Introduction to Psychology

Therapy and Treatment

History of Mental Health Treatment

• 18th century – asylums

(right) were created to
house people with
psychological disorders and
keep them away from
society. People were often
mistreated.
• 1950s and 60s -
antipsychotic medications
introduced.
• 1963 – Deinstitutionalization
closed large asylums with
the goal of treating people
in their communities.
How Common is Mental Illness?

• 19% of U.S. adults experienced mental illness in

2012
• In 2008, 13.4% of adults received treatment for a
mental health issue
• People with mental illness are over-represented in
homeless (a) and prison (b) populations
Where Do People Get Mental Health Treatment?

• Primary care physician then referred to a mental

health practitioner
• Community mental health centers
• Psychiatric hospitals
• Schools
• Prison
Why do people seek treatment?

• Voluntary
treatment: A
person chooses to
seek treatment in
order to obtain
relief from her
symptoms
• Involuntary
treatment: A
person is required
by the courts or
other systems to
seek treatment
Types of Therapy

Psychotherapy is a psychological treatment that

employs various methods to help someone
overcome personal problems, or to attain personal
growth
• In modern practice, it has evolved into what is
known as psychodynamic therapy, which will be
discussed later.
Biomedical therapy involves medication and/or
medical procedures to treat psychological
disorders
Psychotherapy Techniques
Type Description Example
Talk therapy based on belief
Psychodynamic that the unconscious and
Patient talks about his past
psychotherapy childhood conflicts impact
behavior
Psychoanalytical therapy
wherein interaction with toys is Patient (child) acts out family scenes
Play therapy
used in child therapy instead of with dolls
talk
Principles of learning applied Patient learns to overcome fear of
Behavior
to change undesirable elevators through several stages of
therapy
behaviors relaxation techniques
Awareness of cognitive
Cognitive process helps patients Patient learns not to overgeneralize
therapy eliminate thought patterns that failure based on single failure
lead to distress
Cognitive- Work to change cognitive Patient learns to identify self-defeating
behavioral distortions and self-defeating behaviors to overcome an eating
therapy behaviors disorder
Increase self-awareness and Patient learns to articulate thoughts
Humanistic
acceptance through focus on that keep her from achieving her
therapy
conscious thoughts goals
Psychoanalysis

Therapeutic orientation
developed by Sigmund
Freud (his couch is at
right) that employs free
association, dream
analysis, and
transference to uncover
repressed feelings
Behavioral
Therapy

Uses principles of
classical and
operant
conditioning to
change behavior
• Aversive
conditioning
• Exposure
therapy (right)
Cognitive Therapy

• Cognitive therapists help their clients change

dysfunctional thoughts in order to relieve distress
• Emotional reactions are the result of your thoughts
about the situation rather than the situation itself.
• By changing your thoughts about the situation,
you can improve your mental health
Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) helps clients

examine how their thoughts affect their
behavior. It aims to change cognitive distortions
and self-defeating behaviors.
Effective for depression, PTSD, anxiety disorders,
eating disorders, bipolar disorder, and substance
abuse.
Cognitive distortions include:
• All-or-nothing thinking
• Overgeneralization
• Jumping to conclusions
Humanistic Therapy

Goal of humanistic therapy is to help people

become more self-aware and accepting of
themselves.
Focus on conscious thoughts and the patient’s
present and future
Client-centered therapy:
• Nondirective therapy
• Active listening
• Unconditional positive regard
Evaluating Psychotherapy

According to the APA three factors work together

to produce successful treatment
1. Use of evidence-based treatment that is
deemed appropriate for your particular issue
2. Clinical expertise of the psychologist or therapist
3. You rown characteristics, values, preferences,
and culture
No studies have found one psychotherapeutic
approach more effective than another
One critical factor is the person’s relationship with
the psychologist or therapist
Biomedical Therapy

Treatment that involves psychotropic medication

and/or medical procedures to treat the symptoms
of psychological disorders
If other treatments don’t work, electroconvulsive
therapy (ECT) uses an electrical current to induce
seizures in a person to help alleviate the effects of
severe depression
 Commonly Prescribed Psychotropic Medications
Type of
Used to Treat Example How They Work Side Effects
Medication

Schizophrenia Treat positive psychotic

Long-term use can lead to tardive
and other Haldol, symptoms such as auditory
Antipsychotic dyskinesia, involuntary movements of
types of Mellaril, and visual hallucinations,
s (developed the arms, legs, tongue and facial
severe Prolixin, delusions, and paranoia by
in the 1950s) muscles, resulting in Parkinson’s-like
thought Thorazine blocking the neurotransmitter
tremors
disorders dopamine

