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Chapter 15

CHAPTER 15 - Treatment of Psychological Disorders

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Eileen Wood

CHAPTER 15: Treatment of Psychological Disorders Psychotherapy- refers to all the diverse approaches used in the treatment of mental disorders and psychological problems - professional treatment by someone with special training History… Breuer: speculated that talking things through, enables a person to drain off bottled-up emotions that cause symptoms of mental illness Freud: applied this insight to other patients, and his success led to the process of psychoanalysis Psychotherapists use many treatment methods, of which can be classified into 3 major categories… 1. Insight Therapies: engage in complex verbal interactions 2. Behaviour Therapies: direct efforts to alter problematic responses and maladaptive behaviour 3. Biomedical Therapies: interventions into a person’s biological functioning The therapeutic triad = therapists + treatments + clients (The greatest diversity of all is seen among the clients) 2 types of Psychologists that may provide therapy… 1. Clinical psychologist- training emphasizes the treatment of full-fledged disorders 2. Counselling psychologists- training is slanted toward the treatment of everyday adjustment problems Psychologists- use either insight or behavioural approaches Psychiatrists- physicians who specialize in the diagnosis and treatment of psychological disorders - more likely to use behavioural techniques and less likely to use psychoanalytic methods - devote more time to relatively severe disorders INSIGHT THERAPIES …involve verbal interactions intended to enhance clients’ self-knowledge and thus promote healthful changes in personality and behaviour Psychoanalysis- an insight therapy that emphasizes the recovery of unconscious conflicts, motives and defenses through techniques such as free association and transference - Freud believed that neurotic problems are caused by unconscious conflicts left over from early childhood - Inner conflicts = battles between the id, ego and superego - Theorized that people use defense mechanisms to avoid confronting these conflicts The therapeutic procedures used in psychoanalysis… Free association- clients spontaneously express their thoughts and feelings exactly as they occur, with as little censorship as possible - these associations are studied for cues about what is going on in the client’s unconscious Dream Analysis- the therapist interprets the symbolic meaning of the client’s dreams; “the royal road to the unconscious” – Freud (Freud’s view of the roots of disorders) Intrapsychic conflict (id, ego, superego)  Anxiety  Reliance of defense mechanisms Interpretation- refers to the therapist’s attempt to explain the inner significance of the client’s thoughts, feelings, memories and behaviours Resistance- refers to largely unconscious defensive maneuvers intended to hinder the progress of therapy - clients don’t want to face up the painful, disturbing conflicts that they have buried in their unconscious - reluctant to consult their real problems Transference- occurs when clients unconsciously start relating to their therapist in ways that mimic critical relationships in their lives - the client transfers conflicting feelings about important people onto the therapist - Freud: once clients recognize the unconscious sources of conflicts, they can resolve these conflicts and discard their neurotic defenses Psychodynamic approaches to therapy- the decedents of psychoanalysis… 1. Client-Centred 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 o Carl Rogers: personal distress is due to inconsistency or “incongruence” between a person’s self-concept and reality o Incongruence- makes people threatened by realist feedback about themselves Believe affection Need to distort relatively from others  shortcoming to feel  incongruent  Recurrent is conditional worthy of affection self-concept Anxiety Defensive behaviour protects inaccurate self-concept o Therapeutic Climate: the process of therapy is not as important as the emotional climate in which the therapy takes place o To create an atmosphere of emotional support, these 3 conditions must be supplied: genuineness, unconditioned positive regard and empathy o Therapeutic Process: the therapist provides feedback to help clients sort out their feelings  clarification 2. Cognitive Therapy: is an insight therapy that emphasizes recognizing and changing negative thoughts and maladaptive beliefs - Aaron Beck: self-instructional training- clients are taught to develop and use verbal statements that help them cope with difficult contexts - goal is to change the way client’s think  use more reasonable standards of evaluation Negative Thinking… - blame setbacks on personal inadequacies increased vulnerability to - focus selectively on negative events  depression - make unduly pessimistic projections about future - draw negative conclusions about personal worth 3. Group Therapy: is the simultaneous treatment of several clients in a group - came to be after WW2 and aftermath - participants essentially function as therapists for one another  acceptance and moral support Evaluation of Insight Therapies… Spontaneous Remission- is a recovery from a disorder that occurs without formal treatment Allegiance Effect- researchers comparing different therapies tend to obtain results that favour the therapeutic approach they champion - see what one wants to see BEHAVIOUR THERAPIES …involve the application of learning principles to direct efforts to change clients’ maladaptive behaviours Difference: Insight therapists treat pathological symptoms as signs of an underlying problem… Behavioural therapists think that the symptoms are the problem Behaviour therapies are based on certain assumptions… - assumed that behaviour is a product of learning - assume that what has been learned can be unlearned - they then apply these conditions to the principles of classical, operant and observational conditioning Systematic Desensitization- a behaviour therapy used to red
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