Behavioral- Behavioral- TreatmentTreatment

Pavlov/Watson/SkinnerPavlov/Watson/Skinner Approach says most psych problems are Approach says most psych problems are

learned and can be changed by learning learned and can be changed by learning new behaviorsnew behaviors

Has been rewarded or reinforced Has been rewarded or reinforced Is a patternIs a pattern

Treatment- unlearn maladaptive behaviorTreatment- unlearn maladaptive behavior Modify the learned responseModify the learned response

BehavioralBehavioral

Operant ConditioningOperant Conditioning Classical ConditioningClassical Conditioning Observational LearningObservational Learning RewardsRewards PunishmentsPunishments Maladaptive thoughts and actions are Maladaptive thoughts and actions are

learned (example Phobias)learned (example Phobias)

Behavioral Treatment Behavioral Treatment needsneeds1.1. Relationship between client and Therapist is Relationship between client and Therapist is

keykey2.2. Careful listing of behaviors and thoughts to Careful listing of behaviors and thoughts to

be changedbe changed Establish treatment goalsEstablish treatment goals Work to change specific thoughts, behaviors, and Work to change specific thoughts, behaviors, and

emotional actionsemotional actions

3.3. Therapist Therapist Provides learning based treatmentsProvides learning based treatments Provides specific plans for dealing with problemsProvides specific plans for dealing with problems

4.4. Continuous monitoring and adjustmentsContinuous monitoring and adjustments

Types of Behavior Types of Behavior TherapyTherapy

Behavior Therapy Behavior Therapy Includes Classical ConditioningIncludes Classical Conditioning

Behavior Modification Behavior Modification Operant ConditioningOperant Conditioning

Cognitive Behavior TherapyCognitive Behavior Therapy Changing thoughtsChanging thoughts

Systematic Systematic DesensitizationDesensitization Joseph Wolpe Joseph Wolpe 19581958 Designed to overcome PhobiasDesigned to overcome Phobias Process- Process- Client visualizes a series of anxiety Client visualizes a series of anxiety

provoking stimuli while remaining relaxed provoking stimuli while remaining relaxed Process gradually weakens the learned Process gradually weakens the learned

associations between the fear/anxiety associations between the fear/anxiety producing objectproducing object

Systematic Desensitization 2Systematic Desensitization 2

Used Used Progressive Relaxation TrainingProgressive Relaxation Training 11stst patient imagines patient imagines Desensitization Hierarchy Desensitization Hierarchy

A sequence of increasingly fear provoking A sequence of increasingly fear provoking situationssituations

Then tolerating the situation then another high Then tolerating the situation then another high fear provoking situation is introducedfear provoking situation is introduced

New application includes live stimuli New application includes live stimuli instead of imaginationinstead of imagination

Behavioral Therapy3Behavioral Therapy3

Flooding- Extinction techniqueFlooding- Extinction technique Continuous exposure to feared stimuliContinuous exposure to feared stimuli

Gradual ExposureGradual Exposure ModelingModeling

Therapist demonstrates behaviorTherapist demonstrates behavior Client learns skillsClient learns skills Shaping processShaping process Vicarious learningVicarious learning Example Assertiveness TrainingExample Assertiveness Training

Behavioral Therapy also4Behavioral Therapy also4

Positive ReinforcementPositive Reinforcement Token economyToken economy PunishmentPunishment – unpleasant stimulus – unpleasant stimulus Extinction-Extinction- taking away reinforcement taking away reinforcement Aversion ConditioningAversion Conditioning

Associate unpleasant stimulus with other Associate unpleasant stimulus with other unwanted stimuliunwanted stimuli

Cognitive Behavior Cognitive Behavior TherapyTherapy Problems exist Problems exist because people have because people have

problems thinking about themselvesproblems thinking about themselves Goal is to change troubled thoughtsGoal is to change troubled thoughts

Method:Method: Use learning principles to help clients change Use learning principles to help clients change

the way they thinkthe way they think Try to identify recurring thoughts Try to identify recurring thoughts Then help them learn new more adaptive ways Then help them learn new more adaptive ways

of thinkingof thinking

Rational Emotive TherapyRational Emotive Therapy

Albert EllisAlbert Ellis Believed psych problems are caused by Believed psych problems are caused by

how people think about eventshow people think about events1. Identify the 1. Identify the Self Defeating Self Defeating beliefsbeliefs““I should be loved… “I must be perfect…”I should be loved… “I must be perfect…”2. Show these are problematic thoughts2. Show these are problematic thoughts3. 3. Use logic Use logic to show the patient to replace to show the patient to replace

thoughts that are realisticthoughts that are realistic4 Homework to practice 4 Homework to practice

