Treatment of Psychological Disorders Essays, Papers, Questions and Answers

Treatment of Psychological Disorders Essays, Papers, Questions and Answers

Treatment of Psychological Disorders

Learning Objectives

What do treatments for psychological problems look like?

How did Freud influence psychotherapy?

What is cognitive-behavior therapy?

Does psychotherapy work?

What is the placebo effect? How do placebos work?

Is it important to “click” with your therapist?

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Overview

What helps?

Different treatments work better for different disorders.

Psychotherapy

The use of psychological techniques and the therapist–client relationship to produce emotional, cognitive, and behavior change

Adherents to different paradigms offer very different treatments (Prochaska & Norcross, 2006).

Most mental health professionals describe themselves as
eclectic
.

Using different treatments for different disorders

Evidence-based treatments

The practical and scientific approach to therapy

According to Kessler et al. (2005), about two-thirds of people with a diagnosable disorder fail to receive treatment.

Four Views of Frances

Biological therapist

Draws an analogy with physical illness

Focuses on diagnosis

Considers genetic predisposition or chemical imbalance

Psychodynamic therapist

Likely to focus on the defensive style

Develop the client’s insight

Expect changes as a result of increased emotional awareness

Cognitive-behavior therapist

Focus on cognitive-behavioral patterns

Therapist is directive

Identify cognitive distortions

Assign homework

Change behaviors

Humanistic therapist

Likely to focus on lack of emotional genuineness

Therapist is nondirective

Encourage the client to “own” her feelings

Biological Treatments

First, a diagnosis is developed and refined.

Second, clues about causes are put together.

Third, scientists experiment with various treatments for preventing or curing the disorder until an effective treatment is found.

Treatment focuses on symptom alleviation.

Psychopharmacology

The use of medications to treat psychological disturbances

Psychotropic medications
are chemical substances that affect psychological states.

21% of American women, and half as many men, are taking antidepressants.

Antipsychotic drugs are also highly prescribed.

Often safe and effective

Alleviate symptoms, not cure causes of illness

Many must be taken for long periods of time.

All medications have side effects.

Psychotropic medications are prescribed by primary care physicians, not psychiatrists.

American population wants a quick fix (as a medication) to treat psychological disorders.

Electroconvulsive Therapy (ECT)

Involves causing seizures by passing electricity through the brain

Developed by Ugo Cerletti and Lucio Bini in 1938

ECT involves 6 to 12 sessions over the course of a few weeks.

Electrical current is approximately 100v.

Bilateral ECT

Current passes through both hemispheres

Unilateral ECT

Current passes through one hemisphere

Psychosurgery

Surgical destruction of specific regions of the brain

Developed by Egas Moniz in 1935

Nearly 10,000–20,000 procedures were done in the United States.

Eventually discredited

Cingulotomy is used to treat very severe cases of OCD.

Freudian Psychoanalysis

Psychoanalysis

Free association
reveals aspects of the unconscious mind.

Free associations, dreams, and slips of the tongue—Freudian slips—are “windows into the unconscious.”

Psychoanalytic Techniques

Insight

Bringing formerly unconscious material into conscious awareness

Interpretation

Analyst suggests hidden meanings to patients’ accounts.

Psychoanalytic Techniques

Resistance

Patient must discover the hidden meaning.

Transference

Patients transfer their feelings about some key figure.

The Decline of Freudian Psychoanalysis

Requires substantial amount of time, expense, and self-exploration

Very little research has been conducted on its effectiveness

Psychodynamic psychotherapy

Derived from psychoanalysis

Psychotherapists are more directive and engaged, and treatment may be brief.

Ego Analysis

Emphasized the role of the ego (e.g., the mediator between the id and the superego)

More concerned with unconscious motivations and dealings with the external world

Emphasized the role of the ego (e.g., the mediator between the id and the superego)

Ego analysts

Sullivan

Horney

Erikson

Therapists more actively involved with patients than psychoanalysts

Short-term psychodynamic psychotherapy

Uses many techniques

Is shorter and less expensive

Amenable to research

Interpersonal therapy (IPT)

Focuses on changing emotions and styles of interacting in close relationships

Cognitive-Behavior Therapy (CBT)

Encourages

Collaborative therapist–client relationships

Focuses on the present

Direct efforts to change problems

Use of research-based techniques

Beginnings can be traced to John B. Watson’s behaviorism.

Early behavior therapists relied heavily on classical conditioning (Pavlov) and operant conditioning (Skinner).

Today, CBT incorporates many learning principles based on cognitive psychology. Treatment of Psychological Disorders Essays, Papers, Questions and Answers

A practical approach oriented to changing behavior than focusing on personality.

Embraces empirical evaluation

Asks, “What works?”

Systematic Desensitization

John Wolpe (1915–1997)

Research focused on eliminating phobias.

Assumed that some phobias were learned through classical conditioning

Developed systematic desensitization for eliminating fears by:

Progressive muscle relaxation

Hierarchy of fears

Learning process

Other Exposure Therapies

In order to conquer your fears, you must confront them (Barlow et al, 2002)

In vivo desensitization

Gradually confronting fears

Flooding

Confronting fears at full intensity

Aversion Therapy

The use of classical conditioning to create, not eliminate, an unpleasant response

Used primarily in treating substance abusers

Effectiveness is not clear.

