5th Edition
Therapy
Chapter 13
Copyright © Prentice Hall 2007 13-1
Therapy Through The Ages
• Throughout history, prevailing views of the
causes of psychological disorders have
influenced t...
Therapy Through The Ages
• In the 18th century, mentally ill people in Paris
were often chained to walls.
• The attendants...
Therapy Through The Ages
• In the mid-19th century, Dorothea Dix, a former
teacher, became concerned about the plight of
h...
Therapy Through The Ages
• As the states assumed more responsibility for
custodial care of the mentally ill, economics
dic...
Therapy Through The Ages
• Sigmund Freud, an early
advocate of hypnotism as a
therapeutic technique,
developed the notion ...
Therapy Through The Ages
• Early in the 20th century, the disorder known as
general paresis, which included symptoms such ...
Therapy Through The Ages
• Beginning in the 1950s, the populations of mental
hospitals began to decline.
• One reason for ...
Therapy Through The Ages
• In 1963, Congress passed the Community
Mental Health Centers Act.
• This law provided funds for...
Therapy Through The Ages
• Psychologists recognize three forms of prevention:
primary, secondary, and tertiary.
• Primary ...
Therapy Through The Ages
• Not everyone who seeks
therapy suffers from a
psychological disorder.
• Some people need help
t...
Therapy Through The Ages
• About 30% of individuals
with a psychological
disorder seek treatment.
• Those with
schizophren...
Therapy Through The Ages
• There are two treatment categories for
psychological disorders: biomedical and
psychological th...
Therapy Through The Ages
• Psychological therapies range from “talk
therapies” to treatments based on the
principles of le...
Therapy Through The Ages
• Members of several professions as well as paraprofessionals
provide psychotherapeutic services....
Psychologically Based Therapies
• Although it is convenient to distinguish among
various forms of psychotherapy, clinical
...
The Primary Theoretical Orientations of
Clinical Psychologists
Copyright © Prentice Hall 2007
13-17
Psychologically Based Therapies
• Psychotherapy involves a special relationship
between a distressed person and a therapis...
Psychologically Based Therapies
• Psychoanalytic therapy is a treatment of
maladaptive behavior developed by
Sigmund Freud...
Psychologically Based Therapies
• In free association, patients are asked to relate
thoughts, feelings, or images without ...
Psychologically Based Therapies
• Resistance occurs during free association when
the patient’s flow of words and thoughts ...
Psychologically Based Therapies
• Humanistic therapies emphasize the present and
the ability of clients to solve their own...
Psychologically Based Therapies
• Rational-emotive behavior therapy is a cognitive
therapy in which the therapist challeng...
Psychologically Based Therapies
Copyright © Prentice Hall 2007
13-24
• Therefore, the role of the therapist is to
challeng...
Psychologically Based Therapies
• Systematic
desensitization is an
effective treatment for
phobias in which clients
are ta...
Psychologically Based Therapies
• Aversion therapy uses
unpleasant or painful
stimuli such as electrical
shock, nausea-ind...
Psychologically Based Therapies
• Aversion therapy is based on classical
conditioning principles; it involves the
repeated...
Psychologically Based Therapies
• In this procedure a person —live or on
videotape—demonstrates gradual contact
with the f...
Psychologically Based Therapies
• Token economy is a technique that reinforces
desirable behaviors with tokens (secondary
...
Psychologically Based Therapies
• Group therapy is a therapy in which clients
discuss problems in groups that may include
...
Psychologically Based Therapies
• Marital therapy (also called couples therapy)
typically attempts to stabilize and improv...
Psychologically Based Therapies
• Most self-help groups are developed and run
by laypersons, although some invite
professi...
The Effectiveness of Psychotherapy
• Therapists are becoming increasingly aware of
the influence of ethnic and cultural fa...
The Effectiveness of Psychotherapy
• The decision to enter psychotherapy should
involve asking questions about;
–the degre...
The Effectiveness of Psychotherapy
• Current forms of psychotherapy are offered in
fewer sessions than in the past.
• Many...
Biomedical Therapies
• Antipsychotic drugs reduce the symptoms of
schizophrenia by blocking dopamine receptors
in the brai...
Biomedical Therapies
• Proponents of drug therapy believe that the
increased use and effectiveness of drugs
heralded a new...
Biomedical Therapies
• But they cannot replace lost social skills or
teach patients how to interact with family
members an...
