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Therapy • Any treatment process for mental disorders • Variety of types Psychological (psychotherapy) Biomedical • Common element: a relationship focused on change. Obstacles to Therapy • • • • Stigma Lack of money or insurance Lack of qualified therapists Certain types of disorders Friend or Therapist ? • Friend may have own needs. • Therapist is confidential. • Friend may not have expertise. Basic Tasks of Therapy • • • • Problem Indentification Etiology (cause) Prognosis Treatment Plan Mental Health Care Professionals • • • • • • • Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor Psychological Therapies • Behavioral--change learned habit patterns. • Cognitive--restructure thinking patterns. • Psychodynamic--develop insight into unresolved hidden conflicts. • Humanistic--emphasize freedom of choice and development of healthy relationships Behavioral Therapies • Based on operant and classical conditioning. – – – – – Counterconditioning Systematic desensitization Aversion therapy Contingency management Token economy Cognitive Therapies • Emphasize rational thinking as key to changing emotions and behavior. • Both – what we think (content) – how we think (process) • Emotional dysfunction comes from irrational beliefs not an event itself. Beck’s Approach • Negative self-talk becomes automatic • Evaluate the evidence for and against these automatic thoughts • Discover alternate thoughts Rational Emotive Behavioral Therapy (REBT) • Founder--Albert Ellis • Emotional and behavioral problem develops from irrational beliefs not the event itself. • Therapist challenges the irrational beliefs. Irrational Beliefs • • • • I must always succeed. I should always receive approval. I should always be treated fairly. My experiences should always be pleasant. Cognitive-behavioral Therapy • Most contemporary form of psychotherapy • Combines cognitive techniques to change thinking with alterations in reinforcement contingencies. Research on Psychotherapy • • • • Therapy better than no therapy. Longer better than short therapy. All forms of therapy equally effective. Best to match specific therapies to specific conditions. Counseling Your Friends/Family • Best to refer to professionals if serious. • Try to avoid advice-giving. • Use non-directive techniques. Non-directive Techniques • Active Listening • Acceptance • Exploration of Alternatives Active Listening • • • • Use paraphrasing. Ask for clarification. Shows interest and empathy. Helps the person organize their thinking about the problem. Unconditional Acceptance • Non-judgmental attitude • Accept the person and the problem. Exploration of Alternatives • • • • Help identifying other potential choices. Explore the consequences of each. Point out that doing Remember the choice is up to the individual who owns the problem. Biomedical Therapies • • • • • Treatments that focus on altering the brain. Based on the medical model of abnormality. Drug Therapy Psychosurgery Electroconvulsive and Magnetic Therapies Antipsychotic Drugs • • • • • Developed in 1950’s Thorazine, Haldol Major tranquilizers Also diminish psychotic symptoms Reduce the activity of neurotransmitter dopamine Antidepressant Drugs • Lift depressed mood. • Most common now are SSRIs. • Prolong action of neurotransmitter serotonin. • Prozac, Zoloft, etc. • Side effects but not addictive. Antianxiety Drugs • Diminish feelings of anxiety. • Increase activity of neruotransmitter GABA • Most common now are benzodiazepines such as Valium or Xanax. • Have side effects and are addictive. Stimulants • Used to treat narcolepsy and ADHD. • Ritalin • Increase availability of neurotransmitters dopamine and/or serotonin. Other Biomedical Therapies • Psychosurgery--frontal lobotomy, split brain • Electroconvulsive Therapy (ECT)-treats depression by causing seizures • Hospitalization--asylum and therapeutic community • Deinstitutionalization--community mental health movement