Treating Mental Disorders

Treating Mental Disorders

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Description: A complete overview of psychotherapy and the basic approaches to the treatment of mental disorders; Insight therapies, Behavior: cognitive, cognitive-behavioral therapies, Group therapies, Biological treatments, and Ethical issues in the practice of psychotherapy. A variety of techniques to help people with emotional and behavioral problems, the goal: provision of effective ways to cope with difficulties.

 
Author: Feyza (Fellow) | Visits: 1928 | Page Views: 1932
Domain:  Medicine Category: Therapy 
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Contents:
Focus of the Lectures

The Treatment of Mental Disorders
Chapter 18

Overview of psychotherapy Basic approaches to the treatment of mental disorders
Insight therapies Behavior, cognitive, cognitive-behavioral therapies cognitiveGroup therapies Biological treatments

Ethical issues in the practice of psychotherapy

Focus of the Lectures
Overview of psychotherapy Basic approaches to the treatment of mental disorders
Psychological therapy model Insight therapies Behavior, cognitive, cognitive-behavioral therapies cognitiveGroup therapies Biological treatments

Focus of the Lectures
Overview of psychotherapy Basic approaches to the treatment of mental disorders
Insight therapies Behavior, cognitive, cognitive-behavioral therapies cognitiveGroup therapies Biological treatments Medical therapy model

Ethical issues in the practice of psychotherapy

Ethical issues in the practice of psychotherapy

Psychotherapy
A variety of techniques to help people with emotional and behavioral problems Goal: Provision of effective ways to cope with difficulties

Some communalities
Common goal: Helping clients solve their problems Quality of the relationship between the client and the therapist Right use of empathy and support Keeping in mind the needs of the clients Being ethical in forming and maintaining the therapeutic relationship!

Why do people seek therapy?
Help in adjusting to everyday problems Serious emotional or behavioral problems Very serious psychological problems (e.g., schizophrenia, drug abuse)

Varieties in Psychological Models of Therapy
Psychodynamic Humanistic
INSIGHT THERAPIES

Varieties in Psychological Models of Therapy
Psychodynamic INSIGHT THERAPIES Humanistic To help people achieve greater awareness of their motivations and give them greater control over their emotions and behaviors.

Psychoanalysis
FOCUS: Repressed unconscious conflicts

Psychoanalysis
INTRAPSYCHIC ANXIETY

Psychoanalytic Techniques

Heavy use of unconscious defenses to repress conflicts conflicts GOAL: Interpreting the origins of intrapsychic conflict Providing the client insight into his or her unconscious conflicts

FREE ASSOCIATION: Client is encouraged to speak freely, without censoring possibly embarrassing or socially unacceptable thoughts or ideas

Psychoanalytic Techniques

DREAM INTERPRETATION: Therapist offers an analysis suggesting the hidden meaning of the dream by interpreting the symbols.

Resistance
Development during therapy in which the client becomes defensive, unconsciously attempting to halt further insight by censoring his or her true feelings

Analysis of Transference
Clients bring into therapy their past troubled relationships; these are transferred to the therapist

Countertransference
The process by which the therapist projects his or her emotions onto the client Important that therapist remains objective and emotionally detached

Contemporary Psychodynamic Therapy
More emphasis on interpersonal experiences Unconscious mental representations of self and caregivers that were formed in early years

Contemporary Psychodynamic Therapy
Current interpersonal relationships and repeated relational difficulties arise from emotional patterns we internalized when young. Therapy: Focuses to modify unhealthy relationship models to help the client have fulfilling relationships with others

Humanistic Therapies

Humanistic Therapies

The goal is to provide the client with a greater understanding of his or her unique potential for personal growth and self-actualization selfClient-centered therapy ClientGestalt Therapy Similarity to psychodynamic Help clients become aware of inner feelings and desires

Humanistic Therapy
Focus of Client-centered Therapy ClientClient's personal aspirations/dreams Client' were disapproved Goal: To foster experiences that will make attainment Goal: of the ideal self more likely Clients need "unconditional" positive regard unconditional" Therapist is nondirective
Listens, reflects, empathy

Humanistic Therapy
Gestalt therapists emphasize that losing touch with one's feelings in order to meet social one' obligations is the root of mental disorder Focus of gestalt therapy is to have people focus on their current feelings Awareness of feelings Here and now Expression and control of feelings

Self-healing, healthy development of the self Selfand successful interpersonal relations

Humanistic Therapy
Empty-chair technique: Emptytechnique: Client imagines that the object of his/her emotion is actually sitting in the chair. The client then is asked to direct conversation to the chair.

Evaluation of Insight Therapies
Evaluation of the effectiveness of psychoanalysis is difficult because few clients are qualified for it. You had to be articulate and intelligent, motivated to uncover unconscious Neither psychoanalysis nor humanistic therapies are generally effective for persons suffering from serious mental disorders such as schizophrenia

Behavioral Therapies
Focus on observable unwanted behavior

Behavioral Techniques
1. Systemic desensitization � A method of treatment
in which the client is trained to relax in the presence of increasingly fearful stimuli Problem: Test anxiety 1st step: Create a hierarchy of anxiety-provoking situations (from mild anxiety to panic situations!) 2nd step: Learn to relax 3rd step: Imagine the anxiety-arousing situation while remaining relaxed

Application of well-established learning wellprinciples to eliminate and replace unwanted behavior

Behavioral Techniques
2. Flooding A technique that attempts to reduce fears by arousing them intensely
Confront the feared situation Remain there until anxiety diminishes through habituation Learning that nothing bad happens

