Transcript meyers AP-unit 13 treatment

Myers’ Psychology for AP*
David G. Myers
PowerPoint Presentation Slides
by Kent Korek
Germantown High School
Additions by Loretta Merlino
Worth Publishers, © 2010
*AP is a trademark registered and/or owned by the College Board, which was not involved in the production of, and does not endorse, this product.
Unit 13:
Treatment of Psychological
Disorders
1. Review Materials-Have by
3/1/14
• Barron’s AP Psychology soft cover- (6th edition,
2014-one without CD)
• Barron’s AP Psychology flash cards (2nd
edition)
Combined, about $27 to $30 at:
bn.com, amazon.com or Barnes and Noble store
2. The ONLY WAY TO GET AP scores: Register
with apcentral.collegeboard.com (by 1/29/14)
Objective
• I will be able to identify and apply the theories
of treatment methods for psychological
disorders on tests and on individual and group
assignments
Essential Questions
• 1. What are the different treatments for
psychological disorders?
• 2. How do these treatment methods differ by
perspective?
• 3. How do we evaluate the effectiveness of
treatment?
Unit Overview
•
•
•
•
The Psychological Therapies
Evaluating Psychotherapies
The Biomedical Therapies
Preventing Psychological
Disorders
Click on the any of the above hyperlinks to go to that section in the presentation.
Introduction-copy *
• History of treatment-reformers:
– Philippe Pinel
– Dorothea Dix
• *Psychotherapy (talk therapies)=
Trained therapist
uses psychological techniques to assist
one seeking to overcome,
or achieve personal growth
Types of Therapy (copy all)
• 1. individual (therapist and client)
• 2. group (therapist and clients with similar
issues; cheaper; helps one realizes others
have same problem)
• 3. family (therapist and all family members;
modify individual habits and family patterns)
• 4. support group (moderator/leader and
people that share same problem-AA,
bereavement, medical, etc..)
Family Therapies
Family therapy
Psychological Therapies =Talk Therapies
(called Psychotherapy) Based on the
Perspectives
Psychotherapy are Talk Therapies based on Perspectives (goals):
Psychoanalysis-(insight therapy) Freud:
Insight into unconscious motives and feelings
1. Psychodynamic Therapy influenced by Freud:
same as above-by identifying themes across important
relationships, including childhood and therapist’s
2. Humanistic Therapy -self acceptance and self fulfillment
Both 1 and 2 are Insight Therapy=Helps people reduce inner
conflict and increase self-understanding; assume that
psychological problems lessen as self-awareness grows
3. Behavior Therapy: uses behavior modification to change
learned behaviors
4. Cognitive Therapy: identifying and changing faulty beliefs
that effect feelings, thoughts and actions
5. Cognitive -Behavior Therapy :
changing both the way we think and act since our irrational,
negative thinking affects our behavior
Eclectic Approach-using a blend of therapies
Biological Approach/Perspective
(copy all)
The Biomedical Therapies performed by
psychiatrist/medical doctor -changing brain’s functioning with:
1.Drugs method called psychopharmacology
2. Electroconvulsive therapy (ECT-shocking brain)
3. Magnetic impulses to brain
4. Psychosurgery prefrontal lobotomy; separating
corpus callosum
Psychoanalysis (copy all)
• Psychoanalysis (Freud)
Aims of therapy:
bring repressed feelings to conscious awareness to gain insight into
origins of one’s issues/problems
Psychoanalysis
Methods (copy all)
• Methods-takes several times a week for several years
– Free association saying whatever comes to mind
– Resistance (you
pause, change subject,
you omit what seems
Irrelevant, your mind goes
blank, you joke-these
blocks are called resistance and
Lead to
• Interpretation
the meaning
– Dream analysis (manifest verses
latent content)
– Transference (strong positive or
Neg. feelings towards therapist
that represent important relationships)
Psychoanalysis
Psychodynamic Therapy (copy)
• Psychodynamic therapy influenced by Freud
Differences with
psychoanalysis:
once a week
for a few weeks or months,
no couch
Humanistic Therapies (copy all)
Humanistic treatment aim= to boost one’s inherent potential for selffulfillment by helping with self-awareness and self-acceptance
• Humanistic focus more on:
-conscious (not unconscious)
– taking responsibility for one’s feelings/actions
– promoting growth instead of curing
As a result use client not patient
Humanistic Therapies (copy)
Client-centered therapy (Carl Rogers)
– Nondirective therapy (listen’s to client without judging, interpreting, or
directing towards
insights)
- therapists show:
1. Genuineness
1. 1.genuineness (no
2. acceptance
(no judging)
3. empathy
(understand clients feelings)
RESULT: clients deepens self-understanding and self-acceptance
Humanistic Therapy
Client-centered therapy (copy all)
(Carl Rogers)
Therapist Demonstrates:
1. Active /Reflective listening
• Paraphrase
• clarify
• Reflect feelings
2. Unconditional positive regard (nonjudgmental
acceptance of client –the most important therapist’s
role)
The result-client accept even his/her worst traits and
feels valued
Behavior Therapies-based on
learning/behavioral perspective
• Behavior Therapy (assumes Abnormal behaviors are
learned)
– Operant conditioning techniques (changing behaviors through
rewards, punishments, ignoring behaviors)
– includes Behavior Modification(reinforce desired behaviors
and withholding reinforcement for, or punishing, undesired
behaviors) such as Token Economies
Joseph Wolpe 1915-1997
Systematic Desensitization
FEAR
What are you afraid of?
Arachnophobia
Behavior Therapies
Classical Conditioning Therapies-Classical conditioning
techniques for everyday issues
Exposure therapies-expose one to fears
Uses Counterconditioning;
Counterconditioning= pairing the unpleasant event/stimulus
(snake, spider, elevator, clown, flying, public speaking, etc…)
with something incompatible with fear (something relaxing)
1.Systematic desensitization-Joseph Wolpe
1. Anxiety Hierarchy (come up with an 8 to10 item hierarchy)
2. Learn Relaxation
3. The person thinks about or experiences each step in the hierarchy, one at a time,
from lowest to highest, while relaxation
2. Virtual reality exposure therapy (ex=flight similator)
3. Aversive conditioning (opposite of # 1)
Substitute a negative (aversive)response for a positive
response to a harmful stimulus (ex=snap rubber band when
curse)
Behavior Therapies
**Aversion Therapy
Behavior Therapies
**Aversion Therapy
Behavior Therapies
Aversion Therapy
Other Counterconditiong
Techniques (copy and leave one
space)
Flooding (with snakes, for example)
Modeling (being assertive, for example)
Cognitive Therapy
(copy) The Goal:
Using Thoughts to Change Emotions and
behaviors by teaching new ways of thinking
1. How might your thoughts affect your
emotions?
2. How might your thoughts affect your
behavior?
What is Wrong with Each Thought and How Might it
Affect Behavior?:
1. Everything I do must be approved and loved by all.
2. I have to be competent and successful at everything
I do.
3. It is a disaster when things do not go the way I want
them to.
4. My unhappiness is not my fault. It is because of
what other people do.
5. The people in my life need to change the way they
are.
6. My boyfriend wouldn’t cheat on me if I were
different
What might I say to myself
instead?
1. Everything I do must be approved and loved by all.
2. I have to be competent and successful at everything
I do.
3. It is a disaster when things do not go the way I want
them to.
4. My unhappiness is not my fault. It is because of
what other people do.
5. The people in my life need to change the way they
are.
6. My boyfriend wouldn’t cheat on me if I were
different
The Premise of Cognitive Therapy
We have Faulty Cognitions (thinking):
irrational beliefs and expectations that distort
our behaviors, attitudes and emotions
Cognitive Therapies Share One or
More of these Goals(leave space
for examples)
Disconfirmation=Client confronted with
evidence that contradicts existing beliefs (give
example)
Reconceptualization=Client forms alternative
beliefs to explain their experiences (give
example)
Insight=Client works on understanding and
forming new beliefs (give example)
Aaron Beck- Cognitive Therapy
Cognitive Therapies
– Beck’s therapy for depression: felt that cognitive
therapy could change Catastrophizing beliefs
Beck’s Focus
Illogical, Maladaptive Thoughts
Client’s told to test thoughts for accuracy
Example: I never have a good time
-Client comes up with times were good.
