Treatment of Mental Disorders

1
Treatment of Mental Disorders

• By Mr. C
  

2

• Whats difference between a psychiatrist,
  clinical psychologist, and counselor?
• How do psychoanalysts treat disorders?
• How do behaviorists treat disorders?
• What are classical conditioning techniques to
  therapy?
• What is manifest content of dreams? Latent
  content?
• What are operant conditioning techniques?
• What is cognitive therapy?
• Who is Albert Ellis?
• Who is Aaron Beck?
• How do Humanists treat disorders?
• What are biomedical therapies?
• Benefits of group therapy?

3
Key Questions for this Unit

• Whats the difference between a Psychiatrist,
  Clinical Psychologist and a Counselor?
• How do Psychoanalysts treat mental disorders?
• How do Behaviorists treat? How do Humanists
  treat? What is Cognitive therapy?

4
What is a psychiatrist?

• Psychiatrists are MDs (medical doctors) with a
  specialty in treating mental disorders, usually
  with a biomedical therapy (medicine) and some
  talk therapy.
• You would see a shrink if you have
  schizophrenia, severe depression, suicidal
  thoughts, and other severe mental problems that
  need medication.

5
What is a clinical psychologist?

• A clinical psychologist has a PhD in psychology
  (no medical school). They treat fairly serious
  mental illnesses with talk therapies.
• They might treat personality disorders, anxiety
  disorders, addictions using insight or talk
  therapy.

6
What is a counselor?

• A counselor uses talk therapy to treat
  non-mental disorders like improving communication
  between family members, grief counseling, marital
  counseling, life strategies.
• Counselors have a Masters Degree with specialty
  training.

7
Types of Mental Health Care Professionals
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
8
Professional Title
Counselors
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
9
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
10
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
11
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
12
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
13
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
14
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
15

• 2. In contrast to a clinical psychologist, a
  psychiatrist is more likely to
• a) engage in an eclectic
• b) use a biomedical/somatic treatment
• c) recognize the importance of group therapy
  with patients having the same disorder
• d) treat clients in community mental health
  centers exclusively

16
Perspectives on Treatment

• Psychoanalytic
• Behavioral
• Humanistic
• Cognitive
• Biophysical

17
What are Psychoanalytic methods?

• Dream Analysis Manifest content (actual
  content) AND Latent content (hidden)
• Transference strong emotional
  outburst/connection with therapist
• Hypnosis
• Free association talk about whatever and Dr.
  analyzes it
• All 5 rely on exposing unconscious thoughts and
  interpreting them.

18
(No Transcript)
19
VII. Psychoanalysis (psychodynamic)

• Unconscious thoughts emotions are brought into
  awareness to be dealt with.
• Psychological problems the result of
  unconscious processes.
• Bringing unpleasant unconscious thoughts into to
  consciousness, produces catharsis.

20
A. What are Psychoanalytic methods of therapy (4
of them on same card if possible)

• 1. Free Association patient reports
  anything that comes to his/her mind.
• The psychoanalyst takes whatever you say
• and treats it like a window into your
  unconscious mind.

21
B. Dream analysis

• Dreams have two types of content
• Manifest content- actual events in dream.
• Latent content hidden message in dream.
• (latent hidden)
• Freud thought that each dream represents a
• form of wish fulfillment. The wish may be
• disguised, but it is always there.

22
C. Transference

• Feelings of love or other emotions (hatred)
• are expressed toward the therapist.
• These feelings are actually unconsciously felt
• toward others the patient is projecting these
• feelings onto the therapist.
• This provides clues about the clients feelings
• about these other people.

23
Hypnosis

• Hypnosis is a psychoanalytic therapeutic
  technique.
• Some people are more susceptible to hypnosis than
  others cant by hypnotized against your will.
• Whatever you think, patients report benefits from
  hypnosis.

