treatment of psychological disorders essay

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timer Asked: May 3rd, 2018

Question Description

reflect on how you could use the information from the chapter in your future professional life. be specific in the application of the course material to your future profession or career. (future career is actress, theatre stage performer).

Chapter 13 Treatment of Psychological Disorders © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. MODULE 40: Psychotherapy: Psychodynamic, Behavioral, and Cognitive Approaches to Treatment • What are the goals of psychologically- and biologically-based treatment approaches? • What are the psychodynamic, behavioral, and cognitive approaches to treatment? 13-2 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Introduction • Psychotherapy: Psychological techniques are used to help a person overcome psychological difficulties • Biomedical therapy: Relies on drugs and other medical procedures to improve psychological functioning 13-3 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Who Provides Treatment? Psychologists: have PhD in clinical or counseling psychology, specialize in diagnosis and treatment of psychological disorders and everyday problems Psychiatrists: medical doctors who specialize in diagnosis and treatment of psychological disorders, focus on more severe cases, can prescribe medication Clinical social workers: have master’s degree and provide therapeutic services Counselors: have master’s degree, work in schools, colleges, agencies 13-4 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Psychodynamic Approaches to Therapy • Psychoanalysis: Seeks to bring unresolved past conflicts and unacceptable impulses from the unconscious into the conscious to reduce their influence over behavior 13-5 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Psychodynamic Approaches to Therapy • Techniques • Free association: client spontaneously expresses thoughts and feelings exactly as they occur with as little censorship as possible. Therapist uses free associations for clues about unconscious • Dream analysis: therapist interprets symbolic meaning of client’s dreams. Dreams are “road to unconscious,” said Freud • Manifest vs. latent content • Transference: occurs when clients relate to therapist in ways that mimic critical relationships in their lives. Brings repressed feelings and conflicts to the surface so client can work through them 13-6 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Evaluating Psychodynamic Therapy • Criticisms • Time consuming (4-5 sessions/wk for years) and expensive • Less articulate patients may not do as well as more articulate ones • Difficulty in determining effectiveness of the therapy • Bias of both patient and therapist report 13-7 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Behavioral Approaches to Therapy • Assume that normal and abnormal behavior are both learned • Make use of the basic processes of learning, such as reinforcement and extinction • Don’t delve into psyche, just teach new behaviors • Classical and operant conditioning treatments… 13-8 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Classical Conditioning Treatments • Aversive conditioning/aversion therapy: Reduces the frequency of undesired behavior by pairing with an aversive stimulus • e.g., learn aversion to CS by pairing with aversive UCS CS Alcohol CR UCS Nausea Emetic drug UR 13-9 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Classical Conditioning Treatments • Systematic desensitization: Gradual exposure to an anxiety-producing stimulus is paired with relaxation • Hierarchy of fears • Goal: to weaken the association between the conditioned stimulus (e.g., a new dog) and the conditioned response of anxiety • Extremely effective in treating phobias 13-10 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Classical Conditioning Treatments • Exposure treatments: People are confronted either suddenly or gradually with a stimulus that they fear without relaxation training to allow maladaptive response of anxiety to extinguish • Graded exposure – video of dogs, then a leashed dog from afar, then unleashed, etc 13-11 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Operant Conditioning Techniques Token system • Rewards a person for desired behavior with a token Contingency contracting • Agreement is drawn stating the behavioral goals the client hopes to achieve with positive consequences if goal achieved 13-12 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Evaluating Behavior Therapy Benefits Criticisms • Treats anxiety, phobias and compulsions • Establishes control over impulses • Helps in learning complex social skills to replace maladaptive behavior • Insight into thoughts and expectations is not gained 13-13 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Observational Learning Techniques Observational learning • Behavior of other people is modeled, to systematically teach people new skills – e.g., modeling fearless behavior toward dogs or eye contact with others or assertiveness 13-14 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Cognitive Approaches to Therapy • Cognitive-behavioral approach • Therapists attempt to change the way people think as well as behavior • Emphasizes recognizing and changing negative and maladaptive thoughts/beliefs • Originally developed to treat depression – catastrophic/negative thinking leads to depression 13-15 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Humanistic Therapy • People have control of their behavior, can make choices about their lives, and are responsible for solving their own problems • Focus on self-development, growth and responsibilities. Seek to help individuals recognize strengths and choices 13-16 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Person-Centered Therapy • Unconditional positive regard • Expressing acceptance and understanding, regardless of the feelings and attitudes the client expresses • Creates