-Clients get homework to test/assess their
thoughts and behaviors (ex=be assertive-see
what happens).
Beck’s Type of Maladaptive
Thoughts
Overgeneralization- blanket judgments (I am a
failure)
Polarized Thinking- putting information into two
categories (people like me-people hate me)
Selective Attention-focusing on only one detail
of many (my friends always criticize me)
Write down Examples for each (you have three
minutes)
Beck’s/ Cognitive Therapy for
depression:
Cognitive Therapies-p 615
Cognitive Therapies-p. 615
Cognitive Therapies-p. 615
Cognitive Therapies-p. 615
Cognitive Therapies-p. 615
Cognitive Therapies-p. 615
Notebook Check-Test Grade
Due on 2/3 and 2/4
• To include:
1. Arrange by chapter and separate with a
labeled tab or by loose leaf paper and
homemade tab
2. A list of vocab. words (not defined)
3. COMPLETED Vocab. definitions
4. COMPLETED Outlines
5. ClassNotes
All in the above order-name or initials in ink
must be on every page of outline and vocab.
Cognitive Behavioral Therapy
• Goal=alter the way we think and act since our
irrational negative thinking affects our
behavior (ex. Telling self, “I will not die if I
leave the house,” Next, taking actions to leave
the house)
• Rational Emotive Therapy or Rational Emotive
Behavioral Therapy(RET or REBT)- by Albert
Ellis
Albert Ellis
RET REBT
Premice of Rational Emotive
Therapy
Emotional problems arise when one’s assumptions are
unrealistic.
Example:
I will fall apart if I am rejected. As a result, I do.
**Ellis’s ABCs
Problems are due to our belief about a situation, not
necessarily due to the situation
Activating Event (say being criticized)
Belief (I must be loved by everyone to be
happy)
Consequent Emotions (unhappiness)
**The goal of RET is to change B=FALSE, SELFDEFEATING BELIEFS
**Techniques of RET/REBT
Role Playing to see how your beliefs affect
relationships
Modeling to demonstrate other ways of thinking
and acting
Humor to show the absurdity of the belief
Persuasion The therapist gives hw – ask a girl
out who will reject you, so you can learn that
you can cope
Comparison of Psychotherapies
P. 618
Evaluating Psychotherapies
Is Psychotherapy Effective?
Who do you think should decide this?
• Regression toward the mean (read page
621-green box)
• Client’s perceptions (very positive)
Why Clients Remain Positive
• enter tx. In crisis and may mis-attribute
improvement to tx.
• have “stake” in believing therapy was worth it
• speak highly of their therapist even if
symptoms remain
Is Psychotherapy Effective?
• Clinician’s perceptions same as client’s
• Research=2/3 of those treated for nonpsychotic disorders improved markedly
Meta-analysis=statistically combine results of many
different research studies.
Show that one who gets therapy end up better off
than 80% of those who do not get treatment
Placebo Effect=the power of our belief in treatment
The Relative Effectiveness of
Different Therapies
• Evidence-based practice basing
treatment methods (what tx. to
use for what) on:
Evaluating Alternative Therapies
• Eye movement desensitization
and reprocessing (EMDR)p. 624
• Light exposure therapy helps with
–Seasonal
affective
disorder
(SAD)
Commonalities Among Psychotherapies
• Hope for demoralized people
• A new perspective
• An empathic,
trusting, caring
relationship
Culture and Values in
Psychotherapy (p. 511)
• Similarities between cultures
• Differences between cultures
Types of Therapists
The Biomedical Therapies
Introduction
Biomedical therapy changing
brain’s functioning with:
–Drugs
–Electroconvulsive therapy
–Magnetic impulses
–Psychosurgery
Only Psychiatrist (md) offer
biomedical Tx.
