Chapter 3 Treatment of Psychological Disorders Copyright © 2006 Pearson Education Canada Inc.

2 Quote of the Day: “Give me a dozen healthy infants, well- formed, and my own special world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select - doctor, lawyer, artist, merchant-chief, and yes, even beggarman and thief.” -- John B. Watson

Copyright © 2006 Pearson Education Canada Inc. 3 Psychological Treatments: What Can Help? Psychotherapy: psychological approaches to promote positive mental health – hundreds of “schools” for adults & children four main paradigms: – biological, psychodynamic, cognitive behavioural, humanistic – eclectic approach most common

Copyright © 2006 Pearson Education Canada Inc. 4 Two Foci of Psychotherapy Research  outcome research – does therapy work?  process research – does the therapist-client relationship matter?

Copyright © 2006 Pearson Education Canada Inc. 5 Case Study: Frances lengthy depression suicidal ideation self-blame vs. resentment  How can we interpret her problem?

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7 Historical Perspective Spiritual/religious tradition – supernatural causes – witchcraft – trephining Naturalistic/scientific tradition – Hippocrates: rest, exercise & healthy diet – insane asylums

Copyright © 2006 Pearson Education Canada Inc. 8 Biological Treatments Electroconvulsive Therapy (ECT) – originally, a treatment for schizophrenia – unilateral vs. bilateral ECT – severe side effects Psychosurgery – Egas Moniz ( ) – prefrontal lobotomy vs. cingulotomy Psychopharmacology

Copyright © 2006 Pearson Education Canada Inc. 9 Psychopharmacology psychotropic medications – i.e. Prozac, Xanax, Ritalin billion dollar industry for pharmaceutical companies offer symptom relief, not a cure unpleasant side effects may need to be taken long-term

Copyright © 2006 Pearson Education Canada Inc. 10 Originators of Psychodynamic Therapies Joseph Breuer ( ) – used hypnosis to treat troubled patients – catharsis Sigmund Freud ( ) – free association to reveal unconscious mind – insight into unconscious will cure disorders – therapeutic neutrality and transference

Copyright © 2006 Pearson Education Canada Inc. 11 Psychodynamic therapies  Psychoanalysis – costly and time consuming – unlikely to “cure” psychotic disorders  Ego Analysis – interpersonal relationships of great importance – power: dominance → submission – closeness: affiliation → hostility

Copyright © 2006 Pearson Education Canada Inc. 12 Cognitive Behaviour Therapy: Overview “actions speak louder than words” abnormal behaviour is learned and can be “unlearned” treatment goal: appropriate learning experiences, behavioural change relies heavily on empirical evaluation

Copyright © 2006 Pearson Education Canada Inc. 13 The Experimental Method hypothesis generation identification of independent & dependent variables random assignment experimental group vs. control group consideration of internal & external validity

Copyright © 2006 Pearson Education Canada Inc. 14 Cognitive Behaviour Therapy: Exposure Therapies systematic desensitization – based on theory of classical conditioning – eliminate unpleasant responses through gradual exposure – relaxation training – used extensively in the treatment of phobias flooding – eliminate unpleasant response through extinction – want to prevent avoidance

Copyright © 2006 Pearson Education Canada Inc. 15 Cognitive Behaviour Therapy: Other Approaches Aversion therapy – goal to induce an unpleasant response in order to extinguish an inappropriate behaviour Contingency management – goal to reward desirable behaviour and punish undesirable behaviour i.e. token economies Social skills training – teach people ways of behaving that are likely to be rewarded in the everyday world

Copyright © 2006 Pearson Education Canada Inc. 16 Cognitive Techniques Self-instruction training – adults model appropriate behaviour to children using self-instructions Cognitive therapy – developed specifically to treat depression – cognitive distortions must be challenged to reveal the world in the truer light Rational-emotive therapy – emotional disorders caused by irrational beliefs that must be challenged

Copyright © 2006 Pearson Education Canada Inc. 17 Humanistic Therapies: Foundations  people have free will and must make decisions  emotional problems stem from alienation and problems finding meaning in life

Copyright © 2006 Pearson Education Canada Inc. 18 Humanistic Therapies client-centered therapy – empathy for the client – unconditional positive regard Gestalt therapy – sincerity and honesty – empty chair technique

Copyright © 2006 Pearson Education Canada Inc. 19 Research on Psychotherapy question: How effective is psychotherapy at relieving symptoms, eliminating disorders, and improving life? research approach: meta-analysis

Copyright © 2006 Pearson Education Canada Inc. 20 Research Considerations spontaneous remission placebo effect

Copyright © 2006 Pearson Education Canada Inc. 21 Psychotherapy Process Research which aspects of therapy work? how do the different approaches measure up against one another? – behavioural interventions slightly better, but very few differences

Copyright © 2006 Pearson Education Canada Inc. 22 Psychotherapy process research psychotherapy as social support – the therapeutic alliance psychotherapy as social influence

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24 Changing Social Systems Couples Therapy – communication & negotiation Family Therapy – parental management training Group Therapy – psycheducational groups

Copyright © 2006 Pearson Education Canada Inc. 25 Canadian Focus: Treatments Multisite research Centre for Addiction and Mental Health Dismantling studies

Copyright © 2006 Pearson Education Canada Inc. 26 Community Psychology ìPrimary prevention – prevent new cases from developing ìSecondary prevention – early detection of problems ìTertiary prevention – providing treatment to people in need