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Chapter

Treatment

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Department
Psychology
Course
PSYC 100
Professor
Prof.
Semester
Fall

Description
Treatment -in the past people with mental disorders were seen as prophets or spiritual leader, possessed by demons and evil spirits -Treatments was painful- trephining (drilling a hole in the skull for evil spirits to escape through), exorcisms, starvation, and beating, and death -Institutionalization (1800s-1900s) -Asylum Movement-people with mental disorder would be put in to be isolated and sedated -no effort to help them or try to bring them back to society -treatment is the placebo effect -mental disorders often reflect abnormal brain function, and deregulation of neurotransmitter systems -mental disorders can be treated by drug therapy, or psychological therapy, or both Clinical Interviews-through interviews conducted by trained professionals designed to elicit information on the client’s history and presenting symptoms -varies in length and detail- some are structured where clinicians have a series of predetermined questions, or unstructured where the clinician asks whatever questions seem relevant, or semi-structured interview which include predetermined set of questions that the clinician expands on depending on the client’s response -can use questionnaires and other paper- or image-base tests -to access clients with brain injuries, learning disabilities, intellectual disabilities, dementia, or various other conditions, psychologists use cognitive or neuropsychological tests to examine various aspects of cognitive functioning- intelligence, academic ability, memory, processing speed, language functions, and executive functioning (ability to plan and reason) -for suspected brain injury, medical imaging techniques used to locate specific damaged areas, such as EEG (electroencephalogram), CAT scan (computerized axial tomography), MRI or fMRI scan (functional magnetic resonance imagining), or PET scan (position emission tomography) Behavioural Monitoring-records specific behaviours and the circumstances Classical Conditioning -learned response to the previously neutral stimulus -a new response can be learnt by associating an unconditional stimulus with a previously neutral stimulus -the neutral stimulus becomes a conditioned stimulus Little Albert Experiment - little baby learned to be afraid of animals using conditioning Assessment -individuals who may have a psychological disorder begin with an assessment designed to elicit their personal history and presenting symptoms so the mental health professional can arrive at a diagnosis and construct a treatment plan -once the diagnosis and treatment plan are complete, treatment begins Operant Conditioning -behaviour modification is based on the consequence -Positive consequence (reward) - increases behaviour -Negative consequence (punishment) - decreases behaviour -Token Economies- systematic reinforcement of target behaviour -Extinction of maladaptive behaviours- removes previously available positive reinforces -Punishment of maladaptive behaviours- administer negative consequences for undesirable behaviour Five-Part Model of Cognitive Behavioural Therapy Mood Body Mind Environment Behaviour Cognitive Distortions -changing maladaptive thoughts and beliefs to more realistic one -Polarized thinking (black and white thinking) -overgeneralizations -personalization -magnification/minimization Treating Psychological Disorders Psychotherapy- processes for resolving personal, emotional, behavioural, and social problems to improve well-being Barriers to Psychological Treatment -Expense and Availability-sessions of therapy and drugs -numerous indirect costs, such as transportation, child care, and time away from work -solution: some community organizations provide offices in lower-income areas where private psychotherapists are scarce and needed -Minimization, Misunderstanding, or Mistrust-minimizes their condition by tending to view their symptoms as less severe as they are -people are unaware that therapy or medication can treat their experiences -solution: educational intervention -Stigma About Mental Health-stigma is the collection of negative stereotypes -solution: being a member of a social group that actively supports psychological treatment can reduce or eliminates fear about stigmatization -Gender Roles- masculine gender roles emphasize emotional strength which conflict with acknowledging and talking through emotions and interpersonal problems and independence- to fight through it -Involuntary and Court-Oriented Treatment-required to contact mental health service by the courts, social service agencies, or employers, for those who have not voluntarily seek help from mental health care -resulting because of legal trouble -most likely in African American and Latinos because of the boundaries -questions legal and ethical -boundaries causes many communities to have juvenile and adult correction system to guarantee treatment, makes people believe that: • Mental health is not a significant problem, but crime is • People with mental health is prone to crime and violence Mental Health Providers and Settings -types of treatment depends on several factors, including age, type, and severity of disorder -mental health services include inpatient care, outpatient office visits, and use of prescription drugs -they