1. CHAPTER 15 Treatment of Psychological Disorders

2. Psychotherapy: techniques employed to improve psychological functioning & promote adjustment to life Three major approaches to therapy: –Insight (personal understanding) –Behavior (maladaptive behaviors) –Biomedical (mental illness & medical treatments, such as drugs) Introductory Definitions

4. Four Major Forms of Insight Therapy Psychoanalysis/ psychodynamic Cognitive Humanistic Group, Family, & Marital

5. Insight Therapies: Psychoanalysis/Psychodynamic Psychoanalysis: Freudian therapy designed to bring unconscious conflicts into consciousness

6. Insight Therapies: Psychoanalyis/Psychodynamic Five major techniques of psychoanalysis:

7. Insight Therapies: Psychoanalysis/Psychodynamic Evaluation of psychoanalysis: limited applicability & lack of scientific credibility Psychodynamic Therapy: briefer, more directive, contemporary form of psychoanalysis focusing on conscious processes & current problems

8. Insight Therapies: Cognitive Cognitive Therapy: focuses on changing faulty thought processes & beliefs –Improvement comes from insight into negative self-talk (internal dialogue) –Cognitive Restructuring: process of challenging & changing destructive thoughts & maladaptive behaviors

9. Insight Therapies: Cognitive (Continued) Albert Ellis’s Rational- Emotive Therapy (RET): eliminates emotional problems through rational examination of irrational beliefs

10. Ellis’s Rational-Emotive Therapy (RET)

11. Aaron Beck’s form of Cognitive- Behavior Therapy works to change destructive thoughts & behaviors Depressive thought patterns: –selective perception –overgeneralization –magnification –all-or-nothing thinking Beck’s Cognitive-Behavior Therapy

12. Insight Therapies: Cognitive (Continued) Evaluation of cognitive therapy Pro: Considerable success with a range of problems Con: Criticized for overemphasizing rationality, ignoring unconscious dynamics, minimizing importance of the client’s past, & progress only comes from behavioral change—not thought processes

13. Insight Therapies: Humanistic Humanistic therapy: seeks to maximize personal growth through affective restructuring (emotional readjustment) Key assumption: Problems = blockage or disruption of normal growth potential, which leads to a defective self- concept

14. Rogers’s Client-Centered Therapy: provides accepting atmosphere & encourages healthy emotional experiences Techniques include: –empathy –unconditional positive regard –genuineness –active listening Insight Therapies: Humanistic (Cont.)

15. Insight Therapies: Humanistic (Continued) Evaluation of humanistic therapy Pro: Empirical evidence of efficacy Con: Outcomes such as self- actualization & self-awareness difficult to test scientifically; research on specific techniques has had mixed results

16. Insight Therapies: Group, Family, & Marital Therapies Group Therapy: a number of people meet together to work toward therapeutic goals Family & Marital Therapies: work to change maladaptive family patterns

17. Behavior Therapies Behavior Therapy: group of techniques based on learning principles used to change maladaptive behaviors Three foundations of behavior therapy: –classical conditioning –operant conditioning –observational learning

18. Behavior Therapies: Classical Conditioning – Aversion Therapy: pairs an aversive (unpleasant) stimulus with a maladaptive behavior

19. Pause & Reflect: Critical Thinking

20. Classical Conditioning: Systematic Desensitization Systematic Desensitization: gradual process of extinguishing a learned fear (or phobia) by working through a hierarchy of fearful stimuli while remaining relaxed Virtual reality therapy offers a type of systematic desensitization with “virtual” vs. real-life therapeutic experiences.

21. Behavior Therapies: Classical Conditioning & Driving Phobia

22. Behavior Therapies: Operant Conditioning Operant conditioning uses techniques to increase ADAPTIVE behaviors: Shaping: rewards successive approximations of target behavior through role-playing, behavior rehearsal, etc. Tokens: symbolic rewards used to immediately reinforce desired behavior

23. Behavior Therapies: Observational Learning Modeling: watching & imitating models that demonstrate desirable behaviors

24. Behavior Therapies (Continued) Evaluation of behavior therapies: Pro: Strong evidence for success with a wide range of problems Con: Questioned & criticized for generalizability & questionable ethics

25. Biomedical Therapies Biomedical Therapy: uses physiological interventions, such as drugs, to reduce or alleviate symptoms of psychological disorders Three forms of biomedical therapy: –Psychopharmacology –Electroconvulsive therapy (ECT) –Psychosurgery

26. Biomedical Therapies: Psychopharmacology Four major categories of drugs:  Antianxiety (increases relaxation; reduces anxiety & muscle tension) 2.Antipsychotic (treats hallucinations & other symptoms of psychosis) 3.Mood Stabilizer (treats manic episodes & depression) 4.Antidepressant (treats symptoms of depression)

28. Biomedical Therapies (Continued) Electroconvulsive Therapy (ECT): based on passing electrical current through the brain; used almost exclusively when other methods have failed Psychosurgery: operative procedures on the brain designed to relieve severe mental symptoms that have not responded to other forms of treatment

29. Evaluating Biomedical Therapies Psychopharmacology: enormously beneficial, but several problems (e.g., side effects, dependency, etc.) Electroconvulsive Therapy (ECT) & Psychosurgery: controversial & generally used as a last resort

30. Therapy Essentials: Five Common Goals

31. Cultural Issues in Therapy Cultural similarities in therapy: naming the problem qualities of the therapist establishing credibility familiar framework applying techniques that bring relief special time & place

32. Cultural differences: –Therapies in individualistic cultures emphasize independence, the self, & control over one’s life. –Therapies in collectivist cultures emphasize interdependence. Cultural Issues in Therapy (Cont.)

33. Key considerations for women & therapy:  higher rates of diagnosis & treatment of mental disorders 2.stresses of poverty 3.stresses of multiple roles 4.stresses of aging 5.violence against women Cultural Issues in Therapy (Cont.)

34. Institutionalization—criteria for involuntary commitment: –dangerous to self or others –believed to be in serious need of treatment –no reasonable alternatives Therapy & Critical Thinking: Institutionalization

35. Deinstitutionalization: discharging as many people as possible from state hospitals & discouraging admissions Community services such as community mental health (CMH) centers work to cope with problems of deinstitutionalization. Therapy & Critical Thinking: Institutionalization (Continued)