Chapter 13: Treating Psychological

Disorders

Amber Gilewski

Tompkins Cortland Community College

Psychological Treatment

Who seeks it?

15% of U.S. population in a given year

Most common presenting problems

Anxiety and Depression

Women more than men

Medical insurance

Education level

Typical sequence of steps

Assessment

Diagnosis

Treatment

Figure 15.2 Therapy utilization rates

Who Provides Treatment?

Clinical psychologists: doctorate degree

Counseling psychologists: doctorate degree

Psychiatrists: medical doctors

Clinical social workers: master’s degree

Psychiatric nurses: bachelor’s/master’s degree

Counselors: master’s degree

Psychological Approach: Psychoanalysis

Sigmund Freud and followers Goal: discover unresolved unconscious conflicts

Free association: spontaneously expressing thoughtsDream analysis: interpreting our unconscious thoughtsInterpretation: understanding the inner meaning

Resistance – unconscious ways of hindering therapy

Transference – unconsciously relating to therapist in a similar way to key relationships in one’s life

Psychological Approach: Person-Centered Therapy

Carl Rogers – humanistic perspective Goal: restructure self-concept to better

correspond to reality Therapeutic Climate

Genuineness

Unconditional positive regard

Empathy

Psychological Approach:Behavior Therapies

B.F. Skinner and colleagues Goal: unlearning maladaptive behavior and learning

adaptive ones Systematic Desensitization – Joseph Wolpe –

reducing phobic anxiety behavior

Classical conditioning

Anxiety hierarchy Aversion therapy

Alcoholism, sexual deviance, smoking, etc. Social skills training

Modeling

Behavioral rehearsal

Psychological Approach:Cognitive Therapy or

Cognitive-Behavioral TherapyAaron Beck Cognitive therapy

Albert Ellis Rational emotive behavior therapy

Goal: to change the way clients think Identify incorrect or distorted beliefs Detect and recognize negative thoughts Reality testing Kinship with behavior therapy

Social Approach:Group Therapies

Advantages Economical More experiences for client to draw upon Social support of the group

Disadvantages Unable to express feelings to group

Couple therapy

Family therapy

Biomedical TherapiesPsychopharmacotherapy

Antianxiety - Valium, Xanax, Buspar Antipsychotic - Thorazine, Mellaril, Haldol

Tardive dyskinesiaClozapine – newer medication

Antidepressants:Tricyclics – Elavil, TofranilMao inhibitors (MAOIs) - NardilSelective serotonin reuptake inhibitors (SSRIs) – Prozac, Paxil, Zoloft

Mood stabilizersLithiumValproic acid

Biomedical TherapiesElectroconvulsive therapy (ECT): electric shock used to induce seizures/convulsions

- unsure why it works

- last resort treatment

- controversial

Psychosurgery (i.e. lobotomies)

- rarely used

- refined versions used today

Transcranial magnetic stimulation (TMS)

- newer treatment; stimulates brain electrically