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Notes Chapter 13-Therapy Psychotherapy-general term for any treatment process aimed at dealing with mental disorders or coping with problems of living. (Insight, behavioral, or interpersonal) Components of therapy 1. Identify the problem 2. Identify the cause of the problem or conditions that maintain the problem 3. Deciding on and carrying out some form of treatment History of therapy Medieval Europe-mental disorders were the work of the devil and. Perform exorcism Put mental people in asylums-First and most infamous asylums-Bethlehem Hospital in London-Bedlam. Modern treatments-Psychological therapies Insight therapies-psychotherapy in which therapist helps patient/client understand (gain insight) into their problems AKA "talk therapy" Having patient gain insight or understanding of their conflicts Psychodynamic/psychoanalytic psychotherapy Psychoanalysis-a method of psychotherapy aimed at revealing and resolving conflicts that are in the unconscious. Free-Association-techniques that involves the client speaking freely about any topic or image that comes into his or her mind Dream analysis-involves identifying and separating: a. Manifest content-portion of the dream that is consciously remembered b. Latent content-symbolic, wishes, fantasies, and impulses Resistance-when the client unconsciously tries to block the process of revealing repressed memories Transference-occurs when patient unconsciously responds to the therapists as though he or she were a significant person in his or her life. (Projection of parental attributes onto therapist) Analysis of transference-patients are better (recover) when relationship with therapist is analyzed because that relationship (after transference) mirrors relationship with parents Modern psychoanalysis-not as long or expensive, lots of neo-Freudians focus on conscious motives now Interpersonal therapy (modern psychoanalysis)-helps patients cope with present problems that may be result of problems from childhood Humanistic therapies Assumes people are generally motivated by healthy needs for growth and psychological well-being Emphasizes striving for and reaching human potential Self-concept-person’s thought’s or perceptions of him or herself (humanists say this is most important) Dispute Freud's Triparte mind Mental disorders occur when conditions interfere with normal healthy development...produces low self-esteem. Client-Centered therapy-Carl Rogers: client has need to self-actualize (to realize their potential), create nurturing environment, enhance self-esteem, create positive self-image Unconditional positive regard-listening without interrupting, being judgmental, or expressing an opinion. Nondirective-let client talk. Client is a valued person who has an active role in recovery Empathy (active listening)-therapist tries to see problems from client perspective through using active listening, making eye contact, etc…. Reflection of feeling-(AKA reflective listening) Rogerian technique of paraphrasing clients words, trying to get them to understand their emotions Congruence (AKA genuineness)-therapist tries to be consistent, open, honest, promotes trust, etc. Cognitive therapies-Aaron Beck, emphasizes rational thinking as opposed to subjective emotions, motivations, repressed conflicts Behavioral therapy-(behavior modification)-undesirable behaviors are learned therefore can be unlearned Counterconditioning-learning of a new conditioned response that is more effective than the original learned response Example-Peter is scared of all furry animals (especially rabbits), Mary Cover Jones brings rabbit to therapy, puts it on a table across room from Peter. Mary gives Peter his favorite snack. Hopefully Peter will associate a positive feeling (getting his favorite snack) with the established original response of fear associated with the rabbit, that would counter the fear. Mary also had other kids play with the rabbit to show Peter it was harmless (observational learning) Bed-wetting? Systematic desensitization-anxiety is extinguished by exposing patient to anxietyprovoking stimulus gradually....imagine them at first....then maybe exposure therapy. Flooding (implosive therapy)-Exposure technique that involves espousing patient directly to the feared stimulus, without chance of escape (but never in any real danger). Not recommended because could cause panic attacks. Aversion therapy-Classical conditioning procedure, present attractive stimulus (drinking alcohol) with an unpleasant (aversive) stimulus (Disulfiram) The purpose is to have the patient associate nausea (conditioned response) with alcohol Token economies-operate on the principles of operant conditioning (positive reinforcement). Sues previously worthless items to get desired behavioral by attaching value to those objects Used with severely mentally retarded individuals, mental institutions, prisons, etc.. Participant Modeling-"Monkey see-monkey do" Rational-Emotive Behavioral Therapy-(REBT)-Albert Ellis said irrational thoughts and behaviors are cause of mental disorders Interpretation of events (not the event itself) leads to feelings of despair ABC model Example-Activating event-can’t find a date to the prom. Belief-“I guess nobody likes me.” Consequences-feelings of despair Hans Eysenck-claimed nearly 2/3 of people with non-psychotic problems recover within two years with or without therapy. Group therapy-Allows person to be around others who have same problem, cost effective, other patients empathize with each other. Biomedical therapies-use Electroconvulsive therapy, medications, or other medical procedures that directly affect the brain and nervous system of a patient experiencing symptoms associated with a psychological disorder. Psychopharmacology-using drugs to treat symptoms of mental disorders, they do not "cure" 4 major categories of drugs 1. Antipsychotic drugs (Neuroleptics)-diminish psychotic symptoms Work by reducing activity of NT dopamine? Thorazine, Haloperidol , Clozapine Tardive dyskinesia-negative side effect of antipsychotic drugs-incurable disorder of motor control, especially facial muscles. 2. Antidepressants (mood stabilizers) "turn up the volume" of serotonin and norepinephrine 1. Tricyclic-reduce neuron's reabsorption of NTs-reuptake. 2. SSRIs-Selective serotonin reuptake inhibitors-Prozac (flouxetine) Paxil, Zoloft 3. MAO-monoamine oxidase inhibitors-limits activity of enzyme MAO. MOA breaks down norepinephrine in the synapse=more norepinephrine Lithium carbonate (lithium) used to stabilize mood. Bipolar disorder. Can be toxic Antidepressants-suicide and suicidal thoughts????? 3. Anti-anxiety drugs (anxiolytics) Barbiturates-depress CNS Benzodiazepines-Valium, Xanax-increase GABA NT. "minor tranquilizers" (beenies) Don't drink alcohol with these! Why? 4. Stimulants Caffeine, nicotine, amphetamines, cocaine, etc.... Used to treat narcolepsy, ADHD (Ritalin) Psychosurgery-surgical intervention into the brain to treat psychological disorders. Prefrontal lobotomy Split-brain surgery-gran mal seizures Phineas Gage-F.A.A.-personality? Brain-Stimulation therapy Electroconvulsive therapy (ECT)-used for severe depression, induce seizure, produces memory loss, Nobody is sure why is works about 50% of the time but most patients relapse into depression. Transcranial Magnetic stimulation (TMS)-Magnetic stimulation to brain Eclectic approach-involves using a variety of therapeutic techniques based n the symptoms and needs of the client Deinstitutionalization-policy of removing patients from mental hospitals, get community treatment, many end up homeless.