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Treatment of Psychological Disorders
TREATMENT OF PSYCHOLOGICAL DISORDERSTreating psych disorders poses one of the biggest problems for psychologists. Important to have a realistic perspective: Can treat the symptoms, but according to most, we cannot cure the disorders.Historically: Very broad array of treatments for mental disorders.Movement from harsh to soft treatments, pioneered by Philippe Pinel in France & Dorothea Dix in the U.S.Fought to get mental patients out of prisons & into mental hospitals.
Trend since 1950s:Move patients out of the mental hospitals, back home, & treat them through medication & support groups.
Treatments today 2 broad categories:
1. Psychotherapy attacks learning-related disorders, like fears. Trained psychologist uses psych techniques to overcome the disorder. There are 4 main approaches:
★ Psychoanalysis★ Humanism★ Behaviorism★ Cognitive
2. Biomedical therapies - medicationExample: schizophreniaPsychologists in the biopsychosocial perspective may try both psychotherapy & medication:
Eclectic Approach
YouTube: 60 Minutes - Advanced PTSD Therapy Prolonged Exposure: Forced to
remember everything these
soldiers are trying to forget.
Insight Therapies:
Involve verbal interactions intended to enhance clients’ self-knowledge & thus promote healthful changes in personality & behavior.
2 types of psychologists may provide therapy:
Clinical Psychologists &
Counseling Psychologists Clinical psychologists’ trainingemphasizes treatment of full-fledged disorders.
In contrast, counseling psychologists’ training is slanted toward the treatment of everyday adjustment problems.
Both types of psychologists must earn a doctoral degree (Ph.D., Psy.D., or Ed.D.).
A doctorate in psychology requires about 5-7 years of training beyond a bachelor’s degree.
Psychiatrists: Physicians who specialize in the diagnosis & treatment of psychological disorders. Many psychiatrists also treat everyday behavioral problems.
However, in comparison to psychologists, psychiatrists devote more time to relatively severe disorders(schizophrenia, mood disorders) and less time to everyday marital, family, job, and school problems.
Psychiatrists have an M.D. degree.
Their graduate training requires 4 years of coursework in medical school and a 4-year apprenticeship in a residency at a hospital.
Their psychotherapy training occurs during their residency, since the required coursework in medical school is essentially the same for everyone, whether they are going into surgery, pediatrics, or psychiatry.
YouTube: 60 Minutes - Jails - “New Asylums”
YouTube: Hank Green - Mass Incarceration in the U.S.
Psychotherapy is a term that describes many forms of talk therapy, all of which aim to explore distressing thoughts, feelings & behaviors.
FREUD’S THERAPEUTIC TECHNIQUE: Goal = help patient uncover unconscious conflicts that give rise to anxiety.
Anxiety typically causes a person difficulty in dealing with everyday life.
Cause of Anxiety:Deep-Rooted in conflicts set in the unconscious
Variety of techniques:Intensive 1-on-1 TherapyPsychoanalysis
FREUD’S THERAPEUTIC TECHNIQUE: Long-term commitment: Typically lasts 1 hour/day, several days/week - possibly several years. Various techniques used to get to unconscious, but set up, according to Freud, is important:Therapist should sit behind a client in a chairthe client should lie in a chaise lounge so she can relax. Therapist asks questions & client answers as honestly as possible. Therapy takes so long because the techniques to get to the unconscious cannot be direct. To uncover what is in the unconscious, the therapist must use techniques that require interpretation before the true meaning can be divined.
DREAM ANALYSIS:
Freud argued that dreams were “Royal Road to the Unconscious”
Using dream analysis, therapist could take notes on manifest content (the dream itself)
& then interpret latent content (the hidden, underlying symbolic meaning).
By using what Freud knew about the symbolism of dreams a therapist can determine some of the potential causes of anxiety.
TRANSFERENCE:
Freud discovered that some of his patients developed
strong feelings about him:
★ some of love
★ some of hate
But after contemplation he realized that these patients
were experiencing strong emotions for their loved ones &
temporarily transferring those to their therapist.
Freud had great insight that this transference was an
unconscious process - and, indeed, a way that he could
illuminate this issue & help the patients see unresolved
conflicts with people they were close to.
HYPNOSIS:
Freud practiced hypnosis early in his
career.
He believed that hypnosis would ease
the grip that the repression had on the
unconscious & allow some of those
issues to percolate to consciousness.
He later argued, however, that it was
far less effective than he once
believed.
FREE ASSOCIATION:
Freud’s preferred method of therapy.
A person says the 1st thing that comes to mind
when a therapist says something.
