Chapter 3 Treatment of Psychological Disorders Copyright © 2006 Pearson Education Canada Inc.

Chapter 3Treatment of Psychological

Disorders

Copyright © 2006 Pearson Education Canada Inc.

Copyright © 2006 Pearson Education Canada Inc. 2

Quote of the Day:

“Give me a dozen healthy infants, well-formed, and my own special world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select - doctor, lawyer, artist, merchant-chief, and yes, even beggarman and thief.”

-- John B. Watson


Psychological Treatments:What Can Help?

Psychotherapy: psychological approaches to promote positive mental health

– hundreds of “schools” for adults & children

four main paradigms:– biological, psychodynamic, cognitive behavioural,

humanistic– eclectic approach most common


Two Foci of Psychotherapy Research

outcome research– does therapy work?

process research – does the therapist-client relationship matter?


Case Study: Frances

lengthy depressionsuicidal ideationself-blame vs. resentment

How can we interpret her problem?


Historical Perspective

Spiritual/religious tradition– supernatural causes– witchcraft– trephining

Naturalistic/scientific tradition– Hippocrates: rest, exercise & healthy diet– insane asylums


Biological Treatments

Electroconvulsive Therapy (ECT)– originally, a treatment for schizophrenia– unilateral vs. bilateral ECT– severe side effects

Psychosurgery– Egas Moniz (1874-1953)– prefrontal lobotomy vs. cingulotomy

Psychopharmacology


Psychopharmacology

psychotropic medications– i.e. Prozac, Xanax, Ritalin

billion dollar industry for pharmaceutical companies

offer symptom relief, not a cure unpleasant side effects may need to be taken long-term


Originators of Psychodynamic Therapies

Joseph Breuer (1842-1925)– used hypnosis to treat troubled patients– catharsis

Sigmund Freud (1856-1939)– free association to reveal unconscious mind– insight into unconscious will cure disorders– therapeutic neutrality and transference


Psychodynamic therapies

Psychoanalysis– costly and time consuming– unlikely to “cure” psychotic disorders

Ego Analysis– interpersonal relationships of great importance– power: dominance→ submission– closeness: affiliation → hostility


Cognitive Behaviour Therapy:Overview

“actions speak louder than words”abnormal behaviour is learned and can

be “unlearned” treatment goal: appropriate learning

experiences, behavioural changerelies heavily on empirical evaluation


The Experimental Method

hypothesis generation identification of independent &

dependent variablesrandom assignmentexperimental group vs. control groupconsideration of internal & external

validity


Cognitive Behaviour Therapy:Exposure Therapies

systematic desensitization– based on theory of classical conditioning – eliminate unpleasant responses through gradual exposure– relaxation training – used extensively in the treatment of phobias

flooding– eliminate unpleasant response through extinction– want to prevent avoidance


Cognitive Behaviour Therapy:Other Approaches

Aversion therapy– goal to induce an unpleasant response in order to

extinguish an inappropriate behaviour

Contingency management– goal to reward desirable behaviour and punish undesirable

behaviour i.e. token economies

Social skills training– teach people ways of behaving that are likely to be

rewarded in the everyday world


Cognitive Techniques

Self-instruction training– adults model appropriate behaviour to children using

self-instructions

Cognitive therapy– developed specifically to treat depression– cognitive distortions must be challenged to reveal the

world in the truer light

Rational-emotive therapy– emotional disorders caused by irrational beliefs that

must be challenged


Humanistic Therapies:Foundations

people have free will and must make decisions

emotional problems stem from alienation and problems finding meaning in life


Humanistic Therapies

client-centered therapy– empathy for the client– unconditional positive regard

Gestalt therapy– sincerity and honesty– empty chair technique


Research on Psychotherapy

question: How effective is psychotherapy at relieving symptoms, eliminating disorders, and improving life?

research approach: meta-analysis


Research Considerations

spontaneous remission

placebo effect


Psychotherapy Process Research

which aspects of therapy work?

how do the different approaches measure up against one another?– behavioural interventions slightly better,

but very few differences


Psychotherapy process research

psychotherapy as social support– the therapeutic alliance

psychotherapy as social influence


Changing Social Systems

Couples Therapy– communication & negotiation

Family Therapy– parental management training

Group Therapy– psycheducational groups


Canadian Focus: Treatments

Multisite research

Centre for Addiction and Mental Health

Dismantling studies


Community Psychology

Primary prevention– prevent new cases from developing

Secondary prevention– early detection of problems

Tertiary prevention– providing treatment to people in need

Chapter 3 Treatment of Psychological Disorders Copyright © 2006 Pearson Education Canada Inc.

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Transcript of Chapter 3 Treatment of Psychological Disorders Copyright © 2006 Pearson Education Canada Inc.