Chapter 16: Treatment of Psychological Disorders

History of Mental Health Treatment

• Early treatments for mental illness were based on superstition and misunderstanding:

  • People displaying unusual behaviors were often locked away or subjected to harsh treatments.

  • Examples of old treatments:

    • Beating to remove "evil spirits."

    • Bleeding to release spirits.

    • Drilling holes in the skull to let spirits escape.

Reforms in Treatment

• Shifted from viewing the "insane" as possessed to seeing them as ill.

• Introduced humane treatments:

  • Treating patients with tenderness instead of harshness.

  • Housing them in hospitals rather than asylums.

  • Developing psychotherapeutic treatments, medications, and community support systems.

Types of Therapy

Psychotherapy

• Involves psychological techniques to treat mental disorders.

• Current Forms of Therapy:

  • Biomedical Therapy: Uses medications or procedures that act directly on physiology.

  • Eclectic Approach: Combines techniques from various therapies to fit the client’s needs.

Noteworthy Schools of Psychotherapy

1. Psychoanalysis (Sigmund Freud):

   • Focuses on resolving unconscious conflicts and repressed feelings.

   • Techniques:

     • Free Association: Patient speaks freely about memories, dreams, and feelings.

     • Interpretation: Therapist suggests unconscious meanings to help the client gain insight.

     • Resistance, Dreams, and Transference: Unconscious meanings are interpreted in these areas.

2. Psychodynamic Therapy:

   • A less intensive version of psychoanalysis.

   • Focuses on self-awareness, insight into unconscious thoughts, and improving relationships.

3. Interpersonal Therapy:

   • Focuses on relational behavior change and symptom relief.

   • Less emphasis on the past, more on current feelings and relationships.

4. Humanistic Therapy (Carl Rogers, Abraham Maslow):

   • Supports personal growth, self-awareness, and self-acceptance.

   • Client-Centered Therapy: Non-directive, genuine, accepting, and empathetic.

   • Techniques:

     • Active Listening: Summarizing, paraphrasing, and reflecting feelings.

5. Behavior Therapy:

   • Uses principles of learning (classical and operant conditioning) to reduce unwanted behaviors or emotions.

   • Techniques:

     • Exposure Therapy: Gradual exposure to feared stimuli.

     • Systematic Desensitization: Associates relaxation with anxiety-triggering stimuli.

     • Virtual Reality Therapy: Uses simulations to treat anxiety.

     • Operant Conditioning: Rewards desired behaviors and punishes problematic ones.

     • Token Economy: Uses tokens as rewards for desired behaviors.

6. Cognitive Therapy:

   • Focuses on altering negative thinking patterns that worsen depression and anxiety.

   • Schools of Cognitive Therapy:

     • Albert Ellis’s Rational-Emotive Behavior Therapy (REBT): Challenges irrational beliefs.

     • Aaron Beck’s Cognitive Therapy for Depression: Corrects cognitive distortions (e.g., catastrophizing).

     • Donald Meichenbaum’s Stress Inoculation Training: Practices healthier thinking before facing stressors.

7. Cognitive Behavioral Therapy (CBT):

   • Combines cognitive and behavioral techniques to treat disorders like OCD.

   • Helps clients resist compulsions and manage obsessive thoughts.

Group and Family Therapies

Group Therapy

• Involves 6-9 people with related needs, facilitated by a therapist.

• Benefits:

  • Lower cost per person.

  • More interaction, feedback, and support.

  • Clients realize they are not alone in their struggles.

Family Therapy

• Focuses on the family system, including patterns of alliances, authority, and communication.

• Couples/Marital Therapy: Addresses relationship issues.

Effectiveness of Psychotherapy

Measures of Effectiveness

• Client satisfaction.

• Client’s sense of improvement.

• Therapist’s observation of improvement.

• Measurable changes in symptoms.

Results of Outcome Research

• Effective for treating:

  • Depression.

  • Anxiety.

  • Phobias.

  • Bedwetting.

Common Factors in Effective Psychotherapy

1. Hope: Therapists believe in the client’s ability to recover.

2. New Perspective: Reframing narratives (e.g., from "victim" to "survivor") improves mood and motivation.

3. Therapeutic Relationship: Empathy, trust, and caring create a supportive environment for growth.

Key Takeaways

• Psychotherapy involves psychological techniques to treat mental disorders.

• Biomedical therapy uses medications or procedures to address physiological aspects.

• Behavior therapy uses learning principles to modify behaviors.

• Cognitive therapy focuses on changing negative thought patterns.

• Group and family therapies provide support and address relational dynamics.

• Effective psychotherapy fosters hope, offers new perspectives, and builds a strong therapeutic relationship.