Treatment Approaches for Psychological Disorders

What is deinstitutionalization in the context of mental health treatment?

Deinstitutionalization is the process of moving individuals with severe mental illnesses out of large psychiatric hospitals and closing these facilities, initiated by the 1963 Community Mental Health Act.

What factors contributed to the deinstitutionalization of mental health treatment?

Factors include the introduction of psychotropic medications like Thorazine in 1955, the enactment of Medicaid and Medicare in the 1960s, and the civil rights movement highlighting mistreatment in psychiatric institutions.

Where does treatment for serious mental illness typically occur today?

Treatment usually occurs in community-based outpatient facilities, with hospitalization reserved for severe symptom exacerbation.

What is the goal of community mental health care?

The goal is to return individuals to their homes for continued outpatient care after hospitalization.

What drives community mental health care today?

Community mental health care is driven by evidence-based interventions, using research data to determine effective treatments.

What are some types of community mental health programs?

Programs vary from residential facilities with case managers to day programs and check-in services.

What challenges does community-based treatment face?

Community-based treatment has shown mixed results, with availability not keeping pace with demand, leading to homelessness or incarceration for some individuals.

What are the two main categories of treatment for mental illness?

The two main categories are the biomedical approach, focusing on biological causes and medical treatments, and psychotherapy, which involves interaction between mental health professionals and individuals.

What are the different approaches within psychotherapy?

Psychotherapy includes psychodynamic, cognitive, behavioral, and humanistic approaches, often using an eclectic approach that combines multiple perspectives.

What did Hans Eysenck's early research suggest about psychotherapy?

Eysenck's research suggested that psychotherapy was not particularly effective, as two-thirds of people improved with or without treatment, though his study was based on a small sample.

What does modern research say about the effectiveness of psychotherapy?

Modern research, including meta-analyses, supports the effectiveness of psychotherapy.

What is meta-analysis in the context of psychotherapy research?

Meta-analysis is a statistical technique that combines the results of multiple studies to determine a common effect.

What were the findings of Mary Lee Smith's 1980 meta-analysis on psychotherapy outcomes?

Smith's meta-analysis found that the average client receiving psychotherapy was better off than 80% of untreated individuals.

What are the three common factors identified in effective psychotherapeutic approaches?

The three common factors are therapeutic alliance, positive expectations, and a specific action plan.

What is the therapeutic alliance in psychotherapy?

The therapeutic alliance is a caring, genuine, understanding, and empathetic relationship between client and therapist.

What role do positive expectations play in psychotherapy?

Positive expectations involve the belief that therapy can lead to improvement.

What is the significance of a specific action plan in psychotherapy?

A specific action plan promotes self-efficacy through new behaviors as prescribed by the therapist.

Who can provide psychotherapy?

Different professionals include clinical psychologists, psychiatrists, advanced practice psychiatric nurses, clinical social workers, marriage and family therapists, and other counselors.

What qualifications do clinical psychologists typically have?

Clinical psychologists usually hold a Ph.D or Psy.D, complete a supervised internship, and undergo postdoctoral training.

What distinguishes psychiatrists from other mental health professionals?

Psychiatrists are physicians (M.D. or D.O.) specializing in psychological disorders and are able to prescribe medications.

What qualifications do advanced practice psychiatric nurses have?

They have graduate-level training and can prescribe medication and provide psychotherapy.

What educational background do clinical social workers typically have?

Clinical social workers usually hold a Master of Social Work (MSW) degree and complete postgraduate supervision.

What is the educational requirement for marriage and family therapists?

Marriage and family therapists typically have a master's degree in Marriage and Family Therapy and postgraduate clinical experience.

What is the importance of cultural humility in therapy?

Cultural humility is important for effective therapists to build a therapeutic alliance, instill hope, and create a specific action plan.

What is cultural humility in therapy?

Cultural humility involves understanding and respecting different cultural values, beliefs, and traditions, allowing therapists to approach clients effectively despite cultural differences.

What are the different modes of therapy?

Modes of therapy include individual psychotherapy, group therapy, family therapy, couples/marriage counseling, and self-help groups.

What are the benefits of group therapy?

Benefits of group therapy include mutual support, seeing that others share similar problems, serving as a social laboratory for new behaviors, being less expensive, and saving the therapist's time.

What characterizes self-help groups?

Self-help groups do not involve a trained psychotherapist and include examples like Alcoholics Anonymous and support groups for addiction or trauma survivors.

What is the principle of nonmaleficence in psychological treatment?

Nonmaleficence means to do no harm to clients.

