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Chapter 16: Treatment of Psychological Disorders

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Approaches to Treatment

• Psychotherapy– Treatment in which a trained professional – a

therapist – uses psychological techniques to help someone overcome psychological difficulties and disorders

• Biomedical therapy– Relies on drugs and other medical procedures

to improve psychological functioning

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Psychodynamic Approaches to 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– Defense mechanisms– Psychoanalysis: Freud’s Therapy

• Free association• Transference

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Behavioral Approaches to Therapy

• Treatment approaches that build o the basic processes of learning, such as reinforcement and extinction, and assume that normal and abnormal behavior are both learned

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Behavioral Approaches to Therapy

• Aversive conditioning– Form of therapy that reduces the frequency of

undesired behavior by paring an aversive, unpleasant stimulus with undesired behavior

• Systematic desensitization– Technique in which gradual exposure to an

anxiety-producing stimulus is paired with relaxation to extinguish the response of anxiety

• Hierarchy of fears

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Behavioral Approaches to Therapy

• Systematic desensitization

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Behavioral Approaches to Therapy

• Operant conditioning techniques– Token system

• Contingency contracting

– Observational learning

• Dialectical behavior therapy– Focus in on getting people to accept who they

are, regardless of whether it matches their ideal

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Cognitive Approaches to Therapy

• Teaches people to think in more adaptive ways by changing their dysfunctional cognitions about the world and themselves– Cognitive-behavioral

• Incorporates basic principles of learning

– Rational-emotive • Attempts to restructure a person’s belief system

into a more realistic, rational, and logical set of views

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Cognitive Approaches to Therapy

• Rational-emotive behavior therapy

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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

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Humanistic Therapy

• Person-centered therapy– “Client centered” therapy– Goal is to reach one’s potential for self-

actualization– Unconditional positive regard– empathic

• Gestalt therapy– Completing any “unfinished business” from

the past that affects the present

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Group Therapy and Family Therapy

• Group therapy– Several unrelated people meet with a

therapist to discuss some aspect of their psychological functioning

• Family therapy– Involves two or more members of the same

family, one (or more) of whose problems led to treatment

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Evaluating Psychotherapy

• Psychotherapy– Is effective for most people– Doesn’t work for everyone– Certain specific types of treatments are

somewhat, although not invariably, better for specific types of problems

– No single form of therapy works best– Spontaneous remission

• Recovery without treatment

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Which Therapy Works Best?

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Which Therapy Works Best?

• Meta-analysis

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Biomedical Therapy: Biological Approaches to Treatment

• Therapy that focuses on brain chemistry and other neurological factors– Drug therapy

• Control of psychological disorders through drugs• Antipsychotic drugs• Antidepressant drugs• Lithium• Antianxiety drugs

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Biomedical Therapy: Biological Approaches to Treatment

• SSRIs – selective serotonin reuptake inhibitors

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Electroconvulsive Therapy

• Electric current of 70 to 150 volts is briefly administered to a patient’s head, causing a loss of consciousness and often causing seizures

• Transcranial magnetic stimulation– Alternative to ETC– Precise magnetic pulse is directed to a

specific area of the brain

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Psychosurgery

• Brain surgery in which the object is to reduce symptoms of mental disorder– Prefrontal lobotomy

• Surgically destroying or removing parts of a patient’s frontal lobes that were thought to control emotionality

– Cingulotomy• Used with rare cases of OCD

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Community Psychology: Focus on Prevention

• Geared toward preventing or minimizing the incidence of psychological disorders– Deinstitutionalization

• Movement of former mental patients out of institutions and into the community

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Seeking Therapy

• You should feel comfortable with your therapist

• Therapist should have appropriate training and credentials and should be licensed by appropriate state and local agencies

• You should feel that you are making progress after therapy has begun, despite occasional setbacks