CHAPTER 16 – TREATMENT OF PSYCHOLOGICAL DISORDERS

* Each year in the U.S., ______% of adults and _______% of children receive some form of mental health services

* Most mental health professionals see themselves as eclectic


WHO PROVIDES THESE TREATMENTS?

* Psychiatrists – M.D. with specialization in psychiatry (can prescribe drugs)

* Psychologists – doctoral degree in clinical or counseling psychology (Ph.D. or Psy.D.)

* Master’s Degree level professionals – clinical social workers, licensed professional counselors, marriage and family therapists

* Paraprofessionals – psychiatric nurses, pastoral counselors


PSYCHOTHERAPIES – treatment of psychological disorders through psychological methods

* Types of psychotherapies

o Psychodynamic
o Humanistic
o Behavioral
o Cognitive-behavioral

CLASSIC PSYCHODYNAMIC PRINCIPLES (PSYCHOANALYSIS)

* Nature of human – driven by _______________________ instincts

* Goals – gain insight into problems by recognizing ____________ thoughts and feelings, and work through how these unconscious elements affect everyday life

* Therapists role –

* Time frame – emphasis on uncovering _________________ conflicts from past


METHODS OF CLASSIC PSYCHODYNAMICISM

* Name to know – Sigmund Freud

* Free association –

* Dream interpretation – 

o Manifest content – 

o Latent content – 


* Freudian slips – 


* Analysis of transference – 


HUMANISTIC PRINCIPLES

* Nature of human – free will, choice, and the capacity for __________________

* Goals – self-acceptance, remove things blocking self-awareness and actualization

* Therapist role – facilitates client’s _________; client is therapist’s _______; client must take the essential responsibility

* Time frame – here and now; focus on _____________ experience


TYPES OF HUMANISTIC PSYCHOTHERAPIES

* Client-Centered Therapy

o Name to know – Carl Rogers

o Unconditional positive regard – 


o Empathy –


o Reflection – 


o Congruence (genuineness) – 


* Gestalt Therapy

o Name to know – Fritz Perls

o Create conditions in which clients can become ____________ and ____________ so they can grow again

o Directly confront ___________________ in clients

o Use ________________ and _________________ exercises


BEHAVIOR THERAPY PRINCIPLES

* Nature of human - 
o product of social __________ and _____________

o behavior results from _________ experience

* Goals – changes in thinking and behaving in particular situations

* Therapist role – help client replace _____________ thoughts/behaviors

* Time frame – current behavior/thoughts, may not need to know origin of behavior


METHODS OF BEHAVIORAL PSYCHOTHERAPIES

* Systematic Desensitization –


* Flooding  - 


* Modeling – 

* Positive Reinforcement –


* Aversive Conditioning – 


* Punishment – 


COGNITIVE-BEHAVIOR THERAPY PRINCIPLES

* Emphasizes the problematic ways in which people think and how it affects their behavior


METHODS OF COGNITIVE-BEHAVIORAL THERAPIES

* Ellis’ Rational-Emotive Behavior Therapy (REBT) – psychological problems, such as anxiety, guilt, and depression, are caused by how person thinks about events

o Therefore, first identify ____________ thoughts and then replace with more _____________ and ______________ ones through:

* Cognitive restructuring – 


* Stress-inoculation training – 


* Beck’s Cognitive Therapy – based on ideas that negative cognitive patterns are maintained by cognitive distortions

o Confront errors in _________ and erroneous ________ and thoughts that minimize the value of one’s accomplishments

o Involves another type of cognitive restructuring

* Notice how __________________ precede anxiety and depression

* Investigate and challenge the truth of these thoughts


EVALUATING PSYCHOTHERAPY

* Does psychotherapy work?

o Most therapists and clients say _______

* Validating with empirical support has been challenging and controversial

* Clinical significance  versus statistical significance -



* Current research suggests – the average psychotherapy client is “better off” than 80% of those who do NOT receive therapy


BIOLOGICAL TREATMENTS

* Electroconvulsive Therapy (ECT) – 


* Psychosurgery (prefrontal lobotomy) – 


* Psychoactive Drugs 

o Neuroleptics (antipsychotics) –


o Antidepressants –


o Lithium – 


o Anxiolytics (tranquilizers) -





DRUGS AND PSYCHOTHERAPY

* No clear evidence that either drugs or psychotherapy are superior

* Combining both drugs and psychotherapy is more effective for some disorders (ADHD< OCD, alcoholism, panic disorders)


ADDITIONAL LEARNING OBJECTIVES

* Describe the difference between Freud’s original psychoanalysis and modern variations. Describe some of the methods used in contemporary psychoanalysis. Discuss the criticisms of psychoanalysis. (see Contemporary Variations on Psychoanalysis)

* Define group, family, and couples therapy. Discuss the advantages and disadvantages of each. (see Group, Family, and Couples Therapy)

* Discuss the cultural influences on the choice of psychotherapy, its goals, and its expectations. (see Cultural Factors in Psychotherapy)

* Describe a client’s rights in a therapeutic relationship. (see Rules and Rights in the Therapeutic Relationship)

* Describe how differences in ethnicity and gender may result in different responses to psychoactive drugs. (see Human Diversity and Drug Treatment)  

* Describe the ways that psychoactive drugs affect neurotransmitters. Define receptor antagonist and reuptake. (see Linkages:  Biological Aspects of Psychology and the Treatment of Psychological Disorders)

* Define community psychology. Describe the types of work involved in community psychologists’ attempts to treat and prevent mental illness. (see Community Psychology:  From Treatment to Prevention)