Early Psychiatry Unit XIII. Treatment

XIII. Treatment of Psychological Disorders College Board - “Acorn Book” Course Description 7-9% Unit XIII. Treatment

“Hey, I’m just messing with your head.” Unit XIII. Treatment

Summary Outline A. Treatment Approaches B. Modes of Therapy (e.g. individual, group) C. Community and Preventive Approaches Unit XIII. Treatment

Good Shrink, Bad Shrink

First, we’ll look for repressed memories of malpractice suits.” Unit XIII. Treatment

“Your problems make my fee seem insignificant.” Unit XIII. Treatment

A. Treatment Approaches 1. Insight Therapies: Psychodynamic/Phenomenological Approaches 2. Behavioral Approaches 3. Cognitive Approaches 4. Biological Approaches Psychopharmacology/psychosurgery Unit XIII. Treatment

Insight Therapy “You only think you’re barking at nothing. We’re all barking at something.” Unit XIII. Treatment

A.1. Insight Therapies Psychoanalysis (Freud) Humanistic Techniques free association dream analysis dream interpretation {latent/manifest content}, resistance transference, counter-transference Humanistic Person-Centered Therapy (Rogers) Gestalt Therapy (Perls) Unit XIII. Treatment

Patient: I’m beginning to think you’re the only one who really listens to me , Doctor . . . Doctor’s notes: Bitch and moan

A.2. Behavioral Approaches Behavior Therapy (Classical conditioning techniques) Counter-conditioning systematic desensitization aversive conditioning Extinction Flooding exposure Unit XIII. Treatment

Behavior Modification (Operant conditioning techniques) Positive Reinforcement (Token economy), Extinction (Removal of reinforcers) Modeling Unit XIII. Treatment

Counter conditioning “Now relax . . . . . Just like last week, I’m going to hold the cape up for the count of 10 . .. . . . . . When you start getting angry, I’ll put it down.”

Well, I just been eatin’ those little guys like popcorn.” “You know those teeny tiny little birds that walk around so trustingly inside a crocodile’s mouth? Well, I just been eatin’ those little guys like popcorn.” Unit XIII. Treatment

A.3. Cognitive Approaches Rational Emotive Therapy (Ellis) Cognitive Therapy (Beck) Unit XIII. Treatment

“Would you like to see the drawing I just did of my doggie?” Unit XIII. Treatment

4. Biological Approaches Electroconvulsive Therapy (ECT) Psychosurgery Psychoactive Drugs Anti-psychotic Anti-depressents Anti-anxiety Unit XIII. Treatment

“May I suggest we up your medication, sire.”

“I used to give a damn, but now they have a patch for that.” Unit XIII. Treatment

“Your tale is very sad, Ben. I’m almost sorry I took an anti-depressant.”

B. Modes of Therapy (e.g. individual, group) Individual Therapy Advantages, disadvantages Group Therapy Group Support Feedback and Information Behavioral Rehearsal Self-Help Groups Family Therapy Unit XIII. Treatment

C. Community and Preventive Approaches Institutionalization Involuntary Commitment Deinstitutionalization Community Health Centers Homelessness, the “Revolving Door,” and Mental Illness Unit XIII. Treatment

Critical Thinking about Psychotherapy Is Psychological Diagnosis Biased? Diagnosis of minorities and the poor / homeless What am I being asked to believe or accept? What evidence is available to support the assertion? Are there alternative ways of interpreting the evidence? What additional evidence would help to evaluate the alternatives? What conclusions are most reasonable?

Dangers in Diagnosis Predisposition to find certain disorders Confirmation Bias Ignoring or not seeing evidence that does not support diagnosis (The benevolent dolphin) Denial confirming the diagnosis (I didn’t have feelings for my mother) Certainty of diagnosis Self-justification /cognitive dissonance Recommendation: Tavris, Carol and Elliot Aronson. Mistakes Were Made (but not by me). Harcourt Publishing Company. 2007.

Activities General description of disorder Symptoms  Worksheet - Briefly describe each of the disorders listed General description of disorder Symptoms Mode of treatment seen as most effective Rational for treatment (relationship to cause)

Biological Therapies Chart Names, How they work, Risks Psychosurgery Deep Lesioning Prefrontal Lobotomy ECT Drug Therapy Antianxiety Antidepressant Antipsychotic

Cognitive Therapies Chart Aims, Terms/Techniques, Definitions Cognitive Therapy – Aaron Beck Specific Terminology Automatic Thoughts Negative Thoughts Rational Emotive Therapy – Albert Ellis Irrational Beliefs ABC Activating event, Belief, Consequence

Insight Therapies Chart Aims, Terms/Techniques, Definitions Psychodynamic Sigmund Freud Humanistic Victor Frankl Existential Therapy (Logotherapy) Fritz Perls Carl Rogers