Lecture 14: Therapy and Treatment

18th century treatment

asylums — keep people away from society, people were mistreated

1950s-60s treatment

antipsychotic medications but still racist, sexist, ableist, and unethical practices

1963 treatment

deinstitutionalization closed large asylums with the goal of treating people in their communities

barriers to treatment

• lack of insurance, transportation, and time

• ethnic minorities less likely to use mental health services

• self-sufficiency, not seeing therapy as effective, language differences, stigma/shame

where do people get mental health treatment?

• primary care physician then referred to a mental health practitioner

• community mental health centers

• psychiatric hospitals

• schools

• prisons

voluntary treatment

a person chooses to seek treatment in order to obtain relief from their symptoms

involuntary treatment

a person is required by the courts or other systems to seek treatment

psychotherapist

a person trained and licensed to help people with a wide range of psychological concerns

ways to find a psychotherapist

• start with your college’s counseling center if they have one

• ask a trusted medical provider or religious leader for a referral

• use the APAs free online locator service

psychotherapist’s code of ethics

• beneficence (doing good) and nonmaleficence (avoiding/minimizing harm to others)

• fidelity and responsibility

• integrity

• justice

• rights and dignity

treating psychological disorders

• psychological approach

• biomedical approach

• sociocultural approach

psychological approach

• involves providing help to individuals or families through psychological therapy

• psychodynamic therapy, humanistic-oriented therapy, and cognitive-behavioral therapy

biomedical approach

• based on the use of medications to treat psychological disorders

• includes brain intervention techniques, such as electroconvulsive therapy, transcranial magnetic stimulation, and psychosurgery

sociocultural approach

• focuses on changing the social environment

• includes group, couples, and family therapy as well as community outreach programs

psychotherapy

a psychological treatment that employs various methods to help someone overcome personal problems, or to attain personal growth

• has evolved into psychodynamic therapy

biomedical therapy

medication and/or medical procedures to treat psychological disorders

psychodynamic psychotherapy

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

• ex. patient talks about his past

play therapy

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

• ex. child acts out family scenes with dolls

behavior therapy

principles of learning applied to change undesirable behaviors

• ex. patient learns to overcome fear of elevators through several stages of relaxation techniques

cognitive therapy

awareness of cognitive process helps patients eliminate thought patterns that lead to distress, by changing your thoughts about the situation, you can improve your mental health

• ex. patient learns not to overgeneralize failure based on single failure

cognitive-behavioral therapy

work to change cognitive distortions and self-defeating behaviors

• ex. patient learns to identify self-defeating behaviors to overcome an eating disorder

humanistic therapy

increase self-awareness and acceptance through focus on conscious thoughts, client centered therapy

• ex. patient learns to articulate thoughts that keep them from achieving their goals

psychoanalysis

therapeutic orientation developed by Sigmund Freud that employs free association, dream analysis, and transference to uncover repressed feelings

behavioral therapy

uses principles of classical and operant conditioning to change behavior

• aversive conditioning

• exposure therapy

systematic desensitization

a type of behavior therapy that combines imagining or experiencing the feared object or situation with relaxation exercises

counter conditioning

• the second incompatible response is conditioned to an already conditioned response through a repeated pairing

• used in systematic desensitization

group therapy

a psychotherapy in which clients receive psychotherapy together with others

• usually 6-12 participants

• cheaper

• CBT is most common

couples therapy

two people discuss issues and concerns about the relationship

• may focus on trust, communication, or desire to improve the relationship

family therapy

family meets together with a therapist

• may be precipitated by a particular problem with one member of the family

• based on the assumption that mental health can be improved by the family working together

effectiveness of psychotherapy

• research supports

• comparison of the group that receives therapy and the one that doesn’t

  • raises ethical question — if treatment is found effective, should the control group go on to receive it?

electroconvulsive therapy

uses an electric current to induce seizures in a person to help alleviate the effects of severe depression

• used since 1930s but very different today

• current goes through right hemisphere

• 80% of people report dramatic relief from depression

transcranial magnetic stimulation

a non-invasive treatment that uses magnetic pulses to stimulate specific areas of the brain

• seems to work by activating the frontal cortex

psychosurgery

surgery that removes or destroys brain tissue in order to improve mental health

• last resort

• used almost exclusively for major depression or OCD

effectiveness of drug therapy

• research supports

• many drugs have negative side effects as well as the potential for addiction

  • decisions must weight based on client needs

  • medications must be prescribed at lowest effective dose

effectiveness of combined psychotherapy and drug therapy

• equally effective

• combination is even more effective

• long-term — psychotherapy outperforms medication for mood disorders