psychology, chapter 13 therapy
TRANSCRIPT
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Cynthia K. Shinabarger Reed
Therapy
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The current view of causes of psychological disorders influence treatments.
People who believed in "possession" by evil spirits Exorcism Trephining
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Treatments
Exorcism
Driving out of evil spirits that are believed to have taken over the individual’s body. The spirits cause the individual to perform evil acts.
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Opening of the skull
Performed for the escape or entrance of spirits.
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Greek philosopher and physician Hippocrates Physical and psychological disorders have natural
causes
Also in ancient Rome Treatments
Baths
Exercise
Massage
16th & 17th centuries Accused of being witches.
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Paris 18th century, mentally ill often chained to walls “Keepers”
Rarely showed compassion
Punished at will
Dr. Philippe Pinel, Needed humane care & treatment
Moral management or moral therapy Providing humane & relaxed environment = + changes in
behavior.
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Benjamin Rush Introduced moral therapy at Philadelphia’s
Pennsylvania Hospital
1st general hospital in the U.S. with a separate unit for mentally ill
Yet he restrained manic patients in his tranquilizer chair He thought more humane than other restraints used
at the time.
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Mid-19th century, Dorothea Dix, Union's Superintendent of Female Nurses during the Civil War
20 years fought for homeless & mentally ill
Insisted states had an obligation to provide care
Convinced legislatures in 20 states to establish or enlarge mental hospitals.
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They built larger institutions to handle more patients.
Expansion caused conditions to deteriorate
Use of restraints increased
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Franz Anton Mesmer Believed he could harness this magnetism as a
form of therapy to treat patients.
With modifications, his techniques evolved into hypnotism.
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Sigmund Freud Psychological disorders result from unconscious
feelings and conflicts
Freud turned to other techniques when hypnosis proved less effective than he had hoped.
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Early 20th century General paresis
Symptoms Paralysis
Memory difficulties
Discovered resulting from syphilis
Stimulated search for biological causes of other psychological disorders
Development of biomedical treatments Psychosurgery
Electroconvulsive (shock) therapy or ECT
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Beginning 1950s, populations of mental hospitals began to decline
Drugs made it possible to control many serious symptoms.
Growing belief that community care was more effective
Deinstitutionalization Policy of discharging large numbers of patients Closing hospitals
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Psychologists recognize 3 forms of prevention:
1. Primary prevention– Prevent disorders from occurring.
2. Secondary prevention– Detect existing disorders
– Provide treatment at early stages.
3. Tertiary prevention– reduce the damage caused by disorders for patients &
society.
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Not everyone who seeks therapy suffers from a psychological disorder.
Cope
Loss of a job
School-related difficulties
Family problems
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About 30% with psychological disorder seek treatment.
More likely to seek treatment than substance abusers Schizophrenias Bipolar disorder Panic disorder
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2 treatment categories for psychological disorders: Biomedical therapies
Psychological therapies
Biomedical therapies Psychotropic drugs
ECT
Psychosurgery
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Psychological therapies “talk therapies” to treatments based on principles
of learning.
Psychotherapy General term that describes psychological
treatments designed to help people resolve behavioral, emotional, and interpersonal problems and improve the quality of their lives.
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Most common licensed psychotherapists are clinical and counseling psychologists, psychiatric nurses, psychiatrists, and social workers.
States regulate many mental health professions
Just beginning to regulate counselors
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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.
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Psychoanalytic therapy
Goal is to uncover unconscious conflicts and feelings and bring them to the conscious level.
Freud (get to unconscious)
Free association
Dream interpretation
Resistance
Transference
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Free association Relate thoughts, feelings, or images without modifying them
in any way.
Freud called dreams “the royal road to the unconscious” and distinguished between two forms of dream content: manifest and latent. Manifest content
Dream you recall when you awaken
Latent content Underlying meaning
Psychoanalyst’s interprets dreams by discovering the latent content.
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Resistance Occurs during free association when the patient’s
flow of words and thoughts stops.
Cessation of associations Indicates the defense mechanism of repression is
operating to protect the ego from the anxiety generated by the thoughts and feelings revealed through the associations.
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Transference
Patient’s + or - reaction to the therapist
Believed to reflect relationship to a significant person outside of therapy.
Countertransference
Therapists reaction to the client
Believed to reflect relationship to a significant person in their life.
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Humanistic therapies
Emphasize the present & the ability of clients to solve their own problems once they are able to accept themselves.
Client-centered therapy
Designed to create an environment in which the client is able to find solutions to his or her problems.
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Cognitive therapies Designed to change cognitions in order to
eliminate maladaptive behaviors. Thinking errors
Rational-emotive behavior therapy (RET) Therapist challenges and questions the client’s
irrational ideas. Thinking errors
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Rational-emotive behavior therapy ABC framework. A = activating event
Related to an important Desire
Goal
Preference (getting the job, in our example
B = belief (thinking error) Related to failure to attain the goal, that follows the
activating event (“I’m no good because I didn’t get the job”).
C = consequences anger, anxiety, and depression.
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Role of the therapist is to challenge the thinking errors.
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Eysenck
Psychotherapy clients just as likely to improve w/o treatment.
Studies show psychotherapy is generally effective, although we are uncertain as to why.
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Therapists increasingly aware of influence of
Ethnic
Cultural factors
Members of ethnic groups drop out early from psychotherapy
Lack of therapists speak native language
Failure to provide appropriate forms of therapy.
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