Psychology Around Us: Chapter 16 Treatment of Psychological Disorders PDF

Psychology Around Us Fourth Canadian Edition Ogden Boyes Field Comer Gould Chapter 16 Treatment of Psychological Disorders Copyright ©2022 John Wiley and Sons Canada, Ltd. Learning Objectives - Chapter 16 1. Treatment in today’s...

Psychology Around Us Fourth Canadian Edition Ogden Boyes Field Comer Gould Chapter 16 Treatment of Psychological Disorders Copyright ©2022 John Wiley and Sons Canada, Ltd. Learning Objectives - Chapter 16 1. Treatment in today’s world – who, how and what 2. Biological treatments: What happens in the brain? 3. Psychodynamic therapies: How we develop 4. Behavioural therapies 5. Cognitive-Behavioural Therapies 6. Humanistic and Existential Therapies 7. Formats of Therapy 8. Does Therapy Work? 9. Final Thoughts  Treatment in Today’s World Three essential features of all therapies 1) A sufferer who seeks help 2) A trained, socially accepted healer 3) A series of contacts with the goal of changing attitudes, emotional states, or behaviours Psychotherapies - use words and acts to overcome psychological difficulties Biological therapies - drugs and physiological interventions such as surgeries.  Who Seeks Therapy? About 20 million North Americans per year More than 3/4 of them seek help with anxiety or depression About 2/3 of clients are women, 1/3 are men White individuals more likely to seek treatment than members of other ethnic groups.  Who Conducts Therapy? Who are clinicians? Clinical psychologists Psychiatrists Social workers Counsellors.  Stigma There has been a significant reduction in the stigma associated with mental illness Perceptions of stigma play a role in people’s decisions about whether to acknowledge their mental issues and to seek treatment.  Where Is Treatment Conducted? Where Public institutions, such as hospitals and clinics, schools, private offices Most people are treated as outpatients Canadians with severe psychological disorders often face a cycle of hospital discharges and readmissions and are often homeless Canadian Mental Health Act - outlines patient rights and conditions for involuntary admittance to hospitals.  Biological Treatments: What Happens in the Brain? Drug therapy Psychotropic drugs - drugs that act (primarily) on the brain Antianxiety drugs Antidepressants Mood Stabilizers Antipsychotics Biological Treatments - Placebo  The Placebo Effect https://www.youtube.com/watch?v=rtPe5lsoHXY. From Harvard Medical School Research:  Placebos are dose dependent  Placebos affect self-appraisal but not the underlying physiological disorder  Placebos alternately affect brain regions and neurotransmitters integral to whatever disorder is being treated:  endorphins, serotonin, cannabinoids  And placebos are getting stronger! Knees: https://www.youtube.com/watch?v=HqGSeFOUsLI Alternative explanations:  Regression to the mean  Misdiagnosis  Normal recovery.  Biological Treatments: Electroconvulsive Therapy (ECT) Electroconvulsive therapy (ECT) - used to treat depression by sending an electrical current through the brain, producing a brain seizure 1) Reduces severe depression in 70% of patients 2) Causes short-term memory problems 3) Developed in the 1930s 4) More traumatic than newer treatments.  Biological Treatments: Vagus Nerve Stimulation In this procedure, an implanted pulse generator sends electrical signals to the left vagus nerve That nerve then delivers electrical signals to the brain, helping to reduce depression in many people.  Biological Treatments: Transcranial Magnetic Stimulation TMS is a non-invasive procedure used to treat depression The electromagnetic coil is placed on the patient’s head and sends a current into the prefrontal cortex. Biological Treatments: Lobotomy Lobotomy - surgical practice of cutting the connections between the frontal lobe and the lower centres of the brain Biological Treatments: Deep Brain Stimulation Implanted electrodes deliver low doses of electricity, used to treat depression, Parkinson’s Disease and a growing list of other disorders.  Assessing the Biological Approaches Strengths: Biological treatments often bring relief when other approaches have failed Research offers promising options Criticisms: Undesirable side effects Does not consider interaction between biological and non-biological factors such as environment and experience.  Psychodynamic Therapies: How We Develop Focus on past emotional trauma About 15% of contemporary clinical psychologists Several types: Psychoanalysis Short-term psychodynamic therapy Relational psychoanalytic therapy.  Psychodynamic Techniques Free association - discussions initiated by client with therapist probing to uncover relevant unconscious events Therapist interpretation Resistance - block in free associations or change in subject Transference - shift feelings for figures from childhood to therapist. Psychodynamic Techniques Catharsis - reliving of past repressed feelings to resolve conflicts Must be accompanied by intellectual insight Working through - repeatedly examine an issue to improve clarity.  Assessing Psychodynamic Approaches Strengths: First practitioners to demonstrate the value of systematically applying both theory and techniques to treatment First to suggest the potential of psychological instead of biological treatment Their ideas have served as a starting point for many other psychological treatments Criticism: Effectiveness not supported by research.  