PSYC 1001: Chapter 16 - Therapy and Treatment

exorcism

involving incantations and prayers said over the individual’s body by a priest/religious figure.

trephining

a hole was made in the skull to release spirits from the body. This often lead to death.

asylums

the first institutions created for the specific purpose of housing people with psychological disorders.

• focus was ostracizing rather than treatment

Philippe Pinel (late 1700s)

• French physician argued for more humane treatment of the mentally ill

• patients benefited and many were able to be released from the hospital

Dorothea Dix (19th century)

• advocated for better treatment of the mentally ill and indigent insane

• Instrumental in creating the first American mental asylum - by relentlessly lobbying state legislatures and Congress to set up and fund such institutions.

American asylums

• filthy, little treatment, individuals institutionalized often for decades

Treatment of American asylums

• submersion into cold baths

• electroshock treatment (electroconvulsive therapy)

electroconvulsive therapy

induces seizures to help alleviate severe depression.

Deinstitutionalization

the closing of large asylums, by providing for people to stay in their communities and be treated locally 

Involuntary treatment

therapy that is not the individuals choice.

Voluntary treatment

the person chooses to attend therapy to obtain relief from symptoms.

Sources of psychological treatment

community mental health centers, private or community practitioners, school counselors, school psychologists or school social workers, group therapy.

Psychodynamic psychotherapy (Freud)

Talk therapy based on belief that the unconscious and childhood conflicts impact behavior

Play therapy

Psychoanalytical therapy wherein interaction with toys is used instead of talk; used in child therapy

Behavior therapy

Principles of learning applied to change undesirable behaviors

Cognitive therapy

Awareness of cognitive process helps patients eliminate thought patterns that lead to distress

Cognitive-behavioral therapy

Work to change cognitive distortions and self-defeating behaviors 

Humanistic therapy

Increase self-awareness and acceptance through focus on conscious thoughts

Free association

patient relaxes and then says whatever comes to mind at the moment.

Dream analysis

therapist interprets the underlying meaning of dreams.

Transference

patient transfers all the positive or negative emotions associated with their other relationships to the psychoanalyst.

Sandplay or sandtray therapy

• children can set up a three dimensional world using various figures and objects that correspond to their inner state (Kalff, 1991). 

• Therapist observes how child interacts with toys in order to understand the roots of the child’s disturbed behavior. Can be used to make a diagnosis.

Nondirective play therapy

children are encouraged to work through problems by playing freely while therapist observes. (uninvolved)

Directive play therapy

therapist provides structure/guidance by suggesting topics, asking questions, and playing with the child. (involved)

Counterconditioning

Client learns a new response to a stimulus that has previously elicited an undesirable behavior. Includes aversive conditioning and exposure therapy.

Aversive conditioning

uses an unpleasant stimulus to stop an undesirable behavior.

• Client is repeatedly exposed to something unpleasant, such as a mild electric shock or bad taste while they engage in a specific behavior → client learns to associate the unpleasant stimulus and unwanted behavior.

Exposure therapy

seeks to change the response to a conditioned stimulus. 

• Client is repeatedly exposed to the object/situation that causes their problem, with the idea that they will eventually get used to it.

Mary Cover Jones

Developed the first type of exposure therapy.

• An unconditioned stimulus is presented over and over just after the presentation of the conditioned stimulus. 

Jones Study (1924)

treated Peter's fear of a white rabbit by associating a pleasant stimulus (food) with the rabbit.

• Repeatedly exposed Peter to a rabbit (CS), while he was eating a snack (in a relaxed state).

• Rabbit started in a cage on the other side of the room and over several days was gradually moved closer to Peter while he ate his snack.

• After 2 months, Peter was able to pet the rabbit (CR) while eating his snack.

Systematic desensitization (Joseph Wolpe)

type of exposure therapy wherein a calm and pleasant state is gradually associated with increasing levels of anxiety-inducing stimuli.