environment in which client can air problems and make better choices toward goal of self-actualization 13-17 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Group Therapies • Therapy in which people meet in a group with a therapist to discuss problems • Often centers on a common difficulty • e.g., alcoholism, bereavement • Group members provide emotional support and advice • More economical means of therapy compared to individual therapy • Criticisms? • Shy and withdrawn individuals may not receive required attention 13-18 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Group Therapies • Family therapy: Focuses on the family and its dynamics • Involves two or more family members, one (or more) of whose problems led to treatment 13-19 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Evaluating Psychotherapy: Does Therapy Work? • Hans Eysenck published a study challenging the effectiveness of therapy • Spontaneous remission? - Recovery without treatment • Meta-analyses and reviews indicate that therapy does yield greater improvement than no therapy 13-20 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. *Placebo group: therapist provided support but not treatment 13-21 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Effectiveness of Psychotherapy • For most people it is effective, but not for all • No single form of therapy works best for every problem, and specific types of treatment are better for specific types of problems • Most successful therapies share several basic similar elements • Client has a positive relationship with therapist • Client receives explanation of symptoms • Client is able to confront negative emotions 13-22 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Figure 1 - Estimates of the Effectiveness of Different Types of Treatment 13-23 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. MODULE 42: Biomedical Therapy: Biological Approaches to Treatment • How are drug, electroconvulsive, and psychosurgical techniques used today in the treatment of psychological disorders? 13-24 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Drug Therapy • Control of psychological disorders through drugs • Works by altering the operation of neurotransmitters and neurons in the brain 13-25 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Figure 1 - Classes of Drugs Used to Treat Psychological Disorders 13-26 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Drug Therapy • Antipsychotic drugs: Temporarily reduce psychotic symptoms such as agitation, hallucinations, and delusions • • • • Chlorpromazine Risperidone Olanzapine Paliperidone • Symptoms reappear when the drug is withdrawn • Long-term side effects – dryness of mouth, dizziness, tremors, etc 13-27 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Drug Therapy • Antidepressant drugs: Medications that improve depressed patient’s mood and feeling of well-being • Work by changing the concentration of serotonin and norepinephrine in the brain • SSRIs, SNRIs, Tricyclics, MAO inhibitors • Very effective • Side effects: weight gain, decreased libido Depression meds video 13-28 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Does Prozac increase risk of suicide? February 1990, Dr. Martin Teicher of Harvard Medical School and his colleagues reported that six depressed patients (five females), who had recently been free of suicidal ideation, developed severe suicidal thoughts after 2–7 weeks of taking Prozac (Teicher, Glod, & Cole, 1990). None had ever had a similar experience while taking any other drug. This thought pattern persisted for 3 days to 3 months after stopping the drug. Five had previously either contemplated or attempted suicide (Toufexis, 1990). Since 1990, many similar reports have been made. Why is this issue so tricky? - Difficult to disentangle the various factors: people who take these meds are depressed…by definition, many depressed people are suicidal. 13-29 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Does Prozac increase risk of suicide? Probability of a Suicide Attempt in Relation to the Initiation of Prescription Drug Treatment Beginning of Treatment 900 800 Suicide Attempts per 100,000 700 600 500 Risk of suicide declines with onset of treatment, but patients should be monitored 400 300 200 100 0 -3 -2 -1 1 2 3 4 5 6 Months Before or After Starting Treatment 13-30 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Drug Therapy • Mood stabilizers: Drugs used to treat mood disorders that prevent manic episodes of bipolar disorder (not depression episodes) • Bipolar disorder treatment • Lithium • Depakote • Tegretol • Can be a preventive treatment, blocking future episodes of manic depression 13-31 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Drug Therapy • Antianxiety drugs: Reduce the level of anxiety a person experiences • Can cause dependence • Side effects: sedating, dizziness, weakness • When taken in combination with alcohol, some antianxiety drugs can be lethal 13-32 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Electroconvulsive Therapy (ECT) • Procedure used in the treatment of severe depression • Under anesthesia, electric current of 70 to 150 volts is briefly administered to a patient’s head • Causes loss of consciousness and seizures • Controversial because of side effects https://www.youtube.com/ watch?v=kRgHjONWFrk (5 min) • Memory loss But quick acting, so has prevented suicides 13-33 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Psychosurgery • Very rare because of risks • Brain surgery to reduce symptoms of a mental disorder • Prefrontal lobotomy to remove frontal lobes (believed to control emotionality) • Often helps, but drastic side effects – personality changes, impulsive, etc • Cingulotomy • For rare cases of OCD • Tissue is destroyed in the anterior cignulate • Gamma knife surgery • Radiation is used to destroy areas of the brain related to OCD 13-34 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

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