Cognitive TherapyCognitive Therapy

Aaron BeckAaron Beck Said disorders can be traced to faulty logic Said disorders can be traced to faulty logic

= = Cognitive Distortions Cognitive Distortions (learned)(learned) Cognitive DistortionsCognitive Distortions

Basically the client never considers that their Basically the client never considers that their judgments are not true or might be faultyjudgments are not true or might be faulty

CatastrophisingCatastrophising All or Nothing ThinkingAll or Nothing Thinking PersonalizationPersonalization

Cognitive Therapy 2Cognitive Therapy 2

Active problem solving approachActive problem solving approach Therapist helps the client to identify the Therapist helps the client to identify the

distorted thoughtsdistorted thoughts Shows the client that these distorted Shows the client that these distorted

hypotheses are need to be testedhypotheses are need to be tested Show them that the false beliefs are falseShow them that the false beliefs are false (Page 660)(Page 660)

Biological TreatmentsBiological Treatments

Psych disorders have physical causesPsych disorders have physical causes Psycho Surgery- Psycho Surgery-

Brain Tissue is destroyedBrain Tissue is destroyed Antonio Egas Moniz Antonio Egas Moniz 19351935 Created the Created the Prefontal Lobotomy Prefontal Lobotomy Holes in forehead Holes in forehead Cut connections Cut connections

Electro-Convulsive Electro-Convulsive TherapyTherapy 1930s Ladislaus Von Meduna1930s Ladislaus Von Meduna Used Used ECTECT to induce schizophrenics + to induce schizophrenics +

depression and sometimes maniadepression and sometimes mania Induced epileptic like seizuresInduced epileptic like seizures Side effects memory loss, confusion, Side effects memory loss, confusion,

speech disordersspeech disorders Fun Fact- ECT is performed more Fun Fact- ECT is performed more

frequently in US than coronary bypass, frequently in US than coronary bypass, appendectomies, tonsillectomies appendectomies, tonsillectomies

Psychoactive DrugsPsychoactive Drugs

Work on Neurotransmitters (page 680 Work on Neurotransmitters (page 680 chart)chart)

ConsciousnessConsciousness Used to treat:Used to treat: SchizophreniaSchizophrenia DepressionDepression ManiaMania Anxiety Anxiety

Psychoactive Drugs2Psychoactive Drugs2

Neuroleptics- aka Anti-PsychoticsNeuroleptics- aka Anti-Psychotics ThorazineThorazine HaldolHaldol Long-term use causes Tardive Long-term use causes Tardive

DyskinesiaDyskinesia Block Dopamine Block Dopamine

Anti-DepressantsAnti-Depressants

Usually Increase Serotonin and Usually Increase Serotonin and NorepinephrineNorepinephrine

Takes week or two to take effectTakes week or two to take effect Monomine Oxidase Inhibitors (MAOIs)Monomine Oxidase Inhibitors (MAOIs)

Treats also panic and anxietyTreats also panic and anxiety

Most common is Prozac (affects Most common is Prozac (affects serotonin) serotonin)

Popular types of antidepressants

are called selective serotonin reuptake inhibitors (SSRIs). These include:

Fluoxetine (Prozac) Citalopram (Celexa) Sertraline (Zoloft) Paroxetine (Paxil) Escitalopram (Lexapro).

LithiumLithium

Mood stabilizerMood stabilizer For BipolarFor Bipolar TranquilizersTranquilizers

Tranquilizers Tranquilizers

The principal minor tranquilizers are the benzodiazepines, among which are diazepam (Valium),chlordiazepoxide (Librium), and alprazolam (Xanax). These drugs have a calming effect and eliminate both the physical and psychological effects of anxiety or fear. Besides the treatment of anxiety disorders, they are widely used to relieve the strain and worry arising from stressful circumstances in daily life. Because of this, benzodiazepines are among the most widely prescribed drugs in the world. Benzodiazepines work by enhancing the action of the neurotransmitter gamma-aminobutyric acid(GABA), which inhibits anxiety by reducing certain nerve-impulse transmissions within the brain. Benzodiazepines resemble barbiturates in their side effects: sleepiness, drowsiness, reduced alertness, and unsteadiness of gait. Though less dangerous than barbiturates, they can produce physical dependency even in moderate dosages, and the body develops a tolerance to them, necessitating the use of progressively larger doses. The drugs are thus intended for short- and medium-term use.