Chapter 16 TREATMENT OF PSYCHOLOGICAL DISORDERS. Analyze This and Analyze That - misconceptions ...
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Transcript of Chapter 16 TREATMENT OF PSYCHOLOGICAL DISORDERS. Analyze This and Analyze That - misconceptions ...
Chapter 16
TREATMENT OF PSYCHOLOGICAL
DISORDERS
Analyze This and Analyze That - misconceptionsTypes of therapies
Insight therapies “talk therapy”
Behavior therapies Changing overt behavior
Biomedical therapies Biological functioning interventions
TYPES OF TREATMENT
15% of U.S population in a given yearMost common presenting problems
Anxiety and Depression Treatment seeking for various disorders – Figure 15.1
Mood disorders Utilization rates – Figure 15.2Women more than menMedical insuranceEducation levelPsychological Disorders and professional treatment – Figure
15.3
WHO SEEKS TREATMENT?
Figure 15-1 – Treatment seeking for various disorders
Figure 15-2 – Therapy utilization rates – Olfson et al. (2002)
XX 15.3
Clinical psychologistsCounseling psychologistsPsychiatristsClinical social workersPsychiatric nursesCounselorsOn-line treatment?
WHO PROVIDES TREATMENT?
INSIGHT THERAPIES: PSYCHOANALYSIS
Sigmund Freud and followers Goal: discover unresolved unconscious conflicts - Figure 15.4
Free association Dream analysis Interpretation
Resistance and transferencePsychodynamic Therapies
INSIGHT THERAPIES: CLIENT CENTERED THERAPY
Carl Rogers Cause: Figure 15.5 Goal: restructure self-concept to better correspond to reality Therapeutic Climate
Genuineness Unconditional positive regard Empathy
THERAPIES INSPIREDBY POSITIVE PSYCHOLOGY
Martin SeligmanUses theory and research to better understand the
positive, adaptive, creative, and fulfilling aspects of human existence well-being therapy positive psychotherapy
can be an effective treatment for depression – F 15.6
Figure 15.6 Positive psychotherapy for depression
OTHER ISSUES
Groups therapy Group size Advantages – social dimension of change
Effectiveness of Insight therapies – Figure 15.7 Spontaneous remission
Talk therapies or other approaches? Common factors contribute to progress in those treated
Figure 15.7 – Recovery as a function of number of therapy sessions
BEHAVIOR THERAPIES
B.F. Skinner and colleagues Goal: unlearning maladaptive behavior and learning adaptive
ones Systematic Desensitization – Joseph Wolpe
Classical conditioning – Figure 15.8 Anxiety/Fear hierarchy – Figure 15.9
Aversion therapy – Figure 15.10 Alcoholism, sexual deviance, smoking, etc.
Social skills training Modeling Behavioral rehearsal
Biofeedback Operant conditioning flooding Classical conditioning
XXX 15.8
XXX 15.10
COGNITIVE-BEHAVIORAL THERAPY
Aaron Beck Cognitive therapy Depression and negative thinking – Figure 15.11
Albert Ellis Rational-emotive therapy
Goal: to change the way clients think Detect and recognize negative thoughts Reality testing
Effectiveness of Behavior Therapies Efficacy of behavioral interventions for a variety of
disorders
XXX 15.11
BIOMEDICAL THERAPIES
Psychopharmacotherapy Antianxiety - Valium, Xanax, Buspar Antipsychotic - Thorazine, Mellaril, Haldol
Tardive dyskinesia Atypical antipsychotic – reduce motor effects and other
neurotransmitters Time course – Figure 15.12
Antidepressant: - Actions - Figure 15.13 Tricyclics – Elavil, Tofranil Mao inhibitors (MAOIs) - Nardil Selective serotonin reuptake inhibitors (SSRIs) – Prozac, Paxil, Zoloft –
side effects – Table 15.1 Risk of suicide – Figure 15.14
Mood stabilizers Lithium, Valproic acid
Electroconvulsive therapy (ECT) Transcranial Magnetic Stimulation Deep brain stimulation
Figure 15.13 Antidepressant drugs’ mechanisms of action
Figure 15.15 Deep brain stimulation
CURRENT TRENDS AND ISSUES IN TREATMENT
Managed careEmpirically validated treatmentsBlending Approaches to treatment – Figure 15.17
Conjunctive therapy – Figure 15.16Multicultural sensitivityDeinstitutionalization
Dorthea Dix - Figure 15.18 Changes in population – Figure 15.19
Factors – treatments, legal, service delivery model Revolving door problem – Slide 26 Homelessness Increase use of criminal justice system
Figure 15.17 The leading approaches to therapy among psychologists
Figure 15-16 – Relapse rates in Reynolds et al. (1999) study
XX 15.19
Slide 26 – Percentage of psychiatric inpatient admissions that are readmissions
Psychopharmacology
Antipsychotics (thorazine, haldol)
Anti-anxiety (valium, barbiturates, Xanax)
Mood Disorders (serotonin reuptake inhibitors)
Bipolar (lithium)
SOMATIC THERAPIES
•Electroconvulsive Therapy (ECT)- for depression
•Psychosurgury - Prefontal lobotomy
SOMATIC THERAPY
LOOKING FOR AT THERAPIST
Factors to consider Sources of services – Table 15.2 Profession Gender Theoretical approach
Comparison of approaches for effectiveness - Figure 15.20
Table 15-2, p. 626
Figure 15.20 Estimates of the effectiveness of various approaches to psychotherapy.