1. Treatment for psychological disorders

2. PSYCHIATRISTS: medical doctors, can prescribe medicines, generally take a biomedical approach CLINICAL PSYCHOLOGISTS: doctoral degree (PhD or PsyD), supervised internship, licensing exam, treat more serious disorders COUNSELING PSYCHOLOGISTS: advanced degree, less severe problems, marital and family therapy

3. Historically seen as possessed by evil spirits or given other supernatural causes Trephining: drilled holes in skull to release spirits Hippocrates: Greek- 1 st to believe physical c auses Medieval: burned at stake, tortured http://commons.wikimedia.org/wiki/File:Trepanated_skull,_Bronze_Age.JPG

4. REFORMERS: Dorothea Dix (US), Philippe Pinel (France) -advocate for separate institutions from criminals, get treatment http://commons.wikimedia.org/wiki/File:The_Rake%27s_Progress_8.jpg http://upload.wikimedia.org/wikipedia/commons/a/a0/Dix-Dorothea-http://upload.wikimedia.org/wikipedia/commons/a/a0/Dix-Dorothea-LOC.jpg

5. Movement to remove patients from hospitals Why: 1. Overcrowding 2. Cost 3. Better medicines 4. Improve quality of life Unintended result: increase in homeless population of schizophrenics who stopped taking their medicines http://upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Homeless_II.jpg/640px- Homeless_II.jpg

6. 2 Main Approaches to Therapy: 1. BIOMEDICAL: disorders have physiological cause, need medical treatment -psychiatrists more likely to use (can prescribe medicines) 2. PSYCHOTHERAPIES: disorders are psychological in nature -psychologists more likely to use Many disorders require both approaches

7. Cause of disorders: neurochemical imbalances, brain structure abnormalities, genetic predispositions Goal of treatment: change physiology Treatment techniques: psychopharmacology, electroconvulsive therapy, psychosurgery

8. Drug therapies Neurochemical imbalances cause disorders, medicines affect neurotransmitters http://commons.wikimedia.org/wiki/File:Prozac_pills.jpg

9. Treats: Schizophrenia How: block dopamine receptors, decreasing amount of dopamine Exs: Thorazine, Haldol, Clozaril Side Effects: Involuntary muscle twitches, tardive dyskinesia, drooling, fatal blood disorder

10. Treats: anxiety disorders How: increases availability of GABA Exs: Benzodiazepines (Valium, Xanax, Librium), BuSpar Side Effects: tolerance, increased anxiety when stop taking, sluggishness, apathy, addiction

11. Treats: Depression How: increase amount of serotonin (norepinephrine, dopamine) available Exs: SSRIs (Prozac, Paxil, Zoloft), Non-SSRIs, MAOIs, Tricyclics Side Effects: nausea, weight gain, sweating, decreased sex drive, anxiety

12. Treats: Bipolar Disorder How: unknown Exs: Lithium Side Effects: excessive thirst, memory problems

13. Treats: ADHD How: activate sympathetic nervous system, reduce inhibitory centers Exs: Ritalin, Dexedrine, Adderall Side Effects: insomnia, loss of appetite, increased heart rate, anxiety

14. Treats: major depression (last resort) How: administer electric shock (about 6x over 2 weeks) that causes seizure -given muscle relaxant and anesthesia Side Effects: memory loss http://historypsychiatry.com/2010/09/15/electroconvulsive-therapy-past-and-present/

15. Removal of brain tissue-last, last resort Lobotomy: 1935-1955-cut frontal lobe from rest of brain -used for many disorders, left many brain damaged Corpus callosum transection (split-brain): to treat epilepsy

16. Are psychologically based therapies Insight therapies: -Psychoanalysis -Humanistic therapies Action therapies: -Behavioral therapies -Cognitive therapies -Cognitive-Behavioral Therapies http://commons.wikimedia.org/wiki/File:Zur%C3%BCcknahme-02.jpg

17. Causes of disorders: unconscious, repressed traumatic events usually from childhood Goal of treatment: reveal unconscious conflicts, urges and desires Founder: Sigmund Freud http://commons.wikimedia.org/wiki/File:Sigmund_Freud.jpg

18. Treatment techniques: -Free association: “talk therapy”-saying whatever comes to mind -Dream interpretation: “royal road to unconscious”-still protect-symbolic -manifest content: actual events of dream -latent content: hidden underlying meaning -Resistance: unwillingness to talk (good stuff) -Transference: patient projects unconscious feelings onto therapist

19. PSYCHOANALYSIS: Evaluation: long-term (2- 3x/week for years), expensive, unconscious is scientifically unverifiable, too much emphasis on sex Psychodynamic therapy: based on psychoanalysis, shorter treatment time, more direct http://upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Diva_de_Freud.jpg/320px- Diva_de_Freud.jpg

20. Causes of disorders: poor self-concept, low self-esteem due to conditions of worth, too much difference between real self and ideal self Goal of treatment: know self, accept self, work toward self-actualization Approaches to therapy: Client-centered therapy, Gestalt therapy

21. HUMANISTIC: CLIENT (PERSON)- CENTERED THERAPY: Founder: Carl Rogers Treatment techniques: Nondirective: client leads discussion, therapist says little Active listening: therapist mirrors back what client says Unconditional positive regard: acceptance Empathy: understanding http://commons.wikimedia.org/wiki/File:Carl_Ransom_Rogers.jpg

22. GESTALT THERAPY: Founder: Fritz Perls Treatment: directive therapy helps clients accept all parts of self Evaluation of Humanistic: little research to support, not practical for more serious disorders, good for career choices

23. Causes of disorders: Maladaptive behavior learned the same way as adaptive behaviors Goal of treatment: change unwanted behavior and replace it will healthy behaviors Treatment techniques: use principles of classical, operant, and observational learning http://commons.wikimedia.org/wiki/File:John_Watson.jpg

24. Counterconditioning: uses classical conditioning - Systematic desensitization: (Joseph Wolpe) phobias-associate fear with relaxation 1.Taught relaxation techniques 2. Create hierarchy of phobia 3. Work through hierarchy, staying relaxed - Flooding: for phobias-directly confront fear, extinction occurs - Aversive conditioning: associate unpleasant stimuli with unwanted behavior (chemical on fingernails to stop biting)

25. Operant conditioning: uses rewards -Behavior modification: given small reward as get closer to goal - Token economies: given token (secondary reinforcer) for desired behavior, can exchange for external rewards Observational learning: observe others, and imitate behavior Evaluation of behavioral: only treat symptoms, not cause of disorder, very effective with many disorders, especially anxiety

26. Cognitive Therapies Causes of disorders: maladaptive thinking Goals of treatment: cognitive restructuring/change to more adaptive, realistic thinking Types: Rational Emotive Therapy, Cognitive Triad Therapy

27. Rational Emotive Behavioral Therapies (REBT) Founder: Albert Ellis Techniques: -Confrontation of ABCs: address irrational thoughts by discussing Actions, Beliefs, Consequences -Homework: journaling, readings

28. Cognitive Triad Therapy Founder: Aaron Beck Beliefs: depression is caused by negative thinking about triad: self, world, future Techniques: non-confrontational, change negative beliefs