Behavioral Techniques
3. Aversive conditioning The client is trained to respond negatively to an originally attractive stimulus that has been paired with an aversive stimulus
1st Step: Pair CS and UCS CS: Alcohol UCS: Drug that produces sickness to stomach UCR: Feeling sick to stomach 2nd Step: CS: Alcohol CR: Feeling sick to stomach

Behavioral Therapies based on Operant Conditioning 1. Reinforcement of Adaptive Behaviors

Behavioral Therapies based on Operant Conditioning 2. Token Economy
Target Behavior (and possible points): Room is neat. This means the bed is made and all clothes and books are put in their proper places. Check at 8:30am (1 token) Check at 6:00pm (1 token)

Tokens = Secondary Reinforcement
MENU OF REWARDS REWARD Read a comic book with mom Trip to McDonald's McDonald' Mom plays with child Soft drink from refrigerator Package of sugarless gum Make popcorn Trip to park Play video game COST IN TOKENS 4 12 4 6 3 9 8 10

Behavioral Therapies based on Operant Conditioning 3. Modeling
Clients make more progress to eliminate their fears when they observe a model who provides samples of successful behavior to imitate

Maintaining Behavioral Change
Desired behaviors may not generalize to other situations A client may be taught self-observation or selfrecognition of when his or her behavior is appropriate

Review
Psychodynamic Humanistic Behavioral, Cognitive, Cognitive-behavioral CognitiveGroup (Family and marital therapy) Preventive interventions in community

Cognitive Therapies and CognitiveBehavior Therapies
Cognitive therapy � based on altering or manipulating one's cognitive processes

Albert Ellis: Irrational beliefs

I absolutely must perform well at all times.

Cognitive restructuring � The process of replacing the client's maladaptive thoughts with more constructive ways of thinking

Other people must treat me considerately and fairly at all times. My life must be always easy, convenient, and gratifying.

Albert Ellis

Albert Ellis

Rational Emotive Therapy

Rational Emotive Therapy

A-B-C process
A = Activating event C = Consequence (emotional)

A-B-C process
A = Activating event B = Belief (irrational) C = Consequence (emotional)
"It is necessary for me to be loved and approved by every person in my life."

Cognitive-Behavioral Therapy Cognitivefor Depression
� Emphasis on clients' clients' perceptions, beliefs, and interpretations � Depressive triad: Negative view of 1. Self 2. World 3. Future � Focuses on faulty logic
Aaron Beck

Faulty Logic
Depressed student gets an A.
Exam was easy! But everyone else got failing grades. Failure to attribute the success to his own mastery

Evaluation of Behavior, Cognitive and Cognitive-Behavioral Therapies CognitiveCritics believe these therapies just treat the symptoms of a disorder and ignore the basic causes Emphasis is on the present rather than the past Therapists are very directive Therapy duration is short-term short-

Group Therapies

4 Advantages of Group Therapy
1. Group therapist observes and interprets the interactions 2. Client gets feedback from all group members 3. Client observes others 4. Client gets support

Family Therapy
Salvador Minuchin

Importance of the process as well as content Focus on the structural issues and the nature of relationships in the family Aim is to restructure the roles, conflicts, and maladaptive family interaction patterns into more adaptive ones
M D S

Couples therapy
Focus on the marital unit or couple Looking for the problematic communication and interactional patterns Goal is for the members of the couple to recognize and alter patterns of interacting Family of origin issues and how they get acted out in the couple is looked at

Preventive Psychology
Goal: To intervene early to prevent the emergence of psychological problems Primary Prevention � handouts informing about the effects of smoking for all students Secondary Prevention - intensive and targeted interventions to support individuals who are at particular risk for psychological problems

Biological Therapies

Any questions?

Drug Therapy Electroconvulsive Therapy Psychosurgery

Drug Therapy
1. Antipsychotic Drugs Used to treat psychotic (schizophrenic) disorders Serious side effects (e.g., disturbances in movement) Recently developed antipsychotic drugs reduce negative side effects Blood tests necessary!

Drug Therapy
2. Antidepressants
Used to treat depression e.g., Prozac, Zoloft SSRI: selective serotonin reuptake inhibitor

Drug Therapy
3. Mood Stabilizing Drugs
Used for bipolar disorders Lithium carbonate Benefits outweigh the negative side effects

Drug Therapy
4. Antianxiety Drugs
Used to treat anxiety disorders e.g., diazepam (Valium), alprazolam (Xanax) Side effects: physical tolerance and withdrawal

Electroconvulsive Therapy (ECT)
A clinician attaches a pair of electrodes to a person's head and passes a brief surge of person' electrical current through them, which produces a seizure. seizure.

Electroconvulsive Therapy (ECT)
Antidepressant drugs require 3-4 weeks to 3take action on mood; the person may be at risk for suicide or is not responding to drug treatment ECT produces immediate improvement in mood Side effects of ECT include memory loss

Psychosurgery
Intentional damage of the brain to change behavior
Don't confuse with neurosurgery (e.g. remove a Don' tumor or a blood clot)

Cutting the nerve fibers that connect the prefrontal cortex with the limbic system Permission of the client!

Do Some Therapies Work Better?
No universal best type of therapy General factors in therapy effectiveness
Support Hope Opening up

The Relationship Between Client and Therapist
Ethical Issues Confidentiality and Privacy Informed Consent

Cognitive-behavioral best to reduce Cognitiveanxiety, fear, depression Humanistic self-esteem issues self-

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