Biomedical Therapies
• Psychosurgery is the alteration of brain tissue
in an attempt to alleviate psychological
disorders....
Upcoming SlideShare
Loading in …5
×

Chapter 13 - www.drewmikita.com

826 views
749 views

Published on

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
826
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
14
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Chapter 13 - www.drewmikita.com

  1. 1. 5th Edition Therapy Chapter 13 Copyright © Prentice Hall 2007 13-1
  2. 2. Therapy Through The Ages • Throughout history, prevailing views of the causes of psychological disorders have influenced treatments. • Some people believed in "possession" by evil spirits, so they used treatments such as exorcism or trephining. • Some cultures still believe in evil spirits causing mental health issues Copyright © Prentice Hall 2007
  3. 3. Therapy Through The Ages • In the 18th century, mentally ill people in Paris were often chained to walls. • The attendants, or “keepers” as they were called, rarely showed compassion and even administered punishment when they deemed it necessary. • A physician, Philippe Pinel, argued that these patients needed humane care and treatment. – How are you suppose to recover unless you get humane treatment? Copyright © Prentice Hall 2007 13-3
  4. 4. Therapy Through The Ages • In the mid-19th century, Dorothea Dix, a former teacher, became concerned about the plight of homeless and disturbed people. • Her survey of Massachusetts institutions that housed the mentally ill yielded numerous examples of misery and horror. • Dix insisted that the states had an obligation to provide care for the mentally ill and she convinced legislatures in 20 states to establish or enlarge mental hospitals. • http://www.forgottenoh.com/Ridges/ridges.html Copyright © Prentice Hall 2007 13-4
  5. 5. Therapy Through The Ages • As the states assumed more responsibility for custodial care of the mentally ill, economics dictated that they build larger institutions to handle more patients. • As the institutions expanded, conditions deteriorated and the use of restraining devices increased. • Thus the level of care went down Copyright © Prentice Hall 2007 13-5
  6. 6. Therapy Through The Ages • Sigmund Freud, an early advocate of hypnotism as a therapeutic technique, developed the notion that psychological disorders result from unconscious feelings and conflicts, which required a different approach to therapy. • Freud later turned to other techniques when hypnosis proved less effective than he had hoped. Copyright © Prentice Hall 2007 13-6
  7. 7. Therapy Through The Ages • Early in the 20th century, the disorder known as general paresis, which included symptoms such as paralysis and memory difficulties, was found to result from syphilis. – Why is this important? • This finding stimulated the search for biological causes of other psychological disorders, as well as the development of biomedical treatments such as psychosurgery and electroconvulsive (shock) therapy. • http://www.ect.org/video/index.shtml – 3rd video down Copyright © Prentice Hall 2007 13-7
  8. 8. Therapy Through The Ages • Beginning in the 1950s, the populations of mental hospitals began to decline. • One reason for this decline was the use of drugs, which made it possible to control many serious symptoms. • At the same time, there was a growing belief that community care was more effective than hospitalization. • Numerous factors led to deinstitutionalization, a policy of discharging large numbers of patients from mental hospitals and then closing part or all of those hospitals. Copyright © Prentice Hall 2007 13-8
  9. 9. Therapy Through The Ages • In 1963, Congress passed the Community Mental Health Centers Act. • This law provided funds for the establishment of community mental health centers in which patients would be treated on an outpatient basis. • In addition, the 1963 law helped finance community-based programs to prevent mental illness. Copyright © Prentice Hall 2007 13-9
  10. 10. Therapy Through The Ages • Psychologists recognize three forms of prevention: primary, secondary, and tertiary. • Primary prevention is designed to prevent disorders from occurring. • Secondary prevention is designed to detect existing disorders and provide treatment at early stages. • The goal of tertiary prevention is to reduce the damage caused by disorders for both the patients and society. Copyright © Prentice Hall 2007 13-10
  11. 11. Therapy Through The Ages • Not everyone who seeks therapy suffers from a psychological disorder. • Some people need help to cope with such lifestyle events as the loss of a job, school-related difficulties, or family disagreements. • Many people go to therapy, high level athletes, business people, me, any one who wants to help improve their life Copyright © Prentice Hall 2007 13-11
  12. 12. Therapy Through The Ages • About 30% of individuals with a psychological disorder seek treatment. • Those with schizophrenia, bipolar disorder, or panic disorder are more likely to seek treatment than individuals with substance-use disorders. Copyright © Prentice Hall 2007 13-12
