Treating Psychological Disorders

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Treating Psychological Disorders

• Chapter 15

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Who Seeks Treatment?

• 15 of U.S. population in a given year
• 4.5 million people
• Most common presenting problems
• Anxiety and Depression
• Demographics
• Women more than men
• Education level
• Barriers to Treatment
• Medical insurance

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Who Provides Treatment?

• Clinical psychologists
• Counseling psychologists
• Psychiatrists
• Clinical social workers
• Psychiatric nurses
• Counselors

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Types of Treatment

• Psychotherapy
• Insight therapies
• talk therapy
• Behavior therapies
• Changing overt behavior
• Biomedical therapies
• Biological functioning interventions

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Psychoanalysis

• Focuses on uncovering unconscious conflicts
  resulting from fixations at early developmental
  stages
• Uses techniques such as...
• Free association
• Dream analysis
• Interpretation
• To minimize
• Resistance
• and facilitate
• Transference
• Goal is to rebuild personality

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Client-Centered Treatment

• Believes disorders result from incongruence
  between self-concept and reality or dependence on
  acceptance from others.
• Uses techniques such as
• Unconditional positive regard
• Empathy
• Genuineness
• Reflection
• Goal is to increase client self-acceptance
  (minimize incongruence)

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Behavioral Therapies

• Believe disorders are maladaptive patterns of
  behavior that have been learned.
• Use techniques such as
• Conditioning (Classical Operant)
• Aversion
• Systematic Desensitization
• Social Skills Training
• Biofeedback
• To eliminate maladaptive behavior and replace
  with adaptive behavior.

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Behavior Therapies

• B.F. Skinner and colleagues
• Goal unlearning maladaptive behavior and
  learning adaptive ones
• Systematic Desensitization Joseph Wolpe
• Classical conditioning
• Anxiety hierarchy
• Aversion therapy
• Alcoholism, sexual deviance, smoking, etc.

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Figure 15.7 The logic underlying systematic
desensitization
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Behavior Therapy

• B.F. Skinner and colleagues
• Social skills training
• Modeling
• Behavioral rehearsal

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Cognitive-Behavioral Therapy

• Aaron Beck
• Cognitive therapy
• Believe disorders result from irrational
  assumptions and negative, self-defeating
  thoughts.
• Use techniques such as
• Thought stopping
• Recording automatic thoughts
• Refuting negative thinking
• Reality testing
• Homework
• Goal is to detect negative, irrational thinking
  and replace with realistic thinking

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Cognitive-Behavioral Therapy

• Martin Seligman
• Learned helplessness and depression
• Difficult to establish helplessness-depression
  link

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Cognitive-Behavioral Therapy

• Martin Seligman
• Explanatory style
• a persons habitual way of explaining events,
  typically assessed along three dimensions
  internal/external, stable/unstable, and
  global/specific

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Biomedical Therapies
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Biomedical Therapies

• Psychopharmacotherapy
• Antianxiety - Valium, Xanax, Buspar
• Antipsychotic - Thorazine, Mellaril, Haldol
• Tardive dyskinesia
• Clozapine
• Antidepressant
• Tricyclics Elavil, Tofranil
• Mao inhibitors (MAOIs) - Nardil
• Selective serotonin reuptake inhibitors (SSRIs)
  Prozac, Paxil, Zoloft

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Figure 15.12 Antidepressant drugs mechanisms of
action
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Biomedical Therapies

• Psychopharmacotherapy
• Mood stabilizers
• Lithium
• Valproic acid
• Electroconvulsive therapy (ECT)

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Current Trends and Issues in Treatment

• Managed care
• Empirically validated treatments
• Blending Approaches to treatment
• Multicultural sensitivity
• Deinstitutionalization
• Revolving door problem
• Homelessness