Therapy

• Any treatment process for mental disorders

• Variety of types

Psychological (psychotherapy)

Biomedical

• Common element: a relationship focused on change.

Obstacles to Therapy

• Stigma

• Lack of money or insurance

• Lack of qualified therapists

• Certain types of disorders

Friend or Therapist ?

• Friend may have own needs.

• Therapist is confidential.

• Friend may not have expertise.

Basic Tasks of Therapy

• Problem Indentification

• Etiology (cause)

• Prognosis

• Treatment Plan

Mental Health Care Professionals

• Counseling psychologist

• Clinical psychologist

• Psychiatrist

• Psychoanalyst

• Psychiatric nurse practitioner

• Clinical social worker

• Pastoral counselor

Psychological Therapies

• Behavioral--change learned habit patterns.

• Cognitive--restructure thinking patterns.

• Psychodynamic--develop insight into unresolved hidden conflicts.

• Humanistic--emphasize freedom of choice and development of healthy relationships

Behavioral Therapies

• Based on operant and classical conditioning.– Counterconditioning– Systematic desensitization– Aversion therapy– Contingency management– Token economy

Cognitive Therapies

• Emphasize rational thinking as key to changing emotions and behavior.

• Both – what we think (content)– how we think (process)

• Emotional dysfunction comes from irrational beliefs not an event itself.

Beck’s Approach

• Negative self-talk becomes automatic

• Evaluate the evidence for and against these automatic thoughts

• Discover alternate thoughts

Rational Emotive Behavioral Therapy (REBT)

• Founder--Albert Ellis

• Emotional and behavioral problem develops from irrational beliefs not the event itself.

• Therapist challenges the irrational beliefs.

Irrational Beliefs

• I must always succeed.

• I should always receive approval.

• I should always be treated fairly.

• My experiences should always be pleasant.

Cognitive-behavioral Therapy

• Most contemporary form of psychotherapy

• Combines cognitive techniques to change thinking with alterations in reinforcement contingencies.

Research on Psychotherapy

• Therapy better than no therapy.

• Longer better than short therapy.

• All forms of therapy equally effective.

• Best to match specific therapies to specific conditions.

Counseling Your Friends/Family

• Best to refer to professionals if serious.

• Try to avoid advice-giving.

• Use non-directive techniques.

Non-directive Techniques

• Active Listening

• Acceptance

• Exploration of Alternatives

Active Listening

• Use paraphrasing.

• Ask for clarification.

• Shows interest and empathy.

• Helps the person organize their thinking about the problem.

Unconditional Acceptance

• Non-judgmental attitude

• Accept the person and the problem.

Exploration of Alternatives

• Help identifying other potential choices.

• Explore the consequences of each.

• Point out that doing

• Remember the choice is up to the individual who owns the problem.

Biomedical Therapies

• Treatments that focus on altering the brain.

• Based on the medical model of abnormality.

• Drug Therapy

• Psychosurgery

• Electroconvulsive and Magnetic Therapies

Antipsychotic Drugs

• Developed in 1950’s

• Thorazine, Haldol

• Major tranquilizers

• Also diminish psychotic symptoms

• Reduce the activity of neurotransmitter dopamine

Antidepressant Drugs

• Lift depressed mood.

• Most common now are SSRIs.

• Prolong action of neurotransmitter serotonin.

• Prozac, Zoloft, etc.

• Side effects but not addictive.

Antianxiety Drugs

• Diminish feelings of anxiety.

• Increase activity of neruotransmitter GABA

• Most common now are benzodiazepines such as Valium or Xanax.

• Have side effects and are addictive.

Stimulants

• Used to treat narcolepsy and ADHD.

• Ritalin

• Increase availability of neurotransmitters dopamine and/or serotonin.

Other Biomedical Therapies

• Psychosurgery--frontal lobotomy, split brain

• Electroconvulsive Therapy (ECT)-treats depression by causing seizures

• Hospitalization--asylum and therapeutic community

• Deinstitutionalization--community mental health movement