Download Unit XIII Notes

Unit 13 Treatment of Psychological Disorders Notes
(2011 update for use with 2007 Myers book)
Dorothea Dix 686 mental illness treatment reformer, 1800s
Biomedical therapy: a medication or medical procedure used on the person’s nervous
system
Psychotherapy
Eclectic approach uses a variety of theories and therapeutic approaches
I.
The Psychological Therapies
A. Psychoanalysis Freud 606
What are the aims and methods of psychoanalysis, and how have they been adapted in
psychodynamic therapy?
Foundation: explore childhood experiences
Methods
1. Central approach: free association
2. Resistance: blocking anxieties from consciousness during therapy
3. Transference: expressing feelings from other relationships toward your
therapist
4. Interpretation: leads to insight
Psychodynamic Therapy 608
Face to face approach over a shorter time period than Freud
Interpersonal model: relieving current symptoms rather than going back to
childhood
B. Humanistic Therapies 609
What are the basic themes of humanistic therapy, such as Rogers’ clientcentered approach?
Insight therapies to increase awareness of problems
1. Carl Rogers and Client centered therapy as non-directive: help
the person find the solution rather than just tell them.
2. Empathy is a major goal; understanding what they say and feel
3. Active listenin: paraphrase, clarify, reflect
4. The patients discover treatment methods on their own
Emphasizes fulfilling your potential
The counseling behaviors of the therapist in the movie Ordinary
People illustrates examples of empathic, active listening.
5. Gestalt Therapy
a. Fritz Perls
b. Combines psychoanalysis with awareness to take responsibility
for one’s actions; more of a challenging approach; calling the patient
on what they don’t see or refuse to confront.
C. Behavior Therapies 610
What are the assumptions and techniques of behavior therapies?
1. Learning principles are used: Classical Conditioning techniques
2. counter conditioning pairing what is troublesome with what is
not
3. Exposure therapy: Mary Cover Jones used this with Peter in
1924 to deal with his fear of rabbits.
4. A form of systematic desensitization is used in some exposure
therapies.
Relaxation technique based on classical conditioning
5. Desensitization associating pleasure with anxieties often used to
treat phobias
Harry Potter movie illustrates examples of overcoming fears: The Prisoner of
Azkaban
Virtual reality exposure therapy uses technology to help people be
accustomed to fears.
Aversive conditioning associating unwanted behavior with the unpleasant
ex: for treating alcoholism see 13.1, p. 613
Operant conditioning: token economy
a. rewarding desired behavior for behavior modification
b. exchange tokens for exhibiting behavior
6. Criticisms of behavior modification:
a. new behaviors may not be intrinsic
b. controlling behavior is unethical
c. another symptom may replace the original one
D. Cognitive Therapies 614
What are the goals and techniques of cognitive therapies?
1. Change your thinking
2. Assumption: thoughts intervene between events and our emotional
reactions
3. Response to depression: stop blaming yourself
4. Best treats depression 615
Aaron Beck challenges patients to discover their irrational beliefs
Stress inoculation training: teaching people to restructure their thinking in
stressful situations
Cognitive-behavior therapy 616
Changing thinking and behaving
4. Rational Emotive Therapy
Confrontational cognitive therapy developed by Albert Ellis
Challenges illogical thought, self-defeating attitudes
E. Group and Family Therapies 617
What are the aims and benefits of group and family therapy?
1. Question for family therapy: What’s your role in the social system?
2. Issue: how unwanted behaviors or tensions are directed or influenced by
the family
3. Group Therapy: Shows people others have similar problems
II.
Evaluating Therapies 619
A. Is Psychotherapy effective?
Does psychotherapy work? Who decides?
Client’s views: Often misleading because they don’t want to
think they wasted money.
1. Clinician’s views: biased toward own approach; sees mistakes of
others
2. Outcome research
The best kinds are randomized clinical trials.
a. meta-analysis: statistically combines results of many
studies 702
b. regression toward the mean the more something is done
the closer it gets to average
c. double blind studies neither researcher nor subjects know
who gets treatment
d. Hans Eysenck: no more beneficial than no treatment at all
e. Those undergoing therapy are more likely to improve.
B. Relative effectiveness of different therapies 622
Are some therapies more effective than others?
1. no type is consistently superior
2. behavior therapy is best at specifics like a phobia
3. cognitive therapy is best at depressed emotion treatment
4. effective when the problem is clear cut
C. Evaluating Alternative Therapies 623
1. placebo effect and therapeutic touch: expectations that you’ll get
better
2. eye movement desensitization and reprocessing (EMDR)
3. light exposure therapy for seasonal affective disorder: used for
depression
D. Commonalities Among Psychotherapies 625
1. Hope for demoralized people
2. new perspective is possible
3. empathy and caring are needed: the therapeutic alliance between
therapist and client
E. Consumer’s Guide: see Close Up 627
1 clinical psychologists
2 psychiatric social workers
3 counselors
4 psychiatrists
F. Culture and Values in Psychotherapy 626
How do culture and values influence the therapist-client relationship?
1. Religion and therapy? A good mix?
2. Albert Ellis was a humanist: “no one and nothing is supreme.”
3. Allen Bergin assumed a supreme being.
4. both point to personal beliefs influence psychotherapy.
III.
The Biomedical Therapies 628
A. Drug therapies
What are the drug therapies? What criticisms have been leveled against
drug therapies?
Double blind procedures are needed to test effectiveness.
The emptying of U.S. mental hospitals: see fig. 13.5 p. 629
1. psychopharmacology: how a drug affect mind and behavior
2. Anti-psychotic drugs block receptor sites for dopamine
Tardive dyskinesia: involuntary movements
Anti-anxiety drugs 630
Depress central nervous system activity
Anti-depressant drugs 630
Life people up
SSRIs selective serotonin re-uptake inhibitors: keep serotonin in
synaptic gap so that it can be absorbed.
Can take a while to work: due to neuro genesis, the growth of
new neurons, which takes time.
Prozac: blocks reabsorption of serotonin from synapses
Alternative to drugs: exercise
Mood stabling medications 632
Lithium: used for bipolar disorder
Brain Stimulation 632
How effective is electroconvulsive therapy, and what other brain
simulation options may offer relief from severe depression?
B. ECT
1. treats severe depression
2. first used in 1938
3. may work by increase norephinephrine and producing new
brain cells
Alternative Neurostimulation Therapies 634
Magnetic stimulation: works similar to ECT
Deep brain simulation: calms the limbic system
C. Psychosurgery 635
What is psychosurgery? Egas Moniz developed approach in 1930s.
1. Removing or destroying brain tissue (lobotomy)
2. Not used much
a. Causes lethargy
b. Irreversible
c. Drugs used instead
Therapeutic Life Style Change 636
How, by caring for their bodies with a healthy life-style, might people find
some relief from depression?
Exercise, enough sleep, exposure to light, social interaction, positive thoughts,
and good nutrition are all part of the plan the therapeutic life-style change.
IV.
Preventing Disorders 637
What is the rationale for preventative mental health programs?
A. establish programs to alleviate poverty
B. reduce burden of meaningless work
C. challenge discrimination and racism
D. challenge sexism
E. improve physical health
Key terms: 640 (see study guide)
AP Quiz: 640-641