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PSYA02H3 (931)
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Chapter 18

chapter 18 textbook notes

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University of Toronto Scarborough
John Bassili

-1Chapter 18 The Treatment of Mental Disorders Four basic approaches to treatment of mental disorders: insight therapies, behaviour therapy and cognitive-behaviour therapies, treatment of groups (including treatment of couples and the development of outreach programs that serve the community), and biological treatments Mental Disorders and Psychotherapy Early Treatment of Mental Disorders: Mental disorders have been with us since the beginning of human existence People with the disorders were regarded with fear or awe Often considered possessed by devils or evil sprits and made to suffer accordingly Earliest known attempts to treat mental disorders - trephining: drilling holes into a persons skull; the opening permitted evil spirits to leave the victims head Signs of healing in prehistoric skulls show that some people survived trephining People were thought to possess evil spirits; exorcisms performed, beatings, starving, near drowning, drinking of foul-tasting concoctions People thought they deserved to be punished because they were evil th A few people in the 18 century decided that disorders reflected diseases and should be treated medically and with compassion (Johann Wier, 16 century was one of first to challenge practices combating witchcraft; his writings were banned from Church and re-emerged in 20 century) People with mental disorders often consigned to various asylums to be cared for; most institutions were very inhumane - kept in chains, wallowed in their own excrement Many treatments were only a little better than the tortures used before to drive out evil spirits - ex. Tied up, doused in cold water, forced to vomit, etc. Humanitarians changed this treatment Philippe Pinel - believed most mental patients would respond well to kind treatment; his patients showed improvement The discovery of antipsychotic drugs and improvements in psychotherapy have freed many people who would otherwise be in institutions The Development of Psychotherapy: Mesmer - theory of magnetic fluxes - he attempted to effect cures by manipulating iron rods and bottles of chemicals He hypnotized his patients and alleviated some of their symptoms; hypnosis was first known as mesmerism Freud created practice of psychoanalysis (ch.14) - his methods are still influential in todays treatment Therapists adopt approaches that fit their views of why people behave the way they do - Therapists who believe that that behaviour is strongly influenced by the environment and peoples perception of them will use cognitive-behavioural approaches www.notesolution.com - Those that believe behaviour is strongly influenced by biological factors are likely to use a combination of drug therapy and psychotherapy Most therapists use a more general, eclectic approach which involves the therapist using whatever methods they feel will work best for a particular client at a particular time seek the form that will best suit the clientoften combining different treatment approaches Insight Therapies (insight will lead to a cure) Insight therapy: assume that people are essentially normal but learn maladaptive thought patters and emotions, which are revealed in maladaptive behaviours Viewing behaviours as symptom of deeper underlying psychological problems once the person understands their problems, the behaviours will cease Some insight therapies focus on the clients past; Client-centered and Gestalt therapies emphasize the present (attempt to get the client to see the effects of their maladaptive thoughts and find more adaptive ways of living) Psychoanalysis: a form of therapy aimed at providing the client with insight into their unconscious motivations and impulses -clues about the origins of intrapsychic conflict are revealed through dreams, physical problems, memory (or failure to remember certain things) manner of speech and their reactions to therapy -main goal is to interpret the clues about the origins of the intrapsychic conflict; clients own interpretations are often biased so theyre inaccurate Clients job is to provide something to interpret Freud felt that veil of amnesia lifts the moment that insight is achieved; client then begins to understand the true nature of hisher problems Successful treatment depends on psychoanalysts interpretations and ensuring the patient has capacity to understand and integrate what is learned in therapy Psychoanalytic Techniques: Free Association: Freud used this technique to encourage the client to speak freely without censoring possibly embarrassing or socially unacceptable thoughts. The client was encouraged to report any thoughts or images that came to mind without worrying about their meaning. He also attempted to minimize any authoritative influence over the clients disclosures by eliminating eye contact Dream interpretation - the evaluation of underlying meaning of dream content; its a hallmark of psychoanalysis The analyst must be able to distinguish between the dreams manifest (actual images and events) and latent (hidden meaning or significance) contents. -the manifest content masks the latent content because the latent content is anxiety- provoking and causes the persons psychological discomfort Resistance: the client often becomes defensive during therapy, unconsciously attempting to halt further insight by censoring their true feelings (when the client changes topic, begin missing appointments, or suddenly forgets what they are talking www.notesolution.com
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