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unit 12 - Coggle Diagram
unit 12
16.1 Treating Psychological Disorders
Mental Health Providers and Settings
Providers
CLINICAL PSYCHOLOGISTS:have obtained PhDs (typically five years of graduate school plus a one-year internship in a clinical setting) and are able to formally diagnose and treat mental health issues ranging from the everyday and mild to the chronic and severe
COUNSELING PSUCHOLOGISTS: mental health professionals who typically work with people who need help with more common problems such as stress and coping; issues concerning identity, sexuality, and relationships; anxiety and depression; and developmental issues such as childhood trauma.
PSYCHIATRISTS: medical doctors who specialize in mental health and who are allowed to diagnose and treat mental disorders through prescribing medications.
Settings
DEINSTITUTIONALIZATION: the movement of large numbers of psychiatric in-patients from their care facilities back into regular society
RESIDENTIAL TREATMENT CENTRES: housing facilities in which residents receive psychological therapy and life skills training, with the explicit goal of helping residents become re-integrated into society
COMMUNITY PSYCHOLOGY: focuses on identifying how individuals’ mental health is influenced by the community in which they live, and emphasizes community-level variables such as social programs, support networks, and community resource centres to help those with mental illness adjust to the challenges of everyday life
Evaluating Treatments
EMPIRICALLY SUPPORTED TREATMENTS: (also called evidence-based therapies) are treatments that have been tested and evaluated using scientific methods
THERAPEUTIC ALLIANCE: the relationship that emerges in therapy between the therapist and the patient
Working the Scientific Literacy Model: Can Self-Help Treatments Be Effective?
BIBLIOTHERAPY: the use of self-help books and other reading materials as a form of therapy
Barriers to Psychological Treatment
Difficulty Defining a Disorder: disorders themselves are inherently ambiguous. Thus, a person may believe they are simply sad, rather than experiencing an episode of depression
Stigma Around Mental Illness:Whereas most adults say they would be open to talking about a cancer diagnosis at work, fewer say they would be open to talking about a mental health condition
Attitudes Towards Treatment: some people do not trust the psychological or psychiatric professions and are skeptical of the usefulness and safety of different treatments.
Gender Roles: In many countries, including Canada and the United States, experiencing psychological distress and going to therapy seem incompatible with the idea of a strong, independent male. This leads people to downplay problems and assume they should just power through any struggles they face
Culture: People from certain cultural groups are less likely to use psychological services. In Canada, Asian Canadians and people of Indigenous descent are both less likely to seek mental health treatment than Canadians of European background
Geographical Barriers: individuals in rural regions have less access to psychological therapies than Canadians living in cities.
Financial Barriers: Unfortunately, government healthcare coverage in Canada generally only includes treatment by psychiatrists, leaving counsellors, psychologists, and many types of therapists less able to reach many people who can’t afford their services.
16.3 Biomedical Therapies
Drug Treatments
PSYCHOTROPIC DRUGS: medications designed to alter psychological functioning
BLOOD-BRAIN BARRIER: a network of tightly packed cells that only allow specific types of substances to move from the bloodstream to the brain in order to protect delicate brain cells against harmful infections and other substances
Psychotropic drugs have been developed to take many different courses of action. First, all psychotropic drugs are designed to cross the blood–brain barrier. After crossing this barrier, psychotropic drugs then affect one or more neurotransmitters. The specific neurotransmitter(s) targeted by a drug will determine which disorders will be responsive to that medication.
ANTI-DEPRESSANT DRUGS: medications designed to reduce symptoms of depression
MONOAMINE OXIDASE INHIBITORS (MAOIs): work by deactivating monoamine oxidase (MAO), an enzyme that breaks down serotonin, dopamine, and norepinephrine at the synaptic clefts of nerve cells
TRICYCLIC ANTIDEPRESSANTS: drugs that block the reuptake of serotonin and norepinephrine
SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRI): a class of antidepressant drugs that block the reuptake of serotonin
Herbal Treatments: ST. JOHN'S WORT: appears to influence several of the neurotransmitter systems that are altered by traditional antidepressant medications, including serotonin. However, its most prominent effect appears to be on the levels of epinephrine, a chemical associated with emotional arousal and stress responses
MOOD STABILIZERS:drugs used to prevent or reduce the severity of mood swings experienced by people with bipolar disorder.
LITHIUM: one of the first mood stabilizers to be prescribed regularly in psychiatry, and from the 1950s to the 1980s was the standard drug treatment for depression and bipolar disorder
ANTIANXIETY DRUGS: affect the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that reduces neural activity
alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan)
ANTIPSYCHOTIC DRUGS: generally used to treat symptoms of psychosis, including delusions, hallucinations, and severely disturbed or disorganized thought. Antipsychotics are the common treatment for schizophrenia and are sometimes prescribed to people with severe mood disorders
First generation antipsychotics often result in TARDIVE DYSKINESIA: a movement disorder involving involuntary movements and facial tics.
ATYPICAL ANTIPSYCHOTICS: or second-generation antipsychotics, are less likely to produce side effects, including movement disorders (like tardive dyskinesia), that commonly occur with first-generation antipsychotics
Working the Scientific Literacy Model: Is MDMA (Ecstasy) an Effective Treatment for PTSD?
Treatment programs that use MDMA include a number of different components. The first group of therapy sessions does not include MDMA. Rather, the patient and therapist(s) complete traditional talk-based sessions in which the patient discusses their experiences. During these appointments, the therapists and patients talk about how MDMA can affect people; the goal is to prepare the patient for the subsequent MDMA sessions.
