Chapter 16 - Therapy and Treatment

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Questions and Answers

What percentage of U.S. adults experienced mental illness in a given year?

50%

33%

19% (correct)

13%

What was the primary focus of asylums established in the 18th century?

Educating the public about mental illness

Providing treatment for psychological disorders

Ostracizing individuals from society (correct)

Rehabilitating individuals into society

Which of the following treatments was NOT used historically for mental illness?

Imprisonment

Exorcism

Trephining

Psychotherapy (correct)

During the period when supernatural explanations for mental illness prevailed, which of the following treatment methods was considered?

Exorcism Signup and view all the answers

What was a significant finding regarding adolescents with mental disorders seeking treatment?

One-third to one-half of adolescents with mental disorders receive treatment Signup and view all the answers

What significant change did Philippe Pinel advocate for in the treatment of the mentally ill?

Humane treatment involving conversation Signup and view all the answers

What was a common characteristic of American asylums in the 19th century?

Long-term institutionalization Signup and view all the answers

Which treatment was commonly used in asylums until the 20th century for individuals with mental disorders?

Submersion into cold baths Signup and view all the answers

What was one of the outcomes of the Mental Retardation Facilities & Community Mental Health Centers Construction Act of 1975?

Deinstitutionalization of many patients Signup and view all the answers

What was introduced in 1954 that significantly changed the treatment of psychosis?

Antipsychotic medications Signup and view all the answers

What challenge emerged from the deinstitutionalization process initiated in the 1970s?

Homelessness among the mentally ill population Signup and view all the answers

How were the conditions of patients in asylums typically described during the 19th century?

Filthy and lacking treatment Signup and view all the answers

What was the primary aim of Mary Cover Jones's study on exposure therapy?

To replace Peter's fear of rabbits with relaxation. Signup and view all the answers

Which technique did Joseph Wolpe refine from Mary Cover Jones's original approach?

Systematic desensitization. Signup and view all the answers

What fundamental principle does the systematic desensitization technique operate on?

Fear and relaxation are incompatible. Signup and view all the answers

Which component is NOT typically involved in the process of progressive relaxation?

Reinforcing positive behaviors. Signup and view all the answers

What is the primary purpose of token economies in behavior therapy?

To reinforce positive behaviors in a controlled setting. Signup and view all the answers

Which aspect of behavior therapy is specifically useful for children with autism?

Operant conditioning techniques. Signup and view all the answers

Virtual reality exposure therapy is utilized primarily when access to anxiety-inducing situations is:

Difficult or impractical to recreate. Signup and view all the answers

What is the outcome desired from applying exposure therapy on a patient with arachnophobia?

Increased comfort around spiders. Signup and view all the answers

Which term refers to the application of operant conditioning techniques to support individuals in developing positive behaviors?

Applied behavior analysis. Signup and view all the answers

What is the average length of stay for psychiatric hospitalization?

Less than two weeks Signup and view all the answers

Which type of treatment is characterized by being mandated rather than chosen?

Involuntary treatment Signup and view all the answers

Which type of therapy focuses on the impact of childhood conflicts and the unconscious mind?

Psychodynamic psychotherapy Signup and view all the answers

What is the primary goal of cognitive-behavioral therapy?

To eliminate negative thought patterns Signup and view all the answers

Who developed the first form of psychotherapy known as psychoanalysis?

Sigmund Freud Signup and view all the answers

Which treatment approach utilizes toys for therapeutic interaction, especially with children?

Play therapy Signup and view all the answers

What is the focus of humanistic therapy?

Increasing self-awareness and acceptance Signup and view all the answers

Which type of therapy applies principles of learning to modify behavior?

Behavior therapy Signup and view all the answers

What is commonly a condition of parole involving therapy sessions?

Involuntary treatment Signup and view all the answers

Study Notes

Therapy and Treatment

Many forms of therapy exist to treat various problems.
The Ocean Therapy program at Camp Pendleton combines surfing with group discussions to help veterans, especially those with PTSD, recover.
Approximately 19% of US adults and 13% of adolescents experience mental illness annually.
Adults seeking treatment for mental health increased slightly from 2004-2008.
About one-third to one-half of US adolescents with a mental disorder receive treatment, with behavior-related disorders being more likely to receive treatment.

Treatment in the Past

Throughout history, mental illness was often attributed to supernatural forces such as witchcraft and demonic possession.
Treatments aimed at supernatural forces included exorcism (prayers and incantations), trephining (creating a hole in the skull), and execution after accusations of witchcraft.

18th Century

Asylums were created for people with psychological disorders.
Focus was on ostracizing individuals rather than treatment.
Individuals were often confined to windowless dungeons, chained to beds, with little contact with caregivers.
A painting of The Madhouse by Francisco Goya depicts mental asylum conditions in the early 1800s, portraying its inhabitants as victims.

