Treatment of Psychological Disorders

Question 1

How many Canadians suffer from mental illness?

Answer 1

1 in 5

Question 2

What percentage of mentally ill Canadians seek help?

Answer 2

40%, but 1 in 3 report needs being unmet or partially unmet

Question 3

What’s the delay in seeking treatment after onset of mental disorder?

Answer 3

A decade

Question 4

Why do people fail to seek treatment?

Answer 4

1. People may not realize they have a mental disorder that can be treated
2. There may be barriers to treatment (beliefs and circumstances)
3. Structural barriers prevent people from physically getting to treatment

Question 5

People may not realize they have a mental disorder that can be treated

Answer 5

• 45% of people think they do not need to be treated
• Mental iIlness often are not taken as serious as
  physical illnesses
• Misunderstanding that mental illness can be
  treated; unsure what treatment looks like

Question 6

Barriers to treatment (beliefs and circumstances)

Answer 6

• Belief they should be able to handle things themselves
• Belief that problem is not severe
• Belief that treatment would be ineffective
• Perceived stigma from others

Question 7

Structural barriers to getting treatment

Answer 7

• Affordability of treatment
• Lack of clinician availability
• Inconvenience of attending treatment
• Trouble finding transport to the appointments

Question 8

Psychologist

Answer 8

PhD or PsyD in clinical psychology, training in therapy, assessment of psychological disorders, and research

Question 9

Psychiatrist

Answer 9

MD with training in assessment and treatment of mental disorders; can prescribe medication

Question 10

Clinical social worker

Answer 10

MA in Social Work and training; clinical or psychiatric social workers receive specialized training

Question 11

Counselor

Answer 11

MA or PhD with specialized training; lots of variety

Question 12

Psychological treatment

Answer 12

People interact w/ a clinician to use environment to change their brain and behaviour

Question 13

Biological treatment

Answer 13

Brain is treated directly with drugs, surgery, or direct

intervention

Question 14

Treatments we’ve moved away from

Answer 14

• Hydrotherapy (pouring cold water on people w/ mental
  disorders)
  – Trephination (drilling holes to let evil spirits escape)
  – Bloodletting (removal of blood from the body)

Question 15

Psychotherapy

Answer 15

Interaction between a clinician and someone suffering from a psychological problem with goal of providing
support or relief for the problem

Question 16

Most common types of psychotherapy

Answer 16

• Psychodynamic
• Humanistic/existential
• Behavioural cognitive therapies
• Group therapies
• Eclectic psychotherapy

Question 17

Eclectic psychotherapy

Answer 17

Drawing on techniques from different forms of therapy depending on client and the problem

Question 18

Psychodynamic therapies

Answer 18

Explore childhood events and encourage individuals to develop insight into psychological problems; encourages clients to bring repressed conflicts into
consciousness so they can understand them and reduce their unwanted influences

Question 19

What goes on in psychodynamic therapy sessions?

Answer 19

• Four/five sessions a week for 3-6 years
  – Client faces away from analyst and is asked to express thoughts
  and feelings that come to mind
  – Therapist may comment, but does not express values orjudgments

Question 20

What happens in psychoanalysis?

Answer 20

• Free association
• Dream analysis
• Interpretation
• Analysis of resistance
• Transference

Question 21

Free association

Answer 21

Client reports every thought that enters their mind

without censorship or filtering; stream of consciousness

Question 22

Dream analysis

Answer 22

Dreams as metaphors for unconscious conflicts or

wishes that contain clues that the therapist can help the client understand

Question 23

Interpretation

Answer 23

Therapist deciphers meaning behind what clients says/does

Question 24

Analysis of resistance

Answer 24

Therapist suggests an interpretation client finds unacceptable; resistance is sign on the right track

Question 25

Transference

Answer 25

Analyst begins to assume a major role in client’s life | and clients reacts based on unconscious childhood fantasies; analyst then responds to it

Question 26

Interpersonal psychotherapy (IPT)

Answer 26

- Focuses on helping clients improve current relationships – No free association or interpretation – Therapists talk to clients about interpersonal feelings and behaviours – Look for signs of grief, role disputes, role transitions, or interpersonal deficits – Therapy is less intensive; few months once a week

Question 27

Goal of IPT

Answer 27

Relief from symptoms

Question 28

How effective are psychodynamic techniques?