The second component of the treatment program consists of one or more day-long sessions in which the patient takes a dose of pure MDMA (i.e., not the tablets you might find at clubs). A male and female therapist then spend the day with the patient, with the aim of making the patient feel comfortable in their environment. This session is non-directive, meaning that the therapists simply tell the patient to “go with the experience” rather than focusing on specific topics related to their PTSD. The increase in empathy and trust that occurs when a person takes MDMA is assumed to break down social barriers for the patient, which can improve the therapeutic alliance with the therapists.
The final component of this form of treatment involves multiple non-drug sessions that occur after the MDMA sessions. In these sessions, the therapists discussed the experiences that the patient had while on the drug. These experiences can include new insights the patient may have had while on MDMA as well as new topics that were broached during the session due to the improved bond the patient felt with the therapists
Technological and Surgical Methods
FRONTAL LOBOTOMY: surgically severing the connections between different regions of the brain
LEUCOTOMY: the surgical destruction of brain tissues in the prefrontal cortex
FOCAL LESIONS: small areas of brain tissue that are surgically destroyed
ELECTROCONVULSIVE THERAPY (ECT): involves passing an electrical current through the brain in order to induce a temporary seizure
REPETITIVE TRANSCRANIAL MAGNETIC STIMULATIONS (rTMS): a therapeutic technique in which a focal area of the brain is exposed to a powerful magnetic field across several treatment sessions
DEEP BRAIN STIMULATION (DBS): a technique that involves electrically stimulating specific regions of the brain
Introduction
PSYCHOPHARMCOTHERAPY: the use of drugs to manage or reduce clients’ symptoms
16.2 Psychological Therapies
Insight Therapies
INSIGHT THERAPIES: a general term referring to therapy that involves dialogue between patient and therapist for the purposes of gaining awareness and understanding of psychological problems and conflicts
PSYCHODYNAMIC THERAPIES: forms of insight therapy that emphasizes the need to discover and resolve unconscious conflicts.
Freudian-Based Psychoanalysis
DREAM ANALYSIS: a method of examining the details of a dream (the manifest content), in order to gain insight into the true meaning of the dream, the emotional, unconscious material that is being communicated symbolically (the latent content)
RESISTANCE: occurs in therapy when the patient engages in strategies that keep unconscious thoughts or motivations that they wish to avoid from fully entering conscious awareness
TRANSFERENCE: whereby patients direct certain patterns or emotional experiences toward the analyst, rather than the original person involved in the experiences (e.g., their parents)
FREE ASSOCIATION: during which patients are encouraged to talk or write without censoring their thoughts in any way
Modern Psychodynamic Theories
OBJECT RELATIONS THERAPY: a variation of psychodynamic therapy that focuses on how early childhood experiences and emotional attachments influence later psychological functioning
Humanistic-Existential Psychotherapy: This humanistic-existential approach can be characterized by at least five key differences from the psychodynamic approaches (listed in Table 16.3). Overall, this new orientation emphasized individual strengths and the potential for growth and assumed that human nature is fundamentally positive, rather than the essentially negative perspective advanced by psychoanalytic approaches.
Humanistic and existential therapies share many similarities: to help people express their authentic selves, to overcome alienation, to become more loving, and to take responsibility for their experiences so that they learn to dwell fully in the present.
The major difference between them is that humanistic therapists focus on removing the obstacles that prevent self-actualization from unfolding naturally.
Existential therapists, on the other hand, emphasize the importance of facing painful experiences such as feelings about isolation, death, and meaninglessness, believing that self-actualization involves transforming by facing one’s fears and negativity.
PHENOMENOLOGICAL APPROACH: the therapist addresses the clients’ feelings and thoughts as they unfold in the present moment, rather than looking for unconscious motives or dwelling in the past.
CLIENT-CENTERED THERAPY (PERSON-CENTERED THERAPY): focuses on individuals’ abilities to solve their own problems and reach their full potential with the encouragement of the therapist (Carl Rogers)
EMOTION-FOCUSED THERAPY (EFT) is one promising type of person-centred therapy that has evolved from the humanistic–existential tradition. EFT is based on the well-supported belief that it is better to face and accept difficult emotions and thoughts than to bottle them inside
Behavioural, Cognitive, and Group Therapies
BEHAVIOURAL THERAPIES: attempt to directly address problem behaviours and the environmental factors that trigger them
SYSTEMATIC DESENSITIZATION: gradual exposure to a feared stimulus or situation is coupled with relaxation training
AVERSIVE CONDITIONING: a behavioural technique that involves replacing a positive response to a stimulus with a negative response, typically by using punishment
COGNITIVE-BEHAVIOURAL THERAPY (CBT): a form of therapy that consists of procedures such as cognitive restructuring, stress inoculation training, and exposing people to experiences they may have a tendency to avoid,
At the behavioural end of CBT, clients are given exercises and guidance in gaining skills they may be lacking
At the cognitive end of CBT, clients are given exercises and strategies to build more functional cognitive habits
MINDFULNESS-BASED COGNITIVE THERAPY: a technique that combines mindfulness meditation with standard cognitive–behavioural therapy tools
DECENTERING: occurs when a person is able to “step back” from their normal consciousness and examine themselves more objectively, as an observer
Family therapies
SYSTEMS APPROACH: an orientation that encourages therapists to see an individual’s symptoms as being influenced by many interacting systems
Working the Scientific Literacy Model: Virtual Reality Therapies
VIRTUAL REALITY EXPOSURE: a treatment that uses graphical displays to create an experience in which the client seems to be immersed in an actual environment