Warm UpWarm Up1.1. Explain the difference between psychological and Explain the difference between psychological and

biomedical therapy?biomedical therapy?2.2. How would a psychoanalytic therapist treat How would a psychoanalytic therapist treat

someone?someone?3.3. How would a Humanistic therapist treat someone?How would a Humanistic therapist treat someone?4.4. How would a behaviorist therapist treat someone?How would a behaviorist therapist treat someone?5.5. What is the difference between systematic What is the difference between systematic

desensitization and flooding?desensitization and flooding?6.6. List 2 difference between the psychoanalytic List 2 difference between the psychoanalytic

perspective and behavioralperspective and behavioral7. How could a token economy help someone with an 7. How could a token economy help someone with an

anxiety disorder?anxiety disorder?

Warm UpWarm Up

Pick up both sheets off of the Pick up both sheets off of the overheadoverhead

Chapter 17 pt. 2: Cognitive Chapter 17 pt. 2: Cognitive and Biomedical Therapyand Biomedical Therapy

The Most Dominant Therapy is The Most Dominant Therapy is the Cognitive Approachthe Cognitive Approach

Assumption and Goal of Assumption and Goal of Cognitive TherapyCognitive Therapy

Cognitive TherapyCognitive Therapy assumes that assumes that thoughts exist between events and thoughts exist between events and responses. A person’s response responses. A person’s response depends on how depends on how they interpret they interpret the situation. the situation.

Goal of Cognitive therapyGoal of Cognitive therapy is to is to teach people new and more teach people new and more realistic, helpful, and adaptive realistic, helpful, and adaptive patterns of thinking and patterns of thinking and acting. acting.

Want to See glass half-full instead Want to See glass half-full instead of half-empty!!of half-empty!!

Negative Thought Patterns Negative Thought Patterns (Cognition) Leads to (Cognition) Leads to

DepressionDepression Lost job

Depression

Internal beliefs:I’m worthless. It’s hopeless.

Lost job

Internal beliefs:My boss is a jerk.I deserve something better.

Nodepression

Aaron Beck’sAaron Beck’s Views on Views on Depression (NOT IN BOOK)Depression (NOT IN BOOK)

Beck believed the key to Beck believed the key to understanding depression was in an understanding depression was in an individual’s thought patternsindividual’s thought patterns..

Argued depressed people’s Argued depressed people’s negative thought patterns and negative thought patterns and creation of negative schemascreation of negative schemas caused them to misinterpret the caused them to misinterpret the world which often caused them to world which often caused them to feel worthless and incompetent. feel worthless and incompetent.

Depressed people tend to view Depressed people tend to view world with “world with “dark sunglassesdark sunglasses.” .”

Beck’s Examples of Beck’s Examples of Negative Schemas (NOT IN Negative Schemas (NOT IN

BOOK)BOOK) Arbitrary Interference:Arbitrary Interference: drawing drawing

negative conclusions from an event negative conclusions from an event without any evidencewithout any evidence. .

Ex:Ex: After an argument thinking “that After an argument thinking “that person hates me.”person hates me.”

Dichotomous Thinking:Dichotomous Thinking: irrational irrational all or nothing thinking. all or nothing thinking.

Ex:Ex: “I can’t be happy unless “I can’t be happy unless everyone likes me.” everyone likes me.”

Albert Ellis’s Rational Albert Ellis’s Rational Emotive Therapy (NOT IN Emotive Therapy (NOT IN

BOOK)BOOK) Albert Ellis also believed that Albert Ellis also believed that

people’s maladaptive thoughts led to people’s maladaptive thoughts led to maladaptive emotional responses. maladaptive emotional responses.

He promoted a form of treatment He promoted a form of treatment known as known as Rational Emotive Rational Emotive Therapy:Therapy: involves getting patients involves getting patients to to recognize the irrationalitiesrecognize the irrationalities within within their thought patterns and helping their thought patterns and helping them create healthier forms of them create healthier forms of thinking and behaving. thinking and behaving.

Rational Emotive Therapy is a Rational Emotive Therapy is a Form of Cognitive-Behavior Form of Cognitive-Behavior

TherapyTherapy Cognitive-Behavior Therapy:Cognitive-Behavior Therapy:

aims to aims to alter the way people alter the way people thinkthink (ex: irrational thought (ex: irrational thought patterns) and act (ex: patterns) and act (ex: compulsions).compulsions).