24

• 5. The goal of psychoanalytical therapy is
• a) to change maladaptive behavior to
  more socially acceptable behavior
• b) to change negative thinking into more
  positive attributions
• c) to attain self-actualization
• d) to bring unconscious conflicts to
  conscious awareness and gain
• insight

25

• 7. Treating the therapist as though he were a
  very important person from ones past, such as a
  parent, defines
• a) resistance
• b) transference
• c) frustration
• d) reaction formation

26
Behavioral Therapy
27
Behavioral causes of disorders?

• Behaviorists believe that mental problems are
  caused by classical conditioning (for example,
  phobias), operant conditioning (addictions,
  depression), and observational learning (we watch
  our parents and friends suffer so we copy them).
• Treatment they change maladaptive behavior.

28
Classical Conditioning Therapeutic Techniques

• Systematic Desensitization (exposure therapy)
  (treats phobias and ocd) gradual exposure to what
  bugs you. If you are afraid of snakes, start with
  worms, calm down, then graduate to having a snake
  in the next room, calm down, then look at
  pictures, calm down, then watch movies, calm
  down, then be in the same room, calm down, then
  get closer, calm down

29
Classical Conditioning

• Flooding (treats phobias) overwhelm the senses
  with what bugs you. (if you are afraid of
  snakes, therapist will throw you in a pit of
  snakes).

30
Classical conditioning

• Aversive conditioning - rids of unwanted
  behaviors by getting one to associate bad stuff
  with it.
• Coyotes are fed poisoned lamb meat so they will
  stop killing sheep.
• Alcoholics take pills that make them sick when
  they drink alcohol.

31
Operant conditioning treatment

• Token economy Therapists will reward desirable
  behaviors with a reward system. This is usually
  applied to groups like hospital mental wards or
  classrooms or workplaces.
• If you dont kill anyone this week, Ill give
  you a nickel. If everyone passes, well have a
  pizza party.

32

• 6. Systematic desensitization is a technique
  based on
• a) classical conditioning
• b) instrumental conditioning
• c) operant conditioning
• d) aversive conditioning

33

• 12. Antabuse is a drug that, when paired with
  alcohol in the bloodstream, bring about extreme
  nausea. For many motivated alcoholics, this has
  proven to be an effective treatment. Under which
  umbrella of psychotherapy would it most likely be
  found?
• a) insight therapy
• b) aversive conditioning
• c) Gestalt therapy
• d) self-help therapy

34
Humanistic Perspective of Psychology
35
Humanism

• What is the root word of Humanism?
• After years of psychoanalysts saying we are a
  bunch of id-driven animals and years of
  behaviorists studying rats in a cage, the
  Humanists came along in the 60s.

36
What is Humanism?

• Major perspective of psychology.
• Focuses on maximizing human potential, free will.
• Important people Carl Rogers, Abraham Maslow.
• Think hippies

37
Who is Carl Rogers?
38
Humanistic therapy?

• Who is Carl Rogers? Carl Rogers was the founder
  of person-centered therapy, reflective listening,
  unconditional positive regard.
• The patient/client has all the answers and the
  means to treat themselves. In client-centered
  therapy, the therapist acts as a sounding board
  for the patient, sometimes rephrasing what the
  patient says (reflective listening). Empathy is
  important!

39
Carl Rogers

• Rogers also said the therapist must have
  unconditional positive regard.
• No judgments can be made! The environment must
  be loving and accepting if the client is to open
  up to you.
• Good for patients with self-esteem issues.

40
Abraham Maslow
41
Maslows hierarchy of needs
respect
42
Maslows hierarchy of needs

• People cannot maximize their potential unless
  their more basic needs are met.
• If a familys home just got destroyed by a
  tornado, can they focus on their communication
  skills?
• If you are hungry, can you worry about your self
  esteem?

43
Do these people have self esteem issues?
44
Which Simpsons character is at the bottom of
Maslows Hierarchy of Needs?
45
(No Transcript)
46
Which character has safety needs?
47
(No Transcript)
48
Who has love and belonging needs?
49
(No Transcript)
50
Who has esteem needs?
51
(No Transcript)
52
Are any Simpsons characters self actualizing?
53
Depends on the episode

• The Simpsons arent real people, but in some
  episodes, Homer and Lisa are. Even Grandpa has
  his day.

54
(No Transcript)
55
Humanistic Therapy

• Humanists are really touchy-feely, but without
  them we are just rats in a cage.
• Rogers and Maslow put the human element back
  into psychology and therapy.
• Their philosophy We are all humans striving to
  maximize our potential. A therapists job is to
  remove obstacles to self-actualization.

