Introduction to Psychology - Chapter 14 PDF

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Detailed notes for chapter 14, covered in the 14th/15th week of class. These were very useful on tests and I finished the class with an A....

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Fall 2018 – November 26th and 28th Textbook: Invitation to Psychology 7th Edition (2017) by Wade, C., Tavris, C., Sommers S., & Shin, L Chapter 14: Approaches to Treatment Section 14.1 Biological Treatment for Mental Disorders: • The Question of Drugs: o The most commonly used biological treatment for mental illnesses is the prescribing of drugs o These medications after the production of, or response to, neurotransmitters in the brain • Drugs Commonly Prescribed for Mental Disorders: o Antipsychotic drugs- used primarily in the treatment of schizophrenia and other psychotic disorders § Designed to block or reduce the sensitivity of brain receptors that respond to dopamine; some also block serotonin § Reduce agitation, delusions, and hallucinations, shorten schizophrenic episodes—but offers little relief from other symptoms § *Associated with problematic side effects o Antidepressant drugs- used primarily in the treatment of depression and anxiety disorders, phobias, and OCD § Monoamine oxidase inhibitors (MAOIs) elevate norepinephrine levels and serotonin in the brain by inhibiting the enzyme that deactivates them § Tricyclic antidepressants boost norepinephrine and serotonin by preventing the normal reuptake of them § Selective serotonin reuptake inhibitors (SSRIs) specifically target serotonin § *All produce unpleasant side effects and MAOIs can interact with certain foods to dangerously elevate blood pressure § *Cause withdrawal if stopped abruptly and can worsen depression o Anti-anxiety drugs (tranquilizers)- commonly prescribed for patients who complain of excessive anxiety or worry § Increases the activity of gamma-aminobutyric acid (GABA) § May help with acute anxiety, but are not considered a long-term treatment § *When the drugs are stopped, symptoms usually return and users usually have trouble with overuse, withdrawal, and tolerance

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Beta-blockers (heart regularities and hypertension) can be prescribed for acute anxiety but are not approved for anxiety disorders o Mood stabilizers- frequently given to people suffering from bipolar disorder § Lithium carbonate, must be given in the right dose and bloodstream levels have to be monitored because too much is toxic § Other drugs include Depakote and Tegretol Some Cautions about Drug Treatments: o Publication bias- tendency for journals to publish positive findings but not negative or ambiguous ones o The Placebo effect- the apparent success of a medication or treatment due to the patient’s expectations or hopes rather than to the drug or treatment itself o Side effects and drug discontinuation o Disregard for effective, possibly better nonmedical treatments o Unknown risks over time and drug interactions o Untested off-label uses Direct Brain Intervention—Psychosurgeries: o Prefrontal lobotomy- drilled holes and crushed nerve fibers in prefrontal lobes § Used to reduce a patient’s emotional symptoms § Never validated scientifically but performed on 40,000 people in the US § Left many patients apathetic, withdrawn, and unable to care for themselves o Anterior cingulotomy- inserting an electrode in a hole in the skull and heating it to make a legion on the dorsal anterior cingulate cortex § Proved to help in OCD and depression o Deep brain stimulation (DBS)- implants electrodes in brain and small box under collarbone § Treats OCD and depression, originally for Parkinson’s and epilepsy § Experimental and risky, may not be adequately tested and long-term effects are unknown o Electroconvulsive therapy (ECT)- procedure used in cases of prolonged and severe major depression, in which an electrical current is applied to the head, triggering a brief seizure § Commonly referred to as shock therapy

Section 14.2 Major Schools of Psychotherapy • Psychodynamic Therapy: o Psychoanalysis- theory of personality and a method of psychotherapy developed by Sigmund Freud that emphasizes unconscious motives and conflicts o Transference- in psychodynamic therapies, a critical process in which the client displaces unconscious emotions or reactions, such as emotional feelings about their parents, onto the therapist Behavior and Cognitive Therapy: • Behavior therapy- a form of therapy that applies principles of classical and operant conditioning to help people change self-defeating or problematic behaviors o Behavioral self-monitoring- keeping careful data on the frequency and consequences of a behavior to be changed o Exposure: § Graduated exposure- method where a person suffering from a phobia or panic attacks is gradually taken to the feared situation until anxiety subsides § Flooding- form of exposure treatment in which the client is taken directly into a feared situation until anxiety subsides § Systematic desensitization- like counterconditioning, involves relaxation during exposure (example: cybertherapy with ritual reality programs) § Skill training- an effort to teach the client skills they may lack, as well as new constructive behaviors to replace self-defeating ones • Cognitive therapy- a form of therapy designed to identify and change irrational, unproductive ways of thinking, and, hence, reduce negative emotions o Rational Emotive Behavior Therapy (REBT)- form of cognitive therapy devised by Albert Ellis designed to challenge the client’s unrealistic thoughts o Cognitive-Behavioral Therapy (CBT)- clients learn to explicitly identify and accept whatever negative thoughts and feelings arise, without trying to eradicate them or letting them derail healthy behavior § Based on mindfulness § Accept feeling and focus on coping techniques despite those feelings Humanist and Existential Therapy: • Humanist Therapy- form of psychotherapy based on the philosophy of humanism, which emphasizes personal growth, resilience, the achievement of human potential, and the client’s ability to change rather than being destined to past conflicts

