1 therapy chapter 17. types of mental health care professionals counseling psychologist clinical...
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Therapy
Chapter 17
Types of Mental Health Care Types of Mental Health Care ProfessionalsProfessionals
Counseling psychologistCounseling psychologist
Clinical psychologistClinical psychologist
PsychoanalystPsychoanalyst
Clinical social workerClinical social worker
PsychiatristPsychiatrist
Psychiatric nurse Psychiatric nurse practitionerpractitioner
Pastoral counselorPastoral counselor
Therapy• Because of new
drugs and better therapy, the U.S. went to a policy of deinstitutionalization.
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Psychological Therapies
We will look at four major forms of psychotherapies based on different
theories of human nature:
1. Psychoanalytical theory
2. Humanistic theory3. Behavioral theory4. Cognitive theory
Psychoanalytic Therapy• Freud• Bring repressed feeling from
the unconscious out through– hypnosis – free association– Dream– Interpretation
• When energy devoted to id-ego-superego conflicts is released, the patient’s anxiety lessens.
• Transference• Resistance
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Psychoanalysis: Criticisms
1. Hard to refute because it cannot be proven or disproven.
2. Takes a long time and is very expensive.
The goal of psychoanalytical therapy is
a) to change maladaptive behavior to more socially acceptable behavior
b) to change negative thinking into more positive attributions
c) to attain self-actualization
d) to bring unconscious conflicts to conscious awareness and gain insight
Treating the therapist as though he were a very important person from one’s past, such as a parent, defines
a) resistance
b) transference
c) frustration
d) reaction formation
Humanistic Therapy• Client-Centered Therapy by Carl Rogers• Aim to promote self-fulfillment by
increasing self-acceptance & self awareness
• Free will – clients makes the decisions and finds the solutions
• Active/reflective listening• Unconditional positive regard • Therapist responds with empathy
Gestalt Therapy by Fritz Perls – Patient experienced problems because his or
her perception of reality was not consistent with what actually was occuring.
. Vic is encouraged to take charge of the therapy session and his therapist uses an active listening approach to mirror back the feelings he hears from him. Which therapy is most likely being described?
a) client-centered therapyb) cognitive therapyc) psychodynamic therapyd) existential therapy
Behavioral Therapies• Applies learning principles to the
elimination of unwanted behaviors • Classical Conditioning
Counterconditioning –Mary JonesAversive ConditioningSystematic desensitizationExpoure/flooding techniquesBell & Pad treatment –bed wetting
(NS)Alcohol + drug (UCS) = nausea (UCR)
Behavioral Therapies• Operant conditioning
Token economy- positive reinforcement
Extinction/nonreinforcement
Modeling
Systematic desensitization is a technique based on
a) classical conditioning
b) instrumental conditioning
c) operant conditioning
d) aversive conditioning
Cognitive (Thinking) Therapy
• Aaron Beck• Teaches people new
methods of thinking & acting. (change our schemas)
• Patient’s negative thoughts are responsible for psychological problem
• Albert Ellis & Rational Emotive Therapy- anxiety is causing their beliefs
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Cognitive Therapy for Depression
Rabin et al., (1986) trained depressed patients to record
positive events each day, and relate how they contributed to
these events. Compared to other depressed patients, trained
patients showed lower depression scores.
Albert Ellis Rational Emotive Therapy
• vigorously challenges people’s illogical, self-defeating attitudes and assumptions; a confrontational therapy
• A-B-C theory of dysfunctional behavior
• A – Activating event
• B – Belief
• C – emotional Consequence based on that belief.
Example of Rational Thinking
• A= fail a midterm examination
• B=It’s unfortunate that I failed-I did not study hard enough and I must make sure that I study harder for the final
• C=no consequences (no emotional disturbance)
A= Fail exam
B= I’m stupid, I’ll never be able to pass this course and I will fail this course
C=depression
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Evaluating PsychotherapiesWithin psychotherapies cognitive
therapies are most widely used, followed by psychoanalytic and family/group
therapies.
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The Relative Effectiveness of Different Therapies
Which psychotherapy would be most effective for treating a particular problem?
Disorder Therapy
Depression Behavior, Cognition, Interpersonal
Anxiety Cognition, Exposure, Stress Inoculation
Bulimia Cognitive-behavior
Phobia Behavior
Bed Wetting
Behavior Modification
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Evaluating Alternative Therapies
Lilienfeld (1998) suggests comparing scientific therapies against popular
therapies through electronic means. The results of such a search are below:
Group Therapy
• Is cheap, effective. • 1 therapist, 6-8 clients,
90 minutes• It allows people to
gain insight into their own behaviors and thoughts
• People don’t feel like they are the only one with their problem
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Light Exposure Therapy
Seasonal Affective Disorder (SAD)
•light exposure therapy
Cou
rtesy o
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ristine B
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The Biomedical Therapies
1. Drug Treatments2. Surgery3. Electric-shock
therapy
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Drug Therapies
Psychopharmacology is the study of drug effects on mind and behavior.
With the advent of drugs, hospitalization in mental institutions has rapidly declined.
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Antipsychotic DrugsClassical antipsychotics (ThorazineThorazine): Remove a number of positive symptoms associated with schizophrenia such as agitation, delusions, and hallucinations.
Atypical antipsychotics (Clozapine): (Clozapine): Remove negative symptoms associated with schizophrenia such as apathy, jumbled thoughts, concentration difficulties, and difficulties in interacting with others.
blocks receptors
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Antidepressant Drugs
Antidepressant drugs like Prozac, Zoloft, and Paxil are Selective Serotonin Reuptake Inhibitors (SSRIs) that improve the mood by elevating levels of serotonin by inhibiting reuptake.
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Mood-Stabilizing Medications
Lithium Carbonate, a common salt, has been used to stabilize manic episodes in bipolar disorders. It moderates the levels of norepinephrine and glutamate neurotransmitters.
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Brain Stimulation
Electroconvulsive Therapy (ECT)
Used for severely depressed patients who do not respond to drugs. The patient is anesthetized and given a muscle relaxant.
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Alternatives to ECT
Transcranial Magnetic
Stimulation (TMS)
a pulsating magnetic coil is placed over prefrontal regions of the brain to treat depression with minimal side effects.
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Psychosurgery
Although used sparingly today, about 200 such operations do take place in the US alone.
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