PowerPoint Presentation

Treatment of Mental Disorders

Whats difference between a psychiatrist, clinical psychologist, and counselor?How do psychoanalysts treat disorders?How do behaviorists treat disorders?What are classical conditioning techniques to therapy?What is manifest content of dreams? Latent content?What are operant conditioning techniques?What is cognitive therapy?Who is Albert Ellis?Who is Aaron Beck?How do Humanists treat disorders?What are biomedical therapies?Benefits of group therapy?

Key Questions for this UnitWhats the difference between a Psychiatrist, Clinical Psychologist and a Counselor?How do Psychoanalysts treat mental disorders?How do Behaviorists treat? How do Humanists treat? What is Cognitive therapy?What is a psychiatrist? Psychiatrists are MDs (medical doctors) with a specialty in treating mental disorders, usually with a biomedical therapy (medicine) and some talk therapy.You would see a shrink if you have schizophrenia, severe depression, suicidal thoughts, and other severe mental problems that need medication.

What is a clinical psychologist?A clinical psychologist has a PhD (more research based) or PsyD (emphasis on therapy) in psychology (no medical school). They treat fairly serious mental illnesses with talk therapies.They might treat personality disorders, anxiety disorders, addictions using insight or talk therapy.

What is a counselor?A counselor uses talk therapy to treat non-mental disorders like improving communication between family members, grief counseling, marital counseling, life strategies.Counselors have a Masters Degree with specialty training.Specialty:Problems of normal livingWork setting:Schools, clinics, other institutionsCredentials:Masters in counseling, PhD, EdD, or PsyDProfessional TitleCounseling psychologistClinical psychologistPsychoanalystClinical social workerPsychiatristPsychiatric nurse practitionerPastoral counselor729Specialty:Those with severe disordersWork setting:Private practice, mental health agencies, hospitalsCredentials:PhD or PsyDProfessional TitleCounseling psychologistClinical psychologistPsychoanalystClinical social workerPsychiatristPsychiatric nurse practitionerPastoral counselor829Specialty:Severe mental disorders (often by means of drug therapies)Work setting:Private practice, clinics, hospitalsCredentials:MDProfessional TitleCounseling psychologistClinical psychologistPsychoanalystClinical social workerPsychiatristPsychiatric nurse practitionerPastoral counselor929Specialty:Freudian therapyWork setting:Private practiceCredentials:MDProfessional TitleCounseling psychologistClinical psychologistPsychoanalystClinical social workerPsychiatristPsychiatric nurse practitionerPastoral counselor1029Specialty:Nursing specialty; licensed to prescribe drugsWork setting:Private practice, clinics, hospitalsCredentials:RN plus special training in treating mental disorders and prescribing drugsProfessional TitleCounseling psychologistClinical psychologistPsychoanalystClinical social workerPsychiatristPsychiatric nurse practitionerPastoral counselor1129Specialty:Social worker with specialty in dealing with mental disordersWork setting:Often employed by governmentCredentials:MSWProfessional TitleCounseling psychologistClinical psychologistPsychoanalystClinical social workerPsychiatristPsychiatric nurse practitionerPastoral counselor1229Specialty:Combines spiritual guidance with practical counselingWork setting:Religious order or ministryCredentials:VariesProfessional TitleCounseling psychologistClinical psychologistPsychoanalystClinical social workerPsychiatristPsychiatric nurse practitionerPastoral counselor1329In contrast to a clinical psychologist, a psychiatrist is more likely toa) engage in an eclectic approachb) use a biomedical/somatic treatmentc) recognize the importance of group therapy with patients having the same disorderd) treat clients in community mental health centers exclusively14Perspectives on TreatmentPsychoanalytic BehavioralHumanisticCognitiveBiophysical

Psychoanalytic (5 methods)Dream AnalysisTransferenceHypnosisFree associationSymptom SubstitutionAll 5 rely on exposing (bringing into conscious) unconscious thoughts and interpreting them.

