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Chapter 13
Therapies for
Psychological Disorders
What is Therapy?
Therapy for psychological
disorders takes a variety of
forms, but all involve some
relationship focused on
improving a person’s mental,
behavioral, or social
functioning
What is Therapy?

Therapy: General term for any
treatment process

In psychology and psychiatry - a variety of
psychological and biomedical techniques
aimed at dealing with mental disorders or
coping with problems of living
The Components of Therapy

Relationship between the therapist and
the patient/client and some or all of the
following processes:



Identifying the problem
Identifying the cause of the problem or the
conditions that maintain the problem
Deciding on and carrying out some form of
treatment
Contemporary Approaches to
Therapy


Psychological therapies: Based on psychological principles (rather than biomedical
approach)
Often collectively called psychotherapy
Contemporary Approaches to
Therapy

Biomedical therapies: Focus on altering the
brain



Drugs
Psychosurgery
Electroconvulsive therapy
Types of Mental Health Care
Professionals
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Professional Title
Specialty:
Counseling psychologist
Clinical psychologist
Psychiatrist
Problems of
normal living
Work setting:
Psychoanalyst
Schools, clinics,
other institutions
Psychiatric nurse practitioner
Credentials:
Clinical social worker
Pastoral counselor
Master’s in
counseling, PhD,
EdD, or PsyD
Professional Title
Specialty:
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Those with severe
disorders
Work setting:
Private practice,
mental health
agencies,
hospitals
Credentials:
PhD or PsyD
Professional Title
Specialty:
Counseling psychologist
Psychiatrist
Severe mental
disorders (often
by means of drug
therapies)
Psychoanalyst
Work setting:
Psychiatric nurse practitioner
Private practice,
clinics, hospitals
Clinical psychologist
Clinical social worker
Pastoral counselor
Credentials:
MD
Professional Title
Counseling psychologist
Specialty:
Clinical psychologist
Freudian therapy
Psychiatrist
Work setting:
Psychoanalyst
Private practice
Psychiatric nurse practitioner
Credentials:
Clinical social worker
Pastoral counselor
MD
Specialty:
Professional Title Nursing specialty;
Counseling psychologist
Clinical psychologist
licensed to
prescribe drugs
Work setting:
Psychiatrist
Private practice,
clinics, hospitals
Psychoanalyst
Credentials:
Psychiatric nurse
practitioner
Clinical social worker
Pastoral counselor
RN – plus special
training in treating
mental disorders
and prescribing
drugs
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Specialty:
Social worker with
specialty in
dealing with
mental disorders
Psychoanalyst
Work setting:
Psychiatric nurse practitioner
Often employed
by government
Clinical social worker
Pastoral counselor
Credentials:
MSW
Professional Title
Counseling psychologist
Specialty:
Psychiatrist
Combines
spiritual guidance
with practical
counseling
Psychoanalyst
Work setting:
Psychiatric nurse practitioner
Religious order or
ministry
Clinical psychologist
Clinical social worker
Pastoral counselor
Credentials:
Varies
Insight Therapies:
Psychodynamic Therapies

Psychoanalysis: Form of psychodynamic
therapy developed by Sigmund Freud



Analysis of transference: Analyzing and
interpreting the patient’s relationship with the
therapist
Dream interpretation, free association
Neo-Freudian psychodynamic therapies:
Developed by psychodynamic theorists who
embraced some of Freud’s ideas, but
disagreed with others (sex, childhood)
How Do Psychologists
Treat Mental Disorders?
Psychologists employ two
main forms of treatment:
the insight therapies
and the behavioral therapies
Insight Therapies:
Humanistic Therapies


Humanistic therapies: tendency for positive
growth and self actualization (may be
blocked by unhealthy environment)
Client-centered therapy: Emphasizes
healthy psychological growth through selfactualization (Rogers)


Reflection of feeling: Paraphrasing client’s
words to capture the emotional tone expressed
Unconditional positive regard: nonjudgmental
and respect for client
Insight Therapies:
Cognitive Therapies


Cognitive therapy: Emphasizes rational
thinking as the key to treating mental
disorder
Cognitive therapy for depression (Aaron
Beck)


Confront destructive thoughts that support it
Can be at least as effective as medication
Insight Therapies

Insight therapies: Psychotherapies in which
the therapist helps others understand (gain
insight) their problems (emotions, thoughts)

AKA – talk therapies


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Psychodynamic – unconscious conflicts
Humanistic – positive growth & self-actualization
Cognitive – emphasizes rational thinking (ex. Beck –
depression; confront thoughts that support it)
Behavior Therapies

