* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Therapy
Anti-psychiatry wikipedia , lookup
Narcissistic personality disorder wikipedia , lookup
Ego-dystonic sexual orientation wikipedia , lookup
Psychiatric and mental health nursing wikipedia , lookup
Psychological evaluation wikipedia , lookup
Dissociative identity disorder wikipedia , lookup
Moral treatment wikipedia , lookup
Child psychopathology wikipedia , lookup
Mental disorder wikipedia , lookup
Emergency psychiatry wikipedia , lookup
Deinstitutionalisation wikipedia , lookup
Diagnostic and Statistical Manual of Mental Disorders wikipedia , lookup
Mental health professional wikipedia , lookup
Pyotr Gannushkin wikipedia , lookup
Classification of mental disorders wikipedia , lookup
Substance dependence wikipedia , lookup
Psychedelic therapy wikipedia , lookup
History of psychiatry wikipedia , lookup
Controversy surrounding psychiatry wikipedia , lookup
History of psychiatric institutions wikipedia , lookup
section 13 Therapies for Psychological Disorders 1 What is Therapy? 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 2 What is Therapy? Therapy – General term for any treatment process; in psychology and psychiatry, therapy refers to a variety of psychological and biomedical techniques aimed at dealing with mental disorders or coping with problems of living 3 The Components of Therapy In addition to the relationship between the therapist and the patient/client, the therapeutic process typically involves 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 4 Contemporary Approaches to Therapy Psychological therapies – Based on psychological principles (rather than biomedical approach) The psychological therapies are often collectively called psychotherapy 5 Contemporary Approaches to Therapy Biomedical therapies – Treatments that focus on altering the brain, especially with drugs, psychosurgery, or electroconvulsive therapy 6 Types of Mental Health Care Professionals Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor 7 Professional Title Counseling psychologist Specialty: Clinical psychologist Problems of normal living Psychiatrist Work setting: Psychoanalyst Schools, clinics, other institutions Psychiatric nurse practitioner Credentials: Clinical social worker Master’s in counseling, PhD, EdD, or PsyD Pastoral counselor 8 Professional Title Counseling psychologist Specialty: Clinical psychologist Those with severe disorders Psychiatrist Work setting: Psychoanalyst Private practice, mental health agencies, hospitals Psychiatric nurse practitioner Clinical social worker Pastoral counselor Credentials: PhD or PsyD 9 Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor Specialty: Severe mental disorders (often by means of drug therapies) Work setting: Private practice, clinics, hospitals Credentials: MD 10 Professional Title Counseling psychologist Clinical psychologist Specialty: Psychiatrist Psychoanalyst Freudian therapy Work setting: Psychiatric nurse practitioner Private practice Clinical social worker Credentials: Pastoral counselor MD 11 Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor Specialty: Nursing specialty; licensed to prescribe drugs Work setting: Private practice, clinics, hospitals Credentials: RN – plus special training in treating mental disorders and prescribing drugs 12 Professional Title Counseling psychologist Clinical psychologist Psychiatrist Specialty: Social worker with specialty in dealing with mental disorders Psychoanalyst Work setting: Psychiatric nurse practitioner Often employed by government Clinical social worker Pastoral counselor Credentials: MSW 13 Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor Specialty: Combines spiritual guidance with practical counseling Work setting: Religious order or ministry Credentials: Varies 14 How Do Psychologists Treat Mental Disorders? Psychologists employ two main forms of treatment: the insight therapies and the behavioral therapies 15 Insight Therapies Insight therapies – Psychotherapies in which the therapist helps patients/clients understand (gain insight into) their problems Freudian psychoanalysis Neo-Freudian therapies Humanistic therapies Cognitive therapies Group therapies 16 Insight Therapies Talk therapies – Psychotherapies that focus on communicating and verbalizing emotions and motives to understand their behavior 17 Insight Therapies Psychodynamic therapies – Insight therapies based on the assumption that mental disorder is caused by powerful (dynamic) mental forces and conflicts 18 Insight Therapies: Psychodynamic Therapies Psychoanalysis – The form of psychodynamic therapy developed by Sigmund Freud Analysis of transference – Analyzing and interpreting the patient’s relationship with the therapist, based on the assumption that this relationship mirrors unresolved conflicts in the patient’s past 19 Insight Therapies: Psychodynamic Therapies Neo-Freudian psychodynamic therapies – Therapies developed by psychodynamic