Download Cognitive therapy

Chapter 13
Treatments for
Mental Disorder
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What is Therapy?
Therapy takes a variety of
forms, common element is a
relationship focused on
altering behavior or mental
processes
The Four Goals of Therapy
• Identifying the problem
• Identifying the etiology, or cause, of the
problem
• Making a prognosis
• Deciding on and carrying out some form of
treatment
Contemporary Approaches to
Therapy
•
Psychological therapies
– Behavioral and Cognitive therapy
– Psychodynamic approach
– Humanistic therapy
•
Biomedical therapies –
Treatments that focus on altering the
brain (drugs, psychosurgery, or
electroconvulsive therapy)
Types of Mental Health Care
Professionals
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Behavior and Cognitive Therapy
• Behavior therapy
–
–
–
–
–
Systematic desensitization.
Aversive conditioning.
Exposure treatments.
Behavioral records and contracts.
Token economies
Insight Therapies
Psychodynamic therapies
• Psychoanalysis
• Different Techniques
– Transference, free association
• Post-Freudian therapies
– Individual’s current social environment
– Social and interpersonal relationships
– Conscious self-concept
Insight Therapies
Humanistic therapies
• Person-centered therapy
– Reflection of feeling –
– Unconditional positive regard –
– Nondirective –
– “Forward looking”
Insight Therapies
Group therapies
• Self-help groups
Organized/run by laypersons
• Marital and family therapy
Insight Therapies
Cognitive therapies
• Cognitive therapy – Rational-emotive behavior
therapy (REBT) (Albert Ellis)
– Unrealistic beliefs/expectations
– Overgeneralization, catastrophizing*
• Cognitive therapy for depression
– Evaluating evidence
– Situational factors
– Alternative solutions
Evaluating the
Psychological Therapies
• Therapy better than no therapy
• Different insight therapies roughly
equivalent in effectiveness
• Specific therapies for specific
conditions
Common Ingredients in
Successful Therapies
• When there is a bond between therapist
and client (a.k.a. Therapeutic Alliance).
• When participants want to be helped.
• When therapists distinguish normal
cultural patterns from individual
psychological problems.
The Question of Drugs
Drug Therapy
• Antipsychotic drugs
– Side effects
• Tardive dyskinesia –
Incurable disorder of motor control
resulting from long-term use of
antipsychotic drugs
Drug Therapy
• Antidepressant drugs
– E.g., Prozac, lithium carbonate (effective
against bipolar disorder)
– Also given for “social phobias”?, PMS?
Drug Therapy
• Antianxiety drugs
– e.g., barbituates
– Should not be used to relieve ordinary
anxieties of everyday life
Drug Therapy
• Placebo effect
• High Relapse and
dropout rates.
• Dosage problems.
• Long-term risks
Other Biomedical Therapies
• Psychosurgery
– Prefrontal lobotomy
(*rare today)
– Severing corpus
callosum
– Hemispherectomy
•Electroconvulsive Therapy