Treatment of Mental
Disorders
What’s difference between a psychiatrist,
clinical psychologist, and counselor?
How do psychoanalysts treat disorders?
How do behaviorists treat disorders?
What are classical conditioning techniques
to therapy?
What is manifest content of dreams? Latent
content?
What are operant conditioning techniques?
What is cognitive therapy?
Who is Albert Ellis?
Who is Aaron Beck?
How do Humanists treat disorders?
What are biomedical therapies?
Benefits of group therapy?
Key Questions for this Unit
What’s the difference between a
Psychiatrist, Clinical Psychologist and
a Counselor?
How do Psychoanalysts treat mental
disorders?
How do Behaviorists treat? How do
Humanists treat? What is Cognitive
therapy?
What is a psychiatrist?
Psychiatrists are MDs (medical doctors)
with a specialty in treating mental
disorders, usually with a biomedical
therapy (medicine) and some talk therapy.
You would see a “shrink” if you have
schizophrenia, severe depression, suicidal
thoughts, and other severe mental
problems that need medication.
What is a clinical psychologist?
A clinical psychologist has a PhD
(more research based) or PsyD
(emphasis on therapy) in psychology
(no medical school). They treat fairly
serious mental illnesses with “talk”
therapies.
They might treat personality
disorders, anxiety disorders,
addictions using insight or “talk”
therapy.
What is a counselor?
A counselor uses “talk” therapy to
treat non-mental disorders like
improving communication between
family members, grief counseling,
marital counseling, life strategies.
Counselors have a Masters Degree
with specialty training.
Professional Title
Counseling psychologist
Specialty:
Clinical psychologist
Problems of
normal living
Psychiatrist
Work setting:
Psychoanalyst
Schools, clinics,
other institutions
Psychiatric nurse practitioner
Credentials:
Clinical social worker
Master’s in
counseling, PhD,
EdD, or PsyD
Pastoral counselor
Professional Title
Counseling psychologist
Specialty:
Clinical psychologist
Those with severe
disorders
Psychiatrist
Work setting:
Psychoanalyst
Private practice,
mental health
agencies,
hospitals
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Credentials:
PhD or PsyD
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Specialty:
Severe mental
disorders (often
by means of drug
therapies)
Work setting:
Private practice,
clinics, hospitals
Credentials:
MD
Professional Title
Counseling psychologist
Clinical psychologist
Specialty:
Psychiatrist
Psychoanalyst
Freudian therapy
Work setting:
Psychiatric nurse practitioner
Private practice
Clinical social worker
Credentials:
Pastoral counselor
MD
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse
practitioner
Clinical social worker
Pastoral counselor
Specialty:
Nursing specialty;
licensed to
prescribe drugs
Work setting:
Private practice,
clinics, hospitals
Credentials:
RN – plus special
training in treating
mental disorders
and prescribing
drugs
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Specialty:
Social worker with
specialty in
dealing with
mental disorders
Psychoanalyst
Work setting:
Psychiatric nurse practitioner
Often employed
by government
Clinical social worker
Pastoral counselor
Credentials:
MSW
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Specialty:
Combines
spiritual guidance
with practical
counseling
Work setting:
Religious order or
ministry
Credentials:
Varies
In contrast to a clinical psychologist, a
psychiatrist is more likely to
a) engage in an eclectic approach
b) use a biomedical/somatic
treatment
c) recognize the importance of
group therapy with patients having
the same disorder
d) treat clients in community
mental health centers exclusively
Perspectives on Treatment
Psychoanalytic
Behavioral
Humanistic
Cognitive
Biophysical
Psychoanalytic (5 methods)
Dream Analysis
Transference
Hypnosis
Free association
Symptom Substitution
All 5 rely on exposing (bringing into
conscious) unconscious thoughts and
interpreting them.
A. What are Psychoanalytic methods of
therapy:
1. Free Association – patient reports
anything that comes to his/her mind.
The psychoanalyst takes whatever you say
and treats it like a window into your
unconscious mind.
B. Dream analysis:
Dreams have two types of content:
Manifest content- actual events in dream.
Latent content – hidden message in dream.
