Treatment of Mental Disorders

1. Treatment of Mental Disorders

2. What’s difference between a psychiatrist, clinical psychologist, and counselor? • How do psychoanalysts treat disorders? • How do behaviorists treat disorders? • What are classical conditioning techniques to therapy? • What is manifest content of dreams? Latent content? • What are operant conditioning techniques? • What is cognitive therapy? • Who is Albert Ellis? • Who is Aaron Beck? • How do Humanists treat disorders? • What are biomedical therapies? • Benefits of group therapy?

3. Key Questions for this Unit What’s the difference between a Psychiatrist, Clinical Psychologist and a Counselor? How do Psychoanalysts treat mental disorders? How do Behaviorists treat? How do Humanists treat? What is Cognitive therapy?

4. What is a psychiatrist? • Psychiatrists are MDs (medical doctors) with a specialty in treating mental disorders, usually with a biomedical therapy (medicine) and some talk therapy. • You would see a “shrink” if you have schizophrenia, severe depression, suicidal thoughts, and other severe mental problems that need medication.

5. What is a clinical psychologist? • A clinical psychologist has a PhD (more research based) or PsyD (emphasis on therapy) in psychology (no medical school). They treat fairly serious mental illnesses with “talk” therapies. • They might treat personality disorders, anxiety disorders, addictions using insight or “talk” therapy.

6. What is a counselor? • A counselor uses “talk” therapy to treat non-mental disorders like improving communication between family members, grief counseling, marital counseling, life strategies. • Counselors have a Masters Degree with specialty training.

7. Specialty: Problems of normal living Work setting: Schools, clinics, other institutions Credentials: Master’s in counseling, PhD, EdD, or PsyD Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor

8. Specialty: Those with severe disorders Work setting: Private practice, mental health agencies, hospitals Credentials: PhD or PsyD Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor

9. Specialty: Severe mental disorders (often by means of drug therapies) Work setting: Private practice, clinics, hospitals Credentials: MD Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor

10. Specialty: Freudian therapy Work setting: Private practice Credentials: MD Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor

11. Specialty: Nursing specialty; licensed to prescribe drugs Work setting: Private practice, clinics, hospitals Credentials: RN – plus special training in treating mental disorders and prescribing drugs Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor

12. Specialty: Social worker with specialty in dealing with mental disorders Work setting: Often employed by government Credentials: MSW Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor

13. Specialty: Combines spiritual guidance with practical counseling Work setting: Religious order or ministry Credentials: Varies Professional Title Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor

14. In contrast to a clinical psychologist, a psychiatrist is more likely to a) engage in an eclectic approach b) use a biomedical/somatic treatment c) recognize the importance of group therapy with patients having the same disorder d) treat clients in community mental health centers exclusively

15. Perspectives on Treatment • Psychoanalytic • Behavioral • Humanistic • Cognitive • Biophysical

16. Psychoanalytic (5 methods) • Dream Analysis • Transference • Hypnosis • Free association • Symptom Substitution All 5 rely on exposing (bringing into conscious) unconscious thoughts and interpreting them.

18. A. What are Psychoanalytic methods of therapy: • 1. Free Association – patient reports anything that comes to his/her mind. • The psychoanalyst takes whatever you say and treats it like a window into your unconscious mind.

19. B.Dream analysis: • Dreams have two types of content: • Manifest content- actual events in dream. • Latent content – hidden message in dream. (latent = hidden) • Freud thought that each dream represents a form of wish fulfillment. The wish may be disguised, but it is always there.

20. C. Transference • Feelings of love or other emotions (hatred) are expressed toward the therapist. • These feelings are actually unconsciously felt toward others; the patient is projecting these feelings onto the therapist. • This provides clues about the client’s feelings about these other people.

21. D. Hypnosis • Hypnosis is a psychoanalytic therapeutic technique. • Supposedly reaches into the unconscious • Whatever you think, patients report benefits from hypnosis.