  13. 13. Therapy Through The Ages • There are two treatment categories for psychological disorders: biomedical and psychological therapies. • The biomedical therapies use psychotropic drugs (drugs that affect the brain), electroconvulsive therapy, and psychosurgery to alter brain functioning and thus reduce symptoms. Copyright © Prentice Hall 2007 13-13
  14. 14. Therapy Through The Ages • Psychological therapies range from “talk therapies” to treatments based on the principles of learning. • Psychotherapy is a general term that describes psychological treatments designed to help people resolve behavioral, emotional, and interpersonal problems and improve the quality of their lives. Copyright © Prentice Hall 2007 13-14
  15. 15. Therapy Through The Ages • Members of several professions as well as paraprofessionals provide psychotherapeutic services. • The term therapist encompasses a diverse group of people with different backgrounds. • Included here are people with a master’s or doctoral degree in psychology and people with a medical degree and special training in psychiatry, as well as self-designated psychotherapists. • Among the most common types of licensed psychotherapists are clinical and counseling psychologists, psychiatric nurses, psychiatrists, and social workers. • Although states regulate many mental health professions, they do not regulate practitioners like psychotherapists or counselors. Copyright © Prentice Hall 2007 13-15
  16. 16. Psychologically Based Therapies • Although it is convenient to distinguish among various forms of psychotherapy, clinical psychologists are increasingly using elements of different therapeutic approaches in treating their clients. • The use of components from several therapies is called an eclectic or integrative approach. Copyright © Prentice Hall 2007 13-16
  17. 17. The Primary Theoretical Orientations of Clinical Psychologists Copyright © Prentice Hall 2007 13-17
  18. 18. Psychologically Based Therapies • 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. • Trust is a big part of counseling! Copyright © Prentice Hall 2007 13-18
  19. 19. Psychologically Based Therapies • Psychoanalytic therapy is a treatment of maladaptive behavior developed by Sigmund Freud; its goal is to uncover unconscious conflicts and feelings and bring them to the conscious level. • Freud used free association, dream interpretation, resistance, and transference to probe beneath the surface of a patient’s conscious feelings and thoughts. Copyright © Prentice Hall 2007 13-19
  20. 20. Psychologically Based Therapies • In free association, patients are asked to relate thoughts, feelings, or images without modifying them in any way. – Volunteer? • Freud called dreams “the royal road to the unconscious” and distinguished between two forms of dream content: manifest and latent. • Manifest content is the dream you recall when you awaken; latent content is the underlying meaning of that dream. • The psychoanalyst’s task is to interpret dreams by discovering the latent content. • With Freud it was all sexual!!! Copyright © Prentice Hall 2007 13-20
  21. 21. Psychologically Based Therapies • Resistance occurs during free association when the patient’s flow of words and thoughts stops. • The cessation of associations might indicate that 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 refers to the patient’s positive or negative reaction to the therapist, which is believed to reflect the patient’s relationship to a significant person outside of therapy. Copyright © Prentice Hall 2007 13-21
  22. 22. Psychologically Based Therapies • Humanistic therapies emphasize the present and the ability of clients to solve their own problems once they are able to accept themselves. • Client-centered therapy is designed to create an environment in which the client is able to find solutions to his or her problems. • Gestalt therapy is a humanistic form of therapy developed by Fritz Perls in which therapists may frustrate and challenge clients to lead them toward self-acceptance. • Cognitive therapies are designed to change cognitions in order to eliminate maladaptive behaviors. Copyright © Prentice Hall 2007 13-22
  23. 23. Psychologically Based Therapies • Rational-emotive behavior therapy is a cognitive therapy in which the therapist challenges and questions the client’s irrational ideas. • Rational-emotive behavior therapy is understood best in terms of what Ellis calls the ABC framework. • A represents an activating event related to an important desire, goal, or preference (getting the job, in our example); B is the belief, usually related to failure to attain the goal, that follows the activating event (“I’m no good because I didn’t get the job”). • That belief determines C, consequences, such as feelings of anger, anxiety, and depression. Copyright © Prentice Hall 2007 13-23
  24. 24. Psychologically Based Therapies Copyright © Prentice Hall 2007 13-24 • Therefore, the role of the therapist is to challenge the client's irrational beliefs.