A. What are Psychoanalytic methods of therapy:1. Free Association patient reports anything that comes to his/her mind.

The psychoanalyst takes whatever you say and treats it like a window into your unconscious mind.

B. Dream analysis:Dreams have two types of content:

Manifest content- actual events in dream.Latent content hidden message in dream. (latent = hidden)Freud thought that each dream represents a form of wish fulfillment. The wish may be disguised, but it is always there.

C. TransferenceFeelings of love or other emotions (hatred) are expressed toward the therapist.

These feelings are actually unconsciously felttoward others; the patient is projecting these feelings onto the therapist.

This provides clues about the clients feelingsabout these other people.

D. HypnosisHypnosis is a psychoanalytic therapeutic technique.Supposedly reaches into the unconsciousWhatever you think, patients report benefits from hypnosis.E. Symptom SubstitutionClient appears to get better from original problem or, but shortly thereafter, a new symptom emergesWhy? Original problem not actually foundThe goal of psychoanalytical therapy isa) to change maladaptive behavior to more socially acceptable behaviorb) to change negative thinking into more positive attributionsc) to attain self-actualizationd) to bring unconscious conflicts to conscious awareness and gain insight23Treating the therapist as though he were a very important person from ones past, such as a parent, definesa) resistanceb) transferencec) frustrationd) reaction formation24Behavioral Therapy

Behavioral TherapyBehaviorists believe that mental problems are caused by classical conditioning (for example, phobias), operant conditioning (addictions, depression), and observational learning (we watch our parents and friends suffer so we copy them).Classical Conditioning Systematic Desensitization (treats phobias) if you are afraid of snakes, start with worms, calm down, then graduate to having a snake in the next room, calm down, then look at pictures, calm down, then watch movies, calm down, then be in the same room, calm down, then get closer, calm downAnxiety HierarchyClassical/Operant Conditioning Counter ConditioningOBJECTIVE: Associate a previously bad stimulus with positive reinforcementExample:Afraid of the dentist? What do you get at the end of every visit??Classical Conditioning Aversive ConditioningOBJECTIVE: Replace a previously good response to a harmful stimulus with a bad responseExamples:Antabuse Alcoholics take pills that make them sick when they drink alcoholCoyotes are fed poisoned lamb meat so they will stop killing sheep.AKA Reconditioning

Classical ConditioningFlooding (treats phobias) if you are afraid of snakes, therapist will throw you in a pit of snakes.AKA Exposure TherpayOperant conditioning treatmentToken economy Therapists will reward desirable behaviors with a reward system. This is usually applied to groups like hospital mental wards or classrooms or workplaces.

If you dont kill anyone this week, Ill give you a nickel. If everyone passes, well have a pizza party.

Systematic desensitization is a technique based ona) classical conditioningb) instrumental conditioningc) operant conditioningd) aversive conditioning32Antabuse is a drug that, when paired with alcohol in the bloodstream, bring about extreme nausea. For many motivated alcoholics, this has proven to be an effective treatment. Under which umbrella of psychotherapy would it most likely be found?a) insight therapyb) aversive conditioningc) Gestalt therapyd) self-help therapy33Humanistic Perspective of Psychology

HumanismWhat is the root word of Humanism?After years of psychoanalysts saying we are a bunch of id-driven animals and years of behaviorists studying rats in a cage, the Humanists came along in the 60s.

Who is Carl Rogers?

Famous HumanistsWho is Carl Rogers? Carl Rogers was the founder of person-centered therapy, active listening, and unconditional positive regard.No judgments can be made! The environment must be loving and accepting if the client is to open up to you.Good for patients with self-esteem issues.The patient/client has all the answers and the means to treat themselves. In client-centered therapy, the therapist acts as a sounding board for the patient, sometimes rephrasing what the patient says (active or reflective listening). Empathy is important!