56

• 8. Vic is encouraged to take charge of the
  therapy session and his therapist uses an active
  listening approach to mirror back the feelings he
  hears from him. Which therapy is most likely
  being described?
• a) client-centered therapy
• b) cognitive therapy
• c) psychodynamic therapy
• d) existential therapy

57
What is cognitive therapy?

• Cognitive therapy focuses on changing how the
  client/patient thinks.
• The therapist focuses on changing/fixing the
  maladaptive thoughts of the patient
• It can be confrontational
• Cognitive therapy also educates the client,
  teaches him/her proper behaviors/thoughts

58
Cognitive perspective

• We are depressed because we are irrational. Our
  expectations are too high and misplaced. We want
  everyone to love us and accept us. We want every
  thing to go our way. We stay angry about stuff
  that happened a looong time ago. WE MUST CHANGE
  THE WAY WE THINK TO BE HAPPY AND SUCCESSFUL.

59
Albert Ellis Rational Emotive Therapy

• vigorously challenges peoples illogical,
  self-defeating attitudes and assumptions a
  confrontational therapy

60
Rational Emotive Therapy Ellis

• A-B-C theory of dysfunctional behavior
• A Activating event
• B Belief
• C emotional Consequence based on that belief.

61
Example of Rational Thinking

• A fail a midterm examination
• BIts unfortunate that I failed-I did not study
  hard enough and I must make sure that I study
  harder for the final
• Cno consequences (no emotional disturbance)

62
Example Irrational Thinking leads to Emotional
Disturbance

• A Fail exam
• B Im stupid, Ill never be able to pass this
  course and I will fail this course
• Cdepression

63
Ellis List of Common Irrational Ideas

• I absolutely must have sincere love and approval
  almost all the time from all the significant
  people in my life
• I must be thoroughly competent, adequate and
  achieving in all respects, or I must at least
  have real competence or talent at something
  important otherwise I am worthless.
• People who harm me or who do a bad thing are
  uniformly bad or wicked individuals, and I should
  severely blame, damn, and punish them for their
  sins and misdeeds

64
Ellis List of Common Irrational Ideas (continued)

• When things do not go the way I would like them
  to go, life is awful, terrible, horrible, or
  catastrophic
• Unhappiness is caused by external events over
  which I have almost no control. I also have
  little ability to control my feelings or rid
  myself of feelings of depression and hostility.

65
Rational Emotive Therapy

• Identify patients irrational beliefs
• Add D and E to A-B-C theory
• Teach the patient to Dispute the beliefs and
  substitute logical and rational beliefs
• Evaluate the effects of disputing their
  irrational beliefs

66
What is Albert Elliss RET therapy?

• This cognitive therapy challenges peoples
  irrational beliefs and replaces them with
  rational ones.

67
Who is Aaron Beck?

• Reality therapy, similar to RET.

68
CBT Effective for Which Disorders?

• Empirically supported treatment for
• Depression
• Generalized anxiety disorder
• Obsessive compulsive disorder
• Panic disorder

69
Group Therapy
70
Benefits of Group Therapy?

• Is cheap, effective. (only 1 professional is
  needed)
• It allows people to gain insight into their own
  behaviors and thoughts
• People dont feel like they are the only one with
  their problem they can witness the therapist
  treat others with similar problems.
• You can cure yourself while curing others.

71

• 10. All of the following are potential benefits
  of group therapy EXCEPT
• a) it is often more economical than 11
  treatment
• b) it does not require the services of a mental
  health professional
• c) clients with similar problems can provide
  helpful insight and feedback to peers
• d) group members can see how their problems
  might impact others

72
How Is the BiomedicalApproach Used toTreat
Mental Disorders?
73
Drug Therapy

• Antipsychotic drugs
• alleviate the symptoms of severe disorders such
  as schizophrenia ExamplesThorazine,
  Clozapine
• many work by blocking dopamine receptor sites
• can produce sluggishness, tremors, and twitches
  similar to those of Parkinsons disease

