In-Depth Notes on Therapy and Treatment of Psychological Disorders
5.5-1 Treating Psychological Disorders
Deinstitutionalization: Movement in the late 20th century to relocate individuals with psychological disorders from institutional facilities into community settings.
Dorothea Dix: A pioneer in the mental health field, advocated for humane treatment of the mentally ill, changing perceptions of mental health care.
Psychotherapy: Treatment involving psychological techniques through interactions between a trained therapist and a patient aiming to overcome difficulties.
Biomedical Therapy: Involves medical procedures or prescribed medications acting directly on physiology.
Statistics: Today, 1 in 5 Americans receives some form of outpatient therapy; therapy often combines psychotherapy and medicine.
Eclectic therapy: Using a combination of different therapies based on the client's unique needs.
5.5-2 Psychoanalysis and Psychodynamic Therapies
Goal of Psychoanalysis: Freud's aim to harmonize the conflicting id, ego, and superego, drawing out repressed memories and giving patients insight into conflicts affecting their growth.
Goals and Techniques of Psychoanalysis
Free Association: Encourages patients to relax and speak freely, revealing unconscious thoughts.
Insight: Uncovering of unconscious influences.
Resistance: Blocking of anxiety-laden material.
Interpretation: Analysts provide insights on dreams and slips of tongue related to the patient's wake life to promote awareness.
Psychoanalysis Techniques
Dream Analysis:
Latent Content: Unconscious meanings of dreams.
Manifest Content: Overt images in dreams.
Counter-transference: Therapist projects personal feelings onto the patient (usually considered negative).
Transference: Patients project emotional responses onto the therapist; significant in the therapeutic relationship.
5.5-3 Humanistic Therapy
Humanistic Approach: Focuses on personal growth and self-fulfillment, reducing inner conflicts through insights.
Core Ideas of Humanistic Therapy:
Self-Acceptance: Shift from ‘patient’ to ‘client’ emphasizing growth.
Focus on the Present: Emphasizes current emotions over past trauma.
Conscious Mind: Prioritizing conscious thoughts and feelings over unconscious.
Person-centered Therapy (Carl Rogers): Utilizes techniques such as active listening in a non-judgmental environment.
Unconditional Positive Regard: Key element for client growth, involves nonjudgmental acceptance.
Active Listening Techniques
Paraphrasing: Restate what you heard in your own words.
Inviting Clarification: Asking for examples or clarifications.
Reflecting Feelings: Acknowledging the emotional tone through language mirroring.
5.5-6 Cognitive Therapies
Cognitive Behavioral Therapy (CBT): Focuses on how thoughts influence emotions and behaviors; changes negative thought patterns.
Rational Emotive Behavior Therapy (REBT) (Albert Ellis): Encourages clients to challenge and redirect irrational thoughts.
Maladaptive Schemas: Cognitive distortions, such as arbitrary inference (conclusions without evidence) and dichotomous thinking (black-and-white thinking).
Selected Cognitive Therapy Techniques
Challenge and Reframe: Question interpretations and replace maladaptive beliefs with more realistic thoughts.
Decatastrophize: Working through worst-case scenarios to reduce anxiety and fear.
5.5-7 Group and Family Therapy
Group Therapy:
Saves time and cost for therapist and clients.
Social laboratory facilitates social skills development.
Provides mutual support among clients.
Family Therapy: Analyzes family dynamics and the influences of interpersonal relations on individual behaviors.
Comparing Modern Psychotherapies
Therapy | Presumed Problem | Therapy Aim | Therapy Technique |
|---|---|---|---|
Psychodynamic | Unconscious conflicts from childhood experiences | Reduce anxiety through self-insight. | Interpret memories and feelings. |
Client-centered | Barriers to self-understanding | Enable growth via unconditional positive regard. | Actively listen and reflect feelings. |
Behavior | Dysfunctional behaviors | Relearn adaptive behaviors. | Classical/operant conditioning techniques. |
Cognitive | Self-defeating thinking | Promote healthier thinking and self-talk. | Challenge and dispute negative thoughts. |
Group and Family | Stressful relationships | Address psychological and emotional family issues. | Family dynamics focus. |
5.5C Evaluating Psychotherapies
Client Perception: Clients often feel improvement, but factors like initial crises may skew results.
Clinician Perception: Clinician biases may influence perceived effectiveness.
Outcome Research: Meta-analysis indicates therapy recipients fare better than those who don’t.
Therapeutic Alliance: A positive, trusting relationship between therapist and client is crucial.
5.5-13 Ethics in Therapy
APA ethical guidelines include:
Beneficence and Non-maleficence: Promote client's well-being and avoid harm.
Fidelity and Responsibility: Build trust with clients.
Integrity: Maintain honesty in therapeutic relationships.
Justice: Promote fairness and equity in treatment.
Respect for Rights and Dignity: Uphold confidentiality and respect for client autonomy.
Biomedical Therapies
Drug Therapy: Various classes of medications used to treat psychological disorders, including antipsychotics, antidepressants, anxiolytics, and mood stabilizers.
Define medication types based on their action on neurotransmitters and associated side effects.
Electroconvulsive Therapy (ECT): Severe depression treatment, now conducted under anesthetic. Side effects include possible amnesia.
Alternative Neurostimulation Therapies: Techniques like transcranial magnetic stimulation and deep brain stimulation as solutions for treatment-resistant depression.