1 PowerPoint Presentations for Philip G. Zimbardo Robert L. Johnson Vivian McCann Prepared by Beth...

11

PowerPoint PowerPoint Presentations forPresentations for

Philip G. Zimbardo Philip G. Zimbardo Robert L. Johnson Robert L. Johnson Vivian Vivian McCannMcCann

Prepared byPrepared byBeth M. SchwartzBeth M. Schwartz

Randolph CollegeRandolph CollegeThis multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program.

Seventh Edition

Copyright © 2012 Pearson Education, Inc. All rights reserved


22This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program.

Chapter 13Chapter 13

Therapies for Psychological Disorders

33

Therapy for psychological disorders takes a variety of

forms, but all involve a therapeutic relationship focused on improving a

person’s mental, behavioral, or social functioning.

What is Therapy?What is Therapy?


44

What is Therapy?What is Therapy?

• General term for any treatment process

• In psychology and psychiatry, therapy refers to a variety of psychological and biomedical techniques aimed at dealing with mental disorders or coping with problems of living.


55

Components of TherapyComponents of Therapy

Identifying the problemIdentifying the problem

Identifying the cause of the Identifying the cause of the problem or the conditions that problem or the conditions that

maintain the problemmaintain the problem

Deciding on and carrying out Deciding on and carrying out some form of treatmentsome form of treatment


66

Types of Mental Health Care Types of Mental Health Care ProfessionalsProfessionals

Counseling PsychologistCounseling Psychologist

Clinical PsychologistClinical Psychologist

PsychoanalystPsychoanalyst

Clinical Social WorkerClinical Social Worker

PsychiatristPsychiatrist

Psychiatric Nurse PractitionerPsychiatric Nurse Practitioner

Pastoral CounselorPastoral Counselor


77

Specialty:Specialty:

Problems of Problems of normal livingnormal living

Work setting:Work setting:

Schools, clinics, Schools, clinics, other institutionsother institutions

Credentials:Credentials:

Master’s in Master’s in counseling, PhD, counseling, PhD,

EdD, or PsyDEdD, or PsyD

Professional TitleProfessional Title

Counseling PsychologistCounseling Psychologist

Clinical Psychologist

Psychoanalyst

Clinical Social Worker

Psychiatrist

Psychiatric Nurse Practitioner

Pastoral Counselor


88


Those with severe Those with severe or less severe or less severe

disordersdisordersWork setting:Work setting:

Private practice, Private practice, mental health mental health

agencies, agencies, hospitalshospitals


PhD or PsyDPhD or PsyD


Counseling Psychologist

Clinical PsychologistClinical Psychologist

Psychoanalyst


Psychiatrist


Pastoral Counselor


99


Physician trained Physician trained to treat mental to treat mental

problems (often problems (often by means of drug by means of drug

therapies)therapies)


Private practice, Private practice, clinics, hospitalsclinics, hospitals


MDMD




Psychoanalyst


PsychiatristPsychiatrist


Pastoral Counselor


1010


Freudian therapyFreudian therapy


Private practicePrivate practice


MD or PhDMD or PhD




PsychoanalystPsychoanalyst


Psychiatrist


Pastoral Counselor


1111


Nursing specialty; Nursing specialty; licensed to licensed to

prescribe drugsprescribe drugs


Private practice, Private practice, clinics, hospitalsclinics, hospitals


RN plus special RN plus special training in treating training in treating mental disorders mental disorders and prescribing and prescribing

drugsdrugs




Psychoanalyst


Psychiatrist

Psychiatric Nurse Psychiatric Nurse PractitionerPractitioner

Pastoral Counselor


1212


Social worker with Social worker with a specialty in a specialty in dealing with dealing with

mental disordersmental disorders


Often employed Often employed by governmentby government


MSWMSW




Psychoanalyst

Clinical or Psychiatric Clinical or Psychiatric Social WorkerSocial Worker

Psychiatrist


Pastoral Counselor


1313


Combines Combines spiritual guidance spiritual guidance

with practical with practical counselingcounseling


Religious order or Religious order or ministryministry


VariesVaries




Psychoanalyst


Psychiatrist


Pastoral CounselorPastoral Counselor


1414

Therapy in Historical ContextTherapy in Historical Context

Medieval Europe:

• Mental disorder the work of devils and demons

• Exorcism needed to “beat the devil” out

More Modern Times

• Mentally ill placed in institutions called asylums, which often resulted in neglect


1515

Modern Approaches to TherapyModern Approaches to Therapy

Modern approaches abandoned demon model and abusive treatments.

• Therapies based on psychological and biological theories of mind and behavior• psychological therapies, often called

psychotherapy• Biological therapies focus on altering the

brain.


1616

Psychologists employ two main forms of treatment:

insight therapies and behavioral therapies.