(latent = hidden)
Freud thought that each dream represents a
form of wish fulfillment. The wish may be
disguised, but it is always there.
C. Transference
Feelings of love or other emotions (hatred)
are expressed toward the therapist.
These feelings are actually unconsciously felt
toward others; the patient is projecting these
feelings onto the therapist.
This provides clues about the client’s feelings
about these other people.
D. Hypnosis
Hypnosis is a psychoanalytic
therapeutic technique.
Supposedly reaches into the
unconscious
Whatever you think, patients report
benefits from hypnosis.
E. Symptom Substitution
Client appears to get better from
original problem or, but shortly
thereafter, a new symptom emerges
Why? Original problem not actually
found
The goal of psychoanalytical therapy is
a) to change maladaptive behavior
to more socially acceptable behavior
b) to change negative thinking into
more positive attributions
c) to attain self-actualization
d) to bring unconscious conflicts to
conscious awareness and gain
insight
Treating the therapist as though he
were a very important person from
one’s past, such as a parent, defines
a) resistance
b) transference
c) frustration
d) reaction formation
Behavioral Therapy
Behavioral Therapy
Behaviorists believe that mental
problems are caused by classical
conditioning (for example, phobias),
operant conditioning (addictions,
depression), and observational
learning (we watch our parents and
friends suffer so we copy them).
Classical Conditioning –
Systematic Desensitization
(treats phobias) if you are afraid of
snakes, start with worms, calm down,
then graduate to having a snake in
the next room, calm down, then look
at pictures, calm down, then watch
movies, calm down, then be in the
same room, calm down, then get
closer, calm down
Anxiety Hierarchy
Classical/Operant Conditioning –
Counter Conditioning
OBJECTIVE: Associate a previously
“bad” stimulus with positive
reinforcement
Example:
Afraid of the dentist? What do you
get at the end of every visit??
Classical Conditioning –
Aversive Conditioning
OBJECTIVE: Replace a previously
“good” response to a harmful stimulus
with a “bad” response
Examples:
Antabuse – Alcoholics take pills that
make them sick when they drink alcohol
Coyotes are fed poisoned lamb meat so
they will stop killing sheep.
AKA Reconditioning
Classical Conditioning
Flooding – (treats phobias) if you are
afraid of snakes, therapist will throw
you in a pit of snakes.
AKA Exposure Therpay
Operant conditioning treatment
Token economy – Therapists will
reward desirable behaviors with a
reward system. This is usually applied
to groups like hospital mental wards
or classrooms or workplaces.
If you don’t kill anyone this week, I’ll
give you a nickel. If everyone passes,
we’ll have a pizza party.
Systematic desensitization is a
technique based on
a) classical conditioning
b) instrumental conditioning
c) operant conditioning
d) aversive conditioning
Antabuse is a drug that, when paired with
alcohol in the bloodstream, bring about
extreme nausea. For many motivated
alcoholics, this has proven to be an
effective treatment. Under which umbrella
of psychotherapy would it most likely be
found?
a) insight therapy
b) aversive conditioning
c) Gestalt therapy
d) self-help therapy
Humanistic Perspective of
Psychology
Humanism
What is the root word of Humanism?
After years of psychoanalysts saying
we are a bunch of id-driven animals
and years of behaviorists studying
rats in a cage, the Humanists came
along in the 60s.
Who is Carl Rogers?
Famous Humanists
Who is Carl Rogers? Carl Rogers was the
founder of person-centered therapy, active
listening, and unconditional positive regard.
No judgments can be made! The environment must be
loving and accepting if the client is to open up to you.
Good for patients with self-esteem issues.
The patient/client has all the answers and
the means to treat themselves. In clientcentered therapy, the therapist acts as a
sounding board for the patient, sometimes
rephrasing what the patient says (active or
reflective listening). Empathy is important!
Abraham Maslow
Maslow’s hierarchy of needs
Maslow’s hierarchy of needs
People cannot maximize their potential
unless their more basic needs are
met.
If a Japanese family’s home just got
destroyed by the earthquake/tsunami,
can they focus on their communication
skills?
If you are hungry, can you worry about
your self esteem?
