Chapter 13 Treatment Flashcards
Enlightment reformers of the mentally ill
- phillippe pinel, France
- Dorothea Dix, US
- helped stop the criminal-like treatment of the mentally ill
- spurred making of separate and kinder institutions
History of psychological illness treatment
1) trephining
2) Greece and Rome- biological factors that could be treated
3) Medieval Europe- demonic spirits was the cause, persecution
4) enlightment- more humane treatment with reformers
5) 1950s- development of drugs, deinstitutionalization
6) more focus on preventative efforts
Deinstitutionalization
- huge boom of ppl being released from mental institutions after development of drugs in 1950s
- but many unable to take care of themselves Once released (like schizophrenics) and ended up homeless
- needs supposed to be met on outpatient basis
Psych disorders preventative efforts
- primary- works to reduce joblessness or homelessness that may cause mental illness
- secondary- works with people at risk for specific mental illness (trauma after earthquake)
- tertiary- working to prevent peoples mental issues from becoming more severe
Psychotherapy
General term to describe any kind of therapy that treats and mind (used by all approaches except biological)
Psychological treatments
Aim to alter client’s behavior, thoughts, and/or emotions
Types of treatment psych disorders
- psychotherapy
- somatic treatments
Somatic treatments
Psych treatment used by bio approach, ex: drugs
Patient
Refers to people that come for psychoanalytic or biological treatment
Client
Refers to people that come for treatment that’s not from psychoanalytic or biological approach
Psychoanalysis
- psych treatment made by Freud
- underlying problem of psych disorder is unconscious conflicts
- lengthy and expensive
1) patient lies on couch
2) hypnosis, free association, and/or dream analysis elude ego defenses
3) therapist interpretation - side effects- transference, resistance, symptom substitution
Symptom substitution
- Side effect Of psychoanalysis
- after a person is successfully treated, develop a new psych problem
Free association
- psychoanalysis technique, patients say whatever comes to mind without thinking (no censor, no ego)
Dream analysis
Psychoanalysis technique- ask patients to describe dreams (ego relaxed in sleep), therapist judges what the latent content is
- manifest content- what the patient reports
- latent content- revealed with therapist interpretation (deeper unconscious meaning)
Transference
- psychoanalysis side effect
- patients begin to redirect strong emotions felt toward ppl they have troubling relationships with to therapist
Psychodynamic treatment
- generally see unconscious as IMp element in treatment process like in psychoanalysis, but also may use other techniques from other perspectives
Insight therapies
Therapies that highlight importance of patients or clients understanding their problems (self discovery)
Resistance
Psychoanalysis expected side effect
- when patients object to therapist interpretations
- since it’s hard for patients to come to terms with deeply repressed thoughts
Humanistic therapy
- focus on helping ppl accept themselves and self actualize
- built on belief ppl are innately good and have free will, just need support to self actualize
- client centered therapy
- gestalt therapy
- existential therapies
Client centered therapy
- Humanistic therapy made by Carl Rogers
- therapist gives patient unconditional positive regard
- non directive
- use active listening.
