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Chapter 14. Therapies. Psychotherapy—use of psychological techniques to treat emotional, behavioral, and interpersonal problems Biomedical—use of medications and other medical therapies to treat the symptoms associated with psychological disorders. Types of Therapy. Origins of Therapy.

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Chapter 14

Chapter 14

Therapies


Types of therapy

Types of Therapy


Origins of Therapy emotional, behavioral, and interpersonal problems

  • Trepanning: For primitive “therapists,” refers to boring, chipping, or bashing holes into a patient’s head; for modern usage, refers to any surgical procedure in which a hole is bored into the skull

    • In primitive times it was unlikely the patient would survive; this may have been a goal

    • Goal presumably to relieve pressure or rid the person of evil spirits


Demonology emotional, behavioral, and interpersonal problems

  • Study of demons and people beset by spirits

    • People were possessed, and they needed an exorcism to be cured

      • Exorcism: Practice of driving off an “evil spirit”


Origins of Therapy Continued emotional, behavioral, and interpersonal problems

  • Ergotism: Psychotic-like symptoms that come from ergot poisoning,

  • Ergot is a natural source of LSD

  • Phillippe Pinel: French physician who initiated humane treatment of mental patients in 1793

    • Created the first mental hospital



Causes of psychological problems

Causes of Psychological Problems


Techniques of psychoanalysis

Techniques of Psychoanalysis


More psychoanalytic techniques

More Psychoanalytic Techniques


Other dynamic therapies
Other Dynamic Therapies unconscious”; interpretation often reveals unconscious conflicts

  • Most therapies today are shorter-term

  • Based on goals that are specific and attainable

  • Therapists are more directive than traditional psychoanalysis

  • Traditional psychoanalysis is seldom practiced today


Humanistic therapies
Humanistic Therapies unconscious”; interpretation often reveals unconscious conflicts

  • Humanistic perspective emphasizes human potential, self-awareness, and free-will

  • Humanistic therapies focus on self-perception and individual’s conscious thoughts and perceptions

  • Client-centered (or person-centered) therapy is the most common form of humanistic therapy

  • Carl Rogers (1902–1987)—developed this technique


Client centered therapy

Client-Centered Therapy


Therapeutic conditions

Therapeutic Conditions


Behavior therapy

Behavior Therapy


Systematic desensitization

  • Based on classical conditioning and abnormal) is learned

  • Uses three steps:

    • Progressive relaxation

    • Development of anxiety hierarchy and control scene

    • Combination of progressive relaxation with anxiety hierarchy

Systematic Desensitization


Sample anxiety hierarchy
Sample Anxiety Hierarchy and abnormal) is learned


Aversion therapy for alcoholism

UCS and abnormal) is learned

(drug)

UCR

(nausea)

CS

(alcohol)

UCS

(drug)

UCR

(nausea)

CS

(alcohol)

CR

(nausea)

  • Relatively ineffective, does not generalize very well beyond therapy

  • Pairs and aversive stimulus with the undesired behavior

Aversion Therapy for Alcoholism


Token economy

  • Based on operant conditioning and abnormal) is learned

  • Use for behavior modification in group settings (prisons, classrooms, hospitals)

  • Has been successful with severely disturbed people

  • Difficult to implement and administer

Token Economy


Cognitive therapy

Cognitive Therapy


Rational emotive therapy

  • Developed by Albert Ellis to maladaptive patterns of thinking

  • ABC model

    • Activating Event

    • Beliefs

    • Consequences

  • Identification and elimination of core irrational beliefs

Rational Emotive Therapy


Aaron beck s cognitive therapy

  • Problems due to negative cognitive bias to maladaptive patterns of thinkingthat leads to distorted perceptions and interpretations of events

  • Recognize the bias then test accuracy of these beliefs

  • Therapist acts as model and aims for a collaborative therapeutic climate

Aaron Beck’s Cognitive Therapy


Cognitive behavioral therapy

Cognitive Behavioral Therapy


Group and family therapy

  • Group therapy—one or more therapists working with several people at the same time.

  • Family therapy—based on the assumption that the family is a system and treats the family as a unit.

  • Couple therapy—relationship therapy that helps with difficulty in marriage or other committed relationships

Group and Family Therapy


Effectiveness of psychotherapy

  • Most people do not seek help with problems people at the same time.

  • Many people report spontaneous remission

  • Meta-analyses show that psychotherapy is more effective than no treatment

  • Generally no differences among the types of psychotherapy

Effectiveness of Psychotherapy


Factors in successful therapy

Factors in Successful Therapy


The rates of improvement for more than 2,000 people in weekly psychotherapy and for 500 people who did not receive psychotherapy. Clearly, psychotherapy accelerates both the rate and the degree of improvement for those experiencing psychological problems. SOURCE: McNeilly & Howard, 1991.


Biomedical therapies

Biomedical Therapies


Typical antipsychotic medications

Typical antipsychotics mid-1950’s

  • Effective against positive symptoms of schizophrenia

  • Have uncomfortable side effects

  • Globally alter brain dopamine levels

  • Tardive dyskinesia—possible motor side effect that could be permanent with long term drug use

Typical Antipsychotic Medications


Atypical antipsychotic medications

Atypical antipsychotics mid-1950’s

  • Newer drugs that may also be effective against negative symptoms of schizophrenia

  • Affect levels of serotonin as well as dopamine

  • Have uncomfortable side effects

  • Symptoms return when medication is discontinued

Atypical Antipsychotic Medications


Antianxiety medications

  • Benzodiazepines (Valium, Xanax) mid-1950’s

    • reduce anxiety through increasing level of GABA

    • side effects include decreased coordination, reaction time, alertness, addiction

  • Non-benzodiazepine—(Buspar)

    • may take a few weeks to work

    • does not reduce alertness

Antianxiety medications


Lithium

Lithium


Anti depressant medication

First generation—tricyclics and MAO inhibitors mid-1950’s

  • Effective for about 75% of patients

  • Produce troubling side effects

    • MAO inhibitors can have serious physiological side effects when taken with some common foods

    • Tricyclics caused weight gain, dry mouth, dizziness, sedation

Anti-Depressant Medication


Anti depressant medication1

Anti-Depressant Medication


Electroconvulsive therapy

  • Used for severe depression effective than earlier drugs (Wellbutrin, Desyrel)

  • Very effective for quick relief of symptoms of severe depression (can be used until medication begins to work)

  • May have cognitive side effects such as memory loss

  • Very controversial treatment

Electroconvulsive Therapy


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