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Chapter 15

Chapter 15 - Treatment of Psychological Disorders.docx

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Dax Urbszat

Chapter 15 - Treatment of Psychological Disorders The Elements of the Treatment Process Treatments: How Many Types Are There? 1. Insight therapies - "talk therapy" 2. Behaviour therapies - based on principles of learning 3. Biomedical therapies - involve interventions into a person's biological functioning Client: Who goes to therapy? People with problems: anxiety, depression (2 most common), unsatisfactory interpersonal relations, troublesome habits, poor self-control, low self-esteem, marital conflicts, self-doubt, a sense of emptiness, and feelings of personal stagnation Therapists: Who practices therapy? Clinical psychologists & counselling psychologists: provide therapy, diagnose and treat psychological disorders & everyday behavioural problems o Require doctoral degree Psychiatrists - physicians who specialize in the diagnosis and treatment of psychological disorders o More time on severe disorders (schizophrenia, mood disorders) Mental health counsellors, clinical social workers, psychiatric nurses - all other professions will be called clinician, therapist, provider Who benefits most from therapy? Patients with some anxiety often do better Patients who are better adjusted to begin with Insight therapies - involve verbal interactions intended to enhance clients’ self-knowledge and thus promote healthful changes in personality and behavior Psychoanalysis is an insight therapy that emphasizes the recovery of unconscious conflicts, motives, and defenses through techniques such as free association and transference Probing the Unconscious o Free association - clients spontaneously express their thoughts and feelings exactly as they occur, with as little censorship as possible o Dream analysis the therapist interprets the symbolic meaning of the client’s dreams Interpretation o Interpretation refers to the therapist’s attempts to explain the inner significance of the client’s thoughts, feelings, memories, and behaviors Resistance o Resistance refers to largely unconscious defensive maneuvers intended to hinder the progress of therapy Transference o Transference occurs when clients unconsciously start relating to their therapist in ways that mimic critical relationships in their lives Modern Psychodynamic Therapies o Interpretation, resistance, and transference continue to play key roles in therapeutic effects Client-Centered Therapy - 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 Therapeutic Climate Therapists must provide three conditions: a. Genuineness b. Unconditional positive regard c. Empathy Therapeutic Process o The therapist’s key task is clarification o Emotion-focused therapy o Client-centered therapy resembles psychoanalysis in that both seek to achieve a major reconstruction of a client’s personality Therapies Inspired by Positive Psychology  Well being therapy (Gava) - seeks to enhance clients’ self-acceptance, purpose in life, autonomy, and personal growth o Treat mood disorders and anxiety disorders  Positive psychotherapy (Seligman) - get clients to recognize their strengths, appreciate their blessings, savor positive experiences, forgive those who have wronged them, and find meaning in their lives o Treat depression Group Therapy  WWII in 1950s  Group therapy is the simultaneous psychological treatment of several clients in a group Participants’ Roles o Consists of 4-15 people with ideal of 8 participants o Participants essentially function as therapists for one another o Therapist’s responsibilities include selecting participants, setting goals for the group, initiating and maintaining the therapeutic process, and protecting clients from harm Advantages of the Group Experience o Save time and money o Same effective as individual treatment o Certain types of problems and clients respond especially well to the social support that group therapy can provide How Effective Are Insight Therapies?  Spontaneous remission - a recovery from a disorder that occurs without formal treatment  They are as effective as other therapies How Do Insight Therapies Work? Approaches to therapy share common factors: 1. Development of a therapeutic alliance with a professional helper 2. Provision of emotional support and empathic understanding by the therapist 3. Cultivation of hope and positive expectations in the client 4. Provision of a rationale for the client's problems and a plausible method for reducing them 5. Opportunity to express feelings, confront problems, gain new insights, and learn new patterns of behaviour Behavior Therapies - involve the application of learning principles to direct efforts to change clients’ maladaptive behaviors Assumptions:  Behaviour is a product of learning  What has been learned can be unlearned Systematic Desensitization  A behavior therapy used to reduce phobic clients’ anxiety responses through counterconditioning (reversal of classical conditioning)  Assumption: most anxiety responses are acquired through classical conditioning 1. Therapist helps the client build an anxiety hierarchy (list of anxiety-arousing stimuli) 2. Training client in deep muscle relaxation 3. Client tries to work through hierarchy, learning how to remain relaxed while imagining each stimulus 4. As clients conquer imagined phobic stimuli, they may be encouraged to confront the real stimuli. Aversion therapy  A behavior therapy in which an aversive stimulus is paired with a stimulus that elicits an undesirable response Social skills training  Behavior therapy designed to improve interpersonal skills that emphasizes modeling (observation), behavioral rehearsal(practice social techniques in structured role-playing exercises), and shaping (clients handle more complicated & delicate social situations) Cognitive-Behavioral Treatments  Use varied combinations of verbal interventions and behavior modification techniques to help clients change maladaptive patterns of thinking  Ex: rational emotive behaviour therapy, mindfulness-based cognitive therapy  Aaron Beck's cognitive therapy uses specific strategies to correct habit
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