Which Simpsons character is
at the bottom of Maslow’s
Hierarchy of Needs?
Which character has safety
needs?
Who has love and belonging
needs?
Who has esteem needs?
Are any Simpsons characters
self actualizing?
Depends on the episode
The Simpsons aren’t real people, but
in some episodes, Homer and Lisa
are. Even Grandpa has his day.
2 Other Humanistic Theories
Gestalt Therapy – Fritz Perls
Integrate all actions, feelings, and
thoughts into a harmonious whole
Existential – subjective meaning of life
is what is important
Humanistic Therapy
Humanists are really touchy-feely, but
without them we are just rats in a cage.
Rogers and Maslow put the “human”
element back into psychology and therapy.
Their philosophy: We are all humans
striving to maximize our potential. A
therapist’s job is to remove obstacles to
self-actualization.
FREE WILL MATTERS; NOT
DETERMINISITC
Vic is encouraged to take charge of the
therapy session and his therapist
uses an active listening approach to
mirror back the feelings he hears from
him. Which therapy is most likely
being described?
a) client-centered therapy
b) cognitive therapy
c) psychodynamic therapy
d) existential therapy
Cognitive therapy
Cognitive therapy focuses on
changing how the client/patient thinks.
It can be confrontational
The therapist focuses on
changing/fixing the irrational thoughts
of the patient
Cognitive therapy also “educates” the
client, teaches him/her proper
behaviors/thoughts
Cognitive Therapy
We are depressed because we are
irrational. Our expectations are too
high and misplaced. We want
everyone to love us and accept us.
We want every thing to go our way.
We stay angry about stuff that
happened a looong time ago. WE
MUST CHANGE THE WAY WE
THINK TO BE HAPPY AND
SUCCESSFUL.
Albert Ellis Rational Emotive
Therapy
vigorously challenges people’s
illogical, self-defeating attitudes and
assumptions; a confrontational
therapy
http://www.youtube.com/watch?v=Jhl
WddAXSRA
Rational Emotive Therapy: Ellis
A-B-C theory of dysfunctional
behavior
A – Activating event
B – Belief
C – emotional Consequence based
on that belief.
Example of Rational Thinking
A= fail a midterm examination
B=It’s unfortunate that I failed-I did
not study hard enough and I must
make sure that I study harder for the
final
C=no consequences (no emotional
disturbance)
Example Irrational Thinking: leads
to Emotional Disturbance
A= Fail exam
B= I’m stupid, I’ll never be able to
pass this course and I will fail this
course
C=depression
Ellis’ List of Common Irrational
Ideas
I absolutely must have sincere love and approval
almost all the time from all the significant people in
my life
I must be thoroughly competent, adequate and
achieving in all respects, or I must at least have
real competence or talent at something important;
otherwise I am worthless.
People who harm me or who do a bad thing are
uniformly bad or wicked individuals, and I should
severely blame, damn, and punish them for their
sins and misdeeds
Ellis’ List of Common Irrational
Ideas (continued)
When things do not go the way I
would like them to go, life is awful,
terrible, horrible, or catastrophic
Unhappiness is caused by external
events over which I have almost no
control. I also have little ability to
control my feelings or rid myself of
feelings of depression and hostility.
Rational Emotive Therapy
Identify patient’s irrational beliefs
Add “D” and “E” to A-B-C theory
Teach the patient to Dispute the
beliefs and substitute logical and
rational beliefs
Evaluate the effects of disputing their
irrational beliefs
CBT: Effective for Which
Disorders?
Empirically supported treatment for
Depression
Generalized anxiety disorder
Obsessive compulsive disorder
Panic disorder
Group Therapy
Group Therapy
Is cheap, effective. (only 1 professional is
needed)
It allows people to gain insight into their
own behaviors and thoughts
People don’t feel like they are the only one
with their problem; they can witness the
therapist treat others with similar problems.
You can cure yourself while curing others.
All of the following are potential benefits of
group therapy EXCEPT
a) it is often more economical than 1:1
treatment
b) it does not require the services of a
mental health professional
c) clients with similar problems can
provide helpful insight and feedback to
peers
d) group members can see how their
problems might impact others
How Is the Biomedical
Approach Used to
Treat Mental Disorders?