Abraham Maslow

Maslows hierarchy of needs

Maslows hierarchy of needsPeople cannot maximize their potential unless their more basic needs are met.If a Japanese familys home just got destroyed by the earthquake/tsunami, can they focus on their communication skills?If you are hungry, can you worry about your self esteem?Which Simpsons character is at the bottom of Maslows Hierarchy of Needs?

Which character has safety needs?

Who has love and belonging needs?

Who has esteem needs?

Are any Simpsons characters self actualizing?

Depends on the episodeThe Simpsons arent real people, but in some episodes, Homer and Lisa are. Even Grandpa has his day.

2 Other Humanistic TheoriesGestalt Therapy Fritz PerlsIntegrate all actions, feelings, and thoughts into a harmonious wholeExistential subjective meaning of life is what is importantHumanistic TherapyHumanists are really touchy-feely, but without them we are just rats in a cage.Rogers and Maslow put the human element back into psychology and therapy.Their philosophy: We are all humans striving to maximize our potential. A therapists job is to remove obstacles to self-actualization.FREE WILL MATTERS; NOT DETERMINISITC Vic is encouraged to take charge of the therapy session and his therapist uses an active listening approach to mirror back the feelings he hears from him. Which therapy is most likely being described?a) client-centered therapyb) cognitive therapyc) psychodynamic therapyd) existential therapy54Cognitive therapyCognitive therapy focuses on changing how the client/patient thinks.It can be confrontationalThe therapist focuses on changing/fixing the irrational thoughts of the patientCognitive therapy also educates the client, teaches him/her proper behaviors/thoughtsCognitive TherapyWe are depressed because we are irrational. Our expectations are too high and misplaced. We want everyone to love us and accept us. We want every thing to go our way. We stay angry about stuff that happened a looong time ago. WE MUST CHANGE THE WAY WE THINK TO BE HAPPY AND SUCCESSFUL.Albert Ellis Rational Emotive Therapyvigorously challenges peoples illogical, self-defeating attitudes and assumptions; a confrontational therapyhttp://www.youtube.com/watch?v=JhlWddAXSRA Rational Emotive Therapy: EllisA-B-C theory of dysfunctional behaviorA Activating eventB BeliefC emotional Consequence based on that belief.58Example of Rational ThinkingA= fail a midterm examinationB=Its unfortunate that I failed-I did not study hard enough and I must make sure that I study harder for the finalC=no consequences (no emotional disturbance)Example Irrational Thinking: leads to Emotional DisturbanceA= Fail examB= Im stupid, Ill never be able to pass this course and I will fail this courseC=depressionEllis List of Common Irrational IdeasI absolutely must have sincere love and approval almost all the time from all the significant people in my lifeI must be thoroughly competent, adequate and achieving in all respects, or I must at least have real competence or talent at something important; otherwise I am worthless.People who harm me or who do a bad thing are uniformly bad or wicked individuals, and I should severely blame, damn, and punish them for their sins and misdeeds61Ellis List of Common Irrational Ideas (continued)When things do not go the way I would like them to go, life is awful, terrible, horrible, or catastrophicUnhappiness is caused by external events over which I have almost no control. I also have little ability to control my feelings or rid myself of feelings of depression and hostility. Rational Emotive TherapyIdentify patients irrational beliefs Add D and E to A-B-C theoryTeach the patient to Dispute the beliefs and substitute logical and rational beliefsEvaluate the effects of disputing their irrational beliefs63CBT: Effective for Which Disorders?Empirically supported treatment forDepressionGeneralized anxiety disorderObsessive compulsive disorderPanic disorderGroup Therapy

Group TherapyIs cheap, effective. (only 1 professional is needed)It allows people to gain insight into their own behaviors and thoughtsPeople dont feel like they are the only one with their problem; they can witness the therapist treat others with similar problems.You can cure yourself while curing others.All of the following are potential benefits of group therapy EXCEPTa) it is often more economical than 1:1 treatmentb) it does not require the services of a mental health professionalc) clients with similar problems can provide helpful insight and feedback to peersd) group members can see how their problems might impact others67