work in many capacities and settings and provides individual or group therapy in an office or institution such as a hospital, or may conduct psychological testing and research Clinical/Psychiatric Social Workers and Psychiatric Nurses- conduct therapy to help people cope with psychological problems Diagnostician- person who specializes in making diagnoses and determining the causes of symptoms Psychological Associates- has a master’s degree in clinical psychology but not a doctoral degree Counsellors/Psychotherapists- people with no educational background Group Therapy-cares for people with serious mental disorders -Advantages: -sense of belonging -Problem-solving and role play as a group -Opportunity to practice skills -less costly than individual sessions -Disadvantages: -Not individualized -Personality clashes -Not suitable for patients in crisis, who are violent, or suicidal -Lack of confidentiality -Can be anxiety provoking -Inflexible scheduling Support Groups and Self Help Groups-designed to help individuals work on issues that doesn’t need treatment -provides members with support and encouragement from similar people -helps people feel more confident with their ability to cope and succeed -brings them back to a functional, healthy state -often led by a mental health professional Halfway Houses, Psychiatric Hospitals, and General Hospitals- care for people with serious mental disorders Nursing Homes-older adults who suffer mental disorders -staff is not trained to treat mental disorders Systems Approach-orientation toward family therapy that involves identifying and understanding what each individual family member contributes to the entire family dynamic -Con: doesn’t address individual issues -similar to Couples Therapy Community Psychology- promotes individual wellness through social change and community empowerment -most people with mental disorders seek treatment in private practice or community agency clinic Inpatient Treatment and Deinstitutionalization Deinstitutionalization-movement pushed for returning people from mental institutions to their communities and families and enabling them to receive treatment on an outpatient basis -Phillippe Pinel- removed restraints and allowed patients to follow a normal and societal routine -Dorothea Dix-activist -raised money for human hospitals -closing mental hospitals -people admitted to psychiatric hospitals only for evaluation, stabilization, and isolation, they begin medication and therapy, and receives education about emergency resources, then released to the care of their family -inpatient treatment’s goal is to protect the individual patient from harm and providing a quick return to society -Low-level people who require long-term serious care live in Residential Treatment Centers- provide psychotherapy and life skills training so that the residents can become integrated into society to the greatest extent possible rather than an asylum -medium- to high-level centers have high restrictions on people so may the hospital may be equipped with a medium-security prison- meant for people with a dangerous history Outpatient Treatments and Prevention -after deinstitutionalization began, homelessness and substance abuse became a major problem for the severely mentally ill -Community Psychology-area of psychology that focuses on identifying how individual’s mental health is influence by the neighbourhood, economics, social groups, and other community-based variables -emphasizes prevention and screening -initiates public awareness campaigns, develop group therapies, and other resources, advocate for jobs and education and offer free or low- costing group counseling in neighbourhoods where private mental health services are not available Evaluating Treatments The U.S Food and Drug Administration (FDA)- requires manufacturers demonstrate the safety and usefulness, by performing experiments, of many over-the-counter drugs and all drugs that require prescription Empirically Supported Treatments or Evidence-Based Therapies-treatments that have been tested and evaluated using sound research designs Therapeutic Alliance- relationship that emerges in therapy Bibliotherapy-use of self-help books and other reading materials as a form of therapy -results aren’t consistent and suggest helpful for mild problems Psychological Therapies Insight Therapies -psychotherapy that involves dialogue between client and therapist for the purposes of gaining awareness and understanding psychological problems and conflicts -Cons: -long term and often very expensive -can have limited application to people with serious disorders Psychodynamic Therapies- emphasizes the need to discover and resolve unconscious conflicts Psychoanalysis: Exploring the Unconscious Psychoanalysis-insight therapy that became the precursor to modern psychodynamic therapies -client provides the material (life experiences, distress) and the therapist interprets it -Neuroses (anxieties) - unconscious conflicts and their effects -unconscious motivation-> Urges are suppressed because they are unacceptable Free Association- instructs the patient to reveal any thought that arise Dream Analysis- method of understanding unconscious thought by interpreting the manifest content (what happens in the dream) to get a sense of the latent content (the unconscious elements that motivated the dream) Resistance- a tenden
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