Biomedical therapies seek to
treat mental disorders by
changing the brain’s
chemistry with drugs, its
circuitry with surgery, or its
patterns of activity with pulses
of electricity or powerful
magnetic fields
Drug Therapy
Antipsychotic drugs
alleviate the symptoms of severe disorders
such as schizophrenia;
Examples:Thorazine, Clozapine
many work by blocking dopamine receptor
sites
can produce sluggishness, tremors, and
twitches similar to those of Parkinson’s
disease
Drug Therapy
Psychopharmacology –
The prescribed use of drugs to help
treat symptoms of mental illness
ostensibly to ensure that individuals
are more receptive to talk therapies
Drug Therapy
Antidepressants and mood stabilizers
Include Prozac, monoamine oxidase (MOA)
inhibitors, and lithium carbonate (effective
against bipolar disorder)
Treat depression and bipolar disorder
Usually affect serotonin and/or norepinephrine
The use of antidepressants to deal with
general feelings of unease is highly
controversial
Drug Therapy
Antianxiety drugs
work by depressing central nervous system
activity
Most common side effect - drowsiness
highly addictive, can be fatal when mixed with
alcohol
sudden cessation after long-term use can result in
severe withdrawal symptoms, including seizures,
increased anxiety,
and in rare cases, death
Xanax, Paxil
Drug Therapy in ADHD
Stimulants suppress activity level in
persons with attentiondeficit/hyperactivity disorder (ADHD)
There is controversy from concern
that the causes and boundaries of
ADHD are vague and the potential
exists for overdiagnosis
The MOST commonly cited side effect
associated with anti-anxiety drugs is
a) insomnia
b) blurred vision
c) drowsiness
d) tachycardia
Prozac and other modern
antidepressant medications work to
a) block dopamine receptors
b) decrease the level of
acetylcholine
c) break down the MAO enzymes
d) block the reuptake of serotonin
Valium is
a) an antidepressant drug
b) an MAO inhibitor
c) an antipsychotic drug
d) an antianxiety drug
Andre suffers from mood swings, alternating
from wild episodes of euphoria and
spending sprees to motionless staring and
hopelessness. If someone from the
biomedical approach were to treat his
condition, the prescription most likely would
be
a) Lithium carbonate
b) Haldol
c) Xanax
d) Thorazine
Psychosurgery
Psychosurgery –
The general term for surgical
intervention in the brain to treat
psychological disorders
Severing the corpus callosum can
reduce life-threatening seizures
Brain-Stimulation Therapies
Electroconvulsive therapy is used for
the treatment of severe depression
Transcranial magnetic stimulation, a
possible alternative to ECT, can also
be used for the treatment of
depression,
schizophrenia, and bipolar disorder
A.
B.
C.
D.
Matt enters therapy to talk about
some issues that have been causing
him distress. The therapist has
earned a PhD and uses a variety of
techniques to alleviate some of
Matt’s distressing symptoms. Matt
is most likely seeing a _____
Psychiatrist
Clinical psychologist
Psychiatric social worker
Clinical counselor
A.
B.
C.
D.
The aim of cognitive-behavioral
therapy is to _____
Discover unconscious motives for
behavior
Change the way people behave
Change the way people think and
behave
Change people’s negative thinking
patterns
A.
B.
C.
D.
Ann is suffering from depression
and no psychological or drug
therapies are working to alleviate
her symptoms. The biomedical
technique of ____ may be used as a
last resort.
Flooding
Systematic desensitization
Electroconvulsive therapy
psychosurgery
Modern antidepressants, such as
Prozac, work to block the reuptake
of which neurotransmitter?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
A.
B.
C.
D.
E.
________ therapy does NOT use
the services of a trained therapist.
Biomedical
Cognitive-behavioral
Behavioral
Humanistic
Self-help
A.
B.
C.
D.
E.
John is a 12-year-old who is having
trouble dealing with his family’s relocation
to a new city. He most likely first sees a
______
Psychiatrist
Counselor
Clinical psychologist
Registered nurse
Psychoanalyst