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o Client-centered (Nondirective) Therapy- developed by Carol Rogers, a humanist approach which emphasizes the therapist’s empathy with the client and the use of unconditional positive regard Existential Therapy- form of therapy designed to help clients explore the meaning of existence and face the great questions of life, such as death, freedom, and loneliness

Family and Couples Therapy: • Assumes problems develop in the context of family, that they are sustained by family dynamics, and that any changes will affect the whole family • Can look for patterns of behavior across generations and create a family tree of psychologically significant events • Family-Systems Perspective- approach to doing therapy by identifying how each family member forms part of a larger interacting system • Couples therapy- resolution of conflicts and breaking out of destructive habits in relationships

Section 14.3 Evaluating Psychotherapy: • The Scientist-Practitioner Gap: o Some psychotherapists believe that evaluating therapy using research methods is futile o Scientists find that therapists who do not keep up with empirical findings are less effective and can harm clients § Therapists must be aware of research on the most beneficial methods, ineffective or potentially harmful techniques, and topics relevant to their practice o Over the years the breach between scientists and therapists has widened, creating the scientist-practitioner gap • Problems in Assessing Therapy: o Economic pressures require empirical assessment of therapies o Testimonials don’t provide a control group o Randomized control trials- research designed to determine the effectiveness of a medication or form of therapy, in which people with a given problem or disorder are randomly assigned to one or more treatment groups or to a control group When Therapy Helps: • Depression—cognitive therapy’s greatest success is in mood disorders • Suicide attempts—people who were given 10 sessions of cognitive therapy afterward were only ½ as likely to attempt again and scored lower in depressive mood and helplessness • Anxiety disorders—exposure techniques are most effective for treatment of PTSD, agoraphobia, and specific phobias; CBT therapy is more effective than medication for panic disorder, generalized anxiety, and OCD • Anger and impulsive behavior—cognitive therapy is often successful in reducing chronic anger, abusiveness, and hostility; teaches people to express their anger constructively • Health problems—cognitive and behavioral therapies help people cope with pain, chronic fatigue, headaches, IBS, quit smoking and other addictions, recover from eating disorders, insomnia, sleeping patterns, and other health problems • Child and adolescent behavior problems—behavior therapy helps in behavior problems ranging from bed-wetting to impulsive anger, and even problems with biological origins, such as autism • Relapses—cognitive-behavioral approaches have helped in reducing the rate of relapse among people with many different problems, such as: substance abuse, depression, sexual offending, and schizophrenia

Special Problems and Populations: • Rehabilitation psychologists are concerned with the assessment and treatment of people who are physically disables and helping them find ways to live independently • Community psychologists set up programs at a community level, coordinating outpatient services at local clinics with support from family and friends o Multisystemic therapy (MST) has been successful in reducing teenage violence, drug abuse, and school problems in troubled communities Biology and Psychotherapy: • Changing behavior and thoughts through psychotherapy can also change brain functions • Often see the same effects with psychotherapy as produced by taking medications • Medicine is often a small part of a program of activities, support, and therapy needed to improve When Interventions Harm: 1. Use of empirically unsupported, potentially dangerous techniques 2. Inappropriate or coercive influence, which can create new problems for the client 3. Prejudice or cultural ignorance on part of the therapist 4. Sexual intimacy or other unethical behavior on the part of the therapist Culture and Psychotherapy: • Many therapists and clients establish successful working relationships in spite of coming from different backgrounds • When clients and psychotherapists are culturally matched, they are more likely to agree on: o Perceptions of what the problem is o The best way of coping o Expectations about what therapy can accomplish...