Here are my notes on this topic:
1. History
6500 BCE
- Trephining
- oldest surgical procedure?
- cave paintings
- making holes in the skull
- cut or scrape
- relieve pressure
- let evil spirits escape
- mentally ill were seen as possessed
Middle Ages
- Hippocrates (Greece 500 B.C.) and Galen (Rome 200 A.D.) thought that mental illness had biological roots
- Europeans still returned to belief in demon possession
- mentally ill persecuted
Enlightenment
- Philippe Pinel (France) and Dorothea Dix (U.S.)
- fought for humane treatment of the mentally ill
- helped the development of kinder institutions
Deinstitutionalization
- 1950s
- development of drugs for the mentally ill
- many people were released from mental institutions
- intended to save money and benefit patients
- many were unable to care for themselves
Preventative Efforts
Primary prevention
- attempt to reduce the incidence of societal problems that give rise to mental health issues
Secondary prevention
- working with people at risk for developing specific problems
Tertiary prevention
- aim to keep people’s mental health issues from becoming more severe
2. Individual Therapy
Overview
- Psychotherapy
- psychoanalytic, humanistic, behavioral, and cognitive psychologists
- Somatic treatments
- biomedical
- drugs
- Patients vs. clients
- patients go to
- biomedical psychologists, psychoanalysts
- clients go to
- other therapists
Psychoanalytic Theories
Psychoanalysis
- a therapeutic technique developed by Freud
- focuses on identifying the underlying causes of a problem
- Other therapies lead to symptom substitution
- after treated for one disorder, a new psychological problem arises
Hypnosis
- patients are less likely to repress thoughts
- Free association
- say whatever comes to mind without thinking
- supposed to elude the ego’s defenses
Dream analysis
- patients asked to describe their dreams
- manifest content
- what the patient reports
- latent content
- the interpreted underlying meaning
Resistance
- protecting yourself from the painful process of psychoanalysis
- disagreeing with your therapist’s interpretations
Transference
- patients redirect strong emotions felt towards others with whom they’ve had a troubling relationship onto the therapist
Insight therapies
- highlight the importance of the patient gaining an understanding of his problems
Humanistic Therapies
Strive to self-actualize
- Beliefs
- people are innately good
- people have free will
- determinism- opposite
Client/Person-centered therapy
- therapist must provide unconditional positive regard
- non-directive
- therapists don’t tell clients what to do
- help clients choose course of action
- active listening
Gestalt therapy
- clients encouraged to get in touch with whole selves
- stress importance of present
- integrate actions, feelings, thoughts into a whole
Existential therapies
- focus on helping clients achieve a subjectively meaningful perception of their lives
Behavioral Therapies
Counterconditioning
- Mary Cover Jones
- an unpleasant conditioned response is replaced with a pleasant one
Systematic desensitization
- Joseph Wolpe
- teach the client to eliminate anxiety through relaxation
- construct anxiety hierarchy
- a rank-ordered list of what the clients fears, from least to most
in vivo desensitization
- the client confronts feared objects or situations
covert desensitization
- client imagines the feared stimuli
- climb the hierarchy, using counterconditioning to replace fear with relaxation
Flooding
- the client addresses the most frightening scenario first
Modeling
- client watches someone else interact with feared object
- client reenacts what he saw
Aversive conditioning
- pairs a habit the client wants to break with an unpleasant stimulus
Operant conditioning
- uses rewards and punishments to modify behavior
- token economy
Cognitive Therapies
- Concentrate on changing unhealthy thought patterns
Cognitive therapy
- most often used to treat depression
- aims to engage clients in pursuits that will bring them success
- make beliefs about cognitive triad more positive
- Aaron Beck
Rational emotive behavior therapy
- REBT/RET
- Albert Ellis
- goals
- show client that his failure is unlikely
- show that even if client does fail, it wouldn’t be a big deal
- expose and confront the client’s dysfunctional thoughts
3. Group Therapy
Group Therapy
- more than 1 therapist
- multiple people at same time
- various formats
Educational-Experiential
- anger management
- skills training
- group process
- leaderless groups
Nonverbal Expressive
- art therapy
- mindfulness
- dance therapy
Family therapy
- Meeting with a number of people experiencing similar difficulties
Self-help groups
- support groups
- don’t involve a therapist
4. Somatic Therapies
Therapies that produce bodily changes
Psychopharmacology/ Chemotherapy
- drug therapy
- more likely to be used for severe disorders
- especially schizophrenia
Antipsychotic drugs
- block receptor sites for dopamine
- used for schizophrenia
- Thorazine, Haldol
- side effect
- tardive dyskinesia (muscle tremors)
Chemotherapy
- used for mood disorders
- increase serotonin activity
- lithium- for manic phase of BPD
- for unipolar depression:
- tricyclic antidepressants
- monoamine oxidase (MAO) inhibitors
- serotonin-reuptake-inhibitor drugs
- Barbiturates
- antianxiety drugs
- types
- Miltown
- benzodiazepines
- ex. xanax, valium
Electroconvulsive therapy (ECT)
- bilateral
- electric current passed through both brain hemispheres
- unilateral
- electrical current through one hemisphere
- more effective
- worse side effects
- memory loss
- brief seizure
- brief loss of consciousness
- used for depression when other methods fail
- less common than chemotherapy
Psychosurgery
- rarest treatment
- last resort
- purposeful destruction of part of the brain to alter a person’s behavior
- prefrontal lobotomy
- cutting the main neurons leading to the frontal lobe
- calms behavior
- makes you a vegetable?
5. Kinds of Therapists
Psychiatrists
- Can prescribe meds
- Less trained in psychotherapy
Clinical Psychologists
- earn Ph.D.s that require at least 4 years of study
Counseling Psychologists
- Graduate degree in psychology
- Deal with less severe problems
Psychoanalysts
- Trained in Freudian methods
- Don’t need medical degree