Treat the negative symptoms

Schizophrenia of schizophrenia, such as
Atypical Can increase the risk of obesity and
and other withdrawal and apathy, by
Antipsychotic Abilify, diabetes as well as elevate
types of targeting both dopamine and
s (developed Risperdal, cholesterol levels; constipation, dry
severe serotonin receptors; newer
in the late Clozaril mouth, blurred vision, drowsiness,
thought medications may treat both
1980s) and dizziness
disorders positive and negative
symptoms
SSRIs: headache, nausea, weight
Depression Prozac,
Alter levels of neurotransmitters gain, drowsiness, reduced sex drive
Anti- and Zoloft
such as serotonin and Tricyclics: dry mouth, constipation,
depressants increasingly Tofranil and
norepinephrine blurred vision, drowsiness, reduced
for anxiety Elavil
sex drive, increased risk of suicide

OCD, PTSD, Xanax,

Anti-anxiety Depress central nervous system Drowsiness, dizziness, headache,
panic Valium,
agents activity fatigue, lightheadedness
disorder Ativan

Excessive thirst, irregular heartbeat,

Mood Bipolar Treat episodes of mania as well itching/rash, swelling (face, mouth,
Lithium
Stabilizers disorder as depression and extremities), nausea, loss of
appetite
Adderall, Improve ability to focus on a Decreased appetite, difficulty
Stimulants ADHD
Ritalin task and maintain attention sleeping, stomachache, headache
How is Addiction Treated?

Goal: to help an addicted

person stop compulsive
drug-seeking behaviors
Treatment usually includes
behavioral therapy and/or
medication, depending
on the individual
About 40%–60% of
individuals relapse, which
means they return to
abusing drugs and/or
alcohol after a period of
improvement
Effective Treatment for Addiction

• 3 months or more is best

• Address communication,
stress management,
relationship issues, parenting,
vocational concerns, and
legal concerns
• Group or family therapy to
offer support, affiliation,
identification, and even
confrontation
• Addresses other mental
health disorders at the same
time (Substance abusers are
twice as likely to have a
mood or anxiety disorder)
Modalities of treatment:

• Individual therapy
• Group therapy
• Couples therapy
• Family therapy
Starting Therapy

Intake: therapist’s first meeting with the client in

which the therapist gathers specific information
about symptoms, support, and goals to address the
client’s immediate needs
Confidentiality means the therapist cannot share
what is said with any third party unless mandated or
permitted by law to do so
Risks and Benefits of Group Therapy

Benefits:
• Can help decrease a client’s shame and isolation
about a problem while offering needed support
• Members can confront each other about their
patterns.
• Economical
Risks:
• Members of the group may be afraid to speak in
front of other people.
• Personality clashes and arguments among group
members.
• Concerns about confidentiality
Couples Therapy

• The couple may be dating, partnered, engaged,

or married.
• The primary therapeutic orientation used is
cognitive-behavioral therapy
• Some couples seek therapy to work out their
problems, while others attend therapy to
determine whether staying together is the best
solution
Family Therapy

• Systems approach
• Structural family therapy
• Strategic family therapy
Cultural Competence in Mental Health Treatment

Mental health professionals must understand and

address issues of race, culture, and ethnicity
The sociocultural model integrates the impact of
cultural and social norms into treatment
Barriers to Treatment

• Ethnic minorities and individuals of low

socioeconomic status report that barriers to
services include lack of insurance, transportation,
and time
• Even controlling for income levels and insurance,
ethnic minorities are far less likely to use mental
health services
• Non-financial barriers include self-sufficiency and
not seeing the need for help, not seeing therapy
as effective, concerns about confidentiality,
language differences, and the many effects of
stigma and shame
Practice Question

A friend is thinking about seeking therapy to get

some tools for managing anxiety. What types of
treatment should she consider?
Quick Review

• How are mental health services delivered today?

• What are psychoanalysis, play therapy and
behavior therapy?
• How cognitive and cognitive-behavioral therapy
used?
• What are the characteristics of humanistic
therapy?
• Compare and evaluate various forms of
psychotherapy
• Explain and compare biomedical therapies
More Quick Review

• What are treatments for addictive disorders?

What makes them effective? Consider the role of
comorbid disorders.
• What are the different modalities of therapy and
what are the benefits of each?
• Why is the sociocultural model is important in
therapy and what type of cultural barriers prevent
some people from receiving mental health
services?