How Is the BiomedicalApproach Used toTreat Mental Disorders?Biomedical therapies seek to treat mental disorders by changing the brains chemistry with drugs, its circuitry with surgery, or its patterns of activity with pulses of electricity or powerful magnetic fields

68Drug TherapyAntipsychotic drugsalleviate the symptoms of severe disorders such as schizophrenia; Examples:Thorazine, Clozapinemany work by blocking dopamine receptor sitescan produce sluggishness, tremors, and twitches similar to those of Parkinsons disease

69

Drug TherapyPsychopharmacology The prescribed use of drugs to help treat symptoms of mental illness ostensibly to ensure that individuals are more receptive to talk therapies70Drug TherapyAntidepressants and mood stabilizersInclude Prozac, monoamine oxidase (MOA) inhibitors, and lithium carbonate (effective against bipolar disorder)Treat depression and bipolar disorderUsually affect serotonin and/or norepinephrineThe use of antidepressants to deal with general feelings of unease is highly controversial

71Drug TherapyAntianxiety drugswork by depressing central nervous system activityMost common side effect - drowsinesshighly addictive, can be fatal when mixed with alcoholsudden cessation after long-term use can result in severe withdrawal symptoms, including seizures, increased anxiety, and in rare cases, death Xanax, Paxil

72Drug Therapy in ADHDStimulants suppress activity level in persons with attention-deficit/hyperactivity disorder (ADHD)There is controversy from concern that the causes and boundaries of ADHD are vague and the potential exists for overdiagnosis

73The MOST commonly cited side effect associated with anti-anxiety drugs isa) insomniab) blurred visionc) drowsinessd) tachycardia 74Prozac and other modern antidepressant medications work toa) block dopamine receptorsb) decrease the level of acetylcholinec) break down the MAO enzymesd) block the reuptake of serotonin75Valium isa) an antidepressant drugb) an MAO inhibitorc) an antipsychotic drugd) an antianxiety drug76Andre suffers from mood swings, alternating from wild episodes of euphoria and spending sprees to motionless staring and hopelessness. If someone from the biomedical approach were to treat his condition, the prescription most likely would bea) Lithium carbonateb) Haldolc) Xanaxd) Thorazine77

PsychosurgeryPsychosurgery The general term for surgical intervention in the brain to treat psychological disordersSevering the corpus callosum can reduce life-threatening seizures78Brain-Stimulation TherapiesElectroconvulsive therapy is used for the treatment of severe depressionTranscranial magnetic stimulation, a possible alternative to ECT, can also be used for the treatment of depression,schizophrenia, and bipolar disorder79Matt enters therapy to talk about some issues that have been causing him distress. The therapist has earned a PhD and uses a variety of techniques to alleviate some of Matts distressing symptoms. Matt is most likely seeing a _____PsychiatristClinical psychologistPsychiatric social workerClinical counselorThe aim of cognitive-behavioral therapy is to _____Discover unconscious motives for behaviorChange the way people behaveChange the way people think and behaveChange peoples negative thinking patternsAnn is suffering from depression and no psychological or drug therapies are working to alleviate her symptoms. The biomedical technique of ____ may be used as a last resort.FloodingSystematic desensitizationElectroconvulsive therapypsychosurgeryModern antidepressants, such as Prozac, work to block the reuptake of which neurotransmitter?DopamineSerotoninAcetylcholineGABA________ therapy does NOT use the services of a trained therapist.BiomedicalCognitive-behavioralBehavioralHumanisticSelf-helpJohn is a 12-year-old who is having trouble dealing with his familys relocation to a new city. He most likely first sees a ______Psychiatrist CounselorClinical psychologistRegistered nursePsychoanalyst