74
Drug Therapy

• Psychopharmacology The prescribed use of drugs
  to help treat symptoms of mental illness
  ostensibly to ensure that individuals are more
  receptive to talk therapies

75
Drug Therapy

• Antidepressants and mood stabilizers
• Include Prozac, monoamine oxidase (MOA)
  inhibitors, and lithium carbonate (effective
  against bipolar disorder)
• Treat depression and bipolar disorder
• Usually affect serotonin and/or norepinephrine
• The use of antidepressants to deal with general
  feelings of unease is highly controversial

76
SSRIs block the reuptake of serotonin between 2
neurons
77
Drug Therapy

• Antianxiety drugs
• work by depressing central nervous system
  activity
• Most common side effect - drowsiness
• highly addictive, can be fatal when mixed with
  alcohol
• sudden cessation after long-term use can result
  in severe withdrawal symptoms, including
  seizures, increased anxiety,
• and in rare cases, death
• Xanax, Paxil

78
Drug Therapy in ADHD

• Stimulants suppress activity level in persons
  with attention-deficit/hyperactivity disorder
  (ADHD)
• There is controversy from concern that the causes
  and boundaries of ADHD are vague and the
  potential exists for overdiagnosis

79
(No Transcript)
80

• 4. The MOST commonly cited side effect
  associated with anti-anxiety drugs is
• a) insomnia
• b) blurred vision
• c) drowsiness
• d) tachycardia

81

• 9. Prozac and other modern antidepressant
  medications work to
• a) block dopamine receptors
• b) decrease the level of acetylcholine
• c) break down the MAO enzymes
• d) block the reuptake of seratonin

82

• 11. Valium is
• a) an antidepressant drug
• b) an MAO inhibitor
• c) an antipsychotic drug
• d) an antianxiety drug

83

• 13. Andre suffers from mood swings, alternating
  from wild episodes of euphoria and spending
  sprees to motionless staring and hopelessness.
  If someone from the biomedical approach were to
  treat his condition, the prescription most likely
  would be
• a) Lithium carbonate
• b) Haldol
• c) Xanax
• d) Thorazine

84
Psychosurgery

• Psychosurgery The general term for surgical
  intervention in the brain to treat psychological
  disorders
• The infamous prefrontal lobotomy is no longer
  performed
• Severing the corpus callosum, however, can reduce
  life-threatening seizures

85
Brain-Stimulation Therapies

• Electroconvulsive therapy is used for the
  treatment of severe depression
• Transcranial magnetic stimulation, a possible
  alternative to ECT, can also be used for the
  treatment of depression,schizophrenia, and
  bipolar disorder

86

• 1930s-1950s
• Frontal lobotomy
• Became Prefrontal lobotomy
• Muniz won Nobel prize for procedure
• Procedure eventually banned
• Destruction of personality
• Replaced in 1954 by first anti-psychotic
  Thorazine

87

• Matt enters therapy to talk about some issues
  that have been causing him distress. The
  therapist has earned a PhD and uses a variety of
  techniques to alleviate some of Matts
  distressing symptoms. Matt is most likely seeing
  a _____
• Psychiatrist
• Clinical psychologist
• Psychiatric social worker
• Clinical counselor

88

• The aim of cognitive-behavioral therapy is to
  _____
• Discover unconscious motives for behavior
• Change the way people behave
• Change the way people think and behave
• Change peoples negative thinking patterns

89

• Ann is suffering from depression and no
  psychological or drug therapies are working to
  alleviate her symptoms. The biomedical technique
  of ____ may be used as a last resort.
• Flooding
• Systematic desensitization
• Electroconvulsive therapy
• psychosurgery

90

• Modern antidepressants, such as Prozac, work to
  block the reuptake of which neurotransmitter?
• Dopamine
• Serotonin
• Acetylcholine
• GABA

91

• ________ therapy does NOT use the services of a
  trained therapist.
• Biomedical
• Cognitive-behavioral
• Behavioral
• Humanistic
• Self-help

92

• John is a 12-year-old who is having trouble
  dealing with his familys relocation to a new
  city. He most likely first sees a ______
• Psychiatrist
• Counselor
• Clinical psychologist
• Registered nurse
• Psychoanalyst