History What we know believe about abnormalities different approaches to treatment Early theories Demon Spirit possession Treatments Exorcisms Trephination Institutionalization Torture Moved to medical treatments Treatments shock therapies surgeries drugs http www youtube com watch v 1Izmyru5T w feature related Mid 1800 s Institutional reform patients rights issues History With the 1900 s Shift to gentler approaches Still a few outliers lobotomies Moniz Freeman 1930 s http www youtube com watch v 0aNILW6ILk feature related Freud introduces talk therapy Evolves into the therapies we know now More sophisticated medical approaches Better drugs more focused surgeries Still some controversy over diagnosis treatments Scientologists attacks http www youtube com watch v HwAaHbmF5S4 Lobotomies Electroconvulsive Therapy ECT Good example of evolution of treatment Sordid history of use Often used with out consent were awake http www youtube com watch v DCUmINGae44 Is it still really used Yes In cases of EXTREME depression EXTREMELY Controversial Different procedure used now Patient s consent Are sedated Don t remember anything Treatments 3 Major Types Insight Therapies talk therapy Already discussed Freud Psychoanalysis pioneered talking therapy Behavior Therapy Biomedical Therapies Often used together Insight Therapy Talk therapy TWO components enhancing self knowledge Promote personality behavior change 3 Types Psychoanalysis already covered Client Centered Therapy Group Therapy Insight Therapy Didn t talk about Humanism CH 12 Applied to therapy client centered Carl Rogers Disorders Self concept GAP Reality Feel threatened defensive Depend on others approval People need to find themselves get in touch with their feelings Goal don t have to please others clients build self acceptance Insight Therapy Humanistic Therapy Climate process Requires supportive atmosphere Therapists should show Genuineness Unconditional Positive Regard Accurate empathy Active listening echoing restating Work together as equals Therapist like a mirror Repeats what client says Provides clarification Insight Therapy Group Therapy Treat several clients at once 6 8 participants is ideal Members share problems views strategies May work harder to improve Accountable to group and therapist Therapist facilitates Builds group initiates maintains discussions prevents harmful interactions promotes cohesiveness CHEAPER Unique problems benefits Group Therapy Pop culture reference http www youtube com watch v jMIDpJ8H7H0 Effectiveness of Insight Therapy Hard to say Patients may improve With or without therapy Depends on severity of issues Insight therapy no treatment placebo Effects generally last General trends 50 improve within 20 sessions 25 improve after 45 sessions Lots of variability How Do Insight Therapies Work Common factors Trusting alliance with therapist Therapist emotional support Client hope positive expectations New explanation for problems solutions Opportunity express confront problems Behavior Therapies INSIGHT WHY You have problems Behavior therapists change maladaptive behavior Ex Risky sexual activity or smoking Assumes behavior is learned or conditioned can be unlearned Use learning conditioning principles Proponents include B F Skinner Are we surprised Behavior Therapies How to learn or unlearn behaviors Gradually expose people to fears reduce anxiety Systematic Desensitization Generally with Phobias Fear of flying snakes snow Assumes learning via classical conditioning must weaken or extinguish the pairing THREE STEPS Client creates anxiety hierarchy Train client in muscle relaxation Try to stay relaxed imagining each step Simple very effective Exposure Therapy Baby steps http www youtube com watch v LcojyGx8q9U Fear of Elevators confronting fear http www youtube com watch v H8GHsjBhWV8 Behavior Therapies Aversion Therapy Classical conditioning Negative association with behavior Like punishment Ex Bitter tasting nail polish to stop biting nails Doesn t address root of problem Nail biting oral fixation parent issues Probably not but maybe anxiety problem Behavior Therapies Social Skills Training Improve interpersonal skills Use modeling rehearsal and shaping Ex imitate others to become less shy Ex practice introducing yourself Ex VH1 s Charm School Behavior Therapies Cognitive Behavioral Therapy CBT Use talk and behavioral therapy Very popular here at RU Cognitive Therapy Change patterns of irrational thoughts Ex What would happen if you failed a class Ex What evidence is there that your girlfriend doesn t love you Behavioral Modification improve behavioral responses via learning Ex Introduce yourself to 3 strangers tomorrow Effectiveness of Behavioral Therapy Different techniques for different problems Desensitization phobias Aversion major problem behavior like self abuse CBT complex problems like eating disorders Can be used with other therapies What might this NOT work as well for Biomedical Therapy Many issues require more than talk Physiological need to reduce symptoms Cause is biological and most are In order of severity Drugs Electroconvulsive Therapy ECT Psychosurgery Biomedical Therapies 4 major categories of drugs Anti anxiety Antipsychotic Anti depressant Mood Stabilizer To reduce tension apprehension nervousness drugs Antianxiety Ex Valium Xanax depress CNS activity Immediate short lived effect Side effects drowsiness dry mouth depression nausea constipation Potential for abuse withdrawal Take it feel better rely on it Stopping depressive symptoms Biomedical Therapies To reduce psychotic symptoms Antipsychotic Drugs Thorazine dampining hallucinations delusions chemical lobotomy Minimizes responsiveness to irrelevant stimuli Dopamine Antagonist Effective in 70 of patients Work gradually Side effects Sluggishness tremors twitches like Parkinsons Biomedical Therapies When typical antipsychotics don t work Atypical Antipsychotic Drugs Clozaril negative symptoms of schizophrenia awakening emotion Work with Dopamine AND Seratonin Commonly used for negative symptoms Or when traditional anti psychotics fail Biomedical Therapies What we re most familiar with Anti depressants elevate mood Several types Most common are SSRIs selective serotonin reuptake inhibitors Ex Prozac Paxil Zoloft Others work on Dopamine Wellbutrin Good if not responding to SSRIs Effective for most may take trial error Few serious side effects except risk of suicide Antidepressant Ads Zoloft A spoof http www youtube com watch v
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