Answer 28

– Less effective than other methods | – Aspects of therapy may be harmful (e.g., interpretations that threaten client-patient relationship)

Question 29

Humanistic/existential therapies

Answer 29

- Emphasize natural tendency for each individual to strive for personal improvement - Issues stem from feelings of alienation and loneliness; failures to reach one’s potential (humanistic) or meaning in life (existential)

Question 30

Types of humanistic/existental therapies

Answer 30

- Person-centered therapy (humanistic) | – Gestalt therapy (existential)

Question 31

Person-centered therapy

Answer 31

- Individuals have a tendency toward growth; facilitated by acceptance and genuine reactions from the therapist - Client creates own goals for therapy; with enough support the client will recognize the right thing to do - Three basic qualities: congruence, empathy and unconditional positive regard

Question 32

Congruence

Answer 32

Openness/honesty across all matters of discussion

Question 33

Empathy

Answer 33

Understand what the client is feeling/thinking; seeing the world from their perspective to appreciate concerns

Question 34

Unconditional positive regard

Answer 34

Nonjudgmental, warm, and accepting environment

Question 35

Gestalt therapy

Answer 35

- Help the client become aware of his or her thoughts, behaviours, experiences, and feelings and to take responsibility - Encouraged to be warm toward their clients but reflect back to client their impressions - Use technique of focusing: asking them to think about how a past experience makes them immediately feel - Use of role-playing to imagine how another person would respond

Question 36

Behavioural and cognitive therapies

Answer 36

Actively changing a person’s current thoughts and | behaviours as a way to decrease or eliminate their psychopathology

Question 37

Types of behavioural/cognitive therapies

Answer 37

- Behavioural therapy - Cognitive therapy - Cognitive behavioural therapy (CBT)

Question 38

Behavioural therapy

Answer 38

Assumes disordered behaviour is learned; symptom relief is achieved through changing overt maladaptive behaviours into more constructive behaviours. Three techniques: eliminating unwanted behaviours, promoting desired behaviours, and reducing unwanted emotional responses.

Question 39

Eliminating unwanted behaviours

Answer 39

Behaviour is influenced by its consequences – Problem behaviour could be eliminated by making consequences less reinforcing and more punishing

Question 40

Promoting desired behaviours

Answer 40

Use of token economies (tokens for desired behaviours which can be used for rewards)

Question 41

Reducing unwanted emotional responses

Answer 41

Use of exposure therapy (confronting an emotion-arousing stimulus directly and repeatedly, leading to a decrease in the emotional response) – Live exposure is better than imaginary exposure – Use of exposure hierarchies

Question 42

Cognitive therapy

Answer 42

Helping a client identify and correct any distorted thinking about self, others, or the world - Technique of cognitive restructuring - Mindfulness meditation

Question 43

Technique of cognitive restructuring

Answer 43

Teaching clients to question the automatic beliefs, assumptions, and predictions that lead to negative emotions and replace negative thinking with more realistic and positive beliefs

Question 44

Mindfulness meditation

Answer 44

Teaches an individual to be fully present in each moment; be aware of thoughts, feelings, sensations; detect symptoms before they become a problem

Question 45

Cognitive behavioural therapy (CBT)

Answer 45

- Most helpful for treating anxiety and depression - Acknowledges there are behaviours that people cannot control with rational thought, but there are ways to help people think more rationally - Transparent, problem focused and action orientated - Client is expected to do things: exercises, practice behaviour change skills, use a diary to monitor symptoms

Question 46

Couples therapy

Answer 46

Married, cohabitating, or dating couple is seen together in therapy to work on problems arising in the relationship; problem is the relationship not individual person

Question 47

Family therapy

Answer 47

Psychotherapy with members of a family; client is the family

Question 48

Group therapy

Answer 48

Multiple participants (who don’t know each other) work on their individual problems in a group atmosphere; common for substance abuse or addictions

Question 49

Self-help and support groups

Answer 49

Discussion groups that focus on a particular disorder or difficult life experience; run by peers that have struggled with the same issues; for both the person suffering and the support people

Question 50

Biological treatments traditionally

Answer 50

- Theriac: different ingredients, including opium! | – Use of cocaine, but negative side effects led to removed use

Question 51

Biological treatments now

Answer 51

Target specific neurotransmitters in the brain associated w/ the cause of mental disorders