1. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 1 Chapter 13 Therapies

2. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 2 Chapter Preview Biological Therapies Psychotherapy Sociocultural Approaches and Issues in Treatment The Effectiveness of Psychotherapy

3. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 3 Biological Therapies Also called biomedical therapies Treatments that reduce symptoms of psychological disorders by altering aspects of body functioning Drug therapy Electroconvulsive therapy Psychosurgery

4. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 4 Drug Therapy Revolutionized mental health care in the 20 th century Psychotherapeutic drugs used mainly in: Anxiety disorders  Antianxiety drugs Mood disorders  Antidepressant drugs Schizophrenia  Antipsychotic drugs

5. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 5 Antianxiety Drugs Commonly known as tranquilizers Bind to receptor sites of neurotransmitters that become overactive during anxiety Benzodiazepines Relatively fast acting Side effects include drowsiness, loss of coordination, fatigue, and mental slowing Can become addictive Nonbenzodiazepines Generalized anxiety disorder

6. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 6 Antidepressant Drugs Regulate mood through effects on neurotransmitters Tricyclics Increase norepinephrine and serotonin levels Monoamine oxidase (MAO) inhibitors Block enzyme that breaks down serotonin and norepinephrine

7. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 7 Antidepressant Drugs Selective serotonin reuptake inhibitors (SSRI) Interfere with reabsorption of serotonin in brain Lithium Solid element used to treat bipolar disorder

8. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 8 Antipsychotic Drugs Neuroleptics Block dopamine’s action in brain Side effects include: Dysphoria  Lack of pleasure Tardive Dyskinesia  Movement disorder Atypical antipsychotic medications Lower risk of side effects Block reuptake of serotonin

9. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 9 Electroconvulsive Therapy Commonly called shock therapy Goal is to set off seizure in brain Used primarily to treat severe depression Patient receives anesthesia and muscle relaxants Controversial

10. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 10 Psychosurgery Irreversible removal or destruction of brain tissue to improve adjustment Prefrontal lobotomy Severing of fibers connecting frontal lobe with thalamus Actual effectiveness questioned Ethical concerns

11. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 11 Psychotherapy Nonmedical process that helps individuals with psychological disorders recognize and overcome their problems Approaches include: Psychodynamic Humanistic Behavioral Cognitive

12. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12 Mental Health Professionals

13. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 13 Psychodynamic Therapies Stress importance of: Unconscious mind Extensive interpretation by therapist Role of early childhood experiences Psychoanalysis (Freud) Contemporary psychodynamic therapies

14. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 14 Psychoanalysis Freud’s therapeutic technique for analyzing unconscious thoughts Goal is to bring unconscious conflicts into conscious awareness Free association Interpretation Dream Analysis

15. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 15 Psychoanalysis Free association Encouraging individuals to say aloud whatever comes to mind Catharsis Release of emotional tension when reliving emotionally-charged or conflicting experiences Interpretation Search for symbolic, hidden meaning

16. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 16 Dream Analysis Interpreting dreams that contain information about unconscious thoughts, wishes, and conflicts Manifest content Conscious, remembered aspects of dream Latent content Unconscious, hidden aspects symbolized by manifest content

17. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 17 Psychonanalysis Transference Inevitable – and essential – aspect of therapeutic relationship Relating to analyst in ways that reproduce or relive important relationships Resistance Unconscious defense strategies

18. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 18 Contemporary Psychodynamic Therapies Accord more power to: Conscious mind Current relationships Kohut’s view Early social relationships with attachment figures are critical Internalized relationships as basis for self

19. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 19 Humanistic Therapies Encourage people to understand themselves and to grow personally Emphasis on self-healing capacities Client-centered therapy (Rogers) Warm, supportive atmosphere to improve self- concept and to encourage insight Reflective speech used to mirror feelings Therapist must enter into an authentic relationship with the client

20. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 20 Behavior Therapies Use principles of learning to reduce or eliminate maladaptive behavior Classical conditioning techniques Systematic desensitization Flooding Aversive conditioning Operant conditioning techniques Applied behavior analysis

21. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 21 Cognitive Therapies Emphasize thoughts as main source of psychological problems Attempt to change feelings and behaviors by changing cognitions Cognitive restructuring Changing pattern of thought presumed to be causing maladaptive behavior or emotion

22. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 22 Cognitive Therapies Albert Ellis’s rational-emotive behavior therapy Aaron Beck’s cognitive therapy Cognitive-behavior therapy

23. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 23 Rational-Emotive Behavior Therapy Emotional reactions to life events as product of irrational beliefs and expectations Central false belief that feelings cannot be controlled Demands (“musterbating”) create dysfunctional, exaggerated beliefs

24. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 24 Rational-Emotive Behavior Therapy Goal of eliminating self-defeating beliefs by rationally examining them Directive, persuasive, confrontational

25. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 25 Beck’s Cognitive Therapy Problems, such as depression, as result of illogical thoughts about self, world, future Emotions as product of cognitions Goal of bringing automatic thoughts to awareness so they can be changed Challenging accuracy of automatic thoughts Logical errors  Erroneous beliefs More open-ended dialogue with therapist

26. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 26 Cognitive-Behavior Therapy Combination of: Cognitive therapy  Reducing self-defeating thoughts Behavior therapy  Changing behavior Self-efficacy (Bandura) Mastering situation and producing positive outcomes

27. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 27 Cognitive-Behavior Therapy Self-instructional methods Teaching to modify own behavior Using reinforcing self-statements to take positive steps

28. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28 Use of Cognitive Therapy Anxiety disorders Panic disorder Post-traumatic stress disorder Generalized anxiety disorder, phobias, OCD Mood disorders Depression Schizophrenia Personality disorders

29. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 29 Therapy Comparisons

30. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 30 Therapy Integrations Integrative therapy Combination of techniques from different therapies based on therapist’s judgment Dialectical behavior therapy Used for borderline personality disorder Includes variety of techniques Also, treated with psychotherapy and drug therapy Conceptually compatible with biopsychosocial model

31. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31 Sociocultural Approaches & Issues Individual as part of social system of relationships, influenced by social and cultural factors Group therapy Family and couples therapy

32. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 32 Sociocultural Approaches & Issues Self-help support groups Community mental health Cultural perspectives on therapy

33. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 33 Group Therapy Individuals sharing psychological disorder brought together in sessions Relationships as key to successful therapy

34. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 34 Group Therapy Features Information Universality Altruism Experiencing a positive family group Development of social skills Interpersonal learning

35. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 35 Family and Couples Therapy Family therapy Group therapy among family members Couples therapy Group therapy with married or unmarried couples with relationship problems Symptoms as function of relationships

36. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 36 Family Therapy Techniques Validation Understanding and acceptance of each family member’s feelings and beliefs Reframing Problems as family (not individual) problems Structural change Restructuring coalitions in family Detriangulation Disentangle situations where scapegoating occurs

37. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 37 Couples Therapy Conflict frequently involves poor communication Attempt to improve communication Focus on roles partners play Addresses diverse problems

38. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 38 Self-Help Support Groups Voluntary organizations of individuals who get together to discuss topics Conducted by paraprofessionals Sympathetic audience for confession, sharing, and emotional release Social support, role modeling, and sharing of concrete problem-solving strategies

39. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 39 Self-Help Support Groups Alcoholics anonymous (AA) Compeer Reduce stress and promote adjustment

40. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 40 Community Mental Health Movement born in 1960s Individuals with disorders ought to remain in society Deinstitutionalization Success depends on resources and commitment of community

41. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 41 Community Mental Health Training those who directly interact with community members to offer services Explicit goal of helping people who are disenfranchised from society

42. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 42 Cultural Perspectives Collectivistic cultures More importance on group, rather than individual Individual psychotherapies may not be as effective Ethnicity Ethnic match between therapist and client Cultural sensitivity and skill Gender Changing roles affect therapy goals

43. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 43 Effectiveness of Psychotherapy Research  Psychotherapy works Meta-analysis Statistical combination of results of different studies No therapy is significantly better than the other Therapy benefits during first 6 months

44. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 44 Health & Wellness Benefits Positive effect of therapy on: Ability to cope with disease, such as cancer Physical health as a result of relieving psychological disorders such as depression Health behavior and physical illness May also prevent psychological and physical problems

45. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 45 Health & Wellness Benefits May enhance positive psychological well- being Well-being therapy (WBT)

46. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 46 Common Themes Effective psychotherapies have common elements of: Expectations Mastery Emotional arousal Therapeutic alliance Relationship between therapist and client Client factors Quality of participation