Treatment and Therapies What is therapy What are

Treatment and Therapies What is therapy? What are the different types of therapy? How does each type address cause of behavior and focus of treatment.

Think of a Bad Habit you have… How would you acquire it using the following approaches? ü Behavioralist. ü Cognitive Approach ü Biological Approach ü Social-Cultural How would you treat it using the same approaches?

What is therapy? �Any treatment process to change mental, behavioral or social functioning �Rosenhan’s Study (1970’s)

Goals of Therapy �Identify the problem (Diagnosis) �Identify the cause of the problem (Etiology) �Decide on a form of treatment �Best treatment for diagnosis

Who goes to therapy? �severe, or persist for an extended amount of time �MUUDI

History of Therapy �Medieval Europe: (1300 -1900) �Work of the devil �Asylum Approach (1500’s) �Shield the stress of the world out �Pioneers in Psych: �Phillipe Pinel: Remove the chains=Calmer patients (1745 -1826) �Hosted Lunatic Balls �Dorothea Dix: helped state funded mental hospitals (1802 -1887)

History of Therapy �Modern Approach (1900 -2000) � 50’s hospitals were not overly helpful (lobotomy) �Deinstutionalized efforts: �Psychological Therapy: � Focus on changing disordered thoughts, feelings and behaviors (psychotherapy, humanistic, cognitive, behavioral, group/family) �Biomedical Therapy: � Focus on changing the underlying biology of the brain � Drugs, Surgery, Electromagnetic probes

Culture influences Treatments �Different religious and spiritual beliefs

Type of Professional Specialty Counseling Psychologists- MA Psych Common problems of normal living (non -disorder)-Talk Therapy Clinical Psychologists---Ph. D in Psych Treat severe disorders- Anxiety, OCDTalk Therapy, Insight Therapy Psychiatrists—Medical Doctor Prescribes medicine (Bio. Medical)Schizophrenia, Severe Depression, Suicide Psychoanalyst- MD Practices Freudian ideas/therapies Psychiatric Nurse-RN with special training Prescribes drugs Clinical Psychiatric Social Worker- MA in Deals with social and environmental Social Work disorders Pastoral Counselor Spiritual Guidance

Perspectives of Therapy �Mirror Perspectives of Psychology: �Insight Therapy: Gain insight to understanding problems �Psychoanalysis: �Humanistic: �Cognitive: �Behavioral Therapy: Change Behaviors �Behavioral- �Bio. Medical Therapy: Change Brain Balance �Biological: Neurotransmitters, Hormones, Drug Therapy, Psychosurgery �ECCLECTIC Blends of Therapies are COMMON!

Psychoanalytic Therapy �Cause of Behavior: � Hidden problems in Un. C (Psycho. Sexual, Trauma) �Goal of Treatment � ID is the Focus: Sexual Desires, childhood � No cure but a long process �Key Terms/Players � Free Association: Say what comes to mind w/o thinking � Dream Anaylsis: Latent vs. Manifest Content � Hypnosis � Freud � Transference (problems of the patient are transferred to therapist) � Catharsis: therapeutic release of emotions/mostly anger!

Neo-Freudian Therapy �Cause of Behavior: �Emphasis on motivation on WHY �More on conscious level �Goal of Treatment �Ego is the central focus (want to strengthen ego) �Social Needs �Meet several times a week �Key Terms/Players �Alfred Adler �Carl Jung �Karen Horney

Humanistic Therapies �Cause of Behavior �Poor Self Concept �Social Pressure �Goals of Treatment �Enhance Self Esteem �Realize full potential (Self-Actualized) �Focus on the PRESENT not PAST

Humanistic Therapies �Key Terms/Players: �Carl Rogers: Client Centered Therapy! Unconditional Positive Regard (geniuness, acceptance and empathy) � Active Listening: Therapist recites thoughts of client so they hear it back � NOT DETERMISTS…. . you CAN CHANGE � �Types of Therapy: �Client Centered Therapy � Unconditioned Positive Regard �Group Therapy � Works with addiction and communication issues � Self Help/Support Systems � AA �Family Therapy � Communication, Support

Behavioral Therapies �Cause of Behavior: �Behaviors have been learned �Goal of Treatment: �To Unlearn negative behaviors �Key Terms/Players: �BF Skinner: Operant Conditioning (Rewards/Consequences) �Mary Cover Jones: Counter-Conditioning ( �Joseph Wolpe: Systematic Desenitization (replace anxiety with relaxation) PHOBIAS!!

