Treatment of Psychological Disorders Flashcards
How many Canadians suffer from mental illness?
1 in 5
What percentage of mentally ill Canadians seek help?
40%, but 1 in 3 report needs being unmet or partially unmet
What’s the delay in seeking treatment after onset of mental disorder?
A decade
Why do people fail to seek treatment?
- People may not realize they have a mental disorder that can be treated
- There may be barriers to treatment (beliefs and circumstances)
- Structural barriers prevent people from physically getting to treatment
People may not realize they have a mental disorder that can be treated
- 45% of people think they do not need to be treated
- Mental iIlness often are not taken as serious as
physical illnesses - Misunderstanding that mental illness can be
treated; unsure what treatment looks like
Barriers to treatment (beliefs and circumstances)
- Belief they should be able to handle things themselves
- Belief that problem is not severe
- Belief that treatment would be ineffective
- Perceived stigma from others
Structural barriers to getting treatment
- Affordability of treatment
- Lack of clinician availability
- Inconvenience of attending treatment
- Trouble finding transport to the appointments
Psychologist
PhD or PsyD in clinical psychology, training in therapy, assessment of psychological disorders, and research
Psychiatrist
MD with training in assessment and treatment of mental disorders; can prescribe medication
Clinical social worker
MA in Social Work and training; clinical or psychiatric social workers receive specialized training
Counselor
MA or PhD with specialized training; lots of variety
Psychological treatment
People interact w/ a clinician to use environment to change their brain and behaviour
Biological treatment
Brain is treated directly with drugs, surgery, or direct
intervention
Treatments we’ve moved away from
- Hydrotherapy (pouring cold water on people w/ mental
disorders)
– Trephination (drilling holes to let evil spirits escape)
– Bloodletting (removal of blood from the body)
Psychotherapy
Interaction between a clinician and someone suffering from a psychological problem with goal of providing
support or relief for the problem
Most common types of psychotherapy
- Psychodynamic
- Humanistic/existential
- Behavioural cognitive therapies
- Group therapies
- Eclectic psychotherapy
Eclectic psychotherapy
Drawing on techniques from different forms of therapy depending on client and the problem
Psychodynamic therapies
Explore childhood events and encourage individuals to develop insight into psychological problems; encourages clients to bring repressed conflicts into
consciousness so they can understand them and reduce their unwanted influences
What goes on in psychodynamic therapy sessions?
- Four/five sessions a week for 3-6 years
– Client faces away from analyst and is asked to express thoughts
and feelings that come to mind
– Therapist may comment, but does not express values orjudgments
What happens in psychoanalysis?
- Free association
- Dream analysis
- Interpretation
- Analysis of resistance
- Transference
Free association
Client reports every thought that enters their mind
without censorship or filtering; stream of consciousness
Dream analysis
Dreams as metaphors for unconscious conflicts or
wishes that contain clues that the therapist can help the client understand
Interpretation
Therapist deciphers meaning behind what clients says/does
Analysis of resistance
Therapist suggests an interpretation client finds unacceptable; resistance is sign on the right track
Transference
Analyst begins to assume a major role in client’s life
and clients reacts based on unconscious childhood fantasies; analyst then responds to it
Interpersonal psychotherapy (IPT)
- Focuses on helping clients improve current relationships
– No free association or interpretation
– Therapists talk to clients about interpersonal feelings and behaviours
– Look for signs of grief, role disputes, role transitions, or interpersonal deficits
– Therapy is less intensive; few months once a week
Goal of IPT
Relief from symptoms
How effective are psychodynamic techniques?
– Less effective than other methods
– Aspects of therapy may be harmful (e.g., interpretations that threaten client-patient relationship)
Humanistic/existential therapies
- Emphasize natural tendency for each individual to
strive for personal improvement - Issues stem from feelings of alienation and
loneliness; failures to reach one’s potential (humanistic) or meaning in life (existential)
Types of humanistic/existental therapies
- Person-centered therapy (humanistic)
– Gestalt therapy (existential)
Person-centered therapy
- Individuals have a tendency toward growth; facilitated by acceptance and genuine reactions from the therapist
- Client creates own goals for therapy; with enough support the client will recognize the right thing to do
- Three basic qualities: congruence, empathy and unconditional positive regard
Congruence
Openness/honesty across all matters of discussion
Empathy
Understand what the client is feeling/thinking; seeing the world from their perspective to appreciate concerns
Unconditional positive regard
Nonjudgmental, warm, and accepting environment
Gestalt therapy
- Help the client become aware of his or her thoughts,
behaviours, experiences, and feelings and to take
responsibility - Encouraged to be warm toward their clients but reflect back to client their impressions
- Use technique of focusing: asking them to think about how a past experience makes them immediately feel
- Use of role-playing to imagine how another person would respond
Behavioural and cognitive therapies
Actively changing a person’s current thoughts and
behaviours as a way to decrease or eliminate their psychopathology
Types of behavioural/cognitive therapies
- Behavioural therapy
- Cognitive therapy
- Cognitive behavioural therapy (CBT)
Behavioural therapy
Assumes disordered behaviour is learned; symptom relief is achieved through changing overt maladaptive behaviours into more constructive behaviours. Three techniques: eliminating unwanted behaviours, promoting desired behaviours, and reducing unwanted emotional responses.
Eliminating unwanted behaviours
Behaviour is influenced by its consequences
– Problem behaviour could be eliminated by making
consequences less reinforcing and more punishing
Promoting desired behaviours
Use of token economies (tokens for desired behaviours which can be used for rewards)
Reducing unwanted emotional responses
Use of exposure therapy (confronting an emotion-arousing stimulus directly and repeatedly, leading to a decrease in the emotional response)
– Live exposure is better than imaginary exposure
– Use of exposure hierarchies
Cognitive therapy
Helping a client identify and correct any distorted thinking about self, others, or the world
- Technique of cognitive restructuring
- Mindfulness meditation
Technique of cognitive restructuring
Teaching clients to question the automatic beliefs, assumptions, and predictions that lead to negative emotions and replace negative thinking with more realistic and positive beliefs
Mindfulness meditation
Teaches an individual to be fully present in each moment; be aware of thoughts, feelings, sensations; detect symptoms before they become a problem
Cognitive behavioural therapy (CBT)
- Most helpful for treating anxiety and depression
- Acknowledges there are behaviours that people
cannot control with rational thought, but there are
ways to help people think more rationally - Transparent, problem focused and action orientated
- Client is expected to do things: exercises, practice
behaviour change skills, use a diary to monitor
symptoms
Couples therapy
Married, cohabitating, or dating couple is seen together in therapy to work on problems arising in the relationship; problem is the relationship not individual person
Family therapy
Psychotherapy with members of a family; client is the family
Group therapy
Multiple participants (who don’t know each other) work on their individual problems in a group atmosphere; common for substance abuse or addictions
Self-help and support groups
Discussion groups that focus on a particular disorder or difficult life experience; run by peers that have struggled with the same issues; for both the person suffering and the support people
Biological treatments traditionally
- Theriac: different ingredients, including opium!
– Use of cocaine, but negative side effects led to removed use
Biological treatments now
Target specific neurotransmitters in the brain associated w/ the cause of mental disorders