  25. 25. Psychologically Based Therapies • Systematic desensitization is an effective treatment for phobias in which clients are taught relaxation techniques and then asked to imagine or approach feared situations gradually. Copyright © Prentice Hall 2007 13-25
  26. 26. Psychologically Based Therapies • Aversion therapy uses unpleasant or painful stimuli such as electrical shock, nausea-inducing drugs, or repugnant tastes or smells to decrease unwanted behavior. Copyright © Prentice Hall 2007 13-26
  27. 27. Psychologically Based Therapies • Aversion therapy is based on classical conditioning principles; it involves the repeated pairing of a problem behavior with an aversive stimulus. • One of the most effective techniques for treating phobias is modeling, or observational learning. Copyright © Prentice Hall 2007 13-27
  28. 28. Psychologically Based Therapies • In this procedure a person —live or on videotape—demonstrates gradual contact with the feared object under controlled or protected circumstances. • The client observes these behaviors and is given the opportunity to engage in similar behaviors. Copyright © Prentice Hall 2007 13-28
  29. 29. Psychologically Based Therapies • Token economy is a technique that reinforces desirable behaviors with tokens (secondary reinforcers), which can be redeemed for other reinforcers, especially primary reinforcers. Copyright © Prentice Hall 2007 13-29
  30. 30. Psychologically Based Therapies • Group therapy is a therapy in which clients discuss problems in groups that may include individuals with similar problems. • Some of the advantages of group therapy are social support and opportunities to practice coping skills and to receive feedback. Copyright © Prentice Hall 2007 13-30
  31. 31. Psychologically Based Therapies • Marital therapy (also called couples therapy) typically attempts to stabilize and improve the relationship of two individuals who regard themselves as marital partners. • Family therapy focuses on the larger family unit: a parent and a child at a minimum, or both parents, stepparents, or grandparents, depending on the environment in which the child lives. Copyright © Prentice Hall 2007 13-31
  32. 32. Psychologically Based Therapies • Most self-help groups are developed and run by laypersons, although some invite professional therapists to help with unusual cases. • People in these groups pool their knowledge, share their experiences with common problems, and help one another. Copyright © Prentice Hall 2007 13-32
  33. 33. The Effectiveness of Psychotherapy • Therapists are becoming increasingly aware of the influence of ethnic and cultural factors on psychotherapy. • Members of many ethnic groups drop out early from psychotherapy, in part because there is a dearth of therapists who share their native language as well as a failure to provide appropriate forms of therapy. Copyright © Prentice Hall 2007 13-33
  34. 34. The Effectiveness of Psychotherapy • The decision to enter psychotherapy should involve asking questions about; –the degree of distress one is experiencing; –one's ability to cope with that distress; –the effect of the symptoms on oneself, one's family, and one's work. Copyright © Prentice Hall 2007 13-34
  35. 35. The Effectiveness of Psychotherapy • Current forms of psychotherapy are offered in fewer sessions than in the past. • Many symptoms, especially distress symptoms, respond quickly to treatment. • There is also a growing recognition that there are limits to what aspects of our behavior can be changed. • A final concern about beginning and continuing therapy deals with stigma. Copyright © Prentice Hall 2007 13-35
  36. 36. Biomedical Therapies • Antipsychotic drugs reduce the symptoms of schizophrenia by blocking dopamine receptors in the brain. • The typical antipsychotic drugs work by blocking dopamine, whereas the atypical drugs (such as Clozapine) also block serotonin. Copyright © Prentice Hall 2007 13-36
  37. 37. Biomedical Therapies • Proponents of drug therapy believe that the increased use and effectiveness of drugs heralded a new era in treating psychological disorders. • Drugs can make some patients more manageable for therapists and hospital staff, reduce patients’ anxiety levels, lift a depressed mood, and eliminate some delusions. Copyright © Prentice Hall 2007 13-37
  38. 38. Biomedical Therapies • But they cannot replace lost social skills or teach patients how to interact with family members and other people. • Many psychotropic drugs are often associated with side effects. Copyright © Prentice Hall 2007 13-38
  39. 39. Biomedical Therapies • Psychosurgery is the alteration of brain tissue in an attempt to alleviate psychological disorders. • In 1935, Egas Moniz devised the first psychosurgery, the prefrontal lobotomy. • Present-day psychosurgical procedures are more refined than the earlier, crude operations; nevertheless, they are rarely performed, and then only as a last resort. Copyright © Prentice Hall 2007 13-39

×