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How do we help people with mental health issues? The treatment of psychological disorders: An overview of modern techniques Treatment approaches Learning or adjustment-related disorders (like phobias): psychotherapy with a trained, compassionate therapist Biologically-influenced disorders (like schizophrenia): biomedical therapy Bio-psycho-social approach: draw from a variety of techniques (drugs and psychotherapy in combination) Eclectic approach: using techniques from different forms of therapy Psychologists/clinical social workers supply the therapy; psychiatrists prescribe and monitor medicines Part 1: Psychotherapy #1: Psychoanalysis Freud Psychological problems caused by childhood’s residue of repressed impulses and conflicts Work through buried feelings and take responsibility for own growth Healthier, less anxious living becomes possible when people release the energy they had previously devoted to id-ego-superego conflicts #1: Psychoanalysis (cont.) Free association; therapist sits out of view Resistance: blocking from consciousness of anxiety-producing material; in the flow of your free associations; when you change the subject, joke, or omit things Interpretation and insight: underlying wishes, feelings, conflicts Transference: the patient’s transfer to the analyst of emotions linked with other relationships Several years, several sessions a week, $$$$$$ Psychodynamic therapies: based on Freud’s ideas; face to face therapy that helps people learn to understand their current symptoms by focusing on important themes in their lives across important relationships. #2: Humanistic Therapy Client-Centered Therapy Developed by Carl Rogers (1902-1987) Non-directive: listens without judgment, interpretation, or directing the client toward certain insights Belief that people already possess the resources for growth Therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients’ growth #2: Humanistic Therapy Boost peoples’ capacity for self-fulfillment by helping them grow in self-awareness and selfacceptance. Focus on the present, not the past. Conscious, rather than unconscious thoughts. Taking immediate responsibility for one’s feelings and actions. Promoting growth instead of curing illness (clients, not patients). #2: Humanistic Therapy (cont.) Active Listening: empathic listening in which the listener echoes, restates, and clarifies; “hearing” http://www.youtube.com/watch?v=DjTpEL8acfo #3: Behavior Therapy Behavior Therapy therapy that applies learning principles to the elimination of unwanted behaviors (behavior modification) Counterconditioning procedure that conditions new responses to stimuli that trigger unwanted behaviors based on classical conditioning includes systematic desensitization and aversive conditioning #3: Behavior Therapy (cont.) Exposure Therapy treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid #3: Behavior Therapy (cont.) Systematic Desensitization type of counterconditioning associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli commonly used to treat phobias Aversive Conditioning type of counterconditioning that associates an unpleasant state with an unwanted behavior nausea ---> alcohol #3: Behavior Therapy (cont.) Systematic Desensitization #3: Behavior Therapy (cont.) Aversion therapy for alcoholics #3: Behavior Therapy (cont.) Token Economy an operant conditioning procedure that rewards desired behavior patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats #4: Cognitive Therapy Cognitive Therapy teaches people new, more adaptive ways of thinking and acting; new habits of mind that are healthier and more productive based on the assumption that thoughts intervene between events and our emotional reactions Aaron Beck’s Treatment for Depression Cognitive therapy can reverse peoples’ catastrophizing beliefs about themselves, their situations, and their futures. Gentle questioning to reveal irrational thinking; persuade people to “remove the dark glasses” through which they view life. Change “self talk;” stress inoculation training; dispute negative thoughts #4: Cognitive Therapy (cont.) The Cognitive Revolution: the most widely used and popular form of therapy! #4: Cognitive Therapy (cont.) A cognitive perspective on psychological disorders #4: Cognitive Therapy (cont.) Cognitive therapy for depression: effective, gets results #5: Cognitive-Behavioral Therapy A popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior); changing how people think and how they act; replace negative ways of thinking and acting with positive ones Very useful for anxiety and depression; learning how to re-label impulses and feelings to “unstick” the brain and change bad habits #6: Group and Family Therapies Family Therapy treats the family as a system views an individual’s unwanted behaviors as influenced by or directed at other family members attempts to guide family members toward positive relationships and improved communication Evaluating Psychotherapies To whom do people turn for help for psychological difficulties? Evaluating Psychotherapies Number of persons Average untreated person Poor outcome 80% of untreated people have poorer outcomes than average treated person Average psychotherapy client Good outcome Evaluating Psychotherapies 89% of people said that they were at least “fairly well satisfied” with their treatment! Part 2: Biomedical therapies Biomedical Therapies The emptying of U.S. mental hospitals Biomedical Therapies Biomedical Therapies Common drugs Antipsychotic drugs: Thorazine, Clozapine, Risperdal, Zyprexa, Seroquel, Abilify Antianxiety drugs: Xanax, Ativan In the final 12 years of the 20th Century, the rate of outpatient treatment for anxiety disorders doubled. Antidepressant drugs: Prozac, Zoloft, Paxil Mood stabilizers: Lithium Other Biomedical Therapies Electroconvulsive Therapy (ECT) therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient Deep brain stimulation, magnetic stimulation Psychosurgery surgery that removes or destroys brain tissue in an effort to change behavior (extremely rare) Electroconvulsive Therapy