Treatment of Psychological Disorders

Psychotherapy: Psychodynamic, Behavioral, and Cognitive Approaches Learning Outcomes to Treatment Explain psychodynamic approaches to therapy Explain behavioral approaches to therapy Explain cognitive approaches to therapy McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 2

Psychotherapy: Psychodynamic, Behavioral, and Cognitive Approaches to Treatment (cont.) Psychotherapy: treatment in which a trained professional (a therapist) uses psychological techniques to help a person overcome psychological difficulties and disorders, resolve problems in living, or bring about personal growth Biomedical therapy: therapy that relies on drugs and other medical procedures to improve psychological functioning McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 3

Psychodynamic Approaches to Therapy Psychodynamic therapy: seeks to bring unresolved past conflicts and unacceptable impulses from the unconscious into the conscious, where patients may deal with the problems more effectively (Sigmund Freud) Psychoanalysis: Freudian psychotherapy in which the goal is to release hidden unconscious thoughts and feelings in order to reduce their power in controlling behavior McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 4

Psychodynamic Approaches to Therapy (cont.) Free association: patient says aloud whatever comes to mind; analyst connects this to the unconscious Dream interpretation: examining dreams for clues to the unconscious Transference: the transfer of feelings to a psychoanalyst of love or anger that had been originally directed to a patient s parents or other authority figures McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 5

Psychodynamic Approaches to Therapy (cont.) Psychodynamic therapy can be timeconsuming, expensive, and it may be difficult to determine effectiveness, but it also may provide solutions to difficult issues, insight, and treatment for psychological disturbance for some people McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 6

Behavioral Approaches to Therapy Behavioral treatment approaches: treatment approaches that build on the basic processes of learning; assumes both normal and abnormal behavior are learned Aversive conditioning: reduces the frequency of undesired behavior by pairing an aversive, unpleasant stimulus with that undesired behavior McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 7

Behavioral Approaches to Therapy (cont.) Systematic desensitization: a behavioral therapy technique in which gradual exposure to an anxietyproducing stimulus is paired with relaxation to extinguish the response of anxiety Hierarchy of fears: a list of the things you associate with your fears, in order of increasing severity Exposure: treatment for anxiety in which people are confronted, either suddenly or gradually, with a stimulus that they fear, but relaxation training is omitted McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 8

Behavioral Approaches to Therapy (cont.) Operant conditioning techniques: treatment based on reward and punishment Token system: reward a person for a desired behavior with a token that can be exchanged for something the person wants Dialectical behavior therapy: focus is on getting people to accept who they are, regardless of whether it matches their ideal McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 9

Behavioral Approaches to Therapy (cont.) Behavior therapy works well for anxiety disorders, phobias and compulsions, impulse control, and learning complex social skills to replace maladaptive behavior; however, people do not necessarily gain insight about their maladaptive behavior McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 10

Cognitive Approaches to Therapy Cognitive treatment approaches: teach people to think in more adaptive ways by changing their dysfunctional cognitions about the world and themselves Cognitive-behavioral approach: incorporates basic principles of learning to change the way people think McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 11

Cognitive Approaches to Therapy (cont.) Rational-emotive behavior therapy: attempts to restructure a person s belief system into a more realistic, rational, and logical set of views by challenging dysfunctional beliefs that maintain irrational behavior Cognitive therapy: also aims to change people s illogical thoughts about themselves and the world, but is less confrontational than REBT (Aaron Beck) McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 12

Cognitive Approaches to Therapy Cognitive therapy has been successful for a wide range of disorders, and combining it with other approaches makes it particularly effective; however, being more reasonable and rational may not always be helpful (cont.) McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 13

Psychotherapy: Humanistic and Group Approaches to Treatment Learning Outcomes Discuss the humanistic approaches to therapy Illustrate interpersonal therapy Explain group therapy, family therapy and selfhelp groups Assess the effectiveness of psychotherapy McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 14

Humanistic Therapy Humanistic therapy: underlying rationale is that people have control of their behavior, can make choices about their lives, and are essentially responsible for solving their own problems; emphasizes self-responsibility Person-centered therapy (a.k.a., client-centered therapy): goal is to reach one s potential for selfactualization McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 15

Humanistic Therapy (cont.) Unconditional positive regard: expressing acceptance and understanding, regardless of the feelings and attitudes the client expresses; does not mean therapist shows approval of everything the client says or does, just that the therapist is nonjudgmental and empathetic (understanding of a client s emotional experiences) McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 16

Interpersonal Therapy Interpersonal therapy (IPT): short-term therapy that focuses on the context of current social relationships, such as conflicts with others, social skills issues, role transitions, or grief McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 17

Group Therapy, Family Therapy, and Self-Help Groups Group therapy: people meet with a therapist to discuss problems with a group Family therapy: focuses on the family (as a unit) and its dynamics Self-help therapy: people with similar problems get together to discuss their shared feelings and experiences (ex.: bereavement support groups; Alcoholics Anonymous) McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 18

Evaluating Psychotherapy: Does Therapy Work? Research shows that, generally, therapy brings about greater improvement than does no treatment at all; spontaneous remission (recovery without treatment) is fairly low For most people, psychotherapy is effective but it doesn t work for everyone McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 19

Evaluating Psychotherapy: Does Therapy Work? (cont.) No single form of therapy works best for every problem, and certain specific types of treatment are better for specific types of problems Most therapies share several basic similar elements (positive relationship with the therapist, explanation of the client s symptoms, and confrontation of negative emotions) McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 20

Biomedical Therapy: Biological Approaches to Treatment Learning Outcomes Discuss options for drug therapy Explain electroconvulsive therapy Offer perspective on biomedical therapies Discuss the community psychology movement McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 21

Drug Therapy Drug therapy: control of psychological disorders through the use of drugs Antipsychotic drugs: temporarily reduce psychotic symptoms such as agitation, hallucinations, and delusions (which may be present in schizophrenia) Atypical antipsychotics: fewer side effects Most antipsychotics work by blocking dopamine receptors at the brain s synapses McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 22

Drug Therapy (cont.) Antidepressant drugs: medications used for severe depression to improve the patient s mood; sometimes used for anxiety disorders and bulimia Tricyclic drugs: increase norepinephrine at the synapses in the brain MAO inhibitors: prevent monoamine oxidase (enzyme) from breaking down neurotransmitters Selective serotonin reuptake inhibitors (SSRIs): increase serotonin at the synapses in the brain McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 23

Drug Therapy (cont.) Mood stabilizers: used to treat mood disorders; prevent manic episodes of bipolar disorder Antianxiety drugs: reduce the level of anxiety a person experiences, essentially by reducing excitability and increasing feelings of well-being McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 24

Electroconvulsive Therapy (ECT) Electroconvulsive therapy (ECT): a procedure used in the treatment of severe depression; an electric current of 70 to 150 volts is briefly administered to a patient s head Transcranial magnetic stimulation (TMS): an alternative to ECT; a precise magnetic pulse is directed to a specific area of the brain McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 26

Biomedical Therapies in Perspective Biomedical therapies have been revolutionary to the field of mental health A current promising experimental treatment is gene therapy: specific genes introduced to particular regions of the brain may then reverse or prevent biochemical events that lead to disorders May sometimes only treat the symptoms of the disorder; can also have side effects Often used in conjunction with psychotherapy McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 27

Community Psychology: Focus on Prevention Community psychology: a branch of psychology that focuses on the prevention and minimization of psychological disorders in the community Deinstitutionalization: transfer of former mental patients from institutions to the community McGraw-Hill 2010 The McGraw-Hill Companies, Inc. All rights reserved. 28