Behavioural Therapies Abnormal behaviour is learned in the same way adaptive behaviours are learned Classical conditioning Operant conditioning Modelling Goal is to discover specific problem-causing behaviours and replace them with healthy behaviours Behavioural therapy is often effective with phobias and anxiety issues  Classical Conditioning Techniques Change client’s dysfunctional reaction to specific stimuli Systematic desensitization - effective in treating phobias, PTSD, asthma attacks Aversion therapy - increase anxiety response to harmful stimuli desired by the client Fear Hierarchy for Systematic Desensitization Aversion Therapy  Operant Conditioning Techniques Consistently provide rewards for desirable behaviour and withhold rewards for undesirable behaviour Successful in hospitalized psychotic patients Works best in institutions and schools Token Economies  Behavioural Therapies Modelling techniques: Therapists exhibit appropriate behaviours so client can imitate, rehearse, and incorporate the behaviours into their lives Social skills training - therapists discuss social deficits and role play social situations with the client. Improve social skills and assertiveness  Assessing the Behavioural Approaches Strengths: Widely studied in research and strongly supported Effective for numerous problems, including specific fears, social deficits, and intellectual disabilities Criticisms: Changes sometimes require later therapies to sustain Not effective with disorders in which distress is non-specific, such as generalized anxiety disorder  Cognitive-Behavioural Therapies Cognitive-behavioural model - behavioural therapies are usually used along with cognitive therapies Cognitive views of abnormal behaviour Disorders are caused or worsened by maladaptive thinking Three kinds: 1) Ellis’s rational-emotive behavioural therapy 2) Beck’s cognitive therapy 3) Second-wave cognitive-behavioural therapies  Cognitive Therapies Ellis’s rational-emotive therapy - goal is to identify irrational assumptions that lead to disordered emotional and behavioural responses 1) Point out irrational assumptions 2) Model the use of alternative assumptions 3) Uses cognitive restructuring 4) Effective for anxiety and assertiveness problems  Cognitive Therapies Beck’s cognitive therapy Widely used for depression Therapists help clients identify negative thoughts and perceptions and guide them to apply alternative ways of thinking About as effective as drug therapy for depression (2/3 improve) Also used for panic disorder and social anxiety disorder  Cognitive Therapies Second-wave cognitive-behavioural therapies Recognize problematic thoughts as just thoughts Clients accept thoughts rather than try to eliminate them Assessing Cognitive-Behavioural Therapies Strengths: Well supported by research Good at treating depression, social anxiety disorder, generalized anxiety disorder, panic disorder, sexual dysfunctions, and other disorders Criticisms: Role of cognition unclear (cause or effect?) Unclear whether cognitive features, behavioural features, or combination are effective  Humanistic and Existential Therapies Humanists - we are all born with the tools to fulfill our potential Existentialists - accept responsibility for our lives and choices Emphasize present events, focus on helping clients see themselves accurately and acceptingly Gestalt therapy - guide clients toward self-acceptance by challenging and frustrating them Skillful frustration, role playing, rules  Humanistic and Existential Therapies Rogers’s client-centred therapy - goal is to create an environment in which clients can see themselves honestly with acceptance Client-centred therapy—supportive environment for clients to feel accepted and to accept self Unconditional positive regard - total acceptance of client Accurate empathy - skillful listening Genuineness - sincere communication  Assessing Humanistic and Existential Therapies Strengths: Appealing to clinicians Emphasize positive human qualities Criticisms: Difficult to research and little research has been done Partially supported by research  Formats of Therapy Individual therapy - one on one with therapist and client Group therapy - therapist meets with several clients with similar problems simultaneously Self-help groups - people with similar problems meet for support without guidance from clinician Assessing group therapy Varies and is therefore difficult to assess Helps many  Range of Formats Individual therapy used to be the only treatment format for psychological problems. Today, other formats are also used, such as group therapy and couple therapy.  Formats of Therapy Family therapy - whole family meets with therapist, who considers family interactions Family systems theory - each family has own rules, structure, and communication patterns that shape behaviour For one person to change, the family system may need to change  Formats of Therapy Couple therapy - two people in a relationship meet together with therapist to consider relationship structure and communication Marital therapy 38% of Canadian marriages do not survive past the 13th anniversary and 25% of all treated couples eventually divorce  Formats of Therapy Community treatment Community mental health treatment allows clients to receive treatment in a familiar environment Key principle is prevention  Does Therapy Work? Empirically supported treatment movement - therapies supported by research should be used Is therapy in general effective? More effective than no treatment or placebo.  Does Therapy Work? Are particular therapies generally effective? Each major form helps some; no one form stands out Effective therapists may share common features Are particular therapies effective for particular problems? Behavioural: phobias Cognitive-behavioural: social anxiety disorder, generalized anxiety disorder, panic disorder, and depression Drug: schizophrenia and bipolar  Does Therapy Work? Is therapy effective across race and gender? Members of ethnic minority groups worldwide seek therapies less and benefit less from them than do majority- group members Culture-sensitive therapies take into account cultural values and stresses specific to the group Gender-sensitive or feminist therapies acknowledge stressors girls and women face Wrapping Up - Covering All Angles To fully understand a mental process such as “intruding thoughts,” today’s psychologists study the phenomenon at many levels. Psychology offers enormous promise for the future understanding of who we are.  Succeeding on MC Tests 1. Study for MC 2. Take notes 3. Test yourself 4. Read the question twice 5. DO NOT look at the answers until you have figured out the answer 6. NEVER answer with something you don’t recognize 7. Monitor your attitude and if you need a break take one 8. Put your time into getting the question right not reviewing your answers  Final Exam 1. 90 questions 2. covers ALL chapters we have covered 3. Chapters 1 (first half), 2, App B, 3, 6, 7, 12 are first 50 questions 4. Chapters 15 & 16 are last 40 questions 5. Two hours 6. Be early 7. Go to the right place 8. Sit in the right row 9. Take your time 10. If you have vocabulary questions put up your hand. Thank you for the semester GOOD LUCK on all your finals!