Treatment of Psychological Disorders
TREATMENT OF PSYCHOLOGICAL DISORDERS Treating 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 - medication Example: schizophrenia Psychologists 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 training emphasizes 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.
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 Therapy Psychoanalysis 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: 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 chair the 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.
Jigsaw In 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 Therapy Exposure Therapy treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid
Behavior Therapy Systematic 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 Therapy Systematic 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.
based on the assumption that thoughts intervene between events and our emotional reactions Cognitive Therapy Cognitive Therapy teaches people new, more adaptive ways of thinking and acting
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)