Class Notes (806,766)
Canada (492,430)
York University (33,491)
Psychology (4,069)
PSYC 1010 (1,329)

Chapter 15.docx

13 Pages
Unlock Document

York University
PSYC 1010
Gerry Goldberg

Chapter 15 The elements of the treatment process - Treatments: how many types are there? o These include discussion, advice, emotional support, persuasion, conditioning, procedures, relaxation training, role playing, drug therapy, biofeedback, and group therapy o Approaches to treatment:  Insight therapies: talk therapy  Behaviour therapy: based on principles of learning  Biomedical therapies: intervention into person’s biological functioning o Who seeks therapy?  The two most common presenting problems are excessive anxiety and depression  One of the biggest road blocks is the stigma surrounding mental health treatment o Therapists: Who provides professional treatment  Psychotherapy: refers to professional treatment by someone with special training  Clinical psychologist’s training emphasizes the treatment of full fledged disorders.  Counselling psychologists training is slanted towards the treatment of everyday adjustment problems.  Psychologists use either insight or behavioural approaches  Psychiatrists are more likely to use behavioural techniques and less likely to use psychoanalytic methods.  Psychiatrists: physicians who specialize in the diagnosis and treatment of psychological disorders. They devote more time to relatively severe disorders like schizophrenia and less time to everyday marital, family job and school problems. Rely more on drug therapies Insight Therapies - Involve verbal interactions intended to enhance client’s self knowledge and thus promote healthful changes in personality and behaviour - Psychoanalysis (helpful or panic disorders, borderline personality disorders, substance abuse) o Is an insight therapy that emphasizes the recovery of unconscious conflicts, motives, and defences through techniques such as free association and transference o Freud believed that neurotic problems are caused by unconscious conflicts left over from early childhood o The analyst functions as a psychological detective, in this effort to explore the unconscious, the therapist relies on free association and dream analysis  In free association clients spontaneously express their thoughts and feelings exactly as they occur with little censorship as possible  In dream analysis, the therapist interprets the symbolic meaning of the client’s dream o Interpretation: refers to the therapist’s attempts to explain the inner significance of the client’s thoughts, feelings, memories, and o behaviours o Resistance refers to largely unconscious defensive manoeuvres intended to hinder the progress of therapy. i.e showing up late, hostility o Transference occurs when client’s unconsciously start relating their therapist in ways that mimic critical relationships in their lives. i.e relate to therapist as though they were overprotective mom or rejecting brother o Psychoanalysts often encourage transference so that clients can re-enact relationships with crucial people in the context of therapy o Evidence suggests that the amount of resistance manifested in psychodynamic therapy predicts the outcome of the therapy. More resistance= less likely to experience a positive outcome and more likely to drop out - Client centered therapy o Is an insight therapy that emphasizes providing a supportive emotional climate for clients who play a major role in determining the pace and direction of their therapy o Rogers maintains that most personal distress is due to inconsistency/incongruence between person’s self concept and reality o This therapy helps clients to realize that they do not have to worry constantly about pleasing others and winning acceptance o Try to foster self acceptance and personal growth o It is critical for therapists to provide a warm, supportive, accepting climate creates safe environment o To create this atmosphere of emotional support, client centred therapists must provide three conditions:  Genuineness  Unconditional positive regard  Empathy o The client and therapist must work together as equals. Therapist offers little guidance and keeps interpretation and advice to a minimum o The therapist’s key task is clarification. They try to function as human mirrors, reflecting statements back to their clients but with enhanced clarity. o Try to help clients understand interpersonal relationships and become more comfortable with their genuine selves - Therapies inspired by positive psychology o They argue for increased research on contentment, self being, human strengths, and positive emotions o Attempts to get clients to recognize their strengths, appreciate their blessings, savour positive experiences, forgive those who have wronged them, and find meaning in their lives o In group therapy, participants essentially function as therapists for one another. Group members describe their problems, trade viewpoints, share experiences, and discuss coping strategies and they provide acceptance and emotional support for each other o The therapist is only responsible for selecting participants, setting group goals and initiating and maintaining the