Psychological Treatment and History

Mental Illness in the U.S.

• Statistics: 18.9% of U.S. adults experienced mental illness in 2017.
  • Children and Adolescents: Approximately 13% of children (ages 8-15) experience mental illness annually, with rates for teens (ages 13-18) being similar to those of adults.

Historical Treatments for Mental Illness

• Exorcism: Common method involving religious figures performing incantations and prayers; sometimes included medicinal drinks.
• Trephining: Drilling a hole in the skull to release spirits; often resulted in death.
• Imprisonment & Execution: These extreme measures were historically used as treatments for those with psychological disorders.

Current Psychological Treatment Facilities

• Community Mental Health Centers: Provide various mental health services but often underfunded and inadequately staffed due to deinstitutionalization issues.
• Psychiatric Hospitals: Focus on short-term care, with average stays less than two weeks. High hospitalization costs (around $800-$1000 per night) limit treatment duration.

Contributions to Psychological Treatment

• Philippe Pinel: Advocated for humane treatment, known as "moral treatment," and contributed to psychiatric nosology.
• Dorothea Dix: Championed reform for mental health care in the U.S., leading to the establishment of mental asylums.
• Sigmund Freud: Developed psychoanalysis, focusing on repressed feelings and childhood trauma through techniques like free association and dream analysis. Introduced the concept of transference.
• Mary Cover Jones: Recognized as the mother of behavior therapy; used exposure therapy to treat fears, notably with her case involving a boy named Peter and his fear of rabbits.
• Albert Ellis: Developed cognitive-behavioral therapy (CBT), addressing cognitive distortions and negative behaviors, showing efficacy across various disorders.
• Carl Rogers: Created client-centered therapy, encouraging self-acceptance and emphasizing unconditional positive regard from therapists.
• Aaron Beck: Introduced cognitive therapy, focusing on challenging dysfunctional thoughts to alleviate depression.

Types of Therapy

• Psychotherapy: Primarily involves talking therapies like psychoanalysis, behavior therapy, and cognitive therapies.
  • Cognitive Behavioral Therapy (CBT): Focuses on changing thought patterns to affect behavior and emotions, effective for PTSD, OCD, anxiety, and depression.
• Biomedical Therapy: Incorporates medication and medical procedures to treat psychological disorders, such as antipsychotics, SSRIs, and mood stabilizers.

Techniques in Psychotherapy

• Free Association: A psychoanalytic technique where clients say anything that comes to mind.
• Dream Analysis: Interprets dreams to uncover hidden feelings.
• Systematic Desensitization: Pairs relaxation techniques with anxiety-provoking stimuli to reduce fear response.
• Token Economy: Reinforces positive behaviors with rewards in group settings, often used in psychiatric hospitals.

Challenges in Treatment

• Cultural Competence: Mental health professionals must understand racial, cultural, and ethnic factors that affect treatment seeking.
• Barriers to Treatment: Stigma, language differences, and social factors contribute to underutilization of mental health services among various ethnic groups.
• Comorbidity: Many individuals experience multiple conditions simultaneously, complicating treatment approaches.

Effectiveness of Treatments

• Drug Treatments: Effective for conditions like depression, anxiety, and schizophrenia, especially when combined with psychotherapy.
• Electroconvulsive Therapy (ECT): Used for severe cases like depression and schizophrenia when other options fail.
• Group Therapy: Offers benefits like reduced isolation and community support, though with limitations in privacy and individualized attention.

Summary of Mental Health Treatments

• Overall effectiveness is determined by the interaction of three factors: evidence-based treatment, therapist expertise, and client characteristics.
• The medical/biological model views psychological disorders as diseases with biological causes, necessitating medication or medical intervention for management.