Chapter 15 Treatment of Abnormal Psych
Chapter Introduction • Therapeutic drugs and community-based treatments are why many mental health hospitals have been empty since the 1950s.
Therapy • Psychotherapy • an emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties • Eclectic Approach • an approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy
Therapy- Psychoanalysis • Psychoanalysis • Freud believed the patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight • use has rapidly decreased in recent years • Resistance • blocking from consciousness of anxiety-laden material
Therapy-Psychoanalysis Psychoanalytic theory creates less anxious individuals for their conflicted energy is now released Free association is when you say aloud whatever is on your mind.
Therapy-Psychoanalysis • The latent content of a dream is the underlying, but censored meaning. • A dream analysis is a suggestion of a dream’s meaning.
Therapy- Psychoanalysis • Interpretation • the analyst’s noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight • Transference • the patient’s transfer to the analyst of emotions linked with other relationships • e.g. love or hatred for a parent
Psychodynamic Therapy • Therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seek to enhance self-insight • The goal is to interpret the patient’s conflict
Humanistic Therapy • Client-Centered Therapy • humanistic therapy developed by Carl Rogers • therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients’ growth • Active Listening-empathic listening in which the listener echoes, restates, and clarifies
Humanistic Therapy • Rogers wanted therapists to focus on GENUINENESS, ACCEPTANCE, AND EMPATHY. • Unconditional positive regard: a caring, accepting, nonjudgmental attitude, which Carl Rogers believed to be conducive to developing self-awareness & acceptance
Humanistic Therapy • Insight therapies: aim to improve the psychological functioning by increasing the client’s awareness of underlying motives and defenses. • focuses more on the present and future more than the client’s past
Behavior Therapy • Behavior Therapy • therapy that applies learning principles to the elimination of unwanted behaviors • Counterconditioning • procedure that conditions new responses to stimuli that trigger unwanted behaviors • based on classical conditioning • includes systematic desensitization and aversive conditioning
Behavior Therapy • Exposure Therapy • treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid
Behavior Therapy • Systematic Desensitization • type of counterconditioning • associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli • commonly used to treat phobias • Aversive Conditioning • type of counterconditioning that associates an unpleasant state with an unwanted behavior • nausea ---> alcohol
Discrimination • Mary Cover Jones did not receive the credit she deserved in psychology because she was a woman.
Systematic Desensitization • Systematic Desensitization: a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety triggering stimuli. • Commonly used to treat phobias.
Progressive Relaxation • Progressive Relaxation: Relaxing one muscle group at a time to receive relaxation and comfort.
Virtual Reality Exposure Therapy • Virtual Reality Exposure Therapy: Anxiety treatment that progressively exposes people to stimulations of their greatest fears such as airplane flying to public speaking.
Virtual Reality Exposure Therapy • This is helpful because your fear is stimulated to help people get through it without a high cost. • Also, using an avatar lets you try out new behaviors in virtual environments for people suffering a social phobia.
Aversive Conditioning • Aversive Conditioning: type of counter-conditioning that associates an unpleasant state with an unwanted behavior.
Aversive Conditioning vs. Systematic Desensitization • Aversive Conditioning is the opposite of systematic desensitization.
Aversive Conditioning • Aversive Conditioning: to get rid of nail biting, you could paint your nails with a nasty tasting nail polish.
Aversive Conditioning • Aversion is much better in the short term rather than long term. • When coyotes stopped eating sheep because there coats were treated with poison, later they began to eat the sheep again.
Aversive Conditioning • Cognition influences aversive conditioning. • After 3 years people treated with alcohol aversion, only 33% stayed away from alcohol.
Behavior Modification • Behavior Modification: reinforcing behaviors and withholding reinforcement for undesired behaviors or punishing them.
Behavior Modification • Children with disabilities have learned to care for themselves. • People suffering from Schizophrenia have learned to behave more rationally.
Token Economy • Token Economy: an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats.
Token Economy • Criticisms: • Will people stop doing the behaviors when the rewards stop. • Is it right to deprive people of something they desire and decide which behaviors to reinforce.
Cognitive Therapies • Cognitive Therapies: therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions.
Cognitive Therapies • Cognitive therapists try to teach new, more constructive ways of thinking.
Aaron Beck • Aaron Beck was originally trained Freudian but turned cognitive therapist. • Beck tries to reverse clients’ catastrophizing beliefs about themselves, situations, and future.
Stress Inoculation Training • Meichenbraum’s stress inoculation training teaches people to restructure their thinking in stressful situations. • After learning how to dispute negative thoughts there was a halved rate of future depression.
Cognitive Behavior Therapy • Cognitive Behavior Therapy: a popular integrated therapy that combines cognitive therapy and behavior therapy.
Group Therapy • Economically, group therapy is good because it saves time and money. • It allows people to see problems similar to their own and receive feedback as they try new ways of behaving.
Family Therapy • Family therapy: therapy that treats the family as a system views an individuals unwanted behaviors as influenced by, or directed at, other family members.
Family Therapy • Goals are beneficial because they open up communication within the family or to help family members.
Group Therapy • AIDS, anorexia, alcohol, and hearing loss have successful support groups. • Whereas hypertension, migraines, ulcers, and vision loss don’t really have support groups.
Alcoholics Anonymous • Worldwide, Alcoholics Anonymous has over 2 million members in 114,000 groups. • Their 12 step program, you need to admit powerless, seek help from a higher power, and to share message with others.
Psychotherapy • Clients testimonials affirm the use of psychotherapy. • Criticisms: • People often enter therapy in a crisis. • Clients may need to believe therapy was worth the effort. • Clients generally speak highly of their therapists.
Placebo Effect Regarding Therapy • Power or belief in the treatment, whether or not it actually is successful.
Regression Towards the Mean • Regression Towards the Mean: tendency for the extremes to fall back towards the average, or what is normal.
Lack of Psychotherapy • Eysenck said that without psychotherapy, roughly 66% of people with depression improved noticeably. • Time heals. • Criticism: • Sample for testing was small.
Research of Therapy • Randomized clinical trials are the best way to study outcome research. • Researchers need to randomly assign people to either a therapy group, or no therapy.
Meta-Analysis • Meta-Analysis: a procedure for statistically combining the results of many different research studies.
Smith’s 1980 Research • Psychotherapists welcomed the first meta-analysis of some 475 psychotherapy outcome studies It showed that the average therapy client ends up better off than 80 percent of the untreated individuals on waiting lists. The claim is modest—by definition, about 50 percent of untreated people also are better off than the average untreated person. Nevertheless, Mary Lee Smith and her colleagues exulted that “psychotherapy benefits people of all ages as reliably as schooling educates them, medicine cures them, or business turns a profit.”
5 Subsequent studies • Proved that: Those not undergoing therapy often improve, but those undergoing therapy are more likely to improve.
Psychotherapy-cost effective • Studies show that when people seek psychological treatment, their search for other medical treatment drops—by 16 percent in one digest of 91 studies. • Given the staggering annual cost of psychological disorders and substance abuse—including crime, accidents, lost work, and treatment—this is a good investment. • Both reduce long-term costs. Boosting employees’ psychological well-being, for example, can lower medical costs, improve work efficiency, and diminish absenteeism.
Clinicians experience • There is little if any connection between clinicians’ experience, training, supervision, and licensing and their clients’ outcomes.