therapeutic process while protecting clients from harm o Advantages: they realize that their misery isn’t unique, learn that others face similar/worse problems. People can work on their social skills in a safe environment - Evaluating insight therapies o A spontaneous remission is a recovery from a disorder that occurs without formal treatment o So if client experiences a recovery after treatment, one cannot automatically assume that the recovery was because of the treatment o Insight therapy > no treatment/placebo treatment and effects are reasonably durable o Roughly equal in efficacy to drug therapies o About 50% of patients show a clinically meaningful recovery within about 20 sessions and another 25% of patients achieve this goal after about 45 sessions - How do insight therapies work? o Much of the improvement seen in clients in therapy may be attributable to the operation of common factors, such as the development of therapeutic alliance, the provision of emotional support and the cultivation of hope Behaviour Therapies - insight therapies treat pathological as signs of an underlying problem whereas behaviour therapies think that the symptoms are the problems - behaviour therapies involve the application of learning principles to direct efforts to change client’s maladaptive behaviours - Based on certain assumptions: it is assumed that behaviour is a product of learning and that what has been learned can be unlearned - Systematic desensitization o Is a behaviour therapy used to reduce phobic client’s anxiety responses through counter conditioning o Involves three steps: o 1. Therapist helps the client build an anxiety hierarchy o 2. Training the client in deep muscle relaxation o 3. The client tries to work through the hierarchy, learning to remain relaxed while imagining such stimulus o They usually follow up with DIRECT exposure to the real anxiety arousing stimuli o The trick is to recondition people so that the conditioned stimulus elicits relaxation instead of anxiety = counter conditioning - Aversion therapy o Is a behaviour therapy in which an aversive stimulus is paired with a stimulus that elicits an undesirable response. i.e alcoholics had emetic drugs (drugs that causes nausea and vomiting) paired with their fave drinks - Social skill training o Is a behaviour therapy designed to improve interpersonal skills that emphasizes modelling, behavioural rehearsal and shaping o Modelling: client is encouraged to watch socially skilled friends and colleagues in order to acquire appropriate responses through observation o In behavioural rehearsals the client tries to practise social techniques in structural role playing exercises. o Shaping: used in that clients are gradually asked to handle more complicated and delicate social situations - Cognitive Behavioural Treatments o Used varied combination of verbal intervention and behaviour modification techniques to help clients change maladaptive patterns of thinking o Cognitive therapy uses specific strategies to correct habitual thinking errors that underlie various types of disorders o It was originally devise as a treatment for depression o Mindfulness emphasizes both attention regulation and an open, accepting approach to experience - Evaluating Behaviour Therapies o Can make important contributions to the treatment of phobias, OCD, sexual dysfunction, schizophrenia, drug related problems, eating disorders, psychosomatic disorders, hyperactivity, autism, and mental retardation Biomedical Therapies - Are physiological interventions intended to reduce symptoms associated with psychological disorders - Treatment with drugs o Psychopharmacotherapy is the treatment of mental disorders with medication  Anti anxiety, anti psychotic, anti depressant drugs  Anti anxiety drugs relieve tension, apprehension and nervousness. Given to millions of people who simply suffer from chronic nervous tension  Antipsychotic drugs are used to gradually reduce psychotic symptoms, including hyperactivity, mental confusion, hallucinations and delusions. Studies suggest that antipsychotic reduce psychotic symptoms in about 70% of patients. Patients usually begin to respond within one to two weeks but considerable variability in responses is seen.  Tardive dyskinesia is a neurological disorder marked by involuntary writhing and tic like movements of the mouth, tongue, face, hands or feet seen in about 20-30% of patients who receive long term treatment with traditional antipsychotics  Antidepressant drugs gradually elevate mood and help bring people out of depression. Exert effects gradually over a period of a few weeks. Most likely to prescribe selective serotonin reuptake inhibitors (SSRIs) which slow the reuptake process at serotonin synapses  good for OCD, panic disorders, and other anxiety disorders may increase risk for suicide especially among adolescents and young adults. New medication inhibits serotonin AND nor epinephrine  Mood stabilizers are drugs used to control mood swings in patients with bipolar mood disorders. Lithium has proven valuable in preventing future episodes of both mania and depression  Critics say that drug therapies are not as effective as advertised and that