Now that you have completed the text and read more about all the various types of psychology and fields of psychology, choose one that interests you. Imagine if you were going into a field of psychology, what would you find interesting, meaningful, worth researching in that one field. **This is an example: If I were to go into any field of psychology it would be Industrial-Organizational Psychology, it applies to psychological and scientific principles to individuals and groups in the workplace. It focuses on the management of employees, overall organizational effectiveness, the proper use of human resources and well being for the people in the workplace. I think that well-being in the workplace is very important and that it would help the employer just as much as the employee.Notes attached
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Sarah Grison • Todd Heatherton • Michael Gazzaniga
Psychology in
Your Life
SECOND EDITION
Chapter 15
Psychological Treatments
1
© 2016 W. W. Norton & Company, Inc.
15.1 How Are Psychological
Disorders Treated? (1)
• During the latter half of the Middle Ages,
people with psychological disorders were
placed in overcrowded institutions called
asylums
– People in asylums were often chained up and
lived in incredibly filthy conditions
– The “treatments” they received included
starvation, beatings, and isolation
2
15.1 How Are Psychological
Disorders Treated? (2)
3
15.1 How Are Psychological
Disorders Treated? (3)
• In 1793, Philippe Pinel, a French
physician, argued that treatments should
be based on what actually works to reduce
psychopathology
– Moral treatment involves close contact with,
and careful observation of, patients
4
15.1 How Are Psychological
Disorders Treated? (3)
• Over the last century, the scientific
methods of psychology have shown that
some treatments are more successful than
others
– What works for one psychological disorder
may not work for another disorder
5
15.1 How Are Psychological
Disorders Treated? (4)
• Three main approaches are used to treat
disorders
1. Psychotherapy
2. Psychotropic medications
3. Alternative treatments
6
Psychotherapy Is Based on
Psychological Principles (1)
• Psychotherapy
– Treatment for psychological disorders in
which a therapist works with clients to help
them understand their problems and work
toward solutions
• Therapists generally use psychotherapy to change
their clients’ patterns of thought or behavior
7
Psychotherapy Is Based on
Psychological Principles (2)
8
Psychotherapy Is Based on
Psychological Principles (3)
• Psychodynamic therapy
– One of the first people to develop treatments
for psychological disorders was Sigmund
Freud
– Along with Josef Breuer, Freud pioneered the
method of psychoanalysis
• Psychoanalytic treatment involved identifying
unconscious conflicts in feelings and drives
• Freud’s techniques included free association and
dream analysis
9
Psychotherapy Is Based on
Psychological Principles (4)
10
Psychotherapy Is Based on
Psychological Principles (5)
– Psychodynamic therapy: Treatment for
psychological disorders in which a therapist
works with clients to help them become aware
of how their unconscious processes may be
causing conflict and impairing daily
functioning
• There is only weak evidence, however, for its
effectiveness in treating most psychological
disorders
11
Psychotherapy Is Based on
Psychological Principles (6)
• Humanistic therapy
– Treatment for psychological disorders in
which a therapist works with clients to help
them develop their full potential for personal
growth through greater self-understanding
• One of the best-known humanistic therapies is
client-centered therapy, which includes
– A safe and comforting setting for clients
– Active listening
– Unconditional positive regard
12
Psychotherapy Is Based on
Psychological Principles (7)
13
Psychotherapy Is Based on
Psychological Principles (8)
• Behavior and cognitive therapies
– Behavior therapy: Treatment for
psychological disorders in which a therapist
works with clients to help them unlearn
behaviors that negatively affect their
functioning
• Treatment often centers around the use of token
economies, social skills training, and modeling
14
Psychotherapy Is Based on
Psychological Principles (9)
• Cognitive therapies
– Cognitive therapy: Treatment for
psychological disorders in which a therapist
works with clients to help them change
distorted thought patterns that produce
maladaptive behaviors and emotions
• Aaron Beck has advocated cognitive restructuring
• Albert Ellis introduced rational-emotive therapy
15
Psychotherapy Is Based on
Psychological Principles (10)
16
Psychotherapy Is Based on
Psychological Principles (11)
• Behavior and cognitive therapies
– Cognitive-behavioral therapy (CBT):
Treatment for psychological disorders in
which a therapist incorporates techniques
from cognitive therapy and behavior therapy
to correct faulty thinking and maladaptive
behaviors
• CBT is one of the most effective therapies for
many types of psychological disorders, especially
anxiety disorders and mood disorders
17
Psychotherapy Is Based on
Psychological Principles (12)
• Group therapy
– The most obvious benefit is cost
– Group therapies vary widely in the types of
clients enrolled in the group, the duration of
treatment, the theoretical perspective of the
therapist running the group, and the group size
• Many groups are organized around a particular type
of problem (e.g., sexual abuse) or a particular type
of client (e.g., adolescents)
18
Psychotherapy Is Based on
Psychological Principles (13)
• Family therapy
– According to a systems approach, an individual
is part of a larger context
• Any change in individual behavior will affect the
whole system
• This effect is often easiest to see within families
19
Psychotherapy Is Based on
Psychological Principles (14)
20
Biological Therapies Are Effective
for Certain Disorders (1)
• Biological therapy
– Treatment for psychological disorders that is
based on medical approaches to illness and
disease
21
Biological Therapies Are Effective
for Certain Disorders (2)
• Psychotropic medications
– Drugs that affect mental processes and that
can be used to treat psychological disorders
• Psychotropic medications act by changing brain
neurochemistry
22
Biological Therapies Are Effective
for Certain Disorders (3)
– Most psychotropic medications fall into five
categories
1.