Effectiveness of Cognitive Effectiveness of Cognitive TherapyTherapy

Nearly all Psychotherapies can be Nearly all Psychotherapies can be Conducted as Group TherapiesConducted as Group Therapies

Less costly and time consuming Less costly and time consuming therapy is often effective b/c it helps therapy is often effective b/c it helps people see that they are people see that they are not alonenot alone in their problem. in their problem.

Family TherapyFamily Therapy: assumes no : assumes no person is an island and that we grow person is an island and that we grow in relation to our families but we also in relation to our families but we also seek to differentiate from them seek to differentiate from them which leads to friction. which leads to friction.

Therapy focuses on maintaining Therapy focuses on maintaining healthy relationships. healthy relationships.

Effectiveness of Effectiveness of Psychotherapy? How do We Psychotherapy? How do We

Evaluate?Evaluate? Is it therapy that helps people Is it therapy that helps people

get better or would it occur get better or would it occur naturally?naturally?

Regression towards the Regression towards the Mean:Mean: the tendency for for the tendency for for unusual emotions unusual emotions (depression/sadness) or events (depression/sadness) or events to return (regress) to return (regress) toward their toward their average state with time. average state with time.

Effectiveness of Effectiveness of Psychotherapy? How do We Psychotherapy? How do We

Evaluate?Evaluate? In order to test impact of treated In order to test impact of treated

vs. untreated, studies using vs. untreated, studies using meta-analysis must be used. meta-analysis must be used.

Meta-analysis:Meta-analysis: procedure for procedure for statistically combining the results statistically combining the results of of many different research many different research studies.studies.

Meta-analysis Illustrates Meta-analysis Illustrates Success of PsychotherapySuccess of Psychotherapy

Which Therapies work for Which Therapies work for which problems which problems

There is no “best” therapyThere is no “best” therapy No difference between group and No difference between group and

ind.ind. Cognitive and behavior therapy- Cognitive and behavior therapy-

depressiondepression Cognitive, exposure- Anxiety Cognitive, exposure- Anxiety Cognitive and behavior- BulimiaCognitive and behavior- Bulimia Behavior modification- bed wettingBehavior modification- bed wetting Behavior- phobias, OCD Behavior- phobias, OCD

Alternative Therapy Alternative Therapy 11. . Therapeutic TouchTherapeutic Touch

– No human energy fieldNo human energy field 2. 2. Eye Movement DesensitizationEye Movement Desensitization

and Reprocessing and Reprocessing – MaybeMaybe– But… probably…. But… probably….

1. Placebo and reliving trauma1. Placebo and reliving trauma 3. Light Exposure3. Light Exposure

– Good for SAD Good for SAD

Who Conducts Therapy?Who Conducts Therapy?

Who Conducts Therapy?Who Conducts Therapy? Clinical psychologistsClinical psychologists

– Most are Most are psychologists with a psychologists with a Ph.DPh.D. and expertise in research, . and expertise in research, assessment, and therapy, assessment, and therapy, supplemented by a supervised supplemented by a supervised internship. internship.

– About half work in agencies and About half work in agencies and institutions, institutions, half in private half in private practice.practice.

Who Conducts Therapy?Who Conducts Therapy? Clinical or Psychiatric social Clinical or Psychiatric social

workerworker– A two-year Master of Social Work A two-year Master of Social Work

graduate program plus postgraduate graduate program plus postgraduate supervision prepares some social supervision prepares some social workers to offer psychotherapy, workers to offer psychotherapy, mostly to people with mostly to people with everyday everyday personal and family problems.personal and family problems.

– About half have earned the National About half have earned the National Association of Social Workers’ Association of Social Workers’ designation of clinical social worker.designation of clinical social worker.

Who Conducts Therapy?Who Conducts Therapy?

CounselorsCounselors– Marriage and family counselorsMarriage and family counselors

specialize in problems arising from specialize in problems arising from family relations.family relations.

– Pastoral counselorsPastoral counselors provide provide counseling to countless people.counseling to countless people.

