Introduction to Psychology

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Introduction to Psychology

• Treatment of Psychological Disorders

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Psychological Therapies

• Whereas the biological therapies view mental
  disorders through the medical model,
  psychological therapies view the roots of
  abnormal behavior in mental states
• Each therapy has its own view as to the cause of
  mental disorder
• Each therapy has its own approach to the
  treatment of mental disorder

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Insight-Oriented Therapy

• E.g. psychoanalysis, humanistic, gestalt
• Help person understand the basis of their
  thinking, behavior, emotions and perceptions
• Insight into the cause will lead to change
• Emotion focused therapy or process experiential

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Action-Oriented Therapy

• E.g. Cognitive-Behavioral therapy,
  Rational-Emotive therapy
• Encourages individuals to change behavior or
  thinking
• Multifaceted and individually tailored
• Strong therapeutic relationship
• Behavioral techniques and cognitive restructuring

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Varieties of Psychological Treatment

• Psychodynamic
• Humanistic
• Cognitive-behavioral
• Biological/Biomedical
• Group therapy
• Family and marital therapy

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Psychodynamic Approach

• The psychodynamic approach was created by S.
  Freud
• Mental symptoms reflect unconscious conflicts
  that induce anxiety
• Insight refers to the situation in a person comes
  to understand their unconscious conflicts
• Therapeutic change requires an alliance
  (relationship) between the patient and therapist

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Psychodynamic Techniques

• The goal of psychodynamic therapy is to achieve
  insight into unconscious conflicts
• Free Association refers to a technique in which
  the patient is encouraged to say whatever comes
  to mind to reveal the unconscious processes of
  the patient
• Interpretation Therapist interprets the
  thoughts, and feelings of the patient in order to
  reveal the hidden conflicts and motivations
• Analysis of transference Patients bring into
  therapy their past troubled relationships these
  are transferred to the therapist

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Humanistic Therapy

• Rogers Client-centered therapy
• Therapeutic Climate
• Genuineness
• Unconditional Positive Regard
• Empathy
• TherapeuticProcess
• Guidance, clarification, become more comfortable
  with genuine self

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Behavior Therapies

• Classical conditioning techniques can alter
  emotional responses
• Systematic desensitization Patient is encouraged
  to confront a feared stimulus (snake) while in a
  relaxed state
• Therapist trains relaxation
• Patient constructs an image hierarchy
• While relaxing, patient imagines the least
  fearful of the images in their hierarchy (e.g.
  being on the planet as a snake)
• Exposure Patient is exposed to the stimulus
  that they fear (locked in a room full of snakes)

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Cognitive Therapies

• Focus of cognitive therapies is on changing
  dysfunctional thought patterns
• Rational Emotive Therapy focuses on the hurtful
  thought patterns of the patient
• Elliss theory suggests that pathology results
  when persons adopt illogic in response to life
  situations
• Therapist notes illogical and self-defeating
  thoughts and teaches alternative thinking that
  promotes rational thought

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Cognitive-Behavioral Therapies

• Cognitive-behavioral therapies focus on the
  current behaviors of a person
• Emphasis is on the present rather than the past
• Cognitive-Behavioral therapists are very
  directive
• Therapy duration is short-term rather than years
  long
• Initial focus is on a detailed behavioral
  analysis focus is on the problem behavior and
  the stimuli associated with it

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Cognitive Restructuring

• Beck or Ellis
• Irrational beliefs
• Extreme emotional reactions
• ABCs or Rational Emotive Therapy
• A activating event
• B belief
• C consequences (emotional)
• D disputing beliefs

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Research indicates

• Receiving psychotherapy is considerably more
  effective than no treatment
• CBT shows a slight but consistent advantage with
  regards to effectiveness compared to
  insight-oriented therapy
• People who do best in therapy are those who have
  the least problems
• personality disorders show less benefit

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The Medical Model

• The Medical Model views abnormal behavior as
  reflecting a biological disorder
• Usually localized within the brain
• Involving either brain damage or a disruption of
  the neurotransmitter processes of the brain
• Person is viewed as a patient, treated by doctors
  in a mental hospital
• Therapies tend to be physical in nature
• Drugs (Pharmacotherapy)
• Surgical alteration of brain (Psychosurgery)

