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General Psychology

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Philippe Pinel Paris Moral treatment! Benjamin Rush American psychiatry ... Most effective in treating the positive symptoms of schizophrenia (such as ... – PowerPoint PPT presentation

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Title: General Psychology


1
General Psychology
  • Chapter 13
  • Treatment and Therapy for the Psychological
    Disorders

2
A Historical Perspective
  • Ancient Greeks and Romans
  • Hippocrates
  • Middle Ages
  • First insane asylum in 1547 in London

3
A Historical Perspective
  • Philippe Pinel Paris Moral treatment!
  • Benjamin Rush American psychiatry
  • Dorethea Dix (1802-1887) American nurse who
    campaigned for reform
  • Clifford Beers book in 1908 credited as impetus
    for mental health movement

4
Psychosurgery
  • Surgical procedures, usually directed at the
    brain, used to affect psychological reactions
  • Split-brain procedure epilepsy
  • Small lesions of limbic system violent
    behaviors
  • Cingulotomy extreme anxiety and symptoms of
    obsessive-compulsive disorder
  • Surgical techniques Parkinsons

5
Psychosurgery
  • Lobotomy severs the major neural connections
    between the prefrontal lobes and the lower brain
    centers

6
Electroconvulsive TherapyECT
  • ECT (shock treatment) involves passing an
    electric current between 70-150 volts across a
    patients head for a fraction of a second

7
Electroconvulsive TherapyECT
  • Depression other symptoms
  • No one knows exactly why it works
  • No more than 10-12 treatments
  • Unilateral ECT

8
Drug Therapy
  • Antipsychotic drugs alleviate or eliminate
    psychotic symptoms
  • Work by blocking receptor sites for the
    neurotransmitter dopamine.

9
Drug Therapy
  • Antipsychotic drugs, cont.
  • Most effective in treating the positive symptoms
    of schizophrenia (such as hallucinations and
    delusions)
  • Clozapine is an exception, because it reduces
    negative symptoms, as well as positive ones

10
Drug Therapy
  • Antidepressant drugs elevate the mood of
    persons who are feeling depressed, and there are
    3 major classes
  • MAO (monoamine oxidase) inhibiters
  • Tricyclics
  • SSRIs (selective serotonin reuptake inhibitors)

11
Drug Therapy MAO Inhibiters
  • Inhibit the enzyme monoamine oxidase, which
    normally breaks down levels of serotonin,
    norepinephrine, and dopamine in the brain
  • Major drawback is that they can be toxic and
    interact with foods containing tyramine

12
Drug Therapy Tricyclics
  • These drugs generally are safer and more
    effective that the older MAO inhibitors
  • They affect the operation of the neurotransmitter
    serotonin

13
Drug Therapy SSRIs
  • These drugs act faster to relieve symptoms and
    have fewer side effects
  • Work by inhibiting the reuptake (or breaking
    down) of serotonin, increasing serotonin levels,
    which elevates mood
  • Prozac, Zoloft, Luvox, and Paxil

14
Drug Therapy Antidepressants
  • Drawbacks
  • Usually take 2-4 weeks to show any effect, and
    may take 6 weeks to be effective
  • Unpleasant side effects
  • Lithium mood stabilizer most useful in
    controlling the manic stage of bipolar disorders

15
Anti-Anxiety Drugs
  • Help reduce the felt aspect of anxiety
  • Majority are benzodiazepines (e.g., Librium,
    Valium, and Xanax), which act directly on CNS
  • Very effective and most commonly prescribed of
    all medications
  • Dependency and addiction may develop
  • Muscle relaxants (e.g., Miltown, Equanil)

16
Who Provides Psychotherapy?
  • Clinical psychologist
  • Psychiatrist
  • Counseling psychologist
  • Licensed professional counselor
  • Psychoanalyst
  • Clinical social worker

17
How Do I Choose the Right Therapist?
  • Many people and agencies can serve as good
    resources
  • Check with your family physician, clergy person,
    local mental health center, college counseling
    center, psychology instructor, family and friends
  • Give the therapist at least three to four
    sessions to see if working together will be
    effective
  • If you do not feel that you are benefiting from
    therapy, discuss this with the therapist and be
    prepared to change if necessary

18
Spotlight Psychotherapy and Minority Groups
  • Minority groups less likely to seek help
  • Even true for high-income minorities
  • Not all research studies address ethnicity
  • African Americans are significantly more likely
    than Caucasians to terminate therapy once it has
    begun

19
Spotlight Psychotherapy and Minority Groups
  • Many members of ethnic minorities
  • Feel alienated
  • Feel a stigma is attached to hospitalization
  • Fear being labeled
  • Feel that they can solve their own problems
  • Tend not to be as open as Caucasian
    clients/patients

