Therapy Any treatment process for mental disorders Variety of types Psychological (psychotherapy) Biomedical Common element: a relationship focused on change.

Obstacles to Therapy Stigma Lack of money or insurance Lack of qualified therapists Certain types of disorders

Friend or Therapist ? Friend may have own needs. Therapist is confidential. Friend may not have expertise.

Basic Tasks of Therapy Problem Indentification Etiology (cause) Prognosis Treatment Plan

Mental Health Care Professionals Counseling psychologist Clinical psychologist Psychiatrist Psychoanalyst Psychiatric nurse practitioner Clinical social worker Pastoral counselor

Psychological Therapies Behavioral--change learned habit patterns. Cognitive--restructure thinking patterns. Psychodynamic--develop insight into unresolved hidden conflicts. Humanistic--emphasize freedom of choice and development of healthy relationships

Behavioral Therapies Based on operant and classical conditioning. –Counterconditioning –Systematic desensitization –Aversion therapy –Contingency management –Token economy

Cognitive Therapies Emphasize rational thinking as key to changing emotions and behavior. Both –what we think (content) –how we think (process) Emotional dysfunction comes from irrational beliefs not an event itself.

Beck’s Approach Negative self-talk becomes automatic Evaluate the evidence for and against these automatic thoughts Discover alternate thoughts

Rational Emotive Behavioral Therapy (REBT) Founder--Albert Ellis Emotional and behavioral problem develops from irrational beliefs not the event itself. Therapist challenges the irrational beliefs.

Irrational Beliefs I must always succeed. I should always receive approval. I should always be treated fairly. My experiences should always be pleasant.

Cognitive-behavioral Therapy Most contemporary form of psychotherapy Combines cognitive techniques to change thinking with alterations in reinforcement contingencies.

Research on Psychotherapy Therapy better than no therapy. Longer better than short therapy. All forms of therapy equally effective. Best to match specific therapies to specific conditions.

Counseling Your Friends/Family Best to refer to professionals if serious. Try to avoid advice-giving. Use non-directive techniques.

Non-directive Techniques Active Listening Acceptance Exploration of Alternatives

Active Listening Use paraphrasing. Ask for clarification. Shows interest and empathy. Helps the person organize their thinking about the problem.

Unconditional Acceptance Non-judgmental attitude Accept the person and the problem.

Exploration of Alternatives Help identifying other potential choices. Explore the consequences of each. Point out that doing Remember the choice is up to the individual who owns the problem.

Biomedical Therapies Treatments that focus on altering the brain. Based on the medical model of abnormality. Drug Therapy Psychosurgery Electroconvulsive and Magnetic Therapies

Antipsychotic Drugs Developed in 1950’s Thorazine, Haldol Major tranquilizers Also diminish psychotic symptoms Reduce the activity of neurotransmitter dopamine

Antidepressant Drugs Lift depressed mood. Most common now are SSRIs. Prolong action of neurotransmitter serotonin. Prozac, Zoloft, etc. Side effects but not addictive.

Antianxiety Drugs Diminish feelings of anxiety. Increase activity of neruotransmitter GABA Most common now are benzodiazepines such as Valium or Xanax. Have side effects and are addictive.

Stimulants Used to treat narcolepsy and ADHD. Ritalin Increase availability of neurotransmitters dopamine and/or serotonin.

Other Biomedical Therapies Psychosurgery--frontal lobotomy, split brain Electroconvulsive Therapy (ECT)-treats depression by causing seizures Hospitalization--asylum and therapeutic community Deinstitutionalization--community mental health movement