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Transcript
Chapter 13 Treatments for Mental Disorder This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program. ISBN: 0-205-37181-7 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