PSYChpater_18_-_The_Treatment_of_Mental_Disorders.doc

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Published on 1 Aug 2012
School
University of Guelph
Department
Psychology
Course
PSYC 1010
Professor
Chapter 18 The Treatment of Mental Disorders
MENTAL DISORDERS AND PSYCHOTHERAPY
4 basic approaches to treatment of mental disorders:
o Insight therapies
o Behaviour therapy
o Cognitive-behaviour therapies
o Treatment of groups
Early Treatment of Mental Disorders
Disorders always there; just viewed differently-example, person with schizophrenia may have
been said to be god’s voice or spirits; possessed with devil or evil
Trephining: surgical procedure in which a hole is made in the skull of a living person
an opening for the spirits of evil to leave the victims head
insults or curses were said to persuade the demon to leave; exorcism was attempted to make
the body an unpleasant place
beatings, starving, drowning, drinking of foul-tasting concoctions
18th century, Johann Wier was first to question witchcraft-said it was an illness instead
Eventually people with disorders were sent to asylums; kept in chains; shown to public for fees;
tied up, doused in cold water, bled, made to vomit; spun in a chair
Philippe Pinel, director of hospital in Paris, as an experiment-took off chains of patients, out of
dungeons-success, hospital was peaceful and quiet
The Development of Psychotherapy
Anton Mesmer- end of 18th century early 19th, devised theory called, ―magnetic fluxes‖
attempted to effect cures by manipulating iron rods and bottles of chemicals; hypnotized
patients
Eclectic approach: form of therapy in which the therapist uses w/e method he or she feels will
work best for a particular client at a particular time; combinations of methods
INSIGHT THERAPIES
Assume that people are essentially normal but learn maladaptive thought patterns and
emotions, which are revealed in maladaptive behaviours
Once patient understands causes of problems, the behaviour will cease
Psychoanalysis and Modern Psychodynamic Approaches
Psychoanalysis: Freud; form of therapy aimed at providing the client with insight into his or
her unconscious motivations and impulses
Early stage of therapy- problems are difficult to identity b/c unaware of unconscious conflicts
Analyst asks questions, encourages client to talk; analyst interprets them to uncover true
meaning and get whole pic of unconscious
Purpose of theory-to create setting where clues about the origins of intrapsychic conflicts are
most likely to be revealed by client; dreams, memory, reactions etc; by exposing client to these
clues, they gain insight
Accurate interpretation is best by therapy with specially trained therapist
Client provides, description of fear and anxieties, thoughts repressed memories; defence
mechanisms are triggered
Psychoanalytic Techniques
Free association: procedure in which client is encouraged to speak freely w/out censoring
possibly embarrassing or socially unacceptable thoughts or ideas
Dream interpretation: evaluation of underlying meaning of dream content
Manifest content: actual images and events
Latent content: hidden meaning or significance
Manifest masks the latent b/c latent is anxiety provoking and causes discomfort
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Something of paradox in getting insight, for the painful and threatening knowledge resulting
from insight is what led to its repression in the first place
Resistance: development during therapy in which client becomes defensive, unconsciously
attempting to halt further insight by censoring true feelings
Transference: client begins to project powerful attitudes and emotions onto therapist
Occurs when clients relive past experiences
Counter-transference: therapist projects emotions onto client-unhealthy and undesirable
according to Freud
Modern Psychodynamic Therapy
Less emphasis on sexual factors during development and more on social and interpersonal
experiences
Ego plays a more active role in thoughts and actions
Brief psychodynamic therapy: 10-25 sessions; focuses on schemata that a client has about
interpersonal relationships and attempts to modify those that are incorrect or that prevent client
from developing relationships with others
Behaviour or overt action is seldom important by itself, rather behaviour is only important to the
extent tha
therapist agreed!
Humanistic Therapy
Humanistic therapy: form of theory focusing on the persons unique potential for personal
growth and self-actualization
2 major forms: Client-Centred Therapy & Gestalt Therapy
Client-centred therapy: developed by Carl Rogers; the client is allowed to decide what to talk
about without strong direction and judgement from the therapist
Incongruence: discrepancy b/w a client’s real and ideal selves
goal is to reduce incongruence
reflection- sensitive rephrasing or mirroring of the client’s statements to make their thoughts
more noticeable
therapist tries to establish empathy
unconditional positive regard: according to Rogers, the therapeutic expression that a client’s
worth as a human being is not dependent on anything that he or she does, says, feels or
thinks
acceptance and approval of the person does not mean approval and acceptance of their
behaviour
Gestalt Therapy: emphasizes the unity if mind and body by teaching the client to ―get in touch‖
