Psych therapy

Copyright 2004 - Prentice Hall 1

PSYCHOLOGYCynthia K. Shinabarger

Reed

Therapy


Therapy Through The Ages

The current view of causes of psychological disorders influence treatments.

People who believed in "possession" by evil spirits Exorcism Trephining


“Possession" by evil spirits

Treatments Exorcism Driving out of evil

spirits that are believed to have taken over the individual’s body. The spirits cause the individual to perform evil acts.


Trephining

Opening of the skull

Performed for the escape or entrance of spirits.


Therapy Through The Ages Greek philosopher and physician

Hippocrates Physical and psychological disorders have

natural causes Also in ancient Rome

Treatments Baths Exercise Massage

16th & 17th centuries Accused of being witches.



Paris 18th century, mentally ill often chained to walls “Keepers” Rarely showed compassion Punished at will

Dr. Philippe Pinel, Needed humane care & treatment Moral management or moral therapy

Providing humane & relaxed environment = + changes in behavior.



Benjamin Rush Introduced moral therapy at

Philadelphia’s Pennsylvania Hospital 1st general hospital in the U.S. with a

separate unit for mentally ill Yet he restrained manic patients in his

tranquilizer chair He thought more humane than other

restraints used at the time.



Mid-19th century, Dorothea Dix, Union's Superintendent of Female Nurses during the Civil War

20 years fought for homeless & mentally ill

Insisted states had an obligation to provide care

Convinced legislatures in 20 states to establish or enlarge mental hospitals.



They built larger institutions to handle more patients.Expansion caused conditions

to deteriorateUse of restraints increased



Franz Anton Mesmer Believed he could harness this

magnetism as a form of therapy to treat patients.

With modifications, his techniques evolved into hypnotism.



Sigmund Freud Psychological disorders result from

unconscious feelings and conflicts Freud turned to other techniques

when hypnosis proved less effective than he had hoped.



Early 20th century General paresis

Symptoms Paralysis Memory difficulties

Discovered resulting from syphilis Stimulated search for biological

causes of other psychological disorders

Development of biomedical treatments Psychosurgery Electroconvulsive (shock) therapy or ECT



Beginning 1950s, populations of mental hospitals began to decline

Drugs made it possible to control many serious symptoms.

Growing belief that community care was more effective

Deinstitutionalization Policy of discharging large numbers of

patients Closing hospitals



Psychologists recognize 3 forms of prevention:

1. Primary prevention– Prevent disorders from occurring.

2. Secondary prevention– Detect existing disorders– Provide treatment at early stages.

3. Tertiary prevention– reduce the damage caused by disorders for

patients & society.



Not everyone who seeks therapy suffers from a psychological disorder.

Cope Loss of a job School-related difficulties Family problems



About 30% with psychological disorder seek treatment.

More likely to seek treatment than substance abusers Schizophrenias Bipolar disorder Panic disorder



2 treatment categories for psychological disorders: Biomedical therapies Psychological therapies

Biomedical therapies Psychotropic drugs ECT Psychosurgery



Psychological therapies “talk therapies” to treatments based on

principles of learning. Psychotherapy

General term that describes psychological treatments designed to help people resolve behavioral, emotional, and interpersonal problems and improve the quality of their lives.



Most common licensed psychotherapists are clinical and counseling psychologists, psychiatric nurses, psychiatrists, and social workers.

States regulate many mental health professions

Just beginning to regulate counselors


Psychologically Based Therapies

Psychotherapy involves a special relationship between a distressed person and a therapist in which the therapist helps the client make changes in his or her thinking, feeling, and behavior.



Psychoanalytic therapy Goal is to uncover unconscious conflicts

and feelings and bring them to the conscious level.

Freud (get to unconscious) Free association Dream interpretation Resistance Transference



Free association Relate thoughts, feelings, or images without

modifying them in any way. Freud called dreams “the royal road to the

unconscious” and distinguished between two forms of dream content: manifest and latent. Manifest content

Dream you recall when you awaken Latent content

Underlying meaning Psychoanalyst’s interprets dreams by discovering

the latent content.



Resistance Occurs during free association when the

patient’s flow of words and thoughts stops.

Cessation of associations Indicates the defense mechanism of

repression is operating to protect the ego from the anxiety generated by the thoughts and feelings revealed through the associations.



TransferencePatient’s + or - reaction to the

therapist Believed to reflect relationship to a

significant person outside of therapy. Countertransference

Therapists reaction to the client Believed to reflect relationship to a

significant person in their life.


Humanistic

Humanistic therapies Emphasize the present & the ability of

clients to solve their own problems once they are able to accept themselves.

Client-centered therapy Designed to create an environment in

which the client is able to find solutions to his or her problems.


Cognitive Therapies

Cognitive therapies Designed to change cognitions in order

to eliminate maladaptive behaviors. Thinking errors

Rational-emotive behavior therapy (RET) Therapist challenges and questions the

client’s irrational ideas. Thinking errors



Rational-emotive behavior therapy ABC framework. A = activating event

Related to an important Desire Goal Preference (getting the job, in our example

B = belief (thinking error) Related to failure to attain the goal, that

follows the activating event (“I’m no good because I didn’t get the job”).

C = consequences anger, anxiety, and depression.


The Effectiveness of Psychotherapy

Eysenck Psychotherapy clients just as likely to

improve w/o treatment. Studies show psychotherapy is

generally effective, although we are uncertain as to why.


The Effectiveness of Psychotherapy

Research shows Little difference among treatments.

Characteristics of therapy may contribute to improvement

Therapist’s ability to communicate empathy

Particular therapies Effective in alleviating certain problem

behaviors.

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Psych therapy