Drug Therapies
• **Psychopharmacology
• *Factors to consider with drug
therapy
–*Normal recovery rate of untreated
patients
–And recovery due to *Placebo
Effect
• *Double blind procedure
Drug Therapies
Drug Therapies
Antipsychotic Drugs
• **Antipsychotic drugs
– *Psychoses (some loss of
reality contact with
delusions and hallucinations)
– *Chlorpromazine
(sold as Thorazine or Haldol)lowers responsiveness to irrelevant
Stimuli: positive symptoms of
schizophrenia
*Antipsychotic drugs similar to molecules in neurotransmitter
Dopamine –they block receptor sites for dopamine
– **Tardive dyskinesia (involuntary movements of facial muscles,
tongue, and limbs from anti-psychotic drugs)
Drug Therapies
Antipsychotic Drugs
– Atypical antipsychotics –Clozaril- are best to
alleviate
negative symptoms of schizophrenia and
cause “awakenings” in these individuals
May also be used for positive symptoms not
responding to other drugs
Overall, antipsychotic drugs are effective
Drug Therapies
Antianxiety Drugs
• **Antianxiety drugs
– Xanax, Ativan, D-cycloserine
– Draw back:
1.Physiological
Dependence
2. Worsening symptoms
When stopped
Drug Therapies
Antidepressant Drugs
• Antidepressant drugs-increase activity of serotonin
– *Use with mood and anxiety disorders increase levels of
norepinephrine or serotonin, neurotransmitters that elevate mood
– *Fluoxetine (common name Prozac), Zoloft and Paxil block removal
of serotonin from synapses and are called:
Selective-serotonin-reuptake
Inhibitors (SSRIs)
*Serotonin promotes Neurogenesis
(birth of new brain cells)
May be why the drugs take up to 4 week to
work
May be just as effective as therapy or
exercise-should use drugs for severe depression
Drug Therapies
Antidepressant Drugs
Drug Therapies
Mood-Stabilizing Medications
• Mood-stabilizing medications
– Lithium carbonate and for the highs and lows of
bipolar
– They are unsure
why these drugs
Work, but are
effective
Brain Stimulation
Electroconvulsive Therapy
• Electroconvulsive therapy (ECT)
P. 633- used severe
for depression that has not
responded to meds.
Brain Stimulation
Electroconvulsive Therapy
Brain Stimulation
Alternative Neurostimulation Therapies
• Magnetic Stimulation (p. 634)
–Repetitive transcranial magnetic
stimulations
(rTMS)
• Deep-Brain
Stimulation
Brain Stimulation
Alternative Neurostimulation Therapies
Psychosurgery
• Psychosurgery (surgery that removes or destroys brain
tissue)
– Lobotomy
• History (Portuguese MD, Monitz, developed in1930s-earned
Nobel Peace Prize
• Procedure-cut nerves connecting frontal lobe with emotion
centers-used for uncontrollably emotional and violent
patients; shock pt. into coma, ice pic like instrument in both
eye sockets, took 10 minutes; 10s of thousands lobotomized
between 1936 and 1954, 35,000 in US)
• Side effects: lethargic, immature, uncreative-Permanent
Lobotomy abandoned when drugs available
Psychosurgery used in rare instances with epilepsy or OCD
by cutting corpus coliseum
The End
Eclectic Approach
= an approach to psychotherapy that,
depending on the client’s problems, uses
techniques from various forms of therapy.
Psychotherapy
= treatment involving psychological
techniques; consists of interactions
between a trained therapist and someone
seeking to overcome psychological
difficulties or achieve personal growth.
Psychoanalysis
= Sigmund Freud’s therapeutic technique.
Freud believed the patient’s free
associations, resistances, dreams, and
transferences – and the therapist’s
interpretations of them – released
previously repressed feelings, allowing the
patient to gain self-insight.
Resistance
= in psychoanalysis, the blocking from
consciousness of anxiety-laden material.
Interpretation
= in psychoanalysis, the analyst’s noting
supposed dream meanings, resistances,
and other significant behaviors and events
in order to promote insight.
Transference
= in psychoanalysis, the patient’s transfer to
the analyst of emotions linked with other
relationships (such as love or hatred for a
parent).