Behavior therapy: based on the principles of
behavioral learning, especially operant and
classical conditioning
Systematic
desensitization
Aversion
therapy
Contingency
management
Token
economies
Classical Conditioning
Therapies

Systematic desensitization: Anxiety is
extinguished by gradually exposing the patient
to an anxiety-provoking stimulus


Exposure therapy: patient directly confronts the
anxiety-provoking stimulus (as opposed to
imagining it)
Aversion therapy: Present an attractive
stimulus with unpleasant stimulation in order to
condition a repulsive reaction
Operant Conditioning
Therapies


Contingency management: Changing
behavior by altering the consequences
(rewards and punishments) of behavior
Token economies: Applied to groups
involving distribution of “tokens” contingent
on desired behaviors
Cognitive-Behavioral Therapy:
A Synthesis

Cognitive-behavioral therapy





Modify irrational thoughts
Set attainable behavioral goals
Develop realistic strategies to attain goals
Evaluate results
Rational-emotive behavior therapy: irrational
thoughts and behaviors are the cause of mental
disorders (REBT)

Albert Ellis – strong approach, no acceptance of
irrational thoughts, may be a heated interaction
How Is the Biomedical Approach Used to
Treat Mental Disorders?
Biomedical therapies seek to
treat mental disorders by
changing the brain’s
chemistry with drugs, its
circuitry with surgery, or its
patterns of activity with pulses
of electricity or powerful
magnetic fields
It’s
your last day
of notes! 
Drug Therapy

Psychopharmacology: The prescribed use
of drugs to help treat symptoms of mental
illness ostensibly to ensure that individuals
are more receptive to talk therapies
Drug Therapy

Antipsychotic drugs




Include chlorpromazine, haloperidol, and
clozapine
Usually affect dopamine pathways (reduce it)
May have side effects
Tardive dyskinesia: Incurable disorder of
motor control resulting from long-term use
of antipsychotic drugs
Drug Therapy

Antidepressants and mood stabilizers

Usually affect serotonin/norepinephrine (increase)

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(MAO) inhibitors – increase norepinephrine
Tryicyclics – inhibit reuptake
SSRIs – inhibit reuptake of serotonin (Prozac)
Lithium carbonate – treats bipolar (can be toxic)
Highly controversial – suicide, using just when
uneasy
Drug Therapy

Antianxiety drugs

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Barbiturates – relax central nervous system
Benzodiazepines – decrease activity in anxiety
regions of brain
Do not



Use to relieve ordinary anxieties of everyday life
Take for more than a few days at a time
Combine with alcohol
ONLY
TWO MORE
SLIDES OF
NOTES FOR THE
YEAR!!! 
Psychosurgery

Psychosurgery: The general term for
surgical intervention in the brain to treat
psychological disorders


The infamous prefrontal lobotomy is no longer
performed
Severing the corpus callosum, however, can
reduce life-threatening seizures
Brain-Stimulation Therapies

Electroconvulsive (ECT) therapy - used for
treatment of severe depression


Side effect – memory disruption
Transcranial magnetic stimulation (TMS): a
possible alternative to ECT- treatment of
depression, schizophrenia, and bipolar
disorder
Hospitalization and
the Alternatives


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Therapeutic community: Program of treating
mental disorder by making the institutional
environment supportive and humane for
patients
Deinstitutionalization: Policy of removing
patients, whenever possible, from mental
hospitals
Community mental health movement: Effort to
deinstitutionalize mental patients and to
provide therapy from outpatient clinics
Drug Therapy


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Stimulants: suppress activity level in
persons with attention-deficit/hyperactivity
disorder (ADHD)
Causes and boundaries of ADHD are vague
and the potential exists for over-diagnosis
Side effects – growth, sleep, later use
Insight Therapies:
Group therapies


Group therapy: Psychotherapy with more
than one client
Self-help support groups: Groups that
provide social support and an opportunity for
sharing ideas about dealing with common
problems


typically run by laypersons (not professional
therapists)
Couples and family therapy
Participant Modeling: An
Observational-Learning Therapy

Participant modeling: Therapist
demonstrates and encourages a client to
imitate a desired behavior
Evaluating the Psychological
Therapies


Eysenck proposed that people with nonpsychotic problems recover just as well
with or without therapy
Reviews of evidence have shown:


That therapy is better than no therapy
It appears advantageous to match specific
therapies with specific conditions
Mental “First Aid”


If someone asks you for help, keep in mind
that serious problems (especially those
involving suicide or threats) require
immediate professional treatment
Otherwise, your best tools may involve



Listening
Acceptance
Exploring alternatives