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Unit 13: Treatment of Psychological Disorders

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  1. Geraldo, a high school senior, is so fearful of asking a girl out that he hasn't had a date in over three years. He has recently contacted a psychotherapist for help in overcoming his fear. Describe how a humanistic therapist and a psychoanalyst would treat Geraldo's problem. (Objectives 1 & 2) • Describe how a therapist might apply operant conditioning techniques to help Rosemary overcome a compulsive habit of eating too much junk food. Be clear about the exact procedures that would be used. (Objective 3) • One of your best friends feels that he fails at everything he does and that his life isn't worth living. When you suggest that he talk to a psychotherapist, your friend responds, “Talking won't help. The more I talk about myself, the more I think about my problems. The more I think about my problems, the more depressed I get.” What procedures would a cognitive therapist use to help your friend overcome his negative feelings? (Objective 4)

  2. Geraldo, a high school senior, is so fearful of asking a girl out that he hasn't had a date in over three years. He has recently contacted a psychotherapist for help in overcoming his fear. Describe how a humanistic therapist and a psychoanalyst would treat Geraldo's problem. (Objectives 1 & 2)

  3. Describe how a therapist might apply operant conditioning techniques to help Rosemary overcome a compulsive habit of eating too much junk food. Be clear about the exact procedures that would be used. (Objective 3)

  4. Unit 13:Treatment of Psychological Disorders

  5. Treatment Psychoanalysis Humanistic Cognitive Behavioral

  6. Psychotherapy Treatment

  7. History of treatment • Philippe Pinel • Dorothea Dix • Psychotherapy • treatment involving psychological techniques • consists of interactions between a trained therapist & someone seeking to overcome psychological difficulties or achieve personal growth. • Eclectic approach

  8. The Psychological Therapies

  9. Psychoanalysis Psychotherapy Treatment

  10. Psychoanalysis • Sigmund Freud • Freud believed the patient’s free associations, resistances, dreams, & transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight. • Childhood impulses &conflicts

  11. PsychoanalysisMethods • Free association • Resistance • Blocking anxiety-laden material • Interpretation • Dream analysis • Transference • in psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent).

  12. PsychoanalysisPsychodynamic Therapy • Psychodynamic therapy • therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight. • Similarities with psychoanalysis • Differences with psychoanalysis

  13. patients unconscious past hidden determinants curing illness Psychoanalysis resistance transference interpret Psychodynamic Psychotherapy Humanistic promoting growth “How does that make you feel?” conscious present & future personal responsibility insight client-centered clients active listening UPR

  14. Humanistic Therapies • Insight therapies • increasing the client’s awareness of underlying motives and defenses • focus more on: • the present rather than the past • conscious rather than the unconscious • taking immediate responsibility • promoting growth instead of curing

  15. Humanistic Therapies • Client-centered therapy(person-centered) • Nondirective therapy • Genuineness, acceptance, and empathy • Active listening • Paraphrase • Invite clarification • Reflect feelings • Unconditional positive regard I know how you feel…. What is an example of that?…. empathetic listening That sounds frustrating… self-awareness self-acceptance

  16. Behavioral behavior mod operant conditioning Psychoanalysis token economy classical conditioning Psychodynamic counter-conditioning Psychotherapy exposure aversion Humanistic desensitization virtual reality insight client-centered active listening UPR

  17. Behavior Therapies • uses learning principles to get rid of unwanted behaviors • Classical conditioning techniques • Operant conditioning techniques

  18. Behavior TherapiesClassical Conditioning Therapies • Counterconditioning • evoke new responses to stimuli that are triggering unwanted behaviors • repeated exposure = less anxious • Exposure therapies • Systematic desensitization • progressive relaxation • anxiety hierarchy • Virtual reality exposure therapy • Aversive conditioning can’t be simultaneously anxious & relaxed

  19. Behavior TherapiesAversion Therapy Sys. Des. = substitute a fearful/negative response with a relaxed/positive response to a HARMLESS stimulus Aversion = substitute a positive response with a negative /aversive response to a HARMFUL stimulus (alcohol)