– Abuse counselorsAbuse counselors work with work with substance abusers and with spouse substance abusers and with spouse and child abusers and their victims.and child abusers and their victims.

Who Conducts Therapy?Who Conducts Therapy? PsychiatristsPsychiatrists

– Physicians who specialize in the Physicians who specialize in the treatment of treatment of psychological disorders. .

– Not all psychiatrists have had Not all psychiatrists have had extensive training in extensive training in psychotherapy, but as M.D.s they psychotherapy, but as M.D.s they can prescribe medicationscan prescribe medications. . Thus, they tend to see those with Thus, they tend to see those with the most serious problems.the most serious problems.

– Many have a Many have a private practiceprivate practice..

Therapies outside of Therapies outside of Psychotherapy Are Often Psychotherapy Are Often

BiomedicalBiomedical The biomedical The biomedical

perspective focuses on perspective focuses on altering body altering body chemistry. chemistry.

Biomedical perspective is Biomedical perspective is rooted in discoveries of rooted in discoveries of psychopharmacology:psychopharmacology: study of the effect of study of the effect of drugs on the mind and drugs on the mind and behaviorbehavior. .

Social Effects of Drug Social Effects of Drug TreatmentsTreatments

Introduction of antipsychotic drugs

Rapid declinein the mental

hospitalpopulation

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990Year

700

600

500

400

300

200

100

0

State and countymental hospital

residents, inthousands

Drug Treatments: Drug Treatments: AntipsychoticsAntipsychotics

AntipsychoticsAntipsychotics are used to treat are used to treat psychotic disorders like psychotic disorders like schizophreniaschizophrenia..

Antipsychotics helps those experiencing Antipsychotics helps those experiencing both both positive and negativepositive and negative symptoms.symptoms.

Most Common Examples:Most Common Examples:– Thorazine:Thorazine: alleviates alleviates

delusions/hallucinations.delusions/hallucinations.– Clozaril:Clozaril: alleviates negative alleviates negative

symptoms and social withdrawal. symptoms and social withdrawal.

Drug Treatments: Drug Treatments: Anxiolytics (Anti-Anxiety)Anxiolytics (Anti-Anxiety)

Anti-Anxiety drugs depress nervous Anti-Anxiety drugs depress nervous system activity.system activity.

Often most Often most heavily abused heavily abused prescription drug. prescription drug.

Most common examples are: Most common examples are: – ValiumValium– LibriumLibrium– Xanax Xanax

Drug Treatments: Drug Treatments: Anti-depressantsAnti-depressants

Most anti-depressants increase the Most anti-depressants increase the availability of norepinephrine and availability of norepinephrine and serotoninserotonin which elevates arousal which elevates arousal and mood. and mood.

Most common examples are:Most common examples are:– Prozac Prozac – ZoloftZoloft – Paxil Paxil

Drug Treatments:Drug Treatments:Bipolar DisorderBipolar Disorder

The salt The salt lithiumlithium is is most frequently used most frequently used to treat the mood to treat the mood swings of swings of bipolar bipolar disorderdisorder. .

Decreases adrenaline Decreases adrenaline and and increases increases serotoninserotonin. .

Electroconvulsive Therapy Electroconvulsive Therapy (ECT)(ECT)

Electroconvulsive Electroconvulsive Therapy:Therapy: used to used to treat the treat the severely severely depresseddepressed after after other treatments other treatments have failed.have failed.

Success rate is Success rate is highhigh. . Side effects can Side effects can

include some include some memory loss. memory loss.

Psychosurgery is Most Psychosurgery is Most Drastic InterventionDrastic Intervention

Psychosurgery involves Psychosurgery involves removing removing or destroying brain tissueor destroying brain tissue in an in an effort to change behavior.effort to change behavior.

Best known procedure is a Best known procedure is a lobotomy:lobotomy: Ice pick like instrument Ice pick like instrument is put through the eye sockets is put through the eye sockets cutting the links between the frontal cutting the links between the frontal lobes and the emotional control lobes and the emotional control centers. Used to be used to “cure” centers. Used to be used to “cure” uncontrollably violent patientsuncontrollably violent patients but now very rare.but now very rare.

LobotomyLobotomy