they often produce superficial, short lived curative effects. Relapse rates are substantial when drug regimens are discontinued. Drugs are over prescribed. - Electroconvulsive Therapy o Is a biomedical treatment in which electric shock is used to produce a cortical seizure accompanied by convulsions o Effectiveness: Contradictory but it is remarkably effect treatment for depression. Overall, there does seem to be enough favourable evidence to justify conservative use of ECT in treating severe mood disorders in patients who have no responded to medication. Treatment must affect neurotransmitter activity in the brain o Risks: memory losses, impaired attention and other cognitive deficits are common short term side effects - New brain stimulation techniques o Transcranial magnetic stimulation is a new technique that permits scientists to temporarily enhance or depress activity in a specific area of the brain. So far treatments delivered to the right and left prefrontal cortex show promise in reducing depressive symptoms o Deep brain stimulation a thin electrode is surgically implanted in the brain and connected to an implanted pulse generator so that various electrical currents can be delivered to brain tissue adjacent to the electrode. Proven to be valuable in the treatment of the motor disturbance associated with Parkinson’s disease, tardive dyskinesia and some seizure disorders, depression and OCD Current Trends and Issues in Treatment - Blending approaches to treatment o There is a movement away strong loyalty to individual schools of thought and a corresponding move toward integrating various approaches to therapy o Eclectism in the practice of therapy involves drawing ideas from two or more systems of therapy instead of committing to just one system o In theoretical integration: two or more therapies are combined/blended and uses the strengths of each o Technical eclecticism involves borrowing ideas, insights and techniques from a variety of sources while tailoring one’s intervention strategy to the unique needs of each client Featured Study- Combing Insight Therapy and Medication - Purpose of study was to determine whether a combination of insight therapy and antidepressant medication could reduce the recurrence of depression in an elderly population - Four maintenance treatment conditions: 1. monthly interpersonal therapy and medication, 2. Medication alone, 3. Monthly interpersonal therapy and placebo medication, 4. Placebo medication alone - The relapse rates for combining interpersonal therapy and medication was significantly less than that for either medication or therapy alone - Increasing multicultural sensitivity in treatment o Barriers include: Cultural barriers, Language barriers and Institutional barriers o More culturally responsive approaches to treatment will require more minority therapists, special training for therapists, and additional investigation of how traditional therapies can be tailored to be more compatible with specific ethnic groups’ cultural heritage Institutional treatment in transition - A mental hospital is a medical institutional specializing in providing inpatient care for psychological disorders - Deinstitutionalization: refers to transferring the treatment of mental illness from inpatient institutions to community based facilities that emphasize outpatient care Personal application - Where do you find therapeutic services o Found in a variety of settings - Is the therapist’s profession or sex important o Researchers have not found any reliable association between therapists professional background and therapeutic efficacy o If you FEEL like the therapist’s sex is important , then for you it is - Is treatment always expensive o Psychotherapy does not have to be prohibitively expensive - Is the therapist’s theoretical approach important? o Most experts seem to think that for certain types of problems, some approaches to therapy are more effective than others - What should you look for in a prospective therapist? o Look for personal warmth and sincere concern o Look for empathy and understanding o Look for self confidence - What if there isn’t any progress? o Poor progress may be due to resistance, you should not be too quick to leave therapy when dissatisfied but your therapist may also not be sufficient so think about it Critical thinking - There are two major reasons that people entering therapy are likely to get better, regardless of whether their treatment is effective. o The power of placebo: people’s expectations lead them to experience some change even though they receive a fake treatment o Regression toward the mean: occurs when people who score extremely high or low on some trait are measured a second time and their new scores fall closer to the mean. If you are near bottom, there’s almost nowhere to go but up and if you are near top, there’s almost no where to go but down Chapter 16 Person Perception: Forming impression of others - Asch demonstrated the importance that what he called central traits can have on the impression we form of others. When you interact with people, you’re
More Less

Related notes for PSYC 1010

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.