  20. Behavior TherapiesAversion Therapy

  21. Behavior TherapiesAversion Therapy DOES IT WORK?

  22. Behavior TherapiesOperant Conditioning • Behavior modification • Token economy • Criticisms?

  23. Behavioral operant conditioning Psychoanalysis http://www.youtube.com/watch?v=GVNgmJ4tIpo Buckbeak 1st 3 minutes classical conditioning Psychodynamic http://www.youtube.com/watch?v=doxxfXqpKYA Boggart’s Wardrobe 4min Psychotherapy Cognitive Cognitive-Behavioral (CBT) Humanistic insight client-centered active listening UPR

  24. Cognitive Therapies • Cognitive therapy • Beck’s therapy for depression • Catastrophizing beliefs • CBT • stress inoculation training • re-label obsessive thoughts • assertive

  25. Assertiveness Test Nonassertive Aggressive Assertive • B A C • A C B • C B A • B A C • C B A • A C B • B A C • C A B • B C A

  26. Cognitive Therapies

  27. Cognitive Therapies

  28. Cognitive Therapies

  29. Cognitive Therapies

  30. Cognitive Therapies

  31. Cognitive Therapies

  32. Behavioral Psychoanalysis Group Therapy Psychodynamic Psychotherapy BioMedical Humanistic Cognitive-Behavioral (CBT)

  33. Objective 5:Group & Family Therapy What are the aims & benefits of group and family therapy?

  34. Evaluating Psychotherapies

  35. (#6)Is Psychotherapy Effective? • Regression toward the mean • Client’s perceptions • crisis • time & $ • speak well of therapist • Mass. Study • Clinician’s perceptions • Feedback usually positive • Outcome research – • time heals • Meta-analysis • Those not in therapy often improve; those in therapy more likely to improve • Placebo treatments

  36. (#7)The Relative Effectiveness of Different Therapies • Behavioral • Bed wetting, phobias, compulsions • Cognitive • Depression • Negative Symptoms of Schizophrenia / change entire personality will see less benefit from psychotherapy alone

  37. The Relative Effectiveness of Different Therapies • Evidence-based practice

  38. (#8)Evaluating Alternative Therapies • Eye movement desensitization & reprocessing (EMDR) • anxious thoughts vanished as eyes darted about • Unlock & reprocess previously frozen memories • What is actually therapeutic is the combination of exposure therapy - repeatedly associating w/ trauma memories a safe context & a robust placebo effect. • Light exposure therapy • Seasonal affective Disorder (SAD) • Morning bright light does dim symptoms as effectively (for some) as antidepressant drugs or CBT

  39. (#9)Commonalities Among Psychotherapies placebo effect • Hope for demoralized people • A new perspective on oneself & the world • An empathic, trusting, caring relationship plausible explanation communicate their concern, show respect, reassure therapeutic alliance

  40. Culture & Values in Psychotherapy (#10) • Similarities between cultures • Differences between cultures • minorities reluctance to seek therapy • religion • Albert Ellis & Allen Bergin rational-emotive therapy

  41. The Biomedical Therapies

  42. Introduction • Biomedical therapy • Drugs • Electroconvulsive therapy • Magnetic impulses • Psychosurgery • Psychiatrist

  43. Drug Therapies (#11) • Psychopharmacology • Factors to consider with drug therapy • Normal recovery rate of untreated patients • Placebo effect • Double blind procedure

  44. Drug Therapies

  45. Drug Therapies

  46. Drug Therapies

  47. Drug Therapies

  48. Drug TherapiesAntipsychotic Drugs • Antipsychotic drugs • Psychoses • Chlorpromazine (Thorazine) • Dopamine block • Tardive dyskinesia • Atypical antipsychotics (clozapine) • negative symptoms (& positive) • xxx • xxx dampens responsiveness

  49. Drug TherapiesAntianxiety Drugs • Antianxiety drugs • Xanax, Ativan, D-cycloserine • acts upon a receptor that helps the extinction of learned fears • Physiological dependence?

  50. Antidepressant drugs • Use with mood and anxiety disorders • 4 weeks • increase the availability of norepinephrine & serotnin • Neurogenesis – birth of new brain cells • Fluoxetine (Prozac), Paxil • Selective-serotonin-reuptake inhibitors • Side effects of antidepressants • aerobic exercise • CT