22. E. Symptom Substitution • Client appears to get better from original problem or, but shortly thereafter, a new symptom emerges • Why? Original problem not actually found

23. The goal of psychoanalytical therapy is a) to change maladaptive behavior to more socially acceptable behavior b) to change negative thinking into more positive attributions c) to attain self-actualization d) to bring unconscious conflicts to conscious awareness and gain insight

24. Treating the therapist as though he were a very important person from one’s past, such as a parent, defines a) resistance b) transference c) frustration d) reaction formation

25. Behavioral Therapy

26. Behavioral Therapy • Behaviorists believe that mental problems are caused by classical conditioning (for example, phobias), operant conditioning (addictions, depression), and observational learning (we watch our parents and friends suffer so we copy them).

27. Classical Conditioning – Systematic Desensitization • (treats phobias) if you are afraid of snakes, start with worms, calm down, then graduate to having a snake in the next room, calm down, then look at pictures, calm down, then watch movies, calm down, then be in the same room, calm down, then get closer, calm down • Anxiety Hierarchy

28. Classical/Operant Conditioning– Counter Conditioning • OBJECTIVE: Associate a previously “bad” stimulus with positive reinforcement • Example: • Afraid of the dentist? What do you get at the end of every visit??

29. Classical Conditioning – Aversive Conditioning • OBJECTIVE: Replace a previously “good” response to a harmful stimulus with a “bad” response • Examples: • Antabuse – Alcoholics take pills that make them sick when they drink alcohol • Coyotes are fed poisoned lamb meat so they will stop killing sheep. • AKA Reconditioning

30. Classical Conditioning • Flooding – (treats phobias) if you are afraid of snakes, therapist will throw you in a pit of snakes. • AKA Exposure Therpay

31. Operant conditioning treatment • Token economy – Therapists will reward desirable behaviors with a reward system. This is usually applied to groups like hospital mental wards or classrooms or workplaces. • If you don’t kill anyone this week, I’ll give you a nickel. If everyone passes, we’ll have a pizza party.

32. Systematic desensitization is a technique based on a) classical conditioning b) instrumental conditioning c) operant conditioning d) aversive conditioning

33. Antabuseis a drug that, when paired with alcohol in the bloodstream, bring about extreme nausea. For many motivated alcoholics, this has proven to be an effective treatment. Under which umbrella of psychotherapy would it most likely be found? a) insight therapy b) aversive conditioning c) Gestalt therapy d) self-help therapy

34. Humanistic Perspective of Psychology

35. Humanism • What is the root word of Humanism? • After years of psychoanalysts saying we are a bunch of id-driven animals and years of behaviorists studying rats in a cage, the Humanists came along in the 60s.

36. Who is Carl Rogers?

37. Famous Humanists • Who is Carl Rogers? Carl Rogers was the founder of person-centered therapy, active listening, and unconditional positive regard. • No judgments can be made! The environment must be loving and accepting if the client is to open up to you. • Good for patients with self-esteem issues. • The patient/client has all the answers and the means to treat themselves. In client-centered therapy, the therapist acts as a sounding board for the patient, sometimes rephrasing what the patient says (active or reflective listening). Empathy is important!

38. Abraham Maslow

39. Maslow’s hierarchy of needs

40. Maslow’s hierarchy of needs • People cannot maximize their potential unless their more basic needs are met. • If a Japanese family’s home just got destroyed by the earthquake/tsunami, can they focus on their communication skills? • If you are hungry, can you worry about your self esteem?

41. Which Simpsons character is at the bottom of Maslow’s Hierarchy of Needs?

43. Which character has safety needs?

45. Who has love and belonging needs?

47. Who has esteem needs?

49. Are any Simpsons characters self actualizing?

50. Depends on the episode • The Simpsons aren’t real people, but in some episodes, Homer and Lisa are. Even Grandpa has his day.