Non directive therapy
- in humanistic therapy, therapists don’t tell patients what to do but help patients create path for themselves
Active listening
- in client centered therapy, when the therapist only talks to clarify what the client is saying
Gestalt therapy
- Humanistic therapy made by fritz perls
- encourage clients to get in touch with their whole selves
- integrating all actions emotions and thoughts into a harmonious whole
- stress importance of the present
Existential therapy
- humanistic therapy
- believe illness caused by failure in life vision
- focus on helping clients form meaningful life perception
Behavioral therapies
- Psych disorder is learned
- counterconditioning used in systematic desensitization
- flooding
- modeling
- aversive conditioning
Counterconditioning
- behavior therapy by Mary cover jones
- unpleasant conditioned response (crying at doctors office) replaced with pleasant one (bringing candy to doctor helps)
Systematic desensitization
- behavioral therapy using counter conditioning
- made by Joseph Wolpe
- used in anxiety disorders esp phobias
- teach client to replace feelings of anxiety with relaxation
1) teach client to relax
2) make anxiety hierarchy
3) in vivo or covert desensitization, keeps going up hierarchy until client feels anxious, then take it one step lower until client is calm again
Anxiety hierarchy
Rank order list used in systematic desensitization starting from least frightening fear confrontation to most
In vivo densenstitization
Client confronts actual feared objects or situations
Covert desensitization
Client imagines the fear inducing stimuli
Flooding
- Behavioral therapy, having client address the most anxiety-inducing scenario first in anxiety hierarchy
- client realizes that their fears are irrational when nothing bad happens
- anxiety/fear extinguished
Modeling treatment
- behavioral therapy
- someone with anxiety learns by observing and imitating another behaving calmly with anxiety inducing stimulus
Aversive conditioning treatment
- behavioral therapy
- pairing a habit a person wishes to break with an unpleasant stimulus
Cognitive therapy
- changing unhealthy thought patterns
- made by Arron beck
- engage clients to engage in pursuits that will bring them success, improve attitude on their cognitive triad
- mostly used in patients with depression
Cognitive triad
People’s beliefs about themselves, their worlds, and their futures
- cognitive therapy attempts to improve your viewpts on these
Cognitive behavioral therapy
- Ex: rational emotive therapy
Rational emotive behavior
- type of cognitive behavioral therapy
- made by Albert Ellis
- therapists look to expose and confront dysfunctional thoughts to the client
- give hw where clients have to engage in the behaviors they fear
Group therapy
- less expensive and offers insight and feedback from both peers and therapist
- family therapy
- just random ppl experiencing similar difficulties
- self help groups
Family therapy
Form of group therapy
- helpful in revealing patterns of interaction bw members and altering behavior of whole family rather than one
Somatic therapies
- Believes disorders cause by biological factors
- treat it with therapies that make bodily changes
- psychopharmacology
- electro convulsive therapy
- psychosurgery
Psychopharmacology
- aka chemotherapy
- somatic drug therapy
- more severe a disorder, more likely drugs will be used to treat it
- most schizophrenics have to use this b they are not coherent enough to get psychotherapy
- drugs used for schizophrenia, mood disorders, and anxiety disorders
Schizophrenia treatment drugs
- drugs that block receptor sites for dopamine
- side effects: tardive dyskinesia
- ex: Thorazine and hardol
Tardive dyskinesia
Parkinson-like chronic muscle tremors
- side effect of antipsychotic drugs for schizophrenics that limit dopamine levels
Mood disorder treatment drugs
For Depression
- tricyclic antidepressants
- monoamine oxidase inhibitors
- serotonin reuptake inhibitor drugs(ex: Prozac)
- all try to increase serotonin
For Manic phase
- lithium
Anxiety treatment drugs
- depress activity of central nervous system
1) barbiturates (ex: Miltown)
2) benzodiasepines (ex:Xanax and Valium)
Electro convulsive therapy
- Patients given muscle relaxant to minimize effects of procedure
- electrical current is passed thru the brain
- causes brief seizure
- can be bilateral (current thru both hemispheres) or unilateral (just one)
- bilateral- more effective but more neg side effects (memory loss)
- used mostly for severe depression
Psychosurgery
- rarest form of somatic treatment, last resort
- purposeful destruction of part of the brain to change or calm patient behavior
Ex: prefrontal lobotomies very common back then
Kinds of therapists
- psychiatrist
- clinical psychologist
- counseling therapist
- psychoanalysts
Psychiatrist
- only therapists allowed to prescribe meds (more biomedical than psychotherapy)
Clinical psychologist
- has phd
- usly deals with ppl with psych disorders
Counseling therapist
- some kind of grad degree
- help ppl with less severe problems than clinical psych
Psychoanalysts
- graduate from special Freudian schools
