UNIT 13: Psychological Treatment

History of Psychological Treatment

• Throughout history, the mentally ill were subjected to irrational and harmful treatments.
  
  

• Philippe Pinel (France) and Dorothea Dix (USA) advocated for humane care for the mentally ill.
  
  

Psychodynamic and Humanistic Therapies

Therapies Overview

• Psychotherapy: Emotionally charged interaction between a trained therapist and a mental patient.
  
  

• Biomedical Therapy: Involves drugs or procedures acting on the nervous system.
  
  

• Eclectic Approach: Combines various healing techniques based on individual client needs.
  
  

4 Major Forms of Psychotherapy

1. Psychoanalytic Therapy
   
   

2. Humanistic Therapy
   
   

3. Behavioral Therapy
   
   

4. Cognitive Therapy
   
   

Insight Therapies

• Aim to improve functioning by increasing awareness of motives and defenses.
  
  

Psychoanalysis and Psychodynamic Therapy

Goals

• Uncover repressed childhood conflicts and bring them to conscious awareness.
  
  

• Resolving id-ego-superego conflicts reduces anxiety.
  
  

Methods

• Free Association: Patient speaks freely to uncover unconscious thoughts.
  
  

• Resistance: Patient hesitates; therapist interprets underlying anxiety.
  
  

• Transference: Patient projects past feelings onto the therapist.
  
  

Criticisms

• Difficult to prove or disprove.
  
  

• Time-consuming and expensive.
  
  

Behavior, Cognitive, and Group Therapies

Behavior Therapy

• Applies learning principles to eliminate unwanted behaviors without focusing on deep-seated causes.
  
  

Classical Conditioning Techniques

• Counterconditioning: Conditions new responses to stimuli.
  
  

• Exposure Therapy: Gradual exposure reduces anxiety.
  
  

• Systematic Desensitization: Pairs relaxation with increasing anxiety stimuli.
  
  

• Aversive Conditioning: Pairs unpleasant states with unwanted behavior.
  
  

Operant Conditioning

• Behavior Modification: Rewards desired behaviors.
  
  

• Token Economy: Tokens for good behavior can be exchanged for privileges.
  
  

Cognitive Therapy

• Teaches new adaptive thinking and acting.
  
  

Rational Emotive Behavior Therapy (REBT) - Albert Ellis

• Challenges illogical and self-defeating thoughts.
  
  

Aaron Beck's Therapy for Depression

• Gently questions negative thoughts like "I can never be happy".
  
  

Cognitive Strategies

• Stress Inoculation Training (Meichenbaum): Restructure thinking in stress.
  
  

• Cognitive-Behavior Therapy: Combines cognitive therapy with behavior modification.
  
  

Evaluating Therapies

Effectiveness of Psychotherapy

• Difficult to measure due to subjective experiences.
  
  

Client Perceptions

• Often positive, but may reflect natural recovery or the desire to justify effort.
  
  

Clinician Perceptions

• Generally positive but may be biased.
  
  

Outcome Research

• Meta-analyses show treated patients fare better (80% improvement rate).
  
  

Relative Effectiveness of Therapies

Disorder

Effective Therapies

Depression

Behavior, Cognitive, Interpersonal

Anxiety

Cognitive, Exposure, Stress Inoculation

Bulimia

Cognitive-Behavioral

Phobia

Behavior

Bed Wetting

Behavior Modification

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  Evidence-Based Practice: Choose therapies based on research and patient preferences.
  
  

Therapists & Their Training

• Clinical Psychologists: PhD, trained in research and therapy.
  
  

• Psychiatric Social Workers: Master's degree, trained in therapy for daily problems.
  
  

• Counselors: Specialize in family, abuse, and substance issues.
  
  

• Psychiatrists: Medical doctors who can prescribe medications.
  
  

Alternative Therapies

• Examples: Meditation, massage, essential oils, spirituality.
  
  

The Biomedical Therapies

• Includes drug treatments, surgery, and electroshock therapy.
  
  

Drug Therapies

• Psychopharmacology: Study of drug effects on mind and behavior.
  
  

• Reduced need for hospitalization.
  
  

Double-Blind Procedures

• Neither patients nor staff know who gets the real drug or placebo.
  
  

Antipsychotic Drugs

• Classical (Thorazine): Targets positive schizophrenia symptoms.
  
  

• Atypical (Clozaril): Targets negative symptoms like apathy.
  
  

Antianxiety Drugs

• Xanax, Ativan: Increase GABA to reduce anxiety.
  
  

Antidepressant Drugs

• SSRIs (Prozac, Zoloft, Paxil): Increase serotonin levels.
  
  

Mood-Stabilizing Medications

• Lithium Carbonate: Stabilizes mood in bipolar disorder.
  
  

Brain Stimulation Therapies

Electroconvulsive Therapy (ECT)

• Used for severe depression unresponsive to other treatments.
  
  

Transcranial Magnetic Stimulation (TMS)

• Magnetic stimulation treats depression with minimal side effects.
  
  

Psychosurgery

• Last resort treatment.
  
  

• Involves irreversible brain tissue removal.
  
  

• Modern methods include stereotactic neurosurgery.
  
  

Therapeutic Lifestyle Changes

• Exercise, sleep, light exposure, social connection, anti-rumination, nutrition – all support mental health improvement.