If a person does this fast enough, according to
Freud, the first thing he says can be a “glimpse”
into the unconscious.
By getting such a glimpse, the therapist can
determine the causes of the anxiety.
JigsawIn your triad – decide who is:
- The Computer
- The Healer
- The Parent
Computers will be investigating Cognitive Theory – pg 500-502
Healers will be investigating Humanistic Theory– pg 496-497
Parents will be investigating Behavioural Theory – 502-505
HUMANISTIC THERAPY:
The most well-known therapy is the approach
championed by Carl Rogers. According to Rogers, and
humanistic theory in general, people are inherently good
and strive to reach their potential. Therapy is designed to
help people understand the essential human
characteristics and help them work towards achieving
their potential.
Essentially, the philosophy of humanistic therapy is to
provide a sounding board for people to voice their opinions
and thoughts. The therapist gives the client unconditional
positive regard. By doing this, he helps the client
understand conditions of worth, which in turn helps her
understand how to deal better with situations in life.
Humanistic Therapy
Active Listening-empathic listening in which the
listener echoes, restates, and clarifies
HUMANISTIC THERAPY:
Much of this therapeutic approach is reflective toward the
person; all that might be required is for a person to hear an
objective opinion. Humanistic psychologists do this by
parroting back to the client what she says. This technique is
known as active listening and it is important part of the
humanistic approach, because it helps people feel that
someone is listening to them and that their concerns are
being validated. Humanistic psychologists often view those
whom they work with not as patients but as clients, so the
term often used for this approach is client-centered
therapy.
BEHAVIORAL THERAPY:
Therapy assumes that psychological disorders are really
behavior disorders.
To treat the “disorder,” we need only treat the behavior.
Techniques that modify human behavior are appropriate to
dealing with the disorders.
The goal: Create an environmental context in conflict with
the behaviors demonstrated by the person with the disorder.
We are able to alter behavior because the reinforcement is
stronger for the alternative behavior choice than it is for the
disordered behavior.
BEHAVIORAL THERAPY:
Best example is called systematic desensitization.
This technique was developed by Joseph Wolpe and
is most effective in dealing with phobias. The
technique borrows from the progressive relaxation
literature. First, a client is taught how to relax. This
is more than just relaxing the way one might do
while watching a baseball game - it is systematic
approach to relaxation.
BEHAVIORAL THERAPY:
In progressive relaxation, a person is taught to relax each
body part in sequence. The relaxation is made observable
to the client by using biofeedback (a technique that
allows one to see a measure of heart rate, breathing rate,
etc.). Finally, in very small steps, the phobia-causing
stimulus is introduced. When the client feels anxiety,
she is told to practice relaxation. In such a way, and in
small steps, the client can learn to relax in the presence
of the phobia-causing stimulus. Behavior approaches
have been shown to be very effective treatments for a
wide variety of disorders.
Behavior TherapyExposure Therapy
treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid
Behavior TherapySystematic Desensitization
type of counterconditioning
associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli
commonly used to treat phobias
Aversive Conditioning
type of counterconditioning that associates an unpleasant state with an unwanted behavior
nausea ---> alcohol
Behavior TherapySystematic Desensitization
Behavior Therapy
Aversion therapy for
alcoholics
COGNITIVE THERAPY:
Cognitive therapies assume that people suffer from
problems when their beliefs about the world are
disconnected from reality itself. One feels anxiety
because the perspective that one brings to the world is
inconsistent and, typically, much worse than reality.
People who see a cognitive therapist will describe their
perspective on reality, to which the therapist responds
by helping them see reality more clearly. In the
technique called cognitive restructuring, the therapist
helps the client restructure his thoughts to make them
more consistent with reality.
COGNITIVE THERAPY:
Cognitive therapies have been used with a variety of
disorders, but the most common disorder they help
is depression. Aaron Beck (among others) pioneered
the use of cognitive therapy with depression when
he learned that depressed people tend to
catastrophize issues in their lives. That is, they tend
to view issues as being worse than they are.
Cognitive restructuring helps these individuals
realize that life situations are not as severe as they
perceive. With that understanding, they can deal
more effectively with their depression.
Cognitive Therapy
Cognitive Therapy
teaches people new, more adaptive ways
of thinking and acting
based on the assumption that thoughts
intervene between events and our emotional
reactions
Cognitive Therapy
Cognitive Therapy
A cognitive perspective on
psychological disorders
Cognitive Therapy
Cognitive-Behavioral Therapy
a popular integrated therapy that
combines cognitive therapy (changing
self-defeating thinking) with behavior
therapy (changing behavior)