April 14, 2014Therapies Psychiatrist Medical doctor who specializes in preventing, diagnosing & treating mental illnesses Can prescribe medication Psychologist Doctoral degree [PhD, PsyD or EdD) or master’s degree in psychology Cannot prescribe medication Licensed mental health counselor Mental health professional who has a master’s degree in psychology, counseling or related field Clinical social worker Has at least a master’s degree in social work Training to be able to evaluate & treat mental illnesses Percentages of types of therapy Cognitive = 49% Psychoanalytic/psychodynamic = 28% Family/systems = 19% Humanistic = 11% Behavioral = 9% Insight-oriented therapy Psychoanalysis [Freud] Time intensive (meet with therapist almost every day for at least 2 years) Lie on couch while therapist sits out of sight & takes notes Has no stood up to empirical investigations Problems are due to unconscious drives Focus on client-therapist relationship Focus on early childhood relationships Psychodynamic Continuation/update of psychoanalysis Problems are due to unconscious drives Focus on current relationships Do not lie on couch engage in face-to-face discussion with therapist Less time intensive (1 or 2 times a week for 12 sessions – a few years) Client-centered therapy [humanistic] Carl Rogers Fulfilling one’s full potential Problems are due to disconnect between ideal self & actual self (who you want to be & who you are) Active listening & mirroring [not parroting] Unconditional positive regard Cognitive-behavioral therapy Reducing problematic behaviors & irrational thoughts Developing more adaptive thoughts & behaviors Behavioral therapies Insight from behaviorism Problems are due to maladaptive behaviors [no interest in underlying cause] Classical conditioning techniques Exposure = repeatedly exposing one to a stimulus, which causes one to become less responsive to that stimulus (e.g. giving speeches when one is afraid of public speaking) Stimulus control = do not put yourself in a situation that elicits the negative response (e.g. if you are trying to stop drinking, do not enter a bar) Systematic desensitization = gradually exposing one to stimulus that causes fear/anxiety (e.g. look at pictures of spiders, see spider in cage, touch spider, hold spider) Operant conditioning techniques Token economy = using rewards to modify behavior (e.g. every time you deny the offer of an alcoholic drink you receive a token, when you have 20 tokens you can exchange them for a reward) Extinction = not reinforcing a behavior will cause it to go away Cognitive therapy Make thoughts more realistic & less distressing Our interpretations [thoughts] of a stimulus can change our response to it Problems are due to irrational/incorrect interpretation of events/experiences Aaron Beck Problems are caused by cognitive distortions Systematic biases in how people think about events Originally developed to treat depression Daily record of dysfunctional thoughts explicitly counter negative thoughts Effective for anxiety, depression & anorexia nervosa Biologically based treatments Psychopharmacology Uses mediations to treat psychological disorders (schizophrenia, depression, anxiety, etc.) Problems caused by chemical imbalances in the brain Drug therapies Antipsychotics = treat positive symptoms of schizophrenia- Target dopamine receptors Antianxiety drugs = treat anxiety, phobias, OCD, PTSD- Calm central nervous system & cause extinction of learned fears Antidepressants = target norepinephrine or serotonin Mood-stabilizing drugs = treat bipolar- Not fully understood how they work Electroconvulsive therapy (ECT) 30-60 seconds of electrical current to the brain Calms overactive neural centers Currently only used for people with severe, disabling psychological disorders Much safer than when it was first developed General mix-and-match of psychopharmacology & talk therapy Other types of therapy Group therapy Family (systems) therapy Self-help therapy Interpersonal therapy Cultural considerations Symptoms associated with disorders appear differently in different cultural contexts What is “normal” in one culture might be “abnormal” in another culture Be cautious of applying American, white, middle-class norms to other
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