How Do PsychologistsHow Do Psychologists Treat Psychological Disorders? Treat Psychological Disorders?


1717Copyright © 2012 Pearson Education, Inc. All rights reserved

Types of PsychotherapyTypes of Psychotherapy

1818

Insight TherapiesInsight Therapies

Insight Therapies

• Psychotherapies in which the therapists help patients/clients understand (gain insight into) their problems

• Aim at revealing and changing a patient’s disturbed mental processes through discussion and interpretation

• Numerous approaches involve this type of therapy.


1919


Freudian Psychoanalysis

• Insight therapies based on the assumption that psychological problems arise from tension created in the unconscious mind by forbidden impulses

• Major goal: To release conflicts and memories from the unconscious


2020

Insight Therapies:Insight Therapies: Psychodynamic Therapies Psychodynamic Therapies

Psychoanalysis

• The form of psychodynamic therapy developed by Sigmund Freud

• Access to unconscious material through free association

• Helps the patient understand the unconscious causes for his or her symptoms


2121


Freudian Psychoanalysis


2222


Psychoanalysis

• The ego blocks unconscious problems from consciousness through defense mechanisms.• e.g., displacement and repression

Analysis of Transference

• Analyzing and interpreting the patient’s relationship with the therapist, based on the assumption that this relationship mirrors unresolved conflicts in the patient’s past


2323


Neo-Freudian Psychodynamic Therapies• Therapies developed by psychodynamic theorists

who embraced some but not all of Freud’s ideas• emphasis on conscious motivation• significance of the self• experiences throughout life• the role of interpersonal relationships• abandoned the psychoanalyst’s couch• see patients once a week


2424

Insight Therapies:Insight Therapies: Humanistic Therapies Humanistic Therapies

Humanistic Therapies

• Mental problems arise from low self-esteem, misguided goals, and unfulfilling relationships.

Client-Centered Therapy: Carl Rogers

• Emphasizes healthy psychological growth through self-actualization• Reflection of feeling: paraphrasing client’s

words to capture the emotional tone expressed


2525

Insight Therapies:Insight Therapies: Cognitive Therapies Cognitive Therapies

Cognitive Therapy

• Emphasizes rational thinking as the key to treating mental disorder

• Helps patients confront destructive thoughts


2626

Insight Therapies:Insight Therapies: Group Therapies Group Therapies

Group Therapy

• Psychotherapy with more than one client

Self-Help Support Groups

• Groups that provide social support and an opportunity for sharing ideas about dealing with common problems; typically organized/run by laypersons (not professional therapists)


2727

Insight Therapies:Insight Therapies: Group Therapies Group Therapies

Couples and Family Counseling • Intended to help clients learn about

relationships• Can be more effective than individual

therapy with one member of the relationship at a time


2828

Systematic Systematic DesensitizationDesensitization

TokenTokenEconomiesEconomies

Contingency Contingency ManagementManagement

AversionAversionTherapyTherapy

ParticipantParticipantModelingModeling

Behavior TherapiesBehavior Therapies

Behavior Therapy

• Any form of psychotherapy based on the principles of behavioral learning: • operant conditioning and classical

conditioning


2929

Classical Conditioning TherapiesClassical Conditioning Therapies

Systematic Desensitization

• Technique in which anxiety is extinguished by exposing the patient to an anxiety-provoking stimulus

Exposure Therapy

• Desensitization therapy in which patient directly confronts the anxiety-provoking stimulus (as opposed to imagining it)


A Sample Anxiety HierarchyA Sample Anxiety Hierarchy


3131

Classical Conditioning TherapiesClassical Conditioning Therapies

Aversion Therapy

• Involves presenting individuals with an attractive stimulus paired with unpleasant stimulation in order to condition a repulsive reaction


3232

Operant Conditioning TherapiesOperant Conditioning Therapies

Contingency Management

• Approach to changing behavior by altering the consequences of behaviors

• Effective in numerous settings• e.g., families, schools, work, and prisons


3333

Operant Conditioning TherapiesOperant Conditioning Therapies

Token Economies

• Applied to groups (e.g., classrooms or mental hospital wards)

• Involves distribution of “tokens” contingent on desired behaviors

• Tokens can later be exchanged for privileges, food, or other reinforcers.


3434

Participant Modeling: An Participant Modeling: An Observational-Learning TherapyObservational-Learning Therapy

Participant Modeling

• The therapist demonstrates and encourages a client to imitate a desired behavior.