with unconscious bodily sensations and emotional feelings
Emphasis on the present not the past
Empathy chair technique-client imagines that they are talking to someone sitting in the chair
beside them- express feelings and emotions to the person in chair
Encourages clients to talk to themselves and inanimate objects to gain better understanding of
feelings
Evaluation of Insight Therapies
The processes proposed by psychoanalytic theory have not been subjected to a great deal of
empirical scrutiny until relatively recently
For classical psychoanalysis only a small proportion of people with mental disorders qualify for
this method of treatment
Among the drawbacks of insight therapies is the relatively narrow range of people that may
benefit by undergoing such therapy.
In general, the people who seem most likely to benefit from insight psychotherapy are those
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who are intelligent and able to articulate their problems
Insight therapies generally are not effective with persons with serious mental disorders such as
schizophrenia
Behaviour and Cognitive Behaviour Therapies
Insight therapies are based on the assumption that understanding leads to behavioural change
In reality, insight is not always followed by behavioural change
Assumption made by behaviour therapists is that people learn maladaptive or self-defeating
behaviour in the same way that they learn adaptive behaviour
Therapies Based on Classical Conditioning:
In classical conditioning; the previously neutral stimulus (ultimately the CS) comes to elicit the
same response as a stimulus (UCS) that naturally elicits that response because the CS reliably
predicts the UCS
Systematic Desensitization- a method of treatment in which the client is trained to relax in
the presence of increasingly fearful stimuli
Scientific evaluations of systematic desensitization have been positive, and several
experiments have found that all elements of the procedure are necessary for its success
For ex: a person will not get rid of a phobia merely by participating in relaxation training
or by constructing hierarchies of fear-producing situations
Implosion Therapy- A form of therapy that attempts to rid people of fears by arousing them
intensely until their responses diminish through habituation and they learn that nothing bad
happens
the therapist describes, as graphically as possible, the most frightening encounters
possible with the object of a client’s phobia
the client tries to imagine the encounter and to experiences intense fear
if the client actually encounters the object of his or her fear, in which case the treatment
is called flooding
eventually the fear response begins to subside, and the client learns that even the
worst imaginable encounter can become tolerable
in a sense, the client learns not to fear his or her own anxiety attack, and avoidance
responses begin to extinguish
Aversion Therapy- a form of treatment in which the client is trained to respond negatively to a
neutral stimulus that has been paired with an aversive stimulus
Sexual attraction to children is one example; a man who is sexually attracted to children
(Michael Jackson) might be given painful electric shocks when a special apparatus
detects an erectile response while he is being shown pictures of children
Aversion Therapy causes serious ethical questions and can involve significant pain, the client’s
participation must be voluntary
Therapies Based on Operant Conditioning:
Behaviour Modification-behaviour therapy based on the principles of operant conditioning
o Involves altering maladaptive behaviour by rearranging the contingencies between
behaviour and its consequences
Increases in desirable behaviour can be brought about through either positive or negative
reinforcement and undesirable behaviour can be reduced through either extinction or
punishment
o Behaviour modification techniques can be found in a number of settings, such as
hospitals, schools, daycare centres, businesses, and even around the home
Behavioural techniques are often used to alter the behaviour of emotionally disturbed people,
and those with mental retardation for whom communication is difficult
Token Economy- a program often used in institutions in which a person’s adaptive behaviour
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Document Summary

Chapter 18 the treatment of mental disorders. 4 basic approaches to treatment of mental disorders: Insight therapies: behaviour therapy, cognitive-behaviour therapies, treatment of groups. Disorders always there; just viewed differently-example, person with schizophrenia may have been said to be god"s voice or spirits; possessed with devil or evil. Trephining: surgical procedure in which a hole is made in the skull of a living person. An opening for the spirits of evil to leave the victims head insults or curses were said to persuade the demon to leave; exorcism was attempted to make the body an unpleasant place. Beatings, starving, drowning, drinking of foul-tasting concoctions. 18th century, johann wier was first to question witchcraft-said it was an illness instead. Eventually people with disorders were sent to asylums; kept in chains; shown to public for fees; tied up, doused in cold water, bled, made to vomit; spun in a chair.

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