2.
3.
4.
5.
Anti-anxiety drugs
Antidepressants
Mood stabilizers
Antipsychotics
Stimulants
23
Biological Therapies Are Effective
for Certain Disorders (4)
24
Biological Therapies Are Effective
for Certain Disorders (5)
• Alternative treatments for extreme cases
– Electroconvulsive therapy (ECT):
Treatment for psychological disorders that
involves administering a strong electrical
current to the client’s brain to produce a
seizure; ECT is effective in some cases of
severe depression
• The general public has a very negative view of
ECT
• Film, One Flew over the Cuckoo’s Nest
25
Biological Therapies Are Effective
for Certain Disorders (6)
26
Biological Therapies Are Effective
for Certain Disorders (7)
– Transcranial magnetic stimulation (TMS):
Treatment for psychological disorders that
uses a magnetic field to interrupt function in
specific regions of the brain
• When rapidly switched on and off, this magnetic
field creates an electrical current in the brain
region directly below the coil, thereby interrupting
the activity of neurons in that region
27
Biological Therapies Are Effective
for Certain Disorders (8)
28
Biological Therapies Are Effective
for Certain Disorders (9)
– Deep brain stimulation (DBS): Treatment for
psychological disorders that involves passing
electricity through electrodes planted in the
client’s brain to stimulate the brain at a certain
frequency and intensity
• DBS may be especially valuable for treating severe
obsessive-compulsive disorder (OCD) and
depression
29
Biological Therapies Are Effective
for Certain Disorders (10)
30
Scientific Evidence Indicates Which
Treatments Are Safe and Effective (1)
• Some treatments widely believed to be
effective not only lack scientific support,
but are actually counterproductive
– It is important to recognize the difference
between evidence-based psychotherapies
and “fringe” therapies
• The only way to determine whether a treatment is
valid is to conduct empirical research using
randomized clinical trials
31
Scientific Evidence Indicates Which
Treatments Are Safe and Effective (2)
32
Scientific Evidence Indicates Which
Treatments Are Safe and Effective (3)
• Three features characterize evidencebased psychological treatments
1. Treatments vary according to the particular
psychological disorder and the client’s
specific symptoms
2. The techniques used in these treatments
have been developed in the laboratory by
psychologists, especially behavioral,
cognitive, and social psychologists
33
Scientific Evidence Indicates Which
Treatments Are Safe and Effective (4)
3. No overall grand theory guides treatment.
Instead, adoption of a specific treatment is
based on the evidence of its effectiveness
34
Various Providers Assist in Treatment for
Psychological Disorders (1)
• Nearly half of all Americans meet
Diagnostic and Statistical Manual (DSM)
criteria for a psychological disorder at
some point in their lives
– In any given year, 25 percent of the
population meets these criteria
35
Various Providers Assist in Treatment
for Psychological Disorders (2)
• Choosing the right treatment provider is
extremely important for ensuring
successful treatment
– The professional must have the appropriate
training and experience for the specific
psychological disorder or life problem, and the
person seeking help must believe the
therapist is trustworthy and caring
36
Various Providers Assist in Treatment
for Psychological Disorders (3)
– Medication is normally prescribed only by
psychiatrists, who hold an MD
– Efforts are under way to give more
practitioners, such as clinical psychologists,
the ability to prescribe medications
– The most important features to look for in a
provider are empathy and experience in the
methods known to be effective in treating
specific psychological disorders
37
Various Providers Assist in Treatment
for Psychological Disorders (4)
38
15.2 What Are Effective
Treatments for Common Disorders?