• Draws on concepts from both operant and classical conditioning


3535

Cognitive-Behavioral Therapy: Cognitive-Behavioral Therapy: A SynthesisA Synthesis

Cognitive-Behavioral Therapy

• Combines cognitive emphasis on thoughts with behavioral strategies that alter reinforcement contingencies

• Assumes irrational self-statements cause maladaptive behavior

• Seeks to help the client develop a sense of self-efficacy


3636

Cognitive-Behavioral Therapy: Cognitive-Behavioral Therapy: A SynthesisA Synthesis

Rational-Emotive Behavior Therapy (REBT)• Albert Ellis• Based on the idea that irrational thoughts and

behaviors are the cause of mental disorders• Attempts to eliminate the self-defeating

thoughtsPositive Psychotherapy (PPT)• Positive emphasis on growth• Emphasis on research


3737

Evaluating the Evaluating the Psychological TherapiesPsychological Therapies

Eysenck (1952) proposed that people with nonpsychotic problems recover just as well with or without therapy.

Reviews of evidence since have shown that:

• Eysenck overestimated the improvement rate in the group without therapy.

• Therapy is better than no therapy.• It appears advantageous to match specific

therapies with specific conditions.


Comparing the Different Types of TherapyComparing the Different Types of Therapy


3939

How Is the BiomedicalHow Is the BiomedicalApproach Used toApproach Used to

Treat Psychological Disorders?Treat Psychological Disorders?

Biomedical therapies seek to treat psychological disorders

by changing the brain’s chemistry with drugs, its

circuitry with surgery, or its patterns of activity with pulses

of electricity or powerful magnetic fields.


4040

Drug TherapyDrug Therapy

Antipsychotic Drugs• E.g., chlorpromazine, haloperidol, and

clozapine• Usually affect dopamine pathways• May have side effects

• tardive dyskinesia: incurable disorder of motor control resulting from long-term use of antipsychotic drugs


4141


Antidepressant Drugs

• Three major categories:• tricyclic compounds (e.g., Tofranil and Elavil)• SSRIs (e.g., Prozac)• Monoamine oxidase (MOA) inhibitors and

lithium carbonate (effective against bipolar disorder)

Mood Stabilizers• E.g., Lithium and Depakote: effective for

bipolar disorders


4242


Antianxiety Drugs• Include barbiturates and benzodiazepines

• May include some antidepressant drugs that work on certain anxiety disorders

• Should not be used to relieve the ordinary anxieties of everyday life

• Should not be taken for more than a few days at a time

• Should not be combined with alcohol


4343


Stimulants (e.g., caffeine, nicotine, cocaine)

• Produce excitement or hyperactivity

• Suppress activity level in persons with attention-deficit/hyperactivity disorder (ADHD)

• Controversy exists concerning the use of these stimulants for children.• side effects• growth slowed• concern regarding overdiagnosis of ADHD


4444

PsychosurgeryPsychosurgery

The general term for surgical intervention in the brain to treat psychological disorders• The infamous prefrontal lobotomy is no

longer performed.

• Severing the corpus callosum, however, can reduce life-threatening seizures.


4545

Brain-Stimulation TherapiesBrain-Stimulation Therapies

Used to treat severe depression

Electroconvulsive Therapy (ECT) • Apply an electric current to temples briefly• Patient is put to “sleep.”• Memory deficits are a side effect.

Transcranial Magnetic Stimulation (TMS) • High-powered magnetic stimulation to the brain• Also effective for bipolar disorderDeep Brain Stimulation• Surgical implants of a micro electrode directly in

the brain• Still highly experimental


4646

Hospitalization Hospitalization and the Alternativesand the Alternatives

Therapeutic Community • Designed to bring meaning to patients’ lives• Hospital setting to help patients cope with the world

outside• Higher costs

Deinstitutionalization• Removing patients, whenever possible, from mental

hospitals

Community Mental Health Movement • Effort to deinstitutionalize mental patients and to

provide therapy from outpatient clinics


How do the Psychological How do the Psychological Therapies and Biomedical Therapies and Biomedical

Therapies Compare?Therapies Compare?While a combination of

psychological and medical therapies is better than either

alone for treating some (but not all) mental disorders, most

people who suffer from unspecified “problems in living”

are best served by psychological treatment alone.


4747

4848

DepressionDepression

Psychological vs. Medical Treatment

• Both are equally effective ways to treat depression in the short run.

• Cognitive behavioral therapy is more effective in the long run.

• A combination of both is most effective.


4949

Anxiety DisordersAnxiety Disorders

Psychological vs. Medical Treatment

• Both can be effective.

• Most effective is a combination of both.


5050

Empirically Supported Therapy (EST)Empirically Supported Therapy (EST)

Therapies validated by research evidence showing that they actually work

This research raises interesting questions about whether counselors/therapists should be limited to these therapies.• Can this guideline help practitioners to avoid

harmful therapies?• Can practitioners still meet individual needs?• How will the insurance companies be

involved?Copyright © 2012 Pearson Education, Inc. All rights reserved

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