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Treatment of Psychological Disorders

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PSYC 1010
Gerry Goldberg

Treatment of Psychological Disorders Breurer and Freud’s “talking therapy” Anna O and Freud: symptoms got better with talking. Approaches: Insight: “talk therapy”. Clients engage in complex verbal interactions with the therapist. Goal is to pursue increased insight and find possible solutions. Behavioural: Based on the principles of learning. Make efforts to alter problematic responses and maladaptive habits. Involve classical conditioning, operant conditioning, or observational learning. Biomedical: Drug therapy and electroconvulsive therapy. Intervene into a person’s biological functioning. 15% of the US population seeks therapy. Most who need it do not receive it as it is not covered by Ontario’s health insurance. There is also the stigma associated with receiving therapy and having a mental condition. 90% of Canadians report that they make an effort to take care of their mental health. Most individuals do not have an identifiable psychological disorder. Who provides professional treatment? - Psychologists/ Psychological Associates: Being a registered psychologist allows you to diagnose and treat patients. M.A’s were called associates before but they now can get licensing to practice psychology. - Psychiatrists: M.D’s. Have the right to prescribe medications. - Clinical Social Workers: Work with patients and families in the community. Master’s degree. - Psychiatric Nurses: registered professionals. Bachelors or Masters Degree. - Counsellors: No license but just a title. Schools, colleges, and assorted organizations. - Marriage and Family Therapists: registered therapists dealing with marriage and family issues. - Ont. College of Psychotherapists: registered and certified therapists with experience. Other sources of treatment: - Pastoral counselling: religious individuals - Self-help groups: AA and suicide preventions. Calgary self-help group ran by lady that later committed suicide. - Peer support teams: work out problems. Insight Therapies: - Psychoanalysis: therapy that emphasizes the recovery of unconscious conflicts, motives, and defences through techniques such as free association and transference. Techniques to probe the unconscious. - Symbols of dreams are ambiguous and have hidden meanings. - Slow and takes a long time to explore the person’s psyche. Can provide great insight. Free association: clients express their thoughts and feelings exactly as they occur with as little censorship as possible. Interpretation: the therapist attempts to explain the inner significance of the client’s thoughts, feeling, memories, and behaviours. Resistance: unconscious defensive manoeuvres intended to hinder the progress of therapy. Transference: clients unconsciously start relating to their therapist in ways that mimic critical relationships in their lives. Client- Centred Therapy (Carl Rogers): - Client sets pace and direction. It is the client that knows what hurts. - Create a comfortable climate. - Incongruence between a person’s self concept and reality. - Overdependence on others for approval and acceptance. - Therapeutic Alliance and Climate: Supportive emotional climate. Warm and soft. Unconditional positive regard (non-judgemental). Empathy. Therapeutic Process: - Clarification over advice - Build toward more far-reaching insights - Emotion focused therapy: understanding the role of emotion in psycotherapeutic change. - Emotion-focused couples therapy: treatment of dysfunctional relationships by understanding the role of emotion. (Leslie Greenfield: York) Therapies and Positive Psychology: - Going past “neutral” or “I’m ok for now” - Focuses on positive behaviour. Group Therapy: - Simultaneous treatment of several clients - Cost and time effective - After WWII, veterans needed help to integrate into society - Peers helping peers - Therapists have their own perspective. Gives people a chance to talk to someone that has been in a similar situation - Therapists protect clients from harm by not crossing boundaries. - Opportunity to develop social skills and see they are not unique in their misery Traumatic Incidents Debriefing: - Critical Incident Stress Debriefing - Aka “The Mitchell Model” - Jeff Mitchell - Technique to get people to talk about their problems - Asks about events that occurred (in rounds) - Every round produces more responses. Gets people to slowly open up and talk Couples and Family Therapy: - Couples or marital therapy: the treatment of both partners in a committed intimate relationship in which the main focus is on the relationship issues. Not limited to married couples. Also provided to cohabitating couples. - Family therapy: involves the treatment of a family unit as a whole in which the main focus is on family dynamics and communication. - Different schools of thought on how to conduct couples and family therapy. - Patterns in behaviour and interactions - Improves communication. Healthier patterns of interaction. Evaluating Insight Therapies: - Eysenk: took a waiting list. People that get therapy had the same rate of improvement as people that did not get therapy. - Spontaneous remission: unexpected improvement - Works better than a placebo - Equivalent to drug therapies How do Insight Therapies Work? - Therapeutic alliance and social support - Hope and positive expectations - Emotional support and empathetic understanding - Reducing problems by coming up with a method. Behaviour Therapies: - Believe insights are not necessary - Knowing why doesn’t change behaviour - Apply learning prin
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