39
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (1)
• There is accumulated evidence that most adult
anxiety disorders are best treated with a
combination of cognitive and behavior therapies
– Anti-anxiety drugs are also beneficial in some cases
because they have a sedative effect that makes
people feel calmer
– The effects of cognitive-behavioral therapy (CBT)
persist long after treatment; this remains the best
treatment in general for anxiety disorders
40
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (2)
• Specific phobia
– Learning theory suggests that specific
phobias are acquired either by experiencing a
trauma or by observing similar fear in others
• Behavior techniques are the treatment of choice,
along with approaches to changing the client’s
thoughts about the fearful stimulus
41
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (3)
– Exposure: Therapy technique that involves
repeatedly exposing clients to an anxietyproducing stimulus or situation, with the goal
of reducing fear
– Systematic desensitization: Therapy
technique that involves exposing clients to
increasingly anxiety-producing stimuli or
situations while coaching them to relax
42
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (4)
43
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (5)
– A recent alternative is to expose clients to
fearful situations without putting them in
danger by using computers to simulate the
environments and the feared objects
44
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (6)
45
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (7)
– Psychotropic medication treatments for
phobias often include anti-anxiety drugs that
are calming
– CBTs are the treatments of choice for phobia
– Antidepressants may be useful for social
phobia (social anxiety disorder)
46
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (8)
• Panic disorder
– It has multiple components and each
symptom may require a different treatment
• Cognitive restructuring is a technique used in
cognitive therapy to address ways of reacting to
the symptoms of a panic attack
• In the treatment of panic attacks, CBT appears to
be as or more effective than medication
47
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (9)
• Obsessive-compulsive disorder
– Exposure and response prevention:
Therapy technique that teaches clients to
relax as they are gradually exposed to
increasingly fear-inducing stimuli or situations
• The goal of treatment is to reduce fear
48
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (10)
49
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (11)
– Exposure and response prevention proved
superior to the use of a specific tricyclic
antidepressant, and both were better than
placebos
– CBT may be more effective at treating OCD
than medication, especially over the long term
– Deep brain stimulation (DBS) may be an
effective treatment for people with OCD
50
Anxiety and Obsessive-Compulsive Disorders Are Best
Treated With Cognitive-Behavioral Therapy (12)
51
Many Effective Treatments Are
Available for Depressive Disorders (1)
• There is no “best” way to treat depression
• Psychotropic drug treatment
– Researchers have attempted to determine
how particular types of people will respond to
antidepressants
• Since selective serotonin reuptake inhibitors
(SSRIs) have the fewest serious side effects, they
tend to be used as the first-line medication
52
Many Effective Treatments Are
Available for Depressive Disorders (2)
– The use of antidepressants is based on the
belief that depression is caused by an
imbalance in neurotransmitters or problems
with neural receptors
• Approximately 60 to 70 percent of clients who take
antidepressants experience relief from their
symptoms, as compared with about 30 percent
who respond to placebos
53
Many Effective Treatments Are
Available for Depressive Disorders (3)
• Cognitive-behavioral treatment
– Research has shown that cognitive-behavioral
therapy (CBT) is just as effective as
antidepressants at treating depression
• The CBT approach helps the client think more
adaptively and eliminate the cognitive triad of
negative thoughts
• CBT can be effective on its own, but combining it
with antidepressant medication may be more
effective than either approach alone
54
Many Effective Treatments Are
Available for Depressive Disorders (4)
• Alternative treatments
– Phototherapy: Treatment for seasonal affective
disorder (SAD) through which the client is exposed to
high-intensity light each day
– Treatment that alters the brain’s electrical function,
such as electroconvulsive therapy (ECT), may be
very effective for some people who are severely
depressed and do not respond to conventional
treatments
55
Many Effective Treatments Are
Available for Depressive Disorders (5)
56
