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Abnormal Psych Treatment
TREATMENT OF PSYCHOLOGICAL
DISORDERS
Treating psychological disorders poses one of the biggest problems
for psychologists.
Important to have a realistic perspective:
We can treat the symptoms, but according to most
perspectives, we cannot cure the disorders.
Historically - very broad array of treatments for mental disorders from
super harsh --> super soft.
Movement from harsh to soft treatments, pioneered by Philippe Pinel
in France & Dorothea Dix in the U.S.
Fought: mental patients out of prisons & into mental hospitals.
Trend since 1950s:
Move patients out of the mental hospitals,
back home, & treat them through medication
& support groups.
Treatments today 2 broad categories:
1. Psychotherapy attacks learning-related
disorders, like fears. Trained psychologist
uses psych techniques to overcome the
disorder. There are 4 main approaches:
★
★
★
★
Psychoanalysis
Humanism
Behaviorism
Cognitive
2. Biomedical therapies - medication
Example: schizophrenia
Psychologists in the biopsychosocial perspective may
try both psychotherapy & medication:
Eclectic Approach
YouTube: 60 Minutes - Advanced PTSD Therapy
Insight Therapies:
Involve verbal interactions
intended to enhance
clients’ self-knowledge &
thus promote healthful
changes in personality &
behavior.
2 types of psychologists
may provide therapy:
Clinical Psychologists &
Counseling Psychologists
Clinical psychologists’ training
emphasizes treatment of full-fledged
disorders.
In contrast, counseling
psychologists’ training is slanted
toward the treatment of everyday
adjustment problems.
Both types of psychologists must earn a doctoral
degree (Ph.D., Psy.D., or Ed.D.).
A doctorate in psychology requires about 5-7
years of training beyond a bachelor’s degree.
Psychiatrists: physicians who specialize in the diagnosis
& treatment of psychological disorders. Many
psychiatrists also treat everyday behavioral problems.
However, in comparison to psychologists, psychiatrists
devote more time to relatively severe disorders
(schizophrenia, mood disorders) and less time to
everyday marital, family, job, and school problems.
Psychiatrists have an M.D. degree.
Their graduate training requires 4 years of
coursework in medical school and a 4-year
apprenticeship in a residency at a hospital.
Their psychotherapy training occurs during their
residency, since the required coursework in medical
school is essentially the same for everyone, whether they
are going into surgery, pediatrics, or psychiatry.
YouTube: Hank Green - Mass Incarceration in the U.S.
YouTube: 60 Minutes - Jails - “New Asylums”
DSM Changes Over Time: This figure demonstrates how one diagnosis, that for Autism, has changed with
each version since the creation of the DSM in 1952. SOURCE: "Inside the Battle to Define Mental Illness | Wired
Magazine | Wired.com." http://www.wired.com/magazine/2010/12/ff_dsmv/all/. Wired Magazine.
FREUD’S
THERAPEUTIC
TECHNIQUE:
Goal = help patient uncover
unconscious conflicts that give rise
to anxiety.
Anxiety typically causes a
person difficulty in dealing
with everyday life.
Cause of Anxiety: DeepRooted in conflicts set in
the unconscious
Variety of techniques:
★ Intensive 1-on-1 Therapy
★ Psychoanalysis
Psychotherapy is a term that describes many forms of
talk therapy, all of which aim to explore distressing
thoughts, feelings & behaviors.
FREUD’S THERAPEUTIC TECHNIQUE:
Long-term commitment: Typically lasts 1 hour/day, several days/week - possibly
several years. Various techniques used to get to unconscious, but set up, according
to Freud, is important:
★ Therapist should sit behind a client in a chair
★ the client should lie in a chaise lounge so she can relax.
★ Therapist asks questions & client answers as honestly as possible.
Therapy takes so long because the techniques to get to the unconscious cannot
be direct. To uncover what is in the unconscious, the therapist must use techniques
that require interpretation before the true meaning can be divined.
DREAM ANALYSIS:
Freud argued that dreams were “Royal Road to the Unconscious”
Using dream analysis, therapist could take notes on manifest content (the dream itself)
& then interpret latent content (the hidden, underlying symbolic meaning).
By using what Freud knew about the symbolism of dreams a therapist can determine
some of the potential causes of anxiety.
TRANSFERENCE:
Freud discovered that some of his
patients developed strong feelings about
him:
★ some of love
★ some of hate
But after contemplation he realized that these
patients were experiencing strong emotions
for their loved ones & temporarily transferring
those to their therapist.
