Treatment and Therapies What is therapy? What are the different types of therapy? How does each type address cause of behavior and focus of treatment. Think of a Bad Habit you have How would you acquire it using the following approaches? Behavioralist. Cognitive Approach Biological Approach Social-Cultural How would you treat it using the same approaches?
What is therapy? Any treatment process to change mental, behavioral or social functioning Rosenhans Study (1970s) Goals of Therapy Identify the problem (Diagnosis) Identify the cause of the problem (Etiology) Decide on a form of treatment Best treatment for diagnosis Who goes to therapy? severe, or persist for an extended amount of time MUUDI
History of Therapy Medieval Europe: (1300-1900) Work of the devil Asylum Approach (1500s) Shield the stress of the world out Pioneers in Psych: Phillipe Pinel: Remove the chains=Calmer patients (17451826) Hosted Lunatic Balls Dorothea Dix: helped state funded mental hospitals (1802-1887) History of Therapy Modern Approach (1900-2000) 50s hospitals were not overly
helpful (lobotomy) Deinstutionalized efforts: Psychological Therapy: Focus on changing disordered thoughts, feelings and behaviors (psychotherapy, humanistic, cognitive, behavioral, group/family) Biomedical Therapy: Focus on changing the underlying biology of the brain Drugs, Surgery, Electromagnetic probes Culture influences Treatments Different religious and spiritual beliefs
Type of Professional Specialty Counseling Psychologists- MA Psych Common problems of normal living (non-disorder)-Talk Therapy Clinical Psychologists---PhD in Psych Treat severe disorders- Anxiety, OCD-Talk Therapy, Insight Therapy
PsychiatristsMedical Doctor Prescribes medicine (BioMedical)Schizophrenia, Severe Depression, Suicide Psychoanalyst- MD Practices Freudian ideas/therapies Psychiatric Nurse-RN with special training Prescribes drugs Clinical Psychiatric Social WorkerMA in Social Work Deals with social and
environmental disorders Pastoral Counselor Spiritual Guidance Perspectives of Therapy Mirror Perspectives of Psychology: Insight Therapy: Gain insight to understanding problems Psychoanalysis: Humanistic: Cognitive: Behavioral Therapy: Change Behaviors BehavioralBioMedical Therapy: Change Brain Balance
Biological: Neurotransmitters, Hormones, Drug Therapy, Psychosurgery ECCLECTIC Blends of Therapies are COMMON! Psychoanalytic Therapy Cause of Behavior: Hidden problems in UnC (PsychoSexual, Trauma) Goal of Treatment ID is the Focus: Sexual Desires, childhood No cure but a long process Key Terms/Players Free Association: Say what comes to mind w/o thinking Dream Anaylsis: Latent vs. Manifest Content Hypnosis
Freud Transference (problems of the patient are transferred to therapist) Catharsis: therapeutic release of emotions/mostly anger! Neo-Freudian Therapy Cause of Behavior: Emphasis on motivation on WHY More on conscious level Goal of Treatment Ego is the central focus (want to strengthen ego) Social Needs Meet several times a week Key Terms/Players Alfred Adler Carl Jung
Karen Horney Humanistic Therapies Cause of Behavior Poor Self Concept Social Pressure Goals of Treatment Enhance Self Esteem Realize full potential (Self-Actualized) Focus on the PRESENT not PAST Humanistic Therapies Key Terms/Players:
Carl Rogers: Client Centered Therapy! Unconditional Positive Regard (geniuness, acceptance and empathy) Active Listening: Therapist recites thoughts of client so they hear it back NOT DETERMISTS..you CAN CHANGE Types of Therapy: Client Centered Therapy
Unconditioned Positive Regard Group Therapy Works with addiction and communication issues Self Help/Support Systems AA Family Therapy Communication, Support
Behavioral Therapies Cause of Behavior: Behaviors have been learned Goal of Treatment: To Unlearn negative behaviors Key Terms/Players: BF Skinner: Operant Conditioning (Rewards/Consequences) Mary Cover Jones: Counter-Conditioning ( Joseph Wolpe: Systematic Desenitization (replace anxiety with relaxation) PHOBIAS!! CounterConditioning & Aversion Therapy Cause of Behavior: Reactions to learned associations Phobias/addictions
Goal of Treatment: Systematic desensitization: Progressive Relaxation, Anxiety Heirarchy Exposure Therapy and Flooding (address most frightening stimuli first) Aversion Therapy: pair a bad habit with something averse Symptom Substitute Key Players: Mary Cover Jones and Joseph Wolpe Operant Conditioning & Token Economies Cause of Behavior Behavior is a result of consequences learned behaviors Goal of Treatment: Shape new behaviors Token Economies: Desired behaviors awarded
with tokens Reward system used in prisons Key Terms/Players Skinner Thorndike Observational Learning Cause of Behavior Learned from watching others (racism, fear of birds) Goal of Treatment Two Types Symbolic: provide models indirectly through
movies, etc Desensitization Therapy: direct exposure Key Terms/Players Bandura Cognitive Therapy Cause of Behavior: Negative Self Talk(Im stupid, Im ugly, I cant) Irrational or Faulty thought processes/perceptions Goal of Treatment Ask questions in a way to solve problems Attributional Style: Internal or External Locus of Control?