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Pharmacotherapy

• Psychotropic medications are drugs that act on
  the brain to alter mental function
• Prior to 1956, schizophrenia was virtually
  untreatable with many patients confined for life
  in mental hospitals
• Chlorpromazine (Thorazine) was found to reduce
  severity of psychotic thought, allowing people to
  live outside of mental institutions
• Reduced size of institutions
• The psychotropic actions of many drugs are often
  accidentally discoveries

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Antipsychotic Medications

• Schizophrenia can be viewed as composed of
• Positive Symptoms Presence of hallucinations
• Negative Symptoms Absence of affect
• Antipsychotic medications refer to drugs that
  alleviate schizophrenia
• Antipsychotic medications are more effective for
  the positive symptoms than for negative symptoms
  of schizophrenia

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Dopamine and Schizophrenia

• The positive symptoms of schizophrenia reflect
  too much brain dopamine activity
• Antipsychotic drugs are effective antagonists of
  dopamine receptors (block the action of dopamine)
• Drugs such as amphetamine release dopamine from
  terminals too much amphetamine exposure can
  induce a psychotic state in humans
• Negative schizophrenic symptoms may reflect brain
  damage enlarged ventricles)

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Antidepressant Medications

• Depression reflects a disturbance of mood, sleep,
  and appetite
• Psychotropic antidepressant drugs can lift
  depression (require 3-4 weeks for effect)
• Tricylic antidepressants Act by blocking the
  reuptake of norepinephrine and serotonin
• Monoamine oxidase (MAO) inhibitors MAO degrades
  transmitters drugs that inhibit MAO allow the
  transmitter to work for longer periods
• Selective serotonin reuptake inhibitors Prozac
  blocks the reuptake of serotonin

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Antianxiety Medications

• Anxiety reflects an intense emotional state of
  dread and apprehension
• Drugs such as Valium increase the activity of the
  transmitter GABA to dampen the neural activity of
  the brain
• Valium is useful in the short-term treatment of
  anxiety
• Antianxiety medications can result in drug
  dependence

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Electroconvulsive Therapy

• Antidepressant drugs require 3-4 weeks to take
  action on mood the person may be at risk for
  suicide or is not responding to drug treatment
• Electroconvulsive shock therapy (ECT) refers to
  the intentional induction of a brain seizure by
  shock administered to either or both hemispheres
• ECT produces immediate improvement in mood
  (explanation is unknown)
• Side effects of ECT include memory loss

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Common Factors in Psychotherapy

• Development of a therapeutic alliance
• Providing a rationale
• Opportunity for catharsis or venting
• Acquisition and practice of new behaviors
• Beneficial therapist qualities (objective,
  confidential, professional)
• Patient positive expectations and hope

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Eclecticism

• Involves using different treatments for different
  clients with different problems
• Using a reasonable combination of various
  treatments for the same client (technical
  eclecticism)
• - all populations can receive different types of
  group therapy

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Advantages to groups

• Efficiency 2. Universality
• Empathy 4. Interaction
• 5. Acceptance 6. Altruism
• Modeling 8. Pressure
• 9. Practice 10. Reality testing
• 11. Transference

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Suicide Risk Factors

• Diathesis
• psychological disorder (90)
• substance use and abuse (25-50)
• family history of suicide
• family breakdown
• societal breakdown
• past suicide attempts

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Suicide Risk Factors

• Stress
• changes in relationships, academic/work, or
  financial situation
• life event that is shameful or humiliating
• significant loss
• homosexuality
• recent suicide

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Suicide

• Warning Signs
• withdrawal
• change in eating, sleeping, friends
• writing and talking about death
• telling statements
• agitation followed by calm resignation
• giving away valued possessions

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What to do as a friend

• Take suicide threats seriously
• Dont be afraid to discuss suicide
• Recognize the warning signs and the risk factors
• Dont leave the person alone
• Get help

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What to do as a therapist

• Ask directly about suicide
• Find out if they have a plan
• Do they feel like they are in control of their
  behaviour?
• Develop a safety plan
• Make a contract
• Treat the psychological disorder
• Crisis situation break confidentiality
• Grief after suicide...