Download Prevalence of Psychological Disorders in U.S.

Treating Psychological
Disorders
Chapter 15
Who Seeks Treatment?

15% of U.S. population in a
given year


Most common presenting
problems


Anxiety and Depression
Demographics



4.5 million people
Women more than men
Education level
Barriers to Treatment

Medical insurance
Who Provides Treatment?
Clinical psychologists
 Counseling psychologists
 Psychiatrists
 Clinical social workers
 Psychiatric nurses
 Counselors

Types of Treatment

Psychotherapy

Insight therapies


Psychodynamic
24%
Behavior therapies


“talk therapy”
Cognitive
8%
Changing overt behavior
Clientcentered
6%
Biomedical therapies

Biological functioning
interventions
Behavioral
11%
Eclectic
35%
Other
16%
Psychoanalysis


Focuses on uncovering unconscious conflicts resulting from fixations at early
developmental stages
Uses techniques such as...




To minimize


Resistance
and facilitate


Free association
Dream analysis
Interpretation
Transference
Goal is to rebuild personality
Client-Centered Treatment


Believes disorders result from incongruence between self-concept and
reality or dependence on acceptance from others.
Uses techniques such as





Unconditional positive regard
Empathy
Genuineness
Reflection
Goal is to increase client self-acceptance (minimize incongruence)
Behavioral Therapies


Believe disorders are maladaptive patterns of behavior that have
been learned.
Use techniques such as






Conditioning (Classical & Operant)
Aversion
Systematic Desensitization
Social Skills Training
Biofeedback
To eliminate maladaptive behavior and replace with adaptive
behavior.
Behavior Therapies

B.F. Skinner and colleagues
Goal: unlearning maladaptive behavior and
learning adaptive ones
 Systematic Desensitization – Joseph Wolpe

 Classical
conditioning
 Anxiety hierarchy

Aversion therapy
 Alcoholism,
sexual deviance, smoking, etc.
Figure 15.7 The logic underlying systematic desensitization
Behavior Therapy

B.F. Skinner and colleagues

Social skills training
 Modeling
 Behavioral
rehearsal
Cognitive-Behavioral Therapy

Aaron Beck

Cognitive therapy


Use techniques such as






Believe disorders result from
irrational assumptions and
negative, self-defeating
thoughts.
Thought stopping
Recording automatic thoughts
Refuting negative thinking
Reality testing
Homework
Goal is to detect negative,
irrational thinking and replace
with realistic thinking
Cognitive-Behavioral Therapy

Martin Seligman

Learned helplessness
and depression

Difficult to establish
helplessness-depression
link
Cognitive-Behavioral Therapy


Martin Seligman
Explanatory style

a person’s habitual way
of explaining events,
typically assessed along
three dimensions:
internal/external,
stable/unstable, and
global/specific
% Remaining after 1 year
70
60
50
40
30
20
10
0
Bottom Bottom
25%
50%
Top
50%
ASQ
Top
25%
Biomedical Therapies
Type
Example
Positive Effects
Adverse Effects
Antianxiety Drugs
Valium,
Xanax
Quick acting
Reduces anxiety
Nausea,
drowsiness,
confusion
Decrease psychotic
symptoms
Tardive dyskinesia
Reduce depressive
symptoms
Dry mouth,
Blurred vision,
Constipation,
Drowsiness
Prevents mood
swings
Reduces depressive
symptoms
Kidney and
Thyroid damage
Memory loss,
Impaired attention
Thorazine,
Haldol
Elavil,
Nardil,
Antidepressant Drugs Prozac,
Paxil,
Zoloft
Antipsychotic Drugs
Bipolar Treatment
ECT
Lithium
Biomedical Therapies

Psychopharmacotherapy
Antianxiety - Valium, Xanax, Buspar
 Antipsychotic - Thorazine, Mellaril, Haldol

 Tardive
dyskinesia
 Clozapine

Antidepressant:
– Elavil, Tofranil
 Mao inhibitors (MAOIs) - Nardil
 Selective serotonin reuptake inhibitors (SSRIs) –
Prozac, Paxil, Zoloft
 Tricyclics
Figure 15.12 Antidepressant drugs’ mechanisms of action
Biomedical Therapies

Psychopharmacotherapy

Mood stabilizers
 Lithium
 Valproic

acid
Electroconvulsive therapy (ECT)
Current Trends and Issues in Treatment


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Managed care
Empirically validated
treatments
Blending Approaches to
treatment
Multicultural sensitivity
Deinstitutionalization


Revolving door problem
Homelessness