What does fidelity refer to in the ethical principles of psychological treatment?

Fidelity refers to maintaining trustworthy relationships with clients.

What is the significance of integrity in psychological treatment?

Integrity involves being honest, accurate, and truthful in clinical practices.

What does respect for people's rights and dignity entail in therapy?

It entails respecting the rights, dignity, and worth of all individuals.

What is psychoanalysis?

Psychoanalysis, developed by Freud, seeks to alleviate anxiety by addressing conflicts between the id, ego, and superego in the unconscious.

What is free association in psychoanalysis?

Free association is a technique where patients relax and say whatever comes to mind, allowing unconscious thoughts to surface.

How is dream analysis used in psychoanalysis?

Dream analysis involves recalling dreams as symbolic representations of unconscious desires or conflicts, providing insight into the patient's issues.

What is transference in psychoanalysis?

Transference occurs when patients project emotions from other relationships onto the analyst, which the analyst helps the patient understand.

What are some criticisms of psychoanalysis?

Criticisms include being time-consuming and expensive, lacking empirical evidence, relying on subjective interpretations, and risking patient dependency.

What are some strengths of psychoanalysis?

Strengths include introducing concepts like transference, emphasizing the therapist-client relationship, and influencing the psychodynamic approach.

What is the psychodynamic approach to therapy?

The psychodynamic approach focuses on current symptoms related to important relationships and childhood experiences, emphasizing unconscious influences.

How does modern psychodynamic therapy differ from traditional psychoanalysis?

Modern psychodynamic therapy is less time-consuming, involves face-to-face interaction, and does not emphasize id-ego-superego conflicts.

What is the humanistic approach to therapy?

The humanistic approach views humans as fundamentally good, emphasizing growth, self-awareness, and self-acceptance, focusing on present experiences.

How are clients referred to in humanistic therapy?

In humanistic therapy, individuals in therapy are referred to as 'clients' or 'persons' rather than 'patients.'

What does the image of hands cradling a plant symbolize in humanistic therapy?

It symbolizes the nurturing aspect of humanistic therapy, emphasizing growth and support for the individual.

What is the role of the therapist in humanistic therapy?

The therapist acts as a facilitator, promoting an environment for self-exploration and personal growth.

What is the focus of the psychodynamic approach?

The psychodynamic approach focuses on understanding how unconscious processes influence current behavior and relationships.

What is the duration of treatment in modern psychodynamic therapy?

Treatment typically lasts a few months, with sessions occurring once per week.

What is the goal of therapy according to the humanistic approach?

The goal is to boost fulfillment by promoting self-awareness and self-acceptance.

What is Person-Centered Therapy also known as?

Client-Centered Therapy or Rogerian Therapy.

Who developed Person-Centered Therapy?

Carl Rogers.

What fundamental belief underlies Person-Centered Therapy?

All humans have a fundamental drive to fulfill their unique and positive potential (self-actualizing tendency).

What causes psychological troubles according to Carl Rogers?

Incongruence, which is the divergence of the real self from the ideal self.

What is the real self in Person-Centered Therapy?

One's natural self; the person they are in their day-to-day lives.

How does the ideal self emerge?

It emerges from interactions with significant people in an individual's life, particularly parents.

What are 'conditions of worth' in Person-Centered Therapy?

Implicit or explicit standards for acceptance and love that separate the ideal self from the real self.

What are the key elements of Person-Centered Therapy?

Nondirective approach, Unconditional Positive Regard, Empathy, and Genuineness.

What does the nondirective approach in therapy entail?

The client guides the therapy while the therapist listens actively without directing toward specific insights.

What is Unconditional Positive Regard?

Nonjudgmental acceptance provided by the therapist, reinforcing the client's inherent value.

What role does empathy play in Person-Centered Therapy?

The therapist tries to understand and feel what the client is experiencing.

What does genuineness mean in the context of therapy?

The therapist models authenticity during interactions, fostering trust and encouraging the client to be their 'real self'.

What is active listening in therapy?

The therapist echoes, restates, and seeks clarification of what the person expresses, reinforcing unconditional positive regard and empathy.

What are some tips for active listening?

Paraphrase, invite clarification, and reflect feelings.

What does research indicate about effective therapeutic approaches?

They involve three 'common factors,' with therapeutic alliance and positive expectations being central.

What is a limitation of research on humanistic therapy?

There is a lack of empirical research on its effectiveness for specific disorders, with most being qualitative and subjective.

What is Applied Behavioral Therapy also known as?

Applied Behavioral Analysis.

