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Chapter 13 Therapies for Psychological Disorders 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 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 How Do Psychologists Treat Mental Disorders? Psychologists employ two main forms of treatment: the insight therapies and the behavioral therapies Insight Therapies Insight therapies (talk therapies): Psychotherapies in which the therapist helps others understand (gain insight) their problems (emotions, thoughts) Humanistic – focus on positive growth & self actualization (may be blocked by unhealthy environment) Client-centered therapy: Emphasizes healthy psychological growth through self-actualization (Rogers) Active Listening: Paraphrasing client’s words to capture the emotional tone expressed Unconditional positive regard: nonjudgmental and respect for client Insight Therapies Psychodynamic – uncover unconscious conflicts through dream interpretation, free association, transference… Analyzing and interpreting the patient’s relationship with the therapist 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 Behavioral Therapy Classical Conditioning: 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: Token economies: 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 Not the events in our lives; it’s the beliefs that we hold that cause us to become depressed, anxious, enraged, etc. 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 Drug Therapy Psychopharmacology: The prescribed use of drugs to help treat symptoms of mental illness to ensure that individuals are more receptive to talk therapies 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 Video clip Drug Therapy Antidepressants and mood stabilizers Usually increase serotonin/norepinephrine (MAO) inhibitors – increase norepinephrine Tryicyclics – inhibit reuptake SSRIs – Selective Serotonin Reuptake Inhibitor (Prozac) Lithium carbonate – treats bipolar (can be toxic) Highly controversial – suicide, using just when uneasy Drug Therapy Antianxiety drugs: Barbiturates – relax central nervous system Benzodiazepines – decrease activity in anxiety regions of brain (Valium, Xanax) Do not Use to relieve ordinary anxieties of everyday life Take for more than a few days at a time Combine with alcohol Stimulants: suppress activity level Attention-deficit/hyperactivity disorder (ADHD) Side effects – growth, sleep, later use Other Biomedical Methods Psychosurgery: The general term for surgical intervention in the brain to treat psychological disorders Electroconvulsive (ECT) therapy: used for treatment of severe depression The infamous prefrontal lobotomy is no longer performed Severing the corpus callosum, however, can reduce lifethreatening seizures Side effect – memory disruption Transcranial magnetic stimulation (TMS): a possible alternative to ECT, less memory loss treatment of depression, schizophrenia, and bipolar Hospitalization and the Alternatives 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 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