Chapter 13 Treatment of Psychological Disorders

Chapter 13

Treatment of Psychological Disorders

Early Treatment of Psychological Disorders (10,000 B.C. – 3,000 B.C.)

• Trepanning: An ancient practice involving cutting holes in the skull to release harmful spirits thought to cause psychological issues.

Historical Perspectives on Psychological Disorders

• Hippocrates (Greek) and Galen (Roman): Proposed that psychological illnesses have biological roots.

• Dark Ages Beliefs: During the Dark Ages, psychological illness was attributed to evil spirits.

Deinstitutionalization Movement

• 1950s Shift: Antipsychotic drugs led to the closing of large mental institutions in the U.S.

• Consequences: Many mentally ill patients did not recover, leading to homelessness and incapacity to care for themselves.

Preventative Efforts in Mental Health

• Primary Prevention: Aims to reduce incidences of issues leading to psychological problems (e.g., joblessness, homelessness).

• Secondary Prevention: Targets individuals at risk for developing mental health issues.

• Tertiary Prevention: Focuses on preventing the worsening of existing mental health issues through treatments (e.g., drugs, behavioral therapy).

Treatment Styles in Psychological Therapy

• Main Treatment Approaches:

  • Psychoanalytic

  • Humanistic

  • Behavioral

  • Biomedical

  • Cognitive

• Types of Therapy:

  • Psychotherapy: Involves discussion with a psychologist; utilized by most types of therapy except behavioral and biomedical.

  • Somatic Treatments: Involve drug treatments affecting the body.

Terminology in Therapy

• Biomedical & Psychoanalysts: Refer to clients as "patients."

• Humanistic Therapists: Prefer the term "clients" for a more positive connotation.

Psychoanalysis Overview

• Core Concept: Psychological disorders arise from unconscious conflicts.

• Insights: Aim to help patients understand their problems.

Techniques in Psychoanalysis

• Hypnosis: Used to access repressed thoughts.

• Free Association: Patient expresses thoughts freely, revealing underlying problems.

• Dream Analysis: Investigates dreams for unconscious conflicts; relies on interpretation by the therapist.

  • Manifest Content: The literal storyline of the dream.

  • Latent Content: The hidden meanings behind the dreams.

Resistance and Transference in Psychoanalysis

• Resistance: Patients may resist therapist interpretations as a protective mechanism.

• Transference: Patients project feelings about significant others onto the therapist, creating complex emotions.

Humanistic Therapy Principles

• Focus: Promotes understanding and acceptance of oneself.

• Self-Actualization: Emphasizes reaching one’s fullest potential, based on Maslow’s concepts.

Maslow's Hierarchy of Needs

• Outlines stages leading to self-actualization:

  • Physiological (basic needs)

  • Safety (security)

  • Love/Belonging

  • Esteem (self-esteem)

  • Self-Actualization (fulfillment of personal potential)

Client-Centered Therapy (Carl Rogers)

• Unconditional Positive Regard: Acceptance of clients without conditions, seen as essential for personal growth.

• Non-Directive Nature: Therapy encourages clients to explore feelings and lead their discussion.

• Active Listening: Therapists reflect back clients' emotions to facilitate understanding.

Other Humanistic Approaches

• Gestalt Therapy (Fritz Perls): Focuses on wholes rather than parts, enhancing awareness of feelings and actions.

• Existential Therapy: Concentrates on finding meaning and purpose in life, addressing clients' lack of direction.

Behavioral Therapies

• Fundamentals: Based on conditioning (classical, operant).

• Counterconditioning: Re-pairing fears with positive experiences (e.g., introducing candy in a doctor's office).

• Systematic Desensitization: Gradually replacing anxiety with relaxation through exposure.

• Desensitization Methods:

  • In vivo (real exposure)

  • Covert (imagined exposure)

  • Flooding (facing fear head-on).

• Aversive Conditioning: Associates unwanted behaviors with negative stimuli (e.g., nausea with nail biting).

Cognitive Therapies

• Rational Emotive Behavior Therapy (REBT): Identifies and challenges irrational thoughts.

• Cognitive Triad (Aaron Beck): Depression stems from negative beliefs about self, world, and future.

• Cognitive-Behavioral Therapy (CBT): Focuses on changing maladaptive thoughts/behaviors to improve symptoms.

Group Therapies

• Family Therapy: Addresses dysfunctional behavior patterns within family dynamics.

• Self-Help Groups: Examples include Alcoholics Anonymous and Gamblers Anonymous.

Somatic Therapies Overview

• Biomedical Perspective: Views disorders as arising from biological factors and imbalances.

Types of Somatic Therapy

• Anxiety Disorders: Treated with benzodiazepines (e.g., Valium).

• Schizophrenia: Managed using antipsychotic medications affecting dopamine.

• Mood Disorders: Treated with various antidepressants boosting serotonin.

  • Bipolar Disorder: Treated with Lithium.

• Electroconvulsive Therapy (ECT): Rarely used, induces seizure through electrical currents for severe depression.

• Psychosurgery: A last-resort measure that destroys brain tissues to alter behavior, risky due to possible side effects.

Eclectic Therapy Approach

• Eclectic Therapy: Combines various therapies; uses medications and behavioral techniques for comprehensive treatment.

Types of Therapists

• Psychiatrists: Medical doctors who can prescribe medication.

• Clinical Psychologists: Hold PhDs and handle severe mental disorders.

• Counseling Therapists: Have Masters or PhDs for less severe cases (e.g., family therapy).

• Psychoanalysts: Utilize Freudian methods; may not hold medical degrees.