psychology, chapter 13 therapy

Copyright 2004 - Prentice Hall 1

Cynthia K. Shinabarger Reed

Therapy

The current view of causes of psychological disorders influence treatments.

People who believed in "possession" by evil spirits Exorcism Trephining


Treatments

Exorcism

Driving out of evil spirits that are believed to have taken over the individual’s body. The spirits cause the individual to perform evil acts.


Opening of the skull

Performed for the escape or entrance of spirits.


Greek philosopher and physician Hippocrates Physical and psychological disorders have natural

causes

Also in ancient Rome Treatments

Baths

Exercise

Massage

16th & 17th centuries Accused of being witches.


Paris 18th century, mentally ill often chained to walls “Keepers”

Rarely showed compassion

Punished at will

Dr. Philippe Pinel, Needed humane care & treatment

Moral management or moral therapy Providing humane & relaxed environment = + changes in

behavior.


Benjamin Rush Introduced moral therapy at Philadelphia’s

Pennsylvania Hospital

1st general hospital in the U.S. with a separate unit for mentally ill

Yet he restrained manic patients in his tranquilizer chair He thought more humane than other restraints used

at the time.


Mid-19th century, Dorothea Dix, Union's Superintendent of Female Nurses during the Civil War

20 years fought for homeless & mentally ill

Insisted states had an obligation to provide care

Convinced legislatures in 20 states to establish or enlarge mental hospitals.


They built larger institutions to handle more patients.

Expansion caused conditions to deteriorate

Use of restraints increased


Franz Anton Mesmer Believed he could harness this magnetism as a

form of therapy to treat patients.

With modifications, his techniques evolved into hypnotism.


Sigmund Freud Psychological disorders result from unconscious

feelings and conflicts

Freud turned to other techniques when hypnosis proved less effective than he had hoped.


Early 20th century General paresis

Symptoms Paralysis

Memory difficulties

Discovered resulting from syphilis

Stimulated search for biological causes of other psychological disorders

Development of biomedical treatments Psychosurgery

Electroconvulsive (shock) therapy or ECT


Beginning 1950s, populations of mental hospitals began to decline

Drugs made it possible to control many serious symptoms.

Growing belief that community care was more effective

Deinstitutionalization Policy of discharging large numbers of patients Closing hospitals


Psychologists recognize 3 forms of prevention:

1. Primary prevention– Prevent disorders from occurring.

2. Secondary prevention– Detect existing disorders

– Provide treatment at early stages.

3. Tertiary prevention– reduce the damage caused by disorders for patients &

society.


Not everyone who seeks therapy suffers from a psychological disorder.

Cope

Loss of a job

School-related difficulties

Family problems


About 30% with psychological disorder seek treatment.

More likely to seek treatment than substance abusers Schizophrenias Bipolar disorder Panic disorder


2 treatment categories for psychological disorders: Biomedical therapies

Psychological therapies

Biomedical therapies Psychotropic drugs

ECT

Psychosurgery


Psychological therapies “talk therapies” to treatments based on principles

of learning.

Psychotherapy General term that describes psychological

treatments designed to help people resolve behavioral, emotional, and interpersonal problems and improve the quality of their lives.


Most common licensed psychotherapists are clinical and counseling psychologists, psychiatric nurses, psychiatrists, and social workers.

States regulate many mental health professions

Just beginning to regulate counselors


Psychotherapy involves a special relationship between a distressed person and a therapist in which the therapist helps the client make changes in his or her thinking, feeling, and behavior.


Psychoanalytic therapy

Goal is to uncover unconscious conflicts and feelings and bring them to the conscious level.

Freud (get to unconscious)

Free association

Dream interpretation

Resistance

Transference


Free association Relate thoughts, feelings, or images without modifying them

in any way.

Freud called dreams “the royal road to the unconscious” and distinguished between two forms of dream content: manifest and latent. Manifest content

Dream you recall when you awaken

Latent content Underlying meaning

Psychoanalyst’s interprets dreams by discovering the latent content.


Resistance Occurs during free association when the patient’s

flow of words and thoughts stops.

Cessation of associations Indicates the defense mechanism of repression is

operating to protect the ego from the anxiety generated by the thoughts and feelings revealed through the associations.


Transference

Patient’s + or - reaction to the therapist

Believed to reflect relationship to a significant person outside of therapy.

Countertransference

Therapists reaction to the client

Believed to reflect relationship to a significant person in their life.


Humanistic therapies

Emphasize the present & the ability of clients to solve their own problems once they are able to accept themselves.

Client-centered therapy

Designed to create an environment in which the client is able to find solutions to his or her problems.


Cognitive therapies Designed to change cognitions in order to

eliminate maladaptive behaviors. Thinking errors

Rational-emotive behavior therapy (RET) Therapist challenges and questions the client’s

irrational ideas. Thinking errors


Rational-emotive behavior therapy ABC framework. A = activating event

Related to an important Desire

Goal

Preference (getting the job, in our example

B = belief (thinking error) Related to failure to attain the goal, that follows the

activating event (“I’m no good because I didn’t get the job”).

C = consequences anger, anxiety, and depression.



Role of the therapist is to challenge the thinking errors.

Eysenck

Psychotherapy clients just as likely to improve w/o treatment.

Studies show psychotherapy is generally effective, although we are uncertain as to why.


Therapists increasingly aware of influence of

Ethnic

Cultural factors

Members of ethnic groups drop out early from psychotherapy

Lack of therapists speak native language

Failure to provide appropriate forms of therapy.


psychology, chapter 13 therapy

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