2.   “madness” was attributed to the supernatural forces, or possession of evil spirits  Treatment was drilling holes in the skull to release the evil spirit, this is known as trepanation.  Diagnosis was occurring and treatment was being sought. Introduction - History

3.  Possible relationship between etiology and treatment Pages 166 - 169

4.   Biomedical  Individual or group therapy  Biopsychosocial approach: Multifaceted approach is know considered to be the most efficient.  Includes drug therapy  cognitive therapy (individual)  or family therapy (group therapy)  Stress related environmental management  ‘Client’ has replaced the term ‘patient’ Contemporary approach to treatment

5.   Not all people will respond to drug therapy the same  Side effects may occur  Dosage levels take time to assess  No conclusive data to pinpoint specific biophysiology to behavior, but rather a general knowledge that neurotransmitters and hormones may contribute. Drug Therapy

6.   Therapist work one-on –one with the client  Most therapy involves some form of cognitive  Works to change negative thought pattern  Highly effective  Personalized/individualized to the client. Individual therapy

7.   A group if clients with similar issues meet with one or two therapist.  Women who have experiences sexual abuse  Abusive family  Depression  Group therapy allows individuals to openly discuss shared experiences in a safe environment;  It provides group support (collectivism),  Cost effective for client  Therapist can work with multiple clients at once  The group setting diminishes the role of the therapist and thus buts the client on the path to self management.  Many disorders are caused or promote poor social skills – group works allows individuals to interact in a safe environment. Group Therapy

8.   Some individuals may not want to express themselves  Confidentiality  Group dynamics Disadvantages of Group

9.  Culture Considerations in treatment Pages 168-169

10.   Not all cultures respond to all treatments the same.  Mutlaq and Chaleby (1995) – problems with group therapy with Arab culture  Gender roles  Deference to members in the group based on age or tribal status  Misperception that this is simply a social activity Culture and treatment

11.   Indigenous healing practices – a combination of western psychotherapy and therapeutic beliefs and practices that are rooted within a given culture.  Commonalities in nonwestern countries of indigenous practices include:  Heavy reliance on family and community networks.  Incorporation of traditional, spiritual and religious beliefs  Malaysia, religion has been incorporated into psychotherapy  Chinese Taoist cognitive psychotherapy – verses from the Taoist writings that highlight main principles, such as restricting selfish desires, learning how to be content, and learning to let go, are read and reflected.  This was found to be more effective in the long term reduction of anxiety disorders than drug therapy Indigenous healing practices

12.   Analyze psychological health from a community level.  Ecological model – Miller (2000), looks at the relationship between people and the settings they live in  Identifies naturally occurring resource within the community that can promote healing/healthy adaptations  Enhancement of coping strategies/response to stress  Development of collaborative, culturally grounded community interventions that actively involve community members in the process of solving their own problems. Community Psychologist

13.   Eclectic approach to therapy – an approach that incorporates principles or techniques from various systems and theories.  Eclectic approach allows for an individualistic approach to each client’s needs.  Cognitive therapy may not be ideal based on the age of the individual or the current state of mind of the individual.  Group therapy is appropriate in all cases – the level of development of the client must be considered.  Drug therapy alone is not significant for long term success.  Rush et al ( 1977) high relapse rate for patients only treated with drug therapy (i.e. no cognitive therapy). The use of eclectic approaches

14.   Cognitive therapies are more effective than drug treatment alone at preventing relapse or reoccurrence, except when drug treatment is long term (Hollon and Beck 1994)  A combination of drug and psychotherapy appears to be moderately more successful than either therapy alone (Klerman et al., 1994)

15.   Eysenck (1961) proposed the idea of spontaneous remission, recovery that came about due to no treatment other than time.  How does one assess is a treatment works?  How long must an individual be symptom free for treatment to be successful?  Should the total absence of symptoms be the only criteria?  Should only observable behavior be the measuring stick?  Can you gather both quantitative and qualitative data when measuring the disorder?  Who decides is the therapy is successful? Measuring the effectiveness of Therapy

16.   Outcome Studies: focus on the results – did the patient show improvements or not?  Not all studies are equal - much depends upon the interpretation and style of the therapist, and the compliance of the patient.  Most treatments have positive effect (Smith et al., 1980) – meta analysis of 475 studies  Some approaches work better for some disorders while other approaches are best for others.  Thus eclectic styles of treatment are often applied. Determining Effectiveness