20
Psychoanalytic Techniques
  • Psychoanalysis based on several assumptions
    involving conflict and the unconscious mind

21
Psychoanalytic Techniques
  • The biological, sexual, and aggressive strivings
    of the id are often in conflict with the superego
    overly cautious, guilty
  • The id can be in conflict with the rational ego
  • Conflicts that are unresolved are repressed into
    the unconscious

22
Psychoanalytic Techniques
  • Free association encouraged patients to say
    aloud whatever entered their minds
  • Resistance unwillingness or inability to
    discuss freely some aspect of ones life

23
Psychoanalytic Techniques
  • Dream interpretation referred to as the royal
    road to the unconscious
  • Manifest content refers to dreams as they are
    recalled
  • Latent content refers to dreams as a symbolic
    representation of the contents of the unconscious

24
Psychoanalytic Techniques
  • Therapist-Patient Relationship
  • Transference occurs when the patient
    unconsciously comes to view and feel about the
    analyst in much the same way as he or she feels
    about another important person in his or her life

25
Psychoanalytic Techniques
  • Therapist-Patient Relationship
  • Countertransference analyst allowing his or her
    feelings and experiences to interfere with
    objective interactions with the patient

26
Post-Freudian Psychoanalysis
  • Most significant change is the concern for
    shortening the length of analysis
  • Todays analyst will take a more active role in
    therapy
  • Focus on present, rather than childhood
    experiences

27
Humanistic Techniques
  • Client-centered therapy goal is to help the
    individual self-actualize (Carl Rogers)
  • Focus is on the present
  • Focuses on ones feelings or affect
  • Therapist attempts to mirror the feelings of the
    person

28
Humanistic Techniques
  • How Does One Mirror?
  • Therapist must be an active listener.
  • Therapist needs to be empathetic able to
    understand and share the essence of anothers
    feelings
  • Therapist will try to express unconditional
    positive regard

29
Gestalt Therapy
  • Associated with Fritz Perls (1893-1970)
  • Goal is to assist person to integrate his or her
    thoughts, feelings, and actions and increase
    self-awareness, acceptance, and growth
  • Sessions are often convened in small-group
    settings

30
Behavioral Techniques
  • Behavior therapy collection of techniques
    focused on the principles of LEARNING!
  • Systematic desensitization applying classical
    conditioning to alleviate feelings of anxiety,
    particularly those associated with phobic
    disorders
  • Aversion therapy stimulus that may be harmful,
    but that produces a pleasant response, is paired
    with an aversive, painful stimulus until the
    original stimulus is avoided

31
Behavioral Techniques
  • Contingency management when the therapist can
    manage the control of rewards and punishments to
    modify behavior
  • Contingency contracting establishing a contract
    with a client so that exhibiting certain
    behaviors will result in certain rewards

32
Behavioral Techniques
  • Modeling acquisition of an appropriate response
    through the imitation of a model
  • Children with phobias
  • Assertiveness training

33
Cognitive Techniques
  • Rational-emotive therapy (Albert Ellis)
  • Premise is that psychological problems arise when
    people try to interpret what happens in the world
    on the basis of irrational beliefs
  • Therapist directive role

34
Cognitive Techniques
  • Cognitive restructuring therapy (Aaron Beck)
  • Less confrontational and direct than RET
  • The patient is given opportunities to test his or
    her beliefs, which will lead to positive outcomes

35
Group Approaches
  • Group therapy label applied to a variety of
    situations in which a number of people are
    involved in a therapeutic setting at the same time

36
Group Approaches
  • Benefits of group therapy
  • Participant realizes that he or she is not the
    only one with problems
  • One can receive support from others
  • Helping someone else can be therapeutic
  • A participant can learn to present him/herself
    more effectively to others

37
Group Approaches
  • Family Therapy the roles, interdependence, and
    communication skills of family members are
    addressed
  • Part of a system all impact one another
  • Improper family communication problems

38
Evaluating Psychotherapy
  • Difficult task
  • Sometimes spontaneous remission of symptoms
  • Difficult to agree on what is meant by recovery
    or care
  • The large, meta-analysis studies showed positive
    results for psychotherapy

39
Evaluating Psychotherapy
  • No evidence that any one type of therapy is
    universally better than others
  • Some types of therapy better suited for some
    problems than others
  • Which therapy is best for what disorder is one of
    the most active areas of research
  • Some therapists are more effective than others

40
Evaluating Psychotherapy
  • Empirically Supported Therapies only therapies
    with demonstrated empirical research support
    would be offered
  • Several problems with this approach
  • Cognitive therapy, for example, means different
    things to different people
  • Many would rather not get into the business of
    prescribing specific therapies
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