46-333 Lecture Notes - Deinstitutionalisation, Psychosurgery

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Published on 19 Apr 2013
School
University of Windsor
Department
Psychology
Course
PSYC 3330
Professor
Therapies)
!
Terms)
symptoms:!behavioral!signs!indicating!a!disorder!is!present!!
diagnosis:!a!classification!of!a!disorder;!typically!the!DSM‐IV!is!used!to!determine!the!diagnosis!!
etiology:!suggestion!of!a!cause!of!a!disorder!!
prognosis:!an!estimate!as!to!the!length!of!time!or!degree!of!effectiveness!in!treating!a!disorder!!
treatment:!a!course!of!action!aimed!at!reducing,!controlling!or!eliminating!the!symptoms!of!a!
disorder!!
!
History)
Trephining‐‐discovered!by!archeologists,!early!process!in!which!holes!were!drilled!into!skulls!to!
let!harmful!human!spirits!leave!
Hippocrates!believed!the!psychological!disorders!were!a!result!of!biological!factors!and!could!be!
treated.!
During!the!Middle!Ages,!disorders!were!the!result!of!evil!sprits!and!the!victims!were!persecuted!
During!the!Enlightenment,!patients!with!psychological!disorders!were!treated!more!humanely!
Philippe!Pinel!(France)!and!Dorothea!Dix!(US)!helped!to!develop!institutionalization!to!care!
for!and!help!their!patients!
Treatment!in!the!United!States:!
1950s‐‐psychotropic!drugs!facilitated!the!release!of!patients!from!institutions!
1960s‐‐in!response!to!released!patients’!inability!to!care!for!themselves,!community‐based!
mental!health!centers!were!set!up!
recent!trends!are!aimed!at!prevention:!
primary1prevention33reduce!the!occurrence!of!societal!problems!that!can!cause!mental!
illness!
secondary1prevention33dealing!with!people!who!are!undergoing!psychological!difficulties!
tertiary1prevention‐‐working!to!make!sure!mental!health!issues!don’t!get!worse!
!
Models)of)Treatment)
There!are!six!recognized!models!of!treatment:!
psychodynamic:!believes!the!key!to!successful!treatment!involves!having!the!patient!gain!
insight!into!their!unconscious!motives,!emotions!or!conflicts!!
behavioral:!advocates!relearning!as!the!preferred!method!of!correcting!past!maladaptive!
behaviors!!
humanistic:!believes!in!the!inherent!goodness!of!people!and!strives!to!make!them!more!fully‐
functioning!!
cognitive:!attempts!to!restructure!the!patient's!incorrect!thought!processes!and!unrealistic!
expectations!into!more!realistic!thoughts!!
biomedical:!advocates!the!treatment!of!psychological!disorders!through!chemical!or!surgical!
processes!!
group)therapy:!allows!other!afflicted!with!similar!disorders!to!share!real‐world!solutions!and!
coping!mechanisms!
!
Albert)Ellis)
Ellis!assumes!that:!
“no!one!and!nothing!is!supreme”!
“self‐gratification”!should!be!encouraged!
“unequivocal!love,!commitment,!service,!and…fidelity!to!any!interpersonal!commitment,!
especially!marriage,!leads!to!harmful!consequences.”!
This!perspective!illustrates!how!a!psychotherapist’s!personal!beliefs!and!values!influence!their!
practice!
therapists!should!divulge!their!values!more!openly!
)
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Psychodynamic)Therapy)
Sigmund!Freud!pioneered!this!form!of!treatment!with!his!"talking!cure,"!a!derivative!of!Joseph!
Breuer's!"chimney!sweeping"!!
Both!of!these!involve!the!cathartic1method,!or!a!treatment!that!results!in!a!cleansing!or!purging!of!
emotions!
The!ultimate!goal!is!to!provide!the!patient!insight!into!past,!unresolved!conflicts!from!emotionally!
abrasive!experiences!during!childhood!
The!patients!may!exhibit!resistance,!or!an!unwillingness!to!discuss!their!thoughts!and!behaviors!
freely!
!
Freud's!psychoanalysis!involves!three!parts:!
free1association:!allowing!the!patient!to!say!whatever!is!important!to!them!at!the!time!with!
minimal!prompting!from!the!therapist!!
hypnosis:!a!mild!state!of!relaxation!and!increased!suggestibility!that!Freud!perfected!through!
his!studies!with!Jean!Martin!Charcot!in!Paris!!
dream1analysis:!an!investigation!into!the!dream!work,!the!process!involved!in!changing!the!
latent1content)of!a!dream!produced!by!the!id!into!the!manifest1content!designed!to!preserve!
ego!integrity!!
!
While!undergoing!therapy,!the!patient!can!experience!both!positive!and!negative!transference!
positive1transference!involves!projecting!the!patient's!warm!feelings!for!their!parents!onto!the!
therapist!
negative1transference!involves!projecting!hostile!feelings!towards!authority!figures!onto!the!
therapist!
The!therapist!can!also!suffer!from!countertransference!where!they!project!feelings!of!affection!or!
hostility!toward!significant!people!in!their!lives!onto!the!patient.!
!
NeoFreudians!or!post‐Freudians!have!emphasized!different!aspects!of!Freud's!theories!
They!don't!believe!the!libido!is!the!primary!motive!in!our!unconscious!actions!
They!believe!that!current!issues!the!individual!is!dealing!with!are!sometimes!more!significant!
than!experiences!in!childhood!
They!include!the!influence!of!social!and!interpersonal!relationships!in!the!patient's!overall!mental!
health!
They!also!believe!that!the!patient's!self‐concept!plays!a!significant!role!in!their!emotional!well‐
being!
!
Behavioral)Therapy)
There!are!a!variety!of!behavioral!techniques!employed!to!correct!maladaptive!learning:!
behavioral1contracting:!!
also!called!behavior1modification!or!contingency1management1
involves!the!use!of!operant!conditioning!in!providing!rewards!for!positive!behaviors!and!
punishment!for!negative!behaviors!
behavioral!contracting!actually!spells!out!the!criteria!for!receiving!rewards!and!
punishment!!
avoidance1conditioning:!!
also!called!aversive1conditioning!
this!technique!teaches!the!patient!to!avoid!negative!behaviors!because!they!will!result!in!
punishment!
patients!may!take!medication!to!make!them!throw!up!if!they!drink!any!alcohol!
systematic1desensitization:!!
a!step‐by‐step!process!in!which!patients!move!closer!to!the!objects!or!situations!they!fear,!
progressing!each!step!only!when!they!feel!comfortable!enough!to!proceed!
a!person!who!is!afraid!of!heights!will!gradually!progress!from!the!bottom!to!the!top!of!a!
tall!building!to!combat!their!acrophobia!!
!
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