Freud had great insight that this
transference was an unconscious process
- and, indeed, a way that he could illuminate
this issue & help the patients see unresolved
conflicts with people they were close to.
HYPNOSIS:
Freud practiced hypnosis early in his
career.
He believed that hypnosis would ease
the grip that the repression had on
the unconscious & allow some of those
issues to percolate to consciousness.
He later argued, however, that it was far
less effective than he once believed.
Crash Course Clip
FREE ASSOCIATION:
Freud’s preferred method of therapy.
A person says the 1st thing that comes to mind
when a therapist says something.
If a person does this fast enough, according to
Freud, the first thing he says can be a
“glimpse” into the unconscious.
By getting such a glimpse, the therapist can
determine the causes of the anxiety.
http://educationportal.com/academy/lesson/psychoanalytictherapy-free-association-dream-analysis-andtransference-resistance.html#lesson
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
Clip
Psychosurgery
surgery that removes or destroys brain tissue in an effort to
change behavior
lobotomy
now-rare psychosurgical procedure once used to calm
uncontrollably emotional or violent patients
Electroconvulsive Therapy
Crash Course Biomedical
Therapies
DRUG
THERAPY
1st course of treatment for many
psychological disorders is to provide
relief of the symptoms.
Drugs are often the most effective
strategy for immediate relief of
symptoms.
DRUGS:
Freud also believed that a variety of drugs (including cocaine) could
be used to alleviate anxiety.
It is interesting to note that Freud did not spend much of the
therapeutic situation practicing these techniques but, rather,
collecting detailed histories of his clients.
He believed that small details of one’s childhood could be critical
in explaining how the anxiety had developed.
After years of intensive therapy and after much of the
unconscious has been laid bare through the treatment, the client
is presumably “cured.”
Other forms of psychoanalysis also focused on determining the
cause of the anxiety in the unconscious but used different
techniques. The underlying assumption is that therapy should
uncover the issues in the unconscious that are the root of anxiety.
Drug Therapy + Talk Therapy:
Drug therapy is typically combined with “talk therapy” to
alleviate symptoms overall and to help the afflicted person
handle the disorder more effectively.
Of the various “talk therapies,” the techniques of Sigmund
Freud have served as the face of psychology. What is
interesting about this is that Freud offered some of the
least testable techniques of any of the therapies.
DEPRESSION:
Antidepressants, including the selective serotonin reuptake inhibitors, such
as Prozac, Wellbutrin, Zoloft.
ANXIETY DISORDERS
Anxiolytics, such as Xanax or Paxil.
Biomedical Therapies
SCHIZOPHRENIA
Early antipsychotics included drugs that caused side
effects such as tardive dyskinesia.
dyskinesia - disorder resulting in involuntary, repetitive
body movements that can be tardive, having a slow or
belated onset.
The most well-known of these drugs was chlorpomazine
(Thorazine). More recent drugs, such as Zeprexa and
Risperdal, reduce the effects on the muscle systems.
Humanistic Therapy
Client-Centered Therapy
humanistic therapy developed by Carl
Rogers
therapist uses techniques such as active
listening within a genuine, accepting,
empathic environment to facilitate clients’
growth
Humanistic Therapy
Active Listening-empathic listening in which the
listener echoes, restates, and clarifies
Behavior Therapy
Behavior Therapy
therapy that applies learning principles to the elimination
of unwanted behaviors
Counterconditioning
procedure that conditions new responses to stimuli that
trigger unwanted behaviors
based on classical conditioning
includes systematic desensitization and aversive
conditioning
Behavior Therapy
Exposure Therapy
treat anxieties by exposing people (in imagination or reality) to
the things they fear and avoid
Behavior Therapy
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
Behavior Therapy
Systematic Desensitization
Behavior Therapy
Aversion
therapy for
alcoholics
Behavior Therapy
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
Cognitive Therapy
Cognitive Therapy
teaches people new, more adaptive
ways of thinking and acting
based on the assumption that
thoughts intervene between events and
our emotional reactions
Cognitive Therapy
The
Cognitive
Revolution
Cognitive Therapy
A cognitive
perspective on
psychological
disorders
Cognitive Therapy
Cognitive
therapy for
depression
Cognitive Therapy
Cognitive-Behavioral Therapy
a popular integrated therapy that
combines cognitive therapy (changing
self-defeating thinking) with behavior
therapy (changing behavior)
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