chapter 3 treatment of psychological disorders copyright © 2006 pearson education canada inc
TRANSCRIPT
Chapter 3Treatment of Psychological
Disorders
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Quote of the Day:
“Give me a dozen healthy infants, well-formed, and my own special world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select - doctor, lawyer, artist, merchant-chief, and yes, even beggarman and thief.”
-- John B. Watson
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Psychological Treatments:What Can Help?
Psychotherapy: psychological approaches to promote positive mental health
– hundreds of “schools” for adults & children
four main paradigms:– biological, psychodynamic, cognitive behavioural,
humanistic– eclectic approach most common
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Two Foci of Psychotherapy Research
outcome research– does therapy work?
process research – does the therapist-client relationship matter?
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Case Study: Frances
lengthy depressionsuicidal ideationself-blame vs. resentment
How can we interpret her problem?
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Historical Perspective
Spiritual/religious tradition– supernatural causes– witchcraft– trephining
Naturalistic/scientific tradition– Hippocrates: rest, exercise & healthy diet– insane asylums
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Biological Treatments
Electroconvulsive Therapy (ECT)– originally, a treatment for schizophrenia– unilateral vs. bilateral ECT– severe side effects
Psychosurgery– Egas Moniz (1874-1953)– prefrontal lobotomy vs. cingulotomy
Psychopharmacology
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Psychopharmacology
psychotropic medications– i.e. Prozac, Xanax, Ritalin
billion dollar industry for pharmaceutical companies
offer symptom relief, not a cure unpleasant side effects may need to be taken long-term
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Originators of Psychodynamic Therapies
Joseph Breuer (1842-1925)– used hypnosis to treat troubled patients– catharsis
Sigmund Freud (1856-1939)– free association to reveal unconscious mind– insight into unconscious will cure disorders– therapeutic neutrality and transference
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Psychodynamic therapies
Psychoanalysis– costly and time consuming– unlikely to “cure” psychotic disorders
Ego Analysis– interpersonal relationships of great importance– power: dominance→ submission– closeness: affiliation → hostility
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Cognitive Behaviour Therapy:Overview
“actions speak louder than words”abnormal behaviour is learned and can
be “unlearned” treatment goal: appropriate learning
experiences, behavioural changerelies heavily on empirical evaluation
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The Experimental Method
hypothesis generation identification of independent &
dependent variablesrandom assignmentexperimental group vs. control groupconsideration of internal & external
validity
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Cognitive Behaviour Therapy:Exposure Therapies
systematic desensitization– based on theory of classical conditioning – eliminate unpleasant responses through gradual exposure– relaxation training – used extensively in the treatment of phobias
flooding– eliminate unpleasant response through extinction– want to prevent avoidance
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Cognitive Behaviour Therapy:Other Approaches
Aversion therapy– goal to induce an unpleasant response in order to
extinguish an inappropriate behaviour
Contingency management– goal to reward desirable behaviour and punish undesirable
behaviour i.e. token economies
Social skills training– teach people ways of behaving that are likely to be
rewarded in the everyday world
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Cognitive Techniques
Self-instruction training– adults model appropriate behaviour to children using
self-instructions
Cognitive therapy– developed specifically to treat depression– cognitive distortions must be challenged to reveal the
world in the truer light
Rational-emotive therapy– emotional disorders caused by irrational beliefs that
must be challenged
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Humanistic Therapies:Foundations
people have free will and must make decisions
emotional problems stem from alienation and problems finding meaning in life
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Humanistic Therapies
client-centered therapy– empathy for the client– unconditional positive regard
Gestalt therapy– sincerity and honesty– empty chair technique
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Research on Psychotherapy
question: How effective is psychotherapy at relieving symptoms, eliminating disorders, and improving life?
research approach: meta-analysis
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Research Considerations
spontaneous remission
placebo effect
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Psychotherapy Process Research
which aspects of therapy work?
how do the different approaches measure up against one another?– behavioural interventions slightly better,
but very few differences
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Psychotherapy process research
psychotherapy as social support– the therapeutic alliance
psychotherapy as social influence
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Changing Social Systems
Couples Therapy– communication & negotiation
Family Therapy– parental management training
Group Therapy– psycheducational groups
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Canadian Focus: Treatments
Multisite research
Centre for Addiction and Mental Health
Dismantling studies
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Community Psychology
Primary prevention– prevent new cases from developing
Secondary prevention– early detection of problems
Tertiary prevention– providing treatment to people in need