Counter. Conditioning & Aversion Therapy �Cause of Behavior: �Reactions to learned associations �Phobias/addictions �Goal of Treatment: �Systematic desensitization: Progressive Relaxation, Anxiety Heirarchy Exposure Therapy and Flooding (address most frightening stimuli first) �Aversion Therapy: pair a bad habit with something averse �Symptom Substitute �Key Players: Mary Cover Jones and Joseph Wolpe

Operant Conditioning & Token Economies �Cause of Behavior �Behavior is a result of consequences “learned behaviors” �Goal of Treatment: �Shape new behaviors �Token Economies: Desired behaviors awarded with tokens � Reward system used in prisons �Key Terms/Players �Skinner �Thorndike

Observational Learning �Cause of Behavior �Learned from watching others (racism, fear of birds) �Goal of Treatment �Two Types � Symbolic: provide models indirectly through movies, etc � Desensitization Therapy: direct exposure �Key Terms/Players �Bandura

Cognitive Therapy �Cause of Behavior: �Negative “Self Talk”(“I’m stupid”, “I’m ugly”, “I can’t”) �Irrational or Faulty thought processes/perceptions �Goal of Treatment �Ask questions in a way to solve problems �Attributional Style: Internal or External Locus of Control? �Key Terms/Players �Aaron Beck’ s Cognitive Triad

Aaron Beck �Similar to Ellis with RET �Believed Depressed people have a cognitive triad that needed to be treated �Depressed people have “dark sunglasses” and they have negative views of � Self � World � Future �Must treat all three views

Cognitive-Behavioral Therapy (CBT) �Cause of Behavior: �Thought process produces behavior �Goal of Treatment �Change one’s thoughts to change actions �Educates client on destructive thoughts �FOCUS on BOTH BEHAVIOR and THOUGHTS �Example: Smoking �Key Terms/Players �Albert Ellis=REBT

Albert Ellis’ REBT �REBT= Rational Emotional Therapy �Challenge people’s perceptions using confrontational therapy �ABC’s of Emotional Disturbance �A=Antecedent (Fail a test) �B=Belief/Behavior (I’m Stupid) �C=Consequence (depression) ----------Ellis adds two things---------�D=Dispute Belief and Consequence substitute new belief �E=Evaluate new feelings

Evaluate Psychological Therapies �Eysenck: �Brit psychologist claimed 2/3 of people with nonpsychotic problems will get better w/in 2 years whether or not they have treatment �Major BACKLASH- lots of studies started in therapy �Some types are better for specific disorders �Smith/Glass=behavior therapy best for anxiety �Therapy is NOT a CURE! �Depression does get better with treatment �Most people do not get help (money, shame, lost in their own emotions, don’t reach out)

Eclectic is BEST! �The BEST therapy is one which is eclectic or mixes various aspects of perspectives to meet the needs of the patients.

Bio. Medical Approach Drug Therapy Purpose Controversy/Side Effects Antipsychotic Drugs. Help with treating (+) Tarditive dyskinesia (loss of Chlorpromazine, Thorazine, symptoms of Schizophrenia, motor control) Clozapine, Haldol Reduce dopamine (block receptors) Antidepressant & Mood Stabilizers: Prozac SSRI (selective serotonin reuptake inhibitor) Prevents serotonin from being reabsorbed SSRI’s mask real problem Antidepressant & Mood Stabilizer: Lithium (metal) Helps in treating both moods (bipolar) Toxic, Suicide Antidepressant & Mood Stabilizer: Monoamine oxidase (MAO) Drug that inhibits an enzyme which breaks down norepinephrine (it is needed to send messages)

Bio. Medical Approach Drug Therapy Purpose of Drug Controversy/Side Effects Antianxiety Drugs: Barbiturates Valium, Xanax, Paxil for (OCD, Phobia, GAD) Relaxation Effects Depresses Nervous System Create more GABA Addicting Dangerous when mixed with other drugs and alcohol Stimulants: Ritalin/Caffeine for ADHD, narcolepsy Increases dopamine, serotonin, glutamate Messes up sleep patterns, slow/stunt growth, over prescribed

Bio. Medical in Review �Lithium= Lithium batteries charged with + and – charges like bipolar (mania and depression) �Xanax=X=Anxiety �Psychopharmacology –The prescribed use of drugs to help treat symptoms of mental illness in order for individuals to be more receptive to talk therapies �Medications can do many things: � Some release specific transmitters � Some block the reuptake of transmitters � Some interact with postsynaptic receptors � Some may act within neuron cells

Psychosurgery �Surgical intervention to treat a mental disorder �Prefrontal lobotomy �Severing Corpus Callusum for Epilepsy �Electroconvulsive Therapy: (ECT) �Brain stimulation through electrodes �Immediate results for reasons unknown �Deep Brain Stimulation…. for Bi. Polar and Depression

Therapeutic Community �Community based on mental health issues � Outpatient basis � Created by Maxwell Jones �Deinstitutionalization means discharging/taking out patients from institutes that deal with mental illness. � As more drug therapies were introduced less institutions were needed. More people were mainstreamed into society. �Common questions before therapy: � Is treatment needed? � What are the specific behavior problems � Would group therapy or client center work best? � Is the problem based on stress, confusion or choice?