Contingency Management

Contingency

Relationship between a behavior and its consequences

Social Skills Training

Teaches clients new ways of behaving that are both desirable and likely to be rewarded in everyday life

Assertiveness training

Teaches clients to be direct about their feelings and wishes

Teaches clients new ways of behaving that are both desirable and likely to be rewarded in everyday life

Role playing

Rehearses new social skills

Social problem-solving

Teaches clients through solving a variety of life’s problems

Cognitive Techniques

Attribution retraining
: people are “intuitive scientists”

Constantly draw conclusions about the causes of events

Self-instruction training
: adults model an appropriate behavior

Child asked to repeat the action

Develop internalization

Beck’s Cognitive Therapy

Developed by Aaron Beck specifically as a treatment for depression

Depression is caused by errors in thinking.

Challenges cognitive errors by having clients analyze their thoughts more carefully (Beck et al., 1979)

Rational–Emotive Therapy

According to Albert Ellis, emotional disorders are caused by irrational beliefs.

Absolute, unrealistic views of the world

Major difference from CBT: challenge client’s beliefs during the therapy (Ellis, 1962)

“Third-Wave” CBT

Dialectical behavior therapy

Acceptance and commitment therapy

Focuses on broad, abstract principles such as mindfulness, acceptance, values, relationships

Dialectical behavior therapy, used for borderline personality disorder

Acceptance and commitment therapy encourages accepting oneself.

Humanistic Therapies

Developed as a “third force” in psychotherapy

A counterpoint to psychodynamic and cognitive behavior therapy

Values humans’ ability to make choices and ability to be responsible for one’s own life

Encourages people to recognize and experience their true feelings

Views the therapist–client relationship as the method of change

Client-Centered Therapy

Carl Rogers (1902–1987)

Viewed three qualities as essential in a therapist:

Warmth

Genuineness

Empathy
—emotional understanding

Encourages therapist self-disclosure

Therapists do not act as experts.

Unconditional positive regard

Valuing clients for who they are

Therapeutic alliance

A bond between therapist and client

Research on Psychotherapy

Does Psychotherapy Work?

Psychotherapy outcome research

Examines the outcome, or result, of psychotherapy

Meta-analysis

A statistical procedure that allows researchers to combine the results from different studies in a standardized way

The average benefit of psychotherapy is .85 standard deviation units (Smith & Glass, 1977).

Many benefits of psychotherapy diminish in the year or two after treatments ends (Westen & Bradley, 2005).

Some treatments may harm.

Improvement without Treatment?

Two-thirds of clients improve as a result of psychotherapy

Spontaneous remission (e.g., improvement without treatment)

Hans Eysenck (1916–1997)

Informal counseling vs. psychotherapy

The Placebo Effect

Any type of treatment that contains no known active ingredient for the condition at hand

The recipient’s belief in a treatment, and expectation of improvement, are responsible for much of what works in psychological as well as physical treatments.

Efficacy and Effectiveness

Efficacy

Whether a treatment can work under prescribed circumstances

Effectiveness

Whether therapy does work in the real world

Consumer Reports
(1995, November): psychotherapy helps many people in the real world, not just in the laboratory

When Does Psychotherapy Work?

Depends on:

Nature of client’s problem

Duration of therapy

Client’s background

YAVIS

Young

Attractive

Verbal

Intelligent

Successful

Psychotherapy Process Research

Common Factors

Do different psychotherapies share common factors that help make them effective?

Motivational interviewing: an evidence-based treatment developed to treat alcohol abuse

Therapy as Social Influence

Client’s relationship with his or her therapist

Pain Relief? Treatment of Psychological Disorders Essays, Papers, Questions and Answers

Psychological pain motivates seeking psychological help.

Couple, Family, and Group Therapy

Couple Therapy

Involves seeing intimate partners together in therapy

The goal is to improve the relationship, not to treat the individual, by improving:

Communication and negotiation skills

Conflict resolution

Can be used for treatment of depression, anxiety, substance abuse, and child behavior problems

Supplement to individual therapy

Family Therapy

Might include two or more family members

Goals are to improve communication, resolving conflicts, and perhaps change family relationships and roles.

Family Systems Therapy

Emphasize interdependence among family members and the importance of viewing the individual within the family system

Parent management training
: teaches parents new parenting skills

Family therapist may call attention to
pattern of alliances
.

Family therapists attempt to improve mental health by altering family relationships.

Group Therapy

Involves treating several people facing similar emotional problems or life issues

Group Therapy

Groups may be small; three to four people; or large, 20 or more.

Psychoeducational groups

Teach specific psychological information or life skills

Experiential group therapy

Relationships are the primary mode of treatment

Groups may be small; three to four people; or large, 20 or more.

Self-help groups

Bringing people together who face a common problem

Prevention. Treatment of Psychological Disorders Essays, Papers, Questions and Answers

Social institutions, school, and work environments contribute to mental health.

Community psychology

Improve individual well-being by promoting social change

Primary prevention

Improve the environment in order to prevent new cases

Social institutions, school, and work environments contribute to mental health.

Secondary prevention

Early detection of emotional problems

Tertiary prevention

Any of the treatments.

Specific Treatments for Specific Disorders

The ultimate goal of treatment research is to identify therapies that have specific active ingredients for treating specific disorders (Nathan & German, 2007).

The mental health professional must inform client(s) about evidence on alternate treatments for their problem(s).

Therapists unskilled in a particular approach must refer the client to someone with specialized training (McHugh & Barlow, 2010).

Treatment of Psychological Disorders Essays, Papers, Questions and Answers