theorists who embraced some of Freud’s ideas, but disagreed with others 20 Insight Therapies: Humanistic therapies Humanistic therapies – Techniques based on the assumption that people have a tendency for positive growth and self actualization, which may be blocked by an unhealthy environment Client-centered therapy – Emphasizes healthy psychological growth through self-actualization Reflection of feeling – Paraphrasing client’s words to capture the emotional tone expressed 21 Insight Therapies: Cognitive therapies Cognitive therapy – Emphasizes rational thinking as the key to treating mental disorder Cognitive therapy for depression involves Evaluating evidence Situational factors Alternative solutions 22 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 organized/run by laypersons (not professional therapists) 23 Insight Therapies: Group therapies For many issues, couples counseling or family therapy can often be more effective than individual therapy with one individual at a time 24 Behavior Therapies Behavior therapy – Any form of psychotherapy based on the principles of behavioral learning, especially operant conditioning and classical conditioning Systematic desensitization Aversion therapy Contingency management Token economies Participant modeling 25 Classical Conditioning Therapies Systematic desensitization – Technique in which anxiety is extinguished by exposing the patient to an anxiety-provoking stimulus Exposure therapy – Desensitization therapy in which patient directly confronts the anxiety-provoking stimulus (as opposed to imagining it) 26 Classical Conditioning Therapies Aversion therapy – Involves presenting individuals with an attractive stimulus paired with unpleasant stimulation in order to condition a repulsive reaction UCS (foul odor) UCR (nausea) CS CR (cigarette smoke) 27 Operant Conditioning Therapies Contingency management – Approach to changing behavior by altering the consequences, especially rewards and punishments, of behavior 28 Operant Conditioning Therapies Token economies – Applied to groups (e.g. classrooms, mental hospital wards) involving distribution of “tokens” contingent on desired behaviors; tokens can later be exchanged for privileges, food, or other reinforcers 29 Participant Modeling: An Observational-Learning Therapy Participant modeling – Therapist demonstrates and encourages a client to imitate a desired behavior 30 Cognitive-Behavioral Therapy: A Synthesis Cognitive-behavioral therapy Combines cognitive emphasis on thoughts with behavioral strategies that alter reinforcement contingencies Assumes irrational self-statements cause maladaptive behavior Seeks to help the the client develop a sense of self-efficacy 31 Cognitive-Behavioral Therapy: A Synthesis Rational-emotive behavior therapy – Based on the idea that irrational thoughts and behaviors are the cause of mental disorders (REBT) 32 Evaluating the Psychological Therapies Eysenck proposed that people with nonpsychotic 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 33 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 34 How Is the Biomedical Approach Used to Treat 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 35 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 36 Drug Therapy Antipsychotic drugs Include chlorpromazine, haloperidol, and clozapine Usually affect dopamine pathways May have side effects Tardive dyskinesia – Incurable disorder of motor control resulting from long-term use of antipsychotic drugs 37 Drug Therapy Antidepressants and mood stabilizers • Include Prozac, monoamine oxidase (MOA) inhibitors, and lithium carbonate (effective against bipolar disorder) • Treat depression and bipolar disorder • Usually affect serotonin and/or norepinephrine The use of antidepressants to deal with general feelings of unease is highly controversial 38 Drug Therapy Antianxiety drugs • Include barbiturates and benzodiazepines • May include some antidepressant drugs which work on certain anxiety disorders • Should not be used to relieve ordinary anxieties of everyday life • Should not be taken for more than a few days at a time • Should not be combined with alcohol 39 Drug Therapy Stimulants suppress activity level in persons with attentiondeficit/hyperactivity disorder (ADHD) There is controversy from concern that the causes and boundaries of ADHD are vague and the potential exists for overdiagnosis 40 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 41 Brain-Stimulation Therapies Electroconvulsive therapy is used for the treatment of severe depression Transcranial magnetic stimulation, a possible alternative to ECT, can also be used for the treatment of depression, schizophrenia, and bipolar disorder 42 Hospitalization and the 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 43 Hospitalization and the Alternatives Community mental health movement – Effort to deinstitutionalize mental patients and to provide therapy from outpatient clinics 44 End of Chapter 13 45