Many Effective Treatments Are
Available for Depressive Disorders (6)
– A series of studies have demonstrated that
changing brain function by using transcranial
magnetic stimulation (TMS) over the left
frontal regions of the brain also reduces
depression significantly
57
Many Effective Treatments Are
Available for Depressive Disorders (7)
– DBS may be valuable for treating severe
depression when all other treatments have
failed
• Several studies have been done using DBS for
treatment-resistant depression, and each time at
least half the clients benefited from the treatment
58
Psychotropic Medications Are Most
Effective for Bipolar Disorders (1)
• Bipolar disorders are one of the few
psychological disorders for which there is a clear
optimal treatment
– The best practice is to use psychotropic medications,
especially the mood stabilizer lithium
• The process by which lithium stabilizes mood is not well
understood, but the drug seems to modulate neurotransmitter
levels
• Lithium has unpleasant side effects, including thirst, hand
tremors, excessive urination, and memory problems
59
Psychotropic Medications Are Most
Effective for Bipolar Disorders (2)
• The drug quetiapine (better known as Seroquel) is
an antipsychotic and is now the most commonly
prescribed drug for bipolar disorders, as combining
lithium with quetiapine improves treatment
outcomes
• As with all psychological disorders, compliance
with drug therapy can be a problem for various
reasons
60
Antipsychotic Medications Are Superior
Treatments for Schizophrenia (1)
• Psychotropic drug treatments
– Early antipsychotic drugs called conventional
antipsychotics reduced the positive symptoms of
schizophrenia, such as delusions, hallucinations, and
disorganized speech and behavior
• These medications have little to no effect on the negative
symptoms
• Tardive dyskinesia— involuntary movement of body parts—is
another devastating side effect of these medications and is
irreversible once it appears
61
Antipsychotic Medications Are Superior
Treatments for Schizophrenia (2)
– Atypical antipsychotics act on different
neurotransmitters. They are beneficial in
treating both the positive symptoms of
schizophrenia and some of the negative
symptoms
• Atypical antipsychotics can have serious side
effects including seizures, heart rate problems, and
substantial weight gain
• Some of these drugs can cause a fatal reduction in
white blood cells
62
Antipsychotic Medications Are Superior
Treatments for Schizophrenia (3)
63
Antipsychotic Medications Are Superior
Treatments for Schizophrenia (4)
• Behavior therapy
– Can include social skills training to elicit
desired behavior, such as appropriate ways to
act in specific social situations
• If a client’s self-care skills are poor, behavioral
interventions can focus on areas such as grooming
and bathing, managing medications, and financial
planning
64
Antipsychotic Medications Are Superior
Treatments for Schizophrenia (5)
• Prognosis in schizophrenia
– Most clients diagnosed with schizophrenia
experience multiple psychotic episodes over
the course of the disorder
• Most clients with schizophrenia also experience a
reduction in symptoms as they get older
65
Antipsychotic Medications Are Superior
Treatments for Schizophrenia (6)
– Prognosis: A prediction of the likely course of
a psychological (or physical) disorder
• People with later onset tend to have a more
favorable prognosis
• Women tend to have a better prognosis than men
• In developing countries, schizophrenia often is less
severe than in developed countries
66
15.3 Can Personality Disorders
Be Treated? (1)
• Most therapists agree that personality
disorders are very difficult to treat
– Some therapies have proven to be helpful for
two of the most disruptive personality
disorders
• Borderline personality disorder
• Antisocial personality disorder
67
15.3 Can Personality Disorders
Be Treated? (2)
68
Dialectical Behavior Therapy Is Most Successful
for Borderline Personality Disorder (1)
• Traditional psychotherapy approaches
have been largely unsuccessful
– Dialectical behavior therapy (DBT): Form of
therapy used to treat borderline personality
disorder
• DBT combines elements of behavior, cognitive,
and psychodynamic therapies with a mindfulness
approach based on Eastern meditative practices
69
Dialectical Behavior Therapy Is Most Successful
for Borderline Personality Disorder (2)
70
Antisocial Personality Disorder Is
Extremely Difficult to Treat (1)
• Treating people with antisocial personality
disorder (APD) often seems impossible
– Individuals with APD apparently have
diminished cortical arousal, so stimulants
have been prescribed to normalize arousal
levels
– Most psychotherapies seem ineffective in
treating APD
71
Antisocial Per …
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