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Chapter 15 Therapies for Psychological Disorders Objectives 15.1 Mental Health Practitioners and Settings • Compare and contrast the roles of psychiatrists, counseling psychologists, and clinical psychologists. • Discuss the settings used by mental health practitioners. 15.2 Psychodynamic Therapy • Define psychodynamic therapy. • Illustrate the techniques used in psychodynamic therapy. • Compare and contrast traditional psychoanalytic therapy and short-term psychodynamic therapy. Objectives 15.3 Humanistic Therapy • Describe the role of genuineness, acceptance, and empathy in client-centered approaches. 15.4 Behavior Therapy • Explain the ways in which behavioral therapies attempt to change maladaptive associations, discourage maladaptive behaviors, or encourage more adaptive ones. • Compare and contrast classical conditioning and operant conditioning. Objectives 15.5 Cognitive Therapies • Discuss Beck’s cognitive therapy and Ellis’s rational emotive therapy as they relate to cognitive therapy. 15.6 Family Systems and Group Therapy • Illustrate how family systems therapy focuses on how individuals function in their relationships through communication patterns. Objectives 15.7 Biomedical Therapies • Explain the focus on changing physiological problems that lead to psychological conditions in biomedical therapies. • Compare and contrast the major classes of antidepressant drugs, the major drug treatments for anxiety, and antipsychotic medications. • Discuss other nondrug medical treatments for psychological conditions. 15.8 Evaluating Therapies for Psychological Disorders • Describe how clinical trials test treatments for psychological conditions. • Discuss types of research that have provided evidence of the efficacy of treatments for psychological disorders. Mental Health Practitioners (slide 1 of 2) • Psychiatry: A branch of medicine that treats mental and behavioral conditions • Counseling psychologist: A mental health professional who helps people experiencing difficulty adjusting to life stressors to achieve greater well-being • Clinical psychologist: A mental health practitioner who researches, evaluates, and treats psychological conditions Mental Health Practitioners (slide 2 of 2) Figure 15.01: Types of psychological training programs. Settings for Mental Health Practitioners • Mental hospital: A medical center that treats psychological conditions • Outpatient: treatment settings that are outside of a hospital The Role of Psychotherapy • Insight: An understanding of the motivation of behavior • Insight therapies: A family of psychotherapies that focus on the unconscious motivations of behavior Psychodynamic Therapy • Free association: A therapy technique that reveals intrapsychic conflicts by interpreting spontaneous responses to given words • Dream analysis: A technique that reveals intrapsychic conflicts through interpretations of dreams • Resistance: A client’s employment of a defense mechanism during therapy • Transference: A type of displacement in which the client will unconsciously act out relationships with the therapist Types of Psychodynamic Therapy Psychoanalysis Figure 15.08: In classic psychoanalysis, the therapist is out of view of the client. Short-Term Psychodynamic Therapy Figure 15.09: In short-term psychodynamic therapy, client and therapist sit face to face in a more goal oriented approach. Humanistic Therapy • Genuineness: Authenticity in a relationship • Acceptance: Communication of respect • Empathy: An attempt to understand the client’s inner world Behavior Therapy • Behavior therapy: A family of therapies that use learning theory to change behavior Classical Conditioning Techniques • Counterconditioning is a behavioral technique in which a response to a stimulus is replaced by a new response. • Exposure therapy involves repeatedly presenting the client with a distressing object in order to reduce anxiety. • Virtual reality exposure therapy involves the repetitive presentation of a simulated distressing object or situation in order to reduce anxiety. • Aversive conditioning pairs an unpleasant stimulus with an undesired behavior in order to reduce the target behavior. Operant Conditioning Techniques • Operant conditioning involves training emitted behaviors to make them more likely to occur again. • Operant techniques include: – Positive reinforcement of adaptive behaviors – Nonreinforcement or punishment of maladaptive behaviors Cognitive Therapies • Beck’s cognitive therapy • Ellis’s rational emotive therapy Family Systems and Group Therapy • Family therapy treats the immediate social system, i.e., the family, to improve individuals’ psychological functioning. • Group therapy treats multiple clients in a collective setting. Biomedical Therapies: Drug Treatments • Biomedical therapies focus on surgery, medication, or other physiological interventions for the treatment of psychological conditions • Psychotropic medications are drugs used to treat psychological conditions. • Psychopharmacologists are researchers and practitioners who study and often prescribe psychiatric medications. Antidepressant Drugs • Monoamine Oxidase Inhibitors • Selective Serotonin Reuptake Inhibitors • Serotonin-Norepinephrine Reuptake Inhibitors Antianxiety Drugs Mood-Stabilizing Drugs Antipsychotic Drugs Medical Procedures • Electroconvulsive therapy (ECT) : A biological treatment in which seizures are induced in anesthetized patients • Psychosurgery: Treatment of mental and behavioral conditions using an invasive biological procedure – Transcranial magnetic stimulation (TMS): A procedure that uses electromagnetic coils to activate nerve cells in the brain – Deep brain stimulation (DBS): A surgical treatment in which a medical device is used to send electrical impulses to parts of the nervous system Effectiveness of Therapies for Psychological Disorders • Clinical trial: The use of the scientific method to test a treatment for a disorder or condition • Meta-analysis: A statistical technique that pools the results of several research studies • Evidence-based practice: Selecting therapy treatments using information gained through research Effectiveness of Different Therapies Common Factors That Increase Effectiveness • Quality of the therapeutic relationship – Genuineness and warmth • Client factors – Support – Motivation • Cultural factors