Key Terms/Players Aaron Beck s Cognitive Triad Aaron Beck Similar to Ellis with RET Believed Depressed people have a cognitive triad that needed to be treated Depressed people have dark sunglasses and they have negative views of Self World Future Must treat all three views
Cognitive-Behavioral Therapy (CBT) Cause of Behavior: Thought process produces behavior Goal of Treatment Change ones thoughts to change actions Educates client on destructive thoughts FOCUS on BOTH BEHAVIOR and THOUGHTS Example: Smoking Key Terms/Players Albert Ellis=REBT Albert Ellis REBT REBT= Rational Emotional Therapy Challenge peoples perceptions using
confrontational therapy ABCs of Emotional Disturbance A=Antecedent (Fail a test) B=Belief/Behavior (Im Stupid) C=Consequence (depression) --------------------Ellis adds two things------------------D=Dispute Belief and Consequence substitute new belief E=Evaluate new feelings Evaluate Psychological Therapies Eysenck: Brit psychologist claimed 2/3 of people with nonpsychotic problems will get better w/in 2 years whether or not they have treatment Major BACKLASH- lots of studies started in therapy
Some types are better for specific disorders Smith/Glass=behavior therapy best for anxiety Therapy is NOT a CURE! Depression does get better with treatment Most people do not get help (money, shame, lost in their own emotions, dont reach out) Eclectic is BEST! The BEST therapy is one which is eclectic or mixes various aspects of perspectives to meet the needs of the patients. BioMedical Approach Drug Therapy
Purpose Controversy/Side Effects Antipsychotic DrugsChlorpromazine, Thorazine, Clozapine, Haldol Help with treating (+) symptoms of Schizophrenia, Reduce dopamine (block receptors) Tarditive dyskinesia
(loss of motor control) Antidepressant & Mood Stabilizers: Prozac SSRI (selective SSRIs mask real serotonin reuptake problem inhibitor) Prevents serotonin from being reabsorbed Antidepressant & Mood Stabilizer: Lithium (metal)
Helps in treating both moods (bipolar) Antidepressant & Mood Stabilizer: Monoamine oxidase (MAO) Drug that inhibits an enzyme which breaks down norepinephrine (it is needed to send messages) Toxic, Suicide BioMedical Approach Drug Therapy
Purpose of Drug Controversy/Side Effects Antianxiety Drugs: Barbiturates Valium, Xanax, Paxil for (OCD, Phobia, GAD) Relaxation Effects Depresses Nervous System Create more GABA
Addicting Dangerous when mixed with other drugs and alcohol Stimulants: Ritalin/Caffeine for ADHD, narcolepsy Increases dopamine, serotonin, glutamate Messes up sleep patterns, slow/stunt growth, over prescribed
BioMedical in Review Lithium= Lithium batteries charged with + and charges like bipolar (mania and depression) Xanax=X=Anxiety Psychopharmacology The prescribed use of drugs to help treat symptoms of mental illness in order for individuals to be more receptive to talk therapies Medications can do many things: Some Some Some Some release specific transmitters block the reuptake of transmitters
interact with postsynaptic receptors may act within neuron cells Psychosurgery Surgical intervention to treat a mental disorder Prefrontal lobotomy Severing Corpus Callusum for Epilepsy Electroconvulsive Therapy: (ECT) Brain stimulation through electrodes Immediate results for reasons unknown Deep Brain Stimulation.for BiPolar and Depression
Therapeutic Community Community based on mental health issues Outpatient basis Created by Maxwell Jones Deinstitutionalization means discharging/taking out patients from institutes that deal with mental illness. As more drug therapies were introduced less institutions were needed. More people were mainstreamed into society. Common questions before therapy: Is treatment needed? What are the specific behavior problems Would group therapy or client center work best? Is the problem based on stress, confusion or choice?