Psychodynamic Therapy
= therapy deriving from the psychoanalytic
tradition that views individuals as
responding to unconscious forces and
childhood experiences, and that seeks to
enhance self-insight.
Insight Therapies
= a variety of therapies that aim to improve
psychological functioning by increasing the
client’s awareness of underlying motives
and defenses.
Client-centered Therapy
= a humanistic therapy, developed by Carl
Rogers, in which the therapist uses
techniques such as active listening within
a genuine, accepting, empathic
environment to facilitate client’s growth.
(Also called person-centered therapy.)
Active Listening
= empathic listening in which the listener
echoes, restates, and clarifies. A feature
of Roger’s client-centered therapy.
Unconditional Positive Regard
= a caring, accepting, nonjudgmental
attitude, which Carl Rogers believed would
help clients to develop self-awareness and
self-acceptance.
Behavior Therapy
= therapy that applies learning principles to
the elimination of unwanted behaviors.
Counterconditioning
= a behavior therapy procedure that used
classical conditioning to evoke new
responses to stimuli that are triggering
unwanted behaviors; includes exposure
therapies and aversive conditioning.
Exposure Therapies
= behavioral techniques, such as systematic
desensitization, that treat anxieties by
exposing people (in imagination or
actuality) to the things they fear and avoid.
Systematic Desensitization
= a type of exposure therapy that associates
a pleasant relaxed state with gradually
increasing anxiety-triggering stimuli.
Commonly used to treat phobias.
Virtual Reality Exposure
Therapy
= an anxiety treatment that progressively
exposes people to simulations of their
greatest fears, such as airplane flying,
spiders, or public speaking.
Aversive Conditioning
= a type of counterconditioning that
associates an unpleasant state (such as
nausea) with an unwanted behavior (such
as drinking alcohol).
Token Economy
= an operant conditioning procedure in
which people earn a token of some sort for
exhibiting a desired behavior and can later
exchange the tokens for various privileges
or treats.
Cognitive Therapy
= therapy that teaches people new, more
adaptive ways of thinking and acting;
based on the assumption that thoughts
intervene between events and our
emotional reactions.
Cognitive-behavioral Therapy
= a popular integrative therapy that
combines cognitive therapy (changing selfdefeating thinking) with behavior therapy
(changing behavior).
Family Therapy
= therapy that treats the family as a system.
Views an individual’s unwanted behaviors
as influenced by, or directed at, other
family members.
Regression Toward the Mean
= the tendency for extreme or unusual
scores to fall back (regress) toward their
average.
Meta-analysis
= a procedure for statistically combining the
results of many different research studies.
Evidence-based Practice
= clinical decision-making that integrates the
best available research with clinical
expertise and patient characteristics and
preferences.
Biomedical Therapy
= prescribed medications or medical
procedures that act directly on the
patient’s nervous system.
Psychopharmacology
= the study of the effects of drugs on mind
and behavior.
Antipsychotic Drugs
= drugs used to treat schizophrenia and
other forms of severe thought disorder.
Tardive Dyskinesia
= involuntary movements of the facial
muscles, tongue, and limbs; a possible
neurotoxic side effect of long-term use of
antipsychotic drugs that target certain
dopamine receptors.
Antianxiety Drugs
= drugs used to control anxiety and
agitation.
Antidepressant Drugs
= drugs used to treat depression; also
increasingly prescribed for anxiety.
Different types work by altering the
availability of various neurotransmitters.
Electroconvulsive Therapy
(ECT)
= a biomedical therapy for severely
depressed patients in which a brief electric
current is sent through the brain of an
anesthetized patient.
Repetitive Transcranial
Magnetic Stimulation (rTMS)
= the application of repeated pulses of
magnetic energy to the brain; used to
stimulate or suppress brain activity.
Psychosurgery
= surgery that removes or destroys brain
tissue in an effort to change behavior.
Lobotomy
= a now-rare psychosurgical procedure once
used to calm uncontrollably emotional or
violent patients. The procedure cut the
nerves connecting the frontal lobes to the
emotion-controlling centers of the inner
brain.
Resilience
= the personal strength that helps most
people cope with stress and recover from
adversity and even trauma.