Virtual reality exposure therapy

uses a stimulation to help conquer fears when it’s too impractical, expensive or embarrassing to recreate anxiety-inducing situations.

Applied behavior analysis

Operant conditioning technique designed to reinforce positive behaviors and punish unwanted behaviors.

• rewards and reinforcers used to motivate children to demonstrate desired behaviors

• punishment used to discourage undesirable behaviors

Token economy

Individuals are reinforced for desired behaviors with tokens (e.g., a poker chip), that can be exchanged for items or privileges.

Overgeneralizing

taking a small situation and making it huge.

Polarized (black &white) thinking

Seeing things in absolutes, ”I am either perfect, or a failure”. (Common in depression).

Jumping to conclusions

assuming that people are thinking negatively about you or reacting negatively to you, without evidence.

Rational-Emotive Therapy (RET)

one of the first forms of cognitive-behavioral therapy, founded by Albert Ellis.

Cognitive-behavioral therapy (CBT)

works to change cognitive distortions and self-defeating behaviors. (Aims to change both how people think and how they act).

• Helps clients examine how their thoughts affect their behavior.

Non-directive therapy

therapist does not give advice or provide interpretations but helps client identify conflicts and understand feelings.

Active listening

therapist acknowledges, restates, and clarifies what the client expresses.

Unconditional positive regard

therapist does not judge clients and simply accepts them for who they are.

Genuineness, empathy, and acceptance towards clients

Rogers felt that therapists should demonstrate these because it helps the client become more accepting of themselves, which results in personal growth.

Psychotropic medications

medications used to treat psychological disorders.

Antipsychotics

treat positive psychotic symptoms such as hallucinations, delusions, and paranoia by blocking dopamine.

Atypical antipsychotics

treat the negative symptoms of schizophrenia such as withdrawal and apathy, by targeting both dopamine and serotonin receptors.

Anti-depressants

alter levels of serotonin and norepinephrine.

• depression & anxiety

Anti-anxiety agents

depress central nervous system activation.

• Anxiety, OCD, PTSD, panic disorder and social phobia.

Mood stabilizers

treat episodes of mania as well as depression (Bipolar disorder).

Stimulants

improve ability to focus on a task and maintain attention (ADHD).

Transcranial magnetic stimulation

magnetic fields stimulate nerve cells to improve depression symptom.

Confidentiality

the therapist cannot disclose confidential communications to any third party unless mandated or permitted to do so by law.

Psycho-educational groups

groups with a strong educational component.

• E.g., group for children whose parents have cancer which teaches them about cancer.

Systems approach

family is viewed as an organized system, and each individual is a contributing member who creates and maintains processes within the system that shape behavior. Each member influences and is influenced by the others.

Structural family therapy

examines and discusses the boundaries and structure of the family. Therapist helps them resolve issues and learn to communicate effectively.

Strategic family therapy

aims to address specific problems within the family that can be dealt with in a short amount of time. 

Relapse

individual returns to abusing a substance after a period of improvement.

Substance related behavior therapy

can help motivate the addict to participate in the treatment program and teach strategies for dealing with cravings and how to prevent relapse.

Duration of treatment

At least 3 months is usually needed to achieve a positive outcome (for treatment to actually be effective)

Holistic treatment

addresses multiple needs, not just the drug addiction, due to psychological, physiological, behavioral, and social aspect of abuse.

Group therapy for substance abuse

addicts are more likely to maintain sobriety in a group format due to the rewarding and therapeutic benefits of the group such as support, affiliation, identification, and even confrontation.

Parental involvement

correlated with greater reduction in use by teen substance abusers.

Cultural competence

mental health professionals must understand and address issues of race, culture, and ethnicity and use strategies to effectively address needs of various populations.

Multicultural counseling and therapy

• Integrates the impact of cultural and social norms.

• Aims to work with clients and define goals consistent with their life experiences and cultural values.

• Advocates the use of universal and culture-specific strategies and roles in the healing process.

Treatment barriers

• access and availability of mental health services

• ethical disparities

• perceptions and attitudes