PYSC Therapy and Treatment

PYSC Test 4 P3

Types of Therapists

Clinical Psychologist (P.h.D or Psy.D)

Work with most serious cases

Types of Therapists

Counseling Psychologists (Ph.D., Psy.D., Ed.D)

Unlikely to work with clients that have serious mental health issues.

Types of Therapists

School Psychologists (Ph.D. Or Ed.D)

Psychological testing, behavioral management.

Types of Therapists

Psychiatrist (MD or DO)

In most states, only degree that can prescribe medication.

Recipients of Treatment

Most people who meet the criteria for DSM diagnoses do not seek treatment

Variability due to sex, education and income level.

Women are more likely to seek treatment than men

college educated seek more treatment than high school educated

Less than 25% of college aged adults seek treatment.

Insight Therapies

Remove distressing symptoms by leading people to understand their causes through deeply felt personal insights.

Behavioral Therapies

Based on principles of learning that focuses on observable measurable behavior.

Cognitive Therapies

Focuses on client’s thoughts rather than his or her own feelings or behaviors.

Biomedical Therapies

Treatments that focus on the biological basis of the disorder.

Types of insight therapies

Psychoanalytic

Person Centered

Group

Psychoanalytic Therapy

Based on Freud’s contention that psychological problems result from conflicts from the unconscious.

Make these problems conscious to solve them.

Analyst’s job is to make about pt’s unconscious conflicts.

Once pt experiences them consciously , can modify or express them.

Pt must accept insight of therpist.

Psychoanalytic therapy

Resistance

Pt resist attempts to bring unconscious into conscious

Material causes anxiety

forgetting

Refusing to discuss topics

Psychoanalytic therapy

Transference

Pt unconscious feelings about someone experienced as feelings toward therapist.

Psychoanalytic therapy

Countertransference

The tendency of the therapist to displace onto clients feelings caused by people in the therapist’s life

Person centered therapy

Focus on thoughts, abilities, cleverness of client.

Not focused on insights of the therapist

Therapist is soundboard for clients thoughts

Person centered therapy

Unconditional Positive Regard:

Client is worthy and capable no matter what client does or says.

creates safe non-judgmental environment

Genuiness : Therapist is truly empathetic and warm

Group therapies

Normally consists of 6-9 people attending

90- minute session: benefit more people with less cost.

Clients benefit from knowing that other people have similar problems.

Types of Group Therapies

Psychotherapy groups

Focus on personality reconstruction or remediation of deep seated psychological problems.

Types of Group Therapies

Support Groups

Deal with special populations and deal with specific issues and offer support, comfort and connectedness to others.

Types of Group Therapies

Self Help Groups

Have no formal or trained group leader. Ex: AA, Gambler Anonymous

Types of Cognitive Therapy

Rational Emotive

Cognitive Behavioral

Cognitive Therapies

People disturb their own thoughts such as;

I must be perfect

Everyone must love me

The past determines the future

It is catastrophic when things don’t go as planned

Goals of Cognitive therapy

Identify maladaptive ways of thinking

replace these with adaptive ways

Rational- Emotive Therapy

Negative emotions arise from people’s irrational interpretations of experiences

Musterbations: Irrational belief that you must do or have something.

Awfulizing: mental exaggeration of setbacks

Cognitive Behavioral Therapy (CBT)

Incorporates techniques from cognitive therapy and behavior therapy

Used to correct faulty thinking and change maladaptive behaviors

Behavior Therapies

Based on classical conditioning

Aversion therapy

Flooding

Systematic desentisization

Aversion therapy

Painful or unpleasant stimulus follows unwanted behaviors.

Used for:

Bad habits

Drinking

Smoking

Gambling

Flooding (implosion therapy)

Immerse consenting person in the fear stimulus.

After fear subsides, calm sets i, is associated with feared object.

Systematic Desensitization

Create a hierarchy ranging from least to most feared stimulus

Work through hierarchy while maintaining calm

Based on operant conditioning

Time outs: Removing the individual from the reinforcing situation

Token Economies: Using tokens that can be exchanged for other items or privileges as a reinforcer.

Stimulus satiation: Giving a person to much of a desired thing so as too reduce it’s attraction

General conclusions About therapy effectiveness

People in treatment do better than those not

Some therapists are better than others

e.g warm understanding ect

Biomedical Therapy

Attempts to solve the disorder by altering bodily processes

History:

Blood letting

Trephining

Drilling holes in head

Modern Biomedical therapies

Pharmacotherapy

Electroconvulsive shock therapy (ECT)

Repetitive transcranial magnetic stimulation

Psychosurgery

Pharmacotherapy (drug therapy)

Use of psychoactive drugs to treat mental illness

psychoactive drugs have been highly successful in reducing in pt population

Antipsychotics

Used for schizophrenia and other psychotic disorders ex: clozapine

Antipsychotics are more effective for the positive symptoms than for negative ones

Problems:

Reduce symptoms but don’t increase life satisfaction

unpleasant and harmful side effects:

Tardive dyskinesia: person who smacks their lips and displays facial grimaces.

Anti depressants

Typically require 3-4 weeks to take effect.

Prozac, zoloft, paxil

Anti-anxiety: depress the CNS

Magic mushrooms: psilocybin

relaxation, introspection, anxiety, paranoia, panic, hallucinations, psychosis

One dose may be able to lift depression in those who are unresponsive to traditional antidepressants

Common Pharmacotherapy problems

General side effects

Weight gain, irritability, sleeplessness, sexual

Common Pharmacotherapy problems

Taking to high of a dose to soon

Taking to high of a dose to soon: increased chance of uncomfortable side effects that make people stop taking meds

Common Pharmacotherapy problems

Stopping a drug to quickly:

Can lead to discontinuation syndrome:

cluster of negative symptoms: irritability, agitation, sleeplessness, mood lability.

ECT

Used in primary cases of severe unrelenting depression.

Modern ECT is much safer than the early ECT.

Pt is given drugs to sedate beforehand: painless

70% of people who don’t respond to other treatments get relief with ECT

Concerns over ECT

Permanent brain damage: No evidence to support

do find temporary disruptions in cognition: memory

ECT can result in loss of memory for events a day or two previous to treatment

Usually returns within a month

rTMS

A pulsating magnetic coil is placed over prefrontal regions of the brain

Used to treat depression

Not as consistently effective as ECT

Psychosurgery

Lobotomy

Prefrontal lobotomy: connections between prefrontal lobes ad rest of the brain are severed.

Severe side effects: incapacitation, impulsivity, excitability, apathy

Not used any more

Psychosurgery

Cingulotonomy

Partial destruction of structures in the limbic system

Focus on areas responsible for integration of emotions and feelings

results show some success with fewer side effects.