Treatment of Psychological Disorders

TREATMENT OF PSYCHOLOGICAL DISORDERSTreating 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 - medicationExample: schizophreniaPsychologists 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’ trainingemphasizes 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.

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: 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 TherapyPsychoanalysis

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 chairthe 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.

JigsawIn 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 TherapyExposure Therapy

treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid

Behavior TherapySystematic 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 TherapySystematic 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.

Cognitive Therapy

Cognitive Therapy

teaches people new, more adaptive ways

of thinking and acting

based on the assumption that thoughts

intervene between events and our emotional

reactions

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)