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