What techniques does Applied Behavioral Therapy use?

Classical conditioning or operant conditioning to help clients unlearn maladaptive behaviors.

What is the focus of behavior therapists in Applied Behavioral Therapy?

They focus on the problematic behaviors themselves, rather than viewing them as symptoms of underlying psychological issues.

What is Exposure Therapy?

A type of therapy that uses classical conditioning to evoke new responses to stimuli that trigger unwanted behaviors.

Who is considered the 'mother of behavioral therapy'?

Mary Cover Jones.

When was the earliest form of exposure therapy developed?

In 1924.

What is classical conditioning?

A learning theory that explains how involuntary responses become associated with new stimuli.

How do modern exposure therapies treat phobias and anxieties?

By exposing people to the things they fear and avoid, either in imaginary or real situations.

What principle did Jones demonstrate to eliminate a little boy's fear of rabbits?

Classical conditioning principles.

How did Jones help Peter overcome his fear of rabbits?

By pairing the fear-evoking rabbit with the pleasurable, relaxed response associated with eating.

What is the process of gradually exposing a client to anxiety-triggering stimuli while practicing relaxation called?

Systematic desensitization.

What are the three steps involved in systematic desensitization?

1. The client learns to practice deep relaxation. 2. The client creates a fear hierarchy from lowest to highest anxiety-producing stimuli. 3. The client is introduced to the least-feared object while practicing relaxation.

What is the main premise of systematic desensitization?

You cannot simultaneously be anxious and relaxed.

What does systematic desensitization aim to achieve in relation to the sympathetic and parasympathetic nervous systems?

It helps the body calm down from the fight-or-flight response.

What is virtual reality exposure therapy?

A type of systematic desensitization treatment that uses virtual reality to expose clients to feared objects or situations.

How does virtual reality exposure therapy benefit clients with PTSD?

It allows for exposure to traumatic experiences that would be impossible to recreate in real life.

What is flooding in the context of exposure therapy?

A method where a client is fully exposed to an anxiety-producing stimulus in a controlled situation from which they cannot escape.

What is a potential risk of flooding therapy?

It can make the phobia worse if the therapist miscalculates the exposure.

What is aversion therapy?

A form of therapy that associates an unwanted behavior with an aversive stimulus.

How might aversion therapy be used to treat alcohol use disorder?

By offering appealing drinks laced with a drug that produces severe nausea, associating drinking with an unpleasant experience.

What is the goal of aversion therapy?

To create a fear or disgust response at the sight of the unwanted behavior.

Who refined Jones' counterconditioning work into systematic desensitization?

Joseph Wolpe in 1958.

What is the significance of creating a fear hierarchy in systematic desensitization?

It helps the client gradually face their fears, starting from the least anxiety-provoking to the most.

What is the role of the therapist in systematic desensitization?

To guide the client through the exposure to fear-inducing stimuli while practicing relaxation.

What is the relationship between the fight-or-flight response and systematic desensitization?

Systematic desensitization helps the body transition from the fight-or-flight response to a relaxed state.

What types of disorders has virtual reality exposure therapy been successfully used to treat?

Anxiety disorders and PTSD.

What advantage does virtual reality exposure therapy provide for phobias?

It allows for safe exposure to feared situations that are difficult or impossible to recreate in real life.

What is the primary focus of exposure therapies?

To reduce anxiety associated with phobias and other anxiety disorders.

How does systematic desensitization relate to classical conditioning?

It uses classical conditioning principles to associate relaxation with anxiety-triggering stimuli.

What is the expected outcome of systematic desensitization?

The client learns to associate feared objects with neutral or relaxed emotions.

Why might flooding be considered quicker than systematic desensitization?

It typically requires fewer sessions to expose the client to the anxiety-producing stimulus.

What is the primary principle behind the treatment that leverages taste aversions?

It utilizes the natural predisposition to develop strong taste aversions, though effectiveness may diminish over time.

Why is it recommended to combine taste aversion therapy with other approaches?

Because individuals know they can drink without fear of nausea outside the therapist's presence.

What technique does Applied Behavioral Therapy primarily use to modify behavior?

Operant Conditioning Techniques, based on B.F. Skinner's principles of reinforcement and punishment.

What is a token economy in behavioral therapy?

A system where individuals earn tokens for desired behaviors, which can be exchanged for rewards or privileges.

In what settings are token economies commonly used?

Institutional settings such as prisons, psychiatric hospitals, and schools.

What is a potential downside of token economies?

Behaviors may cease when extrinsic rewards (tokens) are removed.