Treatment of Abnormal Behavior

1. Treatment of Abnormal Behavior As Per College Board, 5-7% of the AP Exam

2. Let’s go back to the Big Picture • Draw a graphic of your choosing (flower, fish, balloons, whatever) • Somewhere on your graphic, identify, define and list names associated with the 6 current perspectives in psychology (listed below) • behavioral, biological, cognitive, evolutionary, humanistic, psychodynamic/psychoanalytic • Describe (Predict) how each perspective would explain the development of a disordered behavior. • List major treatment orientations used in therapy • Note To Teacher: This may be a preview or review of content.

3. Psychological Treatment • When a psychological disorder becomes serious enough to cause problems in everyday functioning, the client may seek to have the disorder treated. • May be outpatient • May be inpatient

4. Treatment • Psychotherapy • Biological Treatment • Combined Treatments

5. Psychotherapy • Applies psychological principles and techniques to treatment • “Talk” therapy • Exercises and techniques • Help client function in everyday life

6. Biological Treatment • Physiological methods are used to treat psychological illnesses • Medically based treatments such as medications, ECT or psychosurgery • MD must prescribe treatment

7. Combined Treatments • Use of both approaches simultaneously is commonly used

8. History of Treatment

9. Early Treatment Approaches • Circa 1300-1900 • Imprisonment, asylums or mental hospitals • Change to humane treatment • Phillipe Pinel • Dorthea Dix • Josef Breuer

10. Contemporary Treatment Approaches • Circa 1900-2012 • Early treatments included harsh medical interventions • ECT (Electro Convulsive Treatment) • Pre-frontal Lobotomy • Deinstitutionalization

11. Specific Treatment Modalities • Psychoanalysis • Behavioral • Humanistic • Cognitive • Biomedical

12. Who provides treatment?

13. Providers • Psychiatrist • Psychologist • Psychiatric social worker or psychiatric nurse • Counselor

14. Ethical Issues • Professionals should adhere to a set of ethical standards issued by their respective organizations (APA) • Adhere to legal stipulations (right to privacy, confidentiality)

15. Insight Therapies • Psychoanalytic Therapies • Humanistic (client-centered)) Therapies • Cognitive Therapies • Insight therapies help patients (clients) develop an understanding of their inner conflicts. (Gain INSIGHT) • It is through this understanding that a patient (client) can begin to solve the problems of daily living.

16. Psychoanalytic Treatment Approaches

17. Psychoanalytic Approach

18. Psychoanalytic Approach • Sigmund Freud • Emphasis on unconsciousness mind as an attempt to understand or gain insight into unconscious conflicts to relieve anxiety

19. Techniques- intensive and long-term therapy • Free association • Resistance • Transference • Catharsis • Dream analysis • Hypnosis

20. Other psychoanalytic therapies (Neo-Freudians) • Carl Jung • Erik Erikson • Karen Horney • All seek to understand the patient’s past to help understand the future

21. Evaluation of Psychoanalytic Therapies • Good? • Bad?

22. Humanistic Treatment Approaches

23. Humanistic Approaches

24. Humanistic Approach • Client –centered Therapies (not patient) • Insight Therapies • Emphasis is on how the therapist views the person who enters therapy • Client and therapist are more equal partners in change • Emphasis on free will of the client to encourage growth or self-actualization (client chooses to change behavior)

25. Client-Centered or Non-directive Therapy • Carl Rogers tells clients to direct their own therapy and worry less about what others think of them • Client-Centered Therapist must ensure the following conditions apply: • Genuineness- completely honest and open • Unconditional Positive Regard- fully accepting the worth of the client • Empathy- emotional understanding

26. Gestalt Therapy • Fritz and Laura Perls • Developed therapy from the perspective that people create their own understanding of the world and continue to grow as long as they have insight into their feelings • More directive and confrontational • Help clients see inconsistencies between how clients see themselves and how they act in the world

27. Other humanistic therapies • Group and Family therapies are considered humanistic therapies due to the emphasis placed on growth of the individual • Group Therapy • Advantages/disadvantages • Family Therapy • Advantages/disadvantages

28. Evaluation of Humanistic Therapies • Good? • Bad?

29. Cognitive Therapy

30. Cognitive Therapies

31. Cognitive Therapy • Designed to help people change the way they think (process, interpret, remember) about their problems • People deal with problems by learning to change their way of thinking, thoughts or cognitions

32. Rational Emotive Behavioral Therapy (REBT) • Albert Ellis • People engage in self-talk that is false • If they can change their beliefs, this will produce a change in emotion • Therapist confront irrational (illogical, maladaptive) beliefs and teaches client to create a realistic perspective

33. Beck’s Cognitive Therapy (for depression) • Aaron Beck • Widely used for depression • Cognitive schemas, methods for organizing the way we view the world, have evolved into a distorted perception • Therapist draws attention to faulty reasoning, challenges validity of statements • Helps change way of thinking using writing assignments to see cognitive schema

34. Behavioral Therapy Treatment

35. Behavioral Therapy

36. Behavioral Therapy • Emphasizes changing learned behaviors rather than understanding feelings • Relatively new approach (1970) • Evolved out of principles of classical and operant conditioning • Goal is to eliminate symptoms • Specific techniques to eliminate issues such as phobias and anxiety disorders

37. Behavioral Therapy Techniques

38. Systematic Desensitization • Mary Cover Jones pioneered the technique and called it counter conditioning using it to treat phobias • Joseph Wolpe popularized the technique • 1) Anxiety hierarchy must be developed 2) Client trained in relaxation techniques 3) Stimuli are identified in the hierarchy and progressively paired with relaxation techniques

39. Aversion Therapy • The opposite of systematic desensitization • An unpleasant stimulus is introduced at the same time as an undesirable response. • Seeks to increase the unpleasant reaction to stimulus • Used as a treatment for alcoholism

40. Extinction Techniques • Principles of operant conditioning are used to reduce or eliminate behavior • Extinction can occur if reinforcements are removed • Flooding can occur if the person is inundated with repeated stimuli, after a period of time, the individual can face the fear

41. Token Economy • Positive reinforcement to encourage engagement in appropriate behaviors • Get token (play money, poker chips or the like) for performing desired behavior • Trade tokens in for the desired reward at a later time • Used often in institutional situations

42. Punishment • Unpleasant stimulus is introduced after an undesired response occurs • Does this work?

43. Behavior Modification • A plan to reward desirable behavior and ignore (extinguish) undesirable behavior • Works well with retarded persons and those confined to hospital settings

44. Biomedical Treatments

45. Biomedical Treatments • Medical Doctors provide specific medical procedures and medications that can help alleviate symptoms of psychological disorders • Often used in conjunction with talk therapies

46. Psychopharmacological Treatments • Medications that work by altering neurochemical systems of the brain • Four broad classes: • Neuroleptics (antipsychotics) • Antidepressants • Lithium and anticonvulsants • Anxiolytics (antianxiety/tranquilizers)

47. Electroconvulsive Therapy (ECT) • An electric current passed through the brain which causes a convulsion, resulting in temporary memory loss. • Used only as a last resort for severely depressed patients

48. Psychosurgery • Lobotomy • Not used as in the past • New techniques

49. Modes of Therapy • Individual • Group • Examples

50. Community Health Movement • Deinstitutionalization • Community Mental Health Centers Act of 1963 • Problems