18th Century (Philippe Pinel)

Philippe Pinel, a French physician, argued for more humane treatment of the mentally ill.
Implemented unchaining and speaking to patients in Paris, leading to improved conditions and patient release.

19th Century

American asylums were typically filthy and provided little treatment.
Individuals were often institutionalized for decades.
Treatments included submersion in cold baths and electroconvulsive therapy (ECT).
These practices continued well into the 20th century.

20th Century

Antipsychotic medications were introduced in 1954, proving successful in treating psychosis symptoms like hallucinations and delusions.
The Mental Retardation Facilities & Community Mental Health Centers Construction Act (1975) provided federal support and funding for community mental health centers, starting the deinstitutionalization process.
Deinstitutionalization, the closing of large asylums and placing people in their communities, was mostly ineffective due to lack of resources and training for local mental health centers.
This led to increases in homelessness.

Mental Health Treatment Today

Mental illness is still common among the homeless population.
A significant percentage (approximately one-quarter) of those in US shelters experience severe mental illness.
Correctional institutions also house a significant number of individuals with mental illnesses.
Psychiatric hospitals and local community hospitals focused on short-term care have replaced asylums.
Emphasis is on short-term stays (less than two weeks) due to high cost and limited insurance coverage.
Individuals are usually hospitalized only if they are an imminent threat to themselves or others.

Types of Treatment

There are various types of therapy: psychodynamic, play, behavior, cognitive, cognitive-behavioral, and humanistic therapy.
Specific techniques, examples of each, and their descriptions are included.

Psychoanalysis

The first form of psychotherapy developed by Sigmund Freud, aimed to uncover repressed feelings.
Techniques include free association, dream analysis, and transference.
Modern psychodynamic psychotherapy is more commonly utilized today, incorporating modern theories and methodology.

Behavior Therapy

Based on learning principles, dysfunctional behaviors are altered by teaching clients more constructive behaviors.
Techniques include classical conditioning, counterconditioning, aversion conditioning and exposure.
Exposure therapy involves gradually exposing clients to feared stimuli to reduce anxiety.

Cognitive Therapy

Developed by Aaron Beck, cognitive therapy emphasizes how thinking affects feelings and actions.
Cognitive therapy helps clients identify and correct cognitive distortions (thinking errors).
Common cognitive distortions include overgeneralization, polarized thinking, and jumping to conclusions.
Cognitive therapy aims to help clients interpret situations more logically.

Cognitive-Behavioral Therapy (CBT)

Combines cognitive therapy (identifying negative thoughts) with behavior therapies (positive approaches to situations).
Works to change cognitive distortions (e.g., overgeneralization, polarized thinking) and self-defeating behaviors.
Uses the ABC model (activating event, belief about the event, consequences of the belief).

Humanistic Therapy

Focuses on helping people achieve their potential.
Emphasizes self-awareness, acceptance, and taking control of one's life.
Techniques include active listening and unconditional positive regard, while helping patients identify conflicts and understand their feelings.

Biomedical Therapies

Psychotropic medications treat the symptoms of psychological disorders, but do not cure the disorder.
Antipsychotics treat positive symptoms, atypical antipsychotics address negative symptoms, and antidepressants alter serotonin and norepinephrine levels.

Treatment Modalities

Includes individual, group, family, and couples therapy.
Individual therapy involves one-on-one sessions to explore feelings, work through challenges, and set goals.
Group therapy benefits from sharing a common issue with others, while family therapy helps to address family dynamics and couples therapy addresses relationship issues.
Effective treatment takes into account holistic needs, such as vocational, stress, parenting concerns.

Addiction

Individuals may initially choose to use a substance voluntarily, but chronic substance use can permanently alter the brain, making it difficult to stop.
Relapse (returning to substance abuse) and comorbid disorders (an additional psychological disorder) are common issues associated with addiction.
Treatment involves medication for detoxification, management of withdrawal symptoms, or prevention of reuse of the drug, and behavioral therapies.

Prevalence of Drug Use

Data charts show trends in drug use prevalence across different age groups (12-17, 18-25, and 26 and older).

Treatment Barriers

Barriers to accessing mental healthcare include lack of insurance, transportation, time, language barriers, stigma, fear of being misunderstood, and lack of education.
Perceptions around self-sufficiency and therapy effectiveness, as well as concerns about confidentiality and hospitalization, also present significant barriers.

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Description

Explore the various forms of therapy designed to treat mental illness, including innovative approaches like Ocean Therapy. Delve into the historical context of mental health treatment, examining past beliefs and practices, and understand the evolving treatment landscape for mental health disorders.