PSYC 2000 Knapp Ch. 16 (Therapy and Treatment)

prevalence

research shows that mental illnesses are common in the United States, affecting tens of millions of people each year; estimates suggest that only half of people with mental illnesses receive treatment

medieval times understanding and treatments

demonic possession, moral failing / sin, exorcisms, 4 humors, bloodletting / herbal remedies, home-based / monastic hospitals

1400-1600s treatments and understanding

very similar to medieval with introduction to early institutionalization

18th century (Asylums) treatment and understanding

warehouses for the "mad," shock treatments, restraints, solitary confinement

Pinel's contribution

Bicêtre Hospital, removed chains for patients, advocate for human care, foundations for "moral treatments"

Dix's contributions

shifted view from criminals to patients in need, public mental health hospitals

antipsychotic medications

used to manage psychological disorders, reduce dopamine activity

deinstitutionalization

mass movement of people outside of large psychiatric hospitals and into community-based care

involuntary treatment

forced treatment on another individual

voluntary treatment

willing surrender to treatment

psychotherapy

treatment approach that utilizes psychological methods, primarily verbal interaction, to help individuals address emotional, behavioral, and mental health challenges

biomedical therapy

using medications and/or medical procedures to treat psychological disorders, addressing the underlying biological basis of mental health conditions

free association

therapeutic technique where a patient is encouraged to verbalize all thoughts, feelings, memories, and images that come to mind, without censorship or filtering, no matter how trivial, irrelevant, or embarrassing they may seem

interpretation

therapist's explanation of the unconscious meaning behind a patient's thoughts, behaviors, dreams, or free associations

dream analysis

"royal road to unconscious," manifest and latent content

resistance

unconscious defense mechanisms that a patient uses to avoid confronting distressing thoughts, memories, or emotions during therapy

transference

process by which a patient unconsciously redirects feelings and desires—often rooted in early relationships, especially with parents—onto the therapist

working through

process problems, you heal you

play therapy

child is given more freedom to choose their activities, and the therapist takes a more passive role, offering a safe and accepting environment for expression

directive play therapy

therapist provides specific activities or structures for the child to follow, guiding them through the process

nondirective play therapy

child is given more freedom to choose their activities, and the therapist takes a more passive role, offering a safe and accepting environment for expression

psychoanalysis

therapeutic approach and theory aiming to explore the unconscious mind to uncover repressed feelings and interpret deep-rooted emotional patterns

behavioral therapy

a broad term for various techniques designed to change maladaptive behaviors by reinforcing desirable ones and eliminating unwanted ones

classical conditioning

dysfunctional behaviors are conditioned responses, seek to recondition

counterconditioning

behavior modification technique where an unwanted emotional response (like fear) to a stimulus is replaced by a positive or neutral response by pairing the stimulus with a positive or neutral experience

aversive conditioning

behavior therapy that uses an unpleasant stimulus to discourage a specific unwanted behavior

exposure therapy

client gradually exposed to stimuli they fear

systematic desensitization

a calm and pleasant state is gradually associated with increasing levels of anxiety-inducing stimuli

how does exposure therapy work?

teach relaxation, list of escalating anxiety-provoking stimuli, start at bottom, work up to top

virtual reality exposure therapy

using a simulation to help conquer fears

token economy

desirable behaviors reinforced with tokens that can be exchanged for items or privileges

cognitive therapy

focuses on how thoughts lead to distress; how you think determines how you feel / act

how cognitive therapists help people

help clients change dysfunctional thought in order to relieve distress; help clients see how they misinterpret situations

cognitive-behavioral therapy

help clients examine how thoughts affect behaviors; make people aware of their irrational / negative thoughts, replace with new, more positive ways of thinking

what does cognitive-behavioral therapy teach?

teaches people how to practice / engage in more positive / healthy approaches to daily situations

ABC model

action (activating event), Belief about event, and Consequences of this belief

overgeneralization

someone takes a small situation and makes it huge

all or nothing thinking

common for people with depression; reflects extremes

jumping to conclusions

assuming people are thinking or reacting to you negatively, even though there is no evidence

focus of humanistic therapy

helping people achieve their potential

goal of humanistic therapy

helping people become more self-aware / accepting of themselves

nondirective therapy

therapist does not give advice or provide interpretations; helps to identify conflicts / understanding feelings

active listening

therapist acknowledges, restates, and clarifies what client expresses

unconditional positive regard

not judging clients and simply accepting them for who they are

psychotropic medications

used to treat psychological disorders

electroconvulsive therapy (ECT)

using an electrical current to induce seizures to help alleviate effects of severe depression

transcranial magnetic stimulations (TMS)

magnetic fields stimulate nerve cells in brain to improve depression symptoms

intake

1st meeting with client

confidentiality

therapist cannot disclose confidential communications to any 3rd party unless mandated or permitted by law to do so

individual therapy

AKA individual psychotherapy or individual counseling - client and clinician meet one-on-one (usually from 45 min to 1 hr)

group therapy

several clients with similar problems

benefits of group therapy

can help dec shame / isolation about a problem while offering needed support; members can confront each other about their patterns; clients can practice social skills in group treatment settings; cheaper than individual, couples, or family therapy

limitations of group therapy

may be afraid to speak in front of other people; may be personality clashes / arguments; concerns about confidentiality

couples therapy

2 people in an intimate relationship who are having difficulties; therapist helps them see how individual backgrounds, beliefs, actions are affecting their relationship

family therapy

group therapy consisting of family

system approach

each member of family creates / maintains processes with in system that shape behavior

goal of system approach

enhance growth of each family member as well as that of family as a whole

structural family therapy

therapist examines / discusses boundaries / structure of family; helps resolve issues and learn to communicate more effectively

strategic family therapy

address specific problems that can be dealt with in a relatively short amount of time

sociocultural perspective

looks at you, your behaviors, and symptoms in context of your culture and background

cultural competence

mental health professionals must understand / address issues of race, culture, and ethnicity

aim of multicultural therapy

tailor process to life experiences and cultural values of clients

why do ethnic minorities tend to utilize mental health services less frequently than white, middle-class Americans

access and availability of mental health services; lack of bilingual treatment, stigma, fear of not being understood, family privacy

percetptions and attitudes toward mental health services

self-sufficiency and not seeing need for help, not seeing therapy as effective, concerns about confidentiality, and effects of stigma and shame