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 that the
Psychodynamic
unconscious and childhood conflicts Patient talks about his past
psychotherapy
impact behavior

Psychoanalytical therapy wherein

Patient (child) acts out family scenes with
Play therapy interaction with toys is used in child
dolls
therapy instead of talk

Patient learns to overcome fear of elevators

Principles of learning applied to
Behavior therapy through several stages of relaxation
change undesirable behaviors
techniques

Awareness of cognitive process helps

Patient learns not to overgeneralize failure
Cognitive therapy patients eliminate thought patterns
based on single failure
that lead to distress

Cognitive- Work to change cognitive distortions Patient learns to identify self-defeating

behavioral therapy and self-defeating behaviors behaviors to overcome an eating disorder

Increase self-awareness and

Humanistic Patient learns to articulate thoughts that keep
acceptance through focus on
therapy her from achieving her goals
conscious thoughts
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 symptoms

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

Treat the negative symptoms of

Schizophrenia
Atypical schizophrenia, such as withdrawal Can increase the risk of obesity and diabetes
and other types Abilify,
Antipsychotics and apathy, by targeting both as well as elevate cholesterol levels;
of severe Risperdal,
(developed in the dopamine and serotonin receptors; constipation, dry mouth, blurred vision,
thought Clozaril
late 1980s) newer medications may treat both drowsiness, and dizziness
disorders
positive and negative symptoms

SSRIs: headache, nausea, weight gain,

Prozac,
Depression and drowsiness, reduced sex drive
Zoloft Alter levels of neurotransmitters such
Anti-depressants increasingly for Tricyclics: dry mouth, constipation, blurred
Tofranil and as serotonin and norepinephrine
anxiety vision, drowsiness, reduced sex drive,
Elavil
increased risk of suicide

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

Excessive thirst, irregular heartbeat,

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