Chapter 14: Treatment of Psychological Disorders Review and Key Points

History of Treatment for Psychological Disorders

• Stone Age people used trephination (drilling holes through skull) to let demons escape

• Philippe Pinel - “moral treatment” (humanitarian approach)

• Dorothea Dix - “mental hygiene movement” (reform asylums)

• Deinstitutionalization - mass movement of people with psychological disorders out of mental institutions and into community

Main Approaches

• Insight therapy (psychoanalysis, psychodynamic therapy, humanistic therapy) - increase awareness of self & environment

  • Psychoanalysis - first formal system of psychotherapy; attempts to uncover unconscious conflicts, making it possible to address and work through them; see therapists many times a week for years; therapists sit quietly to the side

  • Psychodynamic therapy - updated form of psychoanalysis that incorporates many of Freud’s core themes; personality characteristics and behavior problems can be traced to unconscious conflicts; therapists see clients once a week for several months; therapists face clients in face-to-face dialogue

  • Humanistic therapy - positive aspects of human nature (desires to form close relationships, treat others with empathy, and grow as individuals); instead of digging up unconscious thoughts and feelings, used conscious experiences and problems in present

  • Person-centered therapy - help clients reach full potential; reduce incongruence between ideal self and real self; create warm and accepting relationship between client and therapist; help clients see they have the power to make changes in their life and follow a path of positive growth

• Behavior therapy - focus on behavioral change

  • Classical conditioning, operant conditions, and observational learning

  • Replace maladaptive behaviors with more adaptive behaviors

  • Exposure therapy, aversion therapy, systemic desensitization, behavior modifications

  • Observable behaviors in the present

• Cognitive therapy - change maladaptive thoughts

  • Identify maladaptive thinking and help clients change the way they view the world and relationships

  • Aaron Beck - patterns of automatic thoughts, or cognitive distortions, lie at the root of psychological disturbances

  • Help clients recognize and challenge cognitive disturbances

  • Sessions are short term, action oriented, and homework intensive

  • Albert Ellis - rational emotive behavior therapy (REBT) to help people identify and correct irrational/illogical ways of thinking

• Biomedical therapy - targets biological basis of disorders, often through the use of medication

  • Psychopharmacology - study of how psychotropic medications alter perception, mood, behavior, and other aspects of psychological functioning

  • Psychotropic drugs include antidepressant, mood-stabilizing, antipsychotic, and anti-anxiety medications

  • Electroconvulsion therapy (ECT) - causes seizures in brain

  • Neurosurgery - destroys some portion of brain or severs connections between different brain areas

  • Biomedical interventions - target roots of psychological disorders

Group Therapy

• Benefits - cost effective; identification with others; accountability; support; encouragement; sense of hope

• Challenges - potential conflicts among group members; discomfort expressing feelings in presence of others

Telepsychology

• psychological care delivered with the help of communication technologies such as video conferencing, phone calls, and email

• Valuable for serving rural areas and providing treatment to those who would otherwise have no access

• Drawbacks - concerns about privacy; reimbursement from insurance companies; communication with nonverbal cues