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57 Cards in this Set
- Front
- Back
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Dorothea Dix (1802-1887)
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reform of U.S. system
moral-treatment movement kindly care led to large, state-supported public asylums overcrowding, loss of public attention |
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Deinstitutionalization (mid-1950s)
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get people out of asylums and back into community
effective antipsychotic medication general mood of optimism in country |
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1963: establishment of community mental health centers
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Remain largely under funded
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Managed Care influence
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Preference for drug therapy and short-term treatment
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Places of treatment
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community mental health centers
private offices public or private mental hospitals general hospitals nursing homes for older patients with mental health needs halfway houses/group homes |
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Psychiatrists
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medical degree (M.D.)
special training/residency in psychiatry mainly hospitals & private practice can prescribe drugs |
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Clinical/Counseling psychologists
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doctoral degree (Ph.D.) in psychology
training in research & practice universities, private practice, community mental health |
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Counselors
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master's degree in psychology
schools & institutions school-or job-related problems |
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Psychiatric social workers
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master's degree in social work
public agencies, home visits |
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Who Gets Treatment?
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Most people who meet criteria for DSM diagnoses do not seek treatment
Variability due to sex, education, race & income level *women seek more treatment than men *college educated seek more treatment than high school educated *whites seek more treatment than nonwhites *higher income seek more treatment than lower income |
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Psychotherapy
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an emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties
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Eclectic Approach
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an approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy
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Psychodynamic Therapy
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Sigmund Freud
Psychological problems result from inner mental conflicts (unconscious) Must make these conflicts conscious to adjust behavior Repressed memories |
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Psychoanalysis
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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
use has rapidly decreased in recent years |
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Resistance
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unconscious material causes anxiety
patients resist attempts to bring unconscious into conscious “forgetting” appointments, no showing refusing to discuss certain topics |
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Transference
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patient’s unconscious feelings about person in their life experienced as feelings toward therapist
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Free association
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patient relaxes and reports everything that comes to mind
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Dream analysis
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Recognition of themes and symbols
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Mistakes
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slips of the tongue
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Insight & Cure
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*Analyst’s job is to make inferences about patient’s unconscious conflicts
*Once patient experiences them consciously, can modify or express them *Patient must accept insights of therapist *Analyst leads patient to insight so patient comes to insight themselves |
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Humanistic Therapy
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Emphasis on inner potential for positive growth
*Similarity to psychodynamic help clients become more aware of inner feelings & desires Differences from psychodynamic *inner feelings & desires are seen as positive & life-promoting *main goal is to help client take control of own life |
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Carl Rogers
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Client-centered therapy
focus on thoughts, abilities, cleverness of client not focused on insights of therapist therapist as a sounding board for client’s thoughts |
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Problems caused by denial of own feelings & distrust of ability to make decisions
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Empathy
Unconditional positive regard Genuineness |
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Empathy
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attempt to comprehend feelings from client’s point of view
use of reflection, rephrasing |
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Unconditional positive regard
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client is worthy & capable no matter what client does or says
creates safe, nonjudgmental atmosphere |
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Behavior Therapy
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Therapy that applies learning principles to the elimination of unwanted behaviors
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Exposure Therapy
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Uses principles of extinction to decrease anxiety
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Types of Behavior Therapy
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Exposure Therapy
Uses principles of extinction to decrease anxiety Systematic Desensitization (counterconditioning) Aversion Therapy |
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Behavioral Treatments
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Used for phobia treatment
Systematic desensitization Flooding |
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Used for phobia treatment
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treat anxieties by exposing people (in imagination or reality-in vivo) to the things they fear and avoid
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Systematic desensitization
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train client in muscle relaxation
then combine imagery of feared object with relaxation use increasingly frightening scenes highly effective for treating phobias |
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Flooding
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expose person to feared stimulus and allow them to experience accompanying fear
Fear gradually declines & disappears |
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Counterconditioning
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procedure that conditions new responses to stimuli that trigger unwanted behaviors
based on classical conditioning |
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Systematic Desensitization
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type of counterconditioning
associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli (stimulus hierarchy) Initial training in progressive muscle relaxation techniques, because relaxation is incompatible to anxiety commonly used to treat phobias |
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Aversion Therapy
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Used for bad habits
Use of operant conditioning principles *painful or unpleasant stimulus follows the unwanted Example Antabuse (induces nausea) for alcohol usage Controversial treatment Limited generalizability of results |
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Other Behavioral Techniques
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Token economies
exchange system often used in inpatient treatment Contingency contracts formal written agreement Assertiveness & social skills training Modeling therapist models adaptive behaviors for client |
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Beck’s Cognitive Therapy
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Treatment of depression
Depressed people distort experiences & maintain negative views of themselves, the world, their future minimize positive & maximize negative experiences misattribute negative experiences to own deficiencies |
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Cognitive Therapy
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teaches people new, more adaptive ways of thinking and acting
based on the assumption that thoughts intervene between events and our emotional reactions |
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Cognitive-Behavioral Therapy
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a popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)
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Group Therapy
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Psychodynamic
Humanistic Cognitive & Behavioral |
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Psychodynamic
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interactions among group members provide clues to hidden motives
gain insight into how unconscious affects relations with others |
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Humanistic
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members gain opportunity to express selves honestly
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Cognitive & Behavioral
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clients can practice new skills, new ways of thinking
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Couple & Family Therapy
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Problem not in individual but interaction between individuals
Family therapy Family systems perspective Intergenerational approach |
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Family Therapy
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see whole family together, observe interactions
help members gain perspective |
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Family systems perspective
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each person accommodates to the family
fix family problems by offering insight into how each affects others |
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Intergenerational approach
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considers influence of previous generations
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General conclusions about therapy effectiveness
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People in treatment do better than those not
Each type of therapy as effective as the others Some types of therapy work better for specific problems cognitive-behavioral best for fear & anxiety humanistic best for self-esteem psychodynamic best for work/school achievement Some therapists are better than others warm, understanding, motivated |
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Nonspecific factors in therapy effectiveness
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Nonspecific = unrelated to specific principles but critical to outcome
Support acceptance, empathy, encouragement, guidance Hope sense of faith in therapy process placebo effect = improvement from belief, rather than actual effect |
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Biomedical Therapies
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Psychopharmacology
Psychotropic Medication |
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Psychopharmacology
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study of the effects of drugs on mind and behavior
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Psychotropic Medication
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Drug used to treat psychological disorder
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Common Types
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Anti-psychotic
Effective, but side effects can often be marked Anti-anxiety Valium, Xanax, Beta blockers, BuSpar Anti-depressants Older tricyclics and MAO inhibitors (worse side effects) New drugs more effective and fewer side effects Prozac, Paxil, Zoloft, Celexa Often successful in treating anxiety as well |
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Biomedical Therapies
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Electroconvulsive Therapy (ECT)
Psychosurgery lobotomy |
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Electroconvulsive Therapy (ECT)
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therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient
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Psychosurgery
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surgery that removes or destroys brain tissue in an effort to change behavior
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lobotomy
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now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients
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