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Chapter 15

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PSYC 320
Sunaina Assanand

Chapter 15: Treatment for Mental Disorders Going to therapy and talking about ones problems (and admitting you have a problem) is not consistent with the male gender role Until the middle of the 19th century, abnormal and socially undesirable behaviour was thought of as a moral or spiritual problem and had few treatments In the late 19th century into the 20th century medicine became the model for understanding these problems. There was a wide acceptance of mental illness as analogous to physical illness and treatment became available Psychoanalysis: Freud's version of talk based treatment. He thought that the cause of mental illness was because people aren't able to deal with problems and they repress them into the unconscious. 1. The unconscious does not function rationally, so repressed material has the potential to remain in the unconscious throughout childhood and adulthood and can produce problems at any time. There mental illnesses are cured by bringing the unconscious to the conscious in order for the patient to gain insight into their conflict and thus cause this conflict to disappear Karen Horney: protested the Freudian view of women and created her alternative approach to dealing with psychological problems with talk based therapy Humanistic Therapies: the thought that people are innately drawn toward fulfilling their human potential. If they fail the reasons lie in their circumstances and in their environments which somehow prevent the complete development of their full potential. Carl Rogers: Created the humanistic client-centered therapy. He proposed that human development follows a natural course toward health unless events block this development. He believed that problems start with distortions in self concept which arise from lack of acceptance of true feelings. 2. Carl Rogers created client-centered therapy which seeks to help people develop their full potential by providing a safe therapeutic environment in which they can form a relationship with an empathic, acceptant, and genuine councillor. 3. A major goal of client centered therapy is to eliminate discrepancies between client’s actual feelings and the feelings they recognize. The councillor does not work directly on changing the clients, their job is to provide clients with therapeutic relationships so that clients can reclaim their abilities to move toward personal growth and development Gestalt therapy: a humanistic therapy. Believed that psychological problems come from feelings of not being whole. Failure to acknowledge emotions leads people to this feeling of not being whole; they have a sense that parts of themselves have been psychologically disowned. Gestalt therapy allowed patients to become whole again through the recognition and expression of emotions Cognitive therapy: cognitive therapists believe that thought processes are the basis of feelings and behaviour; they create psychological problems and also provide the potential of alleviating those problems. Behaviour and emotion follow from cognition so changes in cognition provide the foundation for changes in behaviour Ellis: Cognitive therapist who developed rational-emotive therapy (RET). He though therapists should set goals and that therapy should be brief and problem oriented. RET views psychological problems as a result of peoples irrational beliefs and attempts to change these beliefs, assuming that changes in beliefs will produce changes in emotions and behaviour Arron Beck: cognitive therapist. Developed a cognitive therapy specifically for depression. Beck thought that people over generalize personal failures into the belief that they are worthless and that they explain positive occurrences as exceptions to the general rule or failure. Depressed persons magnify the enormity of negative emotions as catastrophic and unchangeable. Becks cognitive therapy attempts to help clients change their negative thinking patterns by testing the beliefs to evaluate their validity and by finding ways to introduce pleasurable experience into the lives of depressed people Behaviour modification: arose from laboratory research in psychology on the process of learning. In exploring learning principles researchers discovered operant conditioning and that reinforcement and punishment are powerful forces in determining behaviour. 1. Behaviours are learned and maintained by reinforcement and punishment and application of these two principles can change unacceptable behaviour. 2. Behaviour modification strives to replace inappropriate or deviant behaviours with other healthier behaviour patterns through operant conditioning. 3. Women are the most common clients for assertiveness problems, eating disorders, depression, and phobias. Emphasizes specific problems and the need to analyze the behaviours that contribute to the problem Cognitive behavioural therapy: differs from behaviour modification. Rather than concentrating on behaviour and ignoring internal cognitive processes it attempts to change through patterns and thereby change behaviour. Therapists are more collaborative than behaviour modification with the client playing an active role. Client may monitor and reward the desired behaviour Medical therapies: psychologists are attempting to change prescribing laws so that they may gain prescription privileges for psychoactive drugs. Since the 1950's use and the number of psychoactive drugs has increased and are used to treat schizophrenia, depression, anxiety, and other disorders. Women receive more drug prescriptions than men. There are higher rates of use for both women and men in the workforce; greater use of tranquilizers by women during early adulthood and middle age compared to men’s use of tranquilizers which peaked at older ages. Women are targeted as consumers for these drugs, both in advertising and in television and magazine ads to consumers urging them to ask for prescriptions. Because the majority of the cases of depression occur in women, they are most frequent recipients of this therapy. This situation has led to the electroconvulsive therapy as a form of violence against women The Freudian theory has become heavily criticized for being sexist. One criticism is that this traditional therapy was designed primarily by men to treat women. The cultural views of gender roles during the late 1800's came to be incorporated into psychoanalysis; the cases treated by Freud and his colleagues reflect men’s view of women and their problems during that era. People believe that psychoanalysis failed to meet the needs of female patients. Sexist use of psychoanalytic concepts is one of the four main causes of gender bias in therapy. The gender bias in psychoanalysis comes from conceptualizing men as the standard and making female development an inferior variation of male development Neither humanistic nor cognitive therapy is inherently gender biased in the way psychoanalysis is; however, both emphasize personal rather than social and environmental factors in functioning. These therapies can become gender biased if therapists apply their own personal values to therapy. Therapists might impose their personal values and encourage a client to adhere to traditional gender roles as a way to handle their problems Behavioural modification is value free; however, the choice of which behaviours to encourage or discouraged can reflect traditional or non-traditional values. Some critics fear that behaviour modification can be and has been used to enforce women's conformity rather than their personal development Medical therapies tend to take men’s symptom reports more seriously than similar reports from women and tend to attribute women’s complaints to psychological rather than physical causes Counselors are likely to view both men and women stereotypically in terms of emotionality-- women as overly emotional and men as lacking in emotion 1. Feminist therapy: 4 principles underlie the practice of feminine therapy. A common element of feminist therapy is striving to modify therapy techniques to make them more compatible with feminist goals. 1. personal and social identities are interdependent 2. The personal is political: Personal experience is embedded within the social and political structure of society. During feminist therapy women have a forum for validating their experiences as women, including the situations and problems that are unique to women. The feminist therapist's position was that significant change was not possible in women’s lives through personal changes in psychological adjustment; only change in society in women’s roles would lead to beneficial changes for women 3. Therapists and clients should form an egalitarian relationship rather than the traditional therapeutic relationship in which therapists are powerful and dominant and clients are subordinate. This ensures that the client understand the types of therapies that they will receive and that they know about the options for other sources of assistance. Feminist therapists endorse more openness and self
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