Neo-Freudian psychodynamic therapies:
Developed by psychodynamic theorists who embraced some of Freud’s ideas, but disagreed with others (sex, childhood)
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Psychologists employ two main forms of treatment:
the insight therapies and the behavioral therapies
How Do PsychologistsTreat Mental Disorders?
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Insight Therapies: Humanistic Therapies
Humanistic therapies: tendency for positive growth and self actualization (may be blocked by unhealthy environment)
Client-centered therapy: Emphasizes healthy psychological growth through self-actualization (Rogers) Reflection of feeling: Paraphrasing client’s
words to capture the emotional tone expressed Unconditional positive regard: nonjudgmental
and respect for client
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Insight Therapies: Cognitive Therapies
Cognitive therapy: Emphasizes rational thinking as the key to treating mental disorder
Cognitive therapy for depression (Aaron Beck) Confront destructive thoughts that support it Can be at least as effective as medication
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Insight Therapies Insight therapies: Psychotherapies in which
the therapist helps others understand (gain insight) their problems (emotions, thoughts) AKA – talk therapies
Psychodynamic – unconscious conflicts Humanistic – positive growth & self-actualization Cognitive – emphasizes rational thinking (ex. Beck –
depression; confront thoughts that support it)
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Systematic Systematic desensitizationdesensitization
TokenTokeneconomieseconomies
Contingency Contingency managementmanagement
AversionAversiontherapytherapy
Behavior Therapies Behavior therapy: based on the principles of
behavioral learning, especially operant and classical conditioning
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Classical Conditioning Therapies
Systematic desensitization: Anxiety is extinguished by gradually exposing the patient to an anxiety-provoking stimulus Exposure therapy: patient directly confronts the
anxiety-provoking stimulus (as opposed to imagining it)
Aversion therapy: Present an attractive stimulus with unpleasant stimulation in order to condition a repulsive reaction
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Operant Conditioning Therapies
Contingency management: Changing behavior by altering the consequences (rewards and punishments) of behavior
Token economies: Applied to groups involving distribution of “tokens” contingent on desired behaviors
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Cognitive-Behavioral Therapy: A Synthesis
Cognitive-behavioral therapy Modify irrational thoughts Set attainable behavioral goals Develop realistic strategies to attain goals Evaluate results
Rational-emotive behavior therapy: irrational thoughts and behaviors are the cause of mental disorders (REBT) Albert Ellis – strong approach, no acceptance of
irrational thoughts, may be a heated interaction
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How Is the Biomedical Approach Used toTreat Mental Disorders?
Biomedical therapies seek to treat mental disorders by
changing the brain’s chemistry with drugs, its
circuitry with surgery, or its patterns of activity with pulses
of electricity or powerful magnetic fields
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It’s your last day of notes!
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Drug Therapy
Psychopharmacology: The prescribed use of drugs to help treat symptoms of mental illness ostensibly to ensure that individuals are more receptive to talk therapies
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Drug Therapy Antipsychotic drugs
Include chlorpromazine, haloperidol, and clozapine
Usually affect dopamine pathways (reduce it) May have side effects
Tardive dyskinesia: Incurable disorder of motor control resulting from long-term use of antipsychotic drugs
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Drug Therapy
Antidepressants and mood stabilizers Usually affect serotonin/norepinephrine (increase)
(MAO) inhibitors – increase norepinephrine Tryicyclics – inhibit reuptake SSRIs – inhibit reuptake of serotonin (Prozac) Lithium carbonate – treats bipolar (can be toxic)
Highly controversial – suicide, using just when uneasy
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Drug Therapy Antianxiety drugs
Barbiturates – relax central nervous system Benzodiazepines – decrease activity in anxiety
regions of brain Do not
Use to relieve ordinary anxieties of everyday life Take for more than a few days at a time Combine with alcohol
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ONLY TWO MORE SLIDES OF NOTES FOR THE YEAR!!!
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Psychosurgery
Psychosurgery: The general term for surgical intervention in the brain to treat psychological disorders The infamous prefrontal lobotomy is no longer
performed Severing the corpus callosum, however, can
reduce life-threatening seizures
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Brain-Stimulation Therapies
Electroconvulsive (ECT) therapy - used for treatment of severe depression Side effect – memory disruption
Transcranial magnetic stimulation (TMS): a possible alternative to ECT- treatment of depression, schizophrenia, and bipolar disorder
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Hospitalization andthe Alternatives
Therapeutic community: Program of treating mental disorder by making the institutional environment supportive and humane for patients
Deinstitutionalization: Policy of removing patients, whenever possible, from mental hospitals
Community mental health movement: Effort to deinstitutionalize mental patients and to provide therapy from outpatient clinics
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Drug Therapy
Stimulants: suppress activity level in persons with attention-deficit/hyperactivity disorder (ADHD)
Causes and boundaries of ADHD are vague and the potential exists for over-diagnosis
Side effects – growth, sleep, later use
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Insight Therapies: Group therapies
Group therapy: Psychotherapy with more than one client
Self-help support groups: Groups that provide social support and an opportunity for sharing ideas about dealing with common problems typically run by laypersons (not professional
therapists) Couples and family therapy
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Participant Modeling: An Observational-Learning Therapy
Participant modeling: Therapist demonstrates and encourages a client to imitate a desired behavior
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Evaluating the Psychological Therapies
Eysenck proposed that people with non-psychotic problems recover just as well with or without therapy
Reviews of evidence have shown: That therapy is better than no therapy It appears advantageous to match specific
therapies with specific conditions
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Mental “First Aid”
If someone asks you for help, keep in mind that serious problems (especially those involving suicide or threats) require immediate professional treatment
Otherwise, your best tools may involve Listening Acceptance Exploring alternatives