18.14 Chapter 14: Treatment of Psychological Disorders

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1. moral treatment
2. a. symptoms
3. Deinstitutionalization was the mass movement of patients with psychological disorders out of mental institutions, in an attempt to reintegrate them into the community. Deinstitutionalization was partially the result of a movement to reduce the social isolation of people with psychological disorders. This movement marked the beginning of new treatment modalities that allowed individuals to better care for themselves and function in society. However, many former patients ended up living on the streets or behind bars. Many people locked up in American jails and prisons are suffering from mental health problems.

1. resistance
2. a. humanistic
3. c. empathy.
4. Psychoanalysis, the first formal system of psychotherapy, attempts to increase awareness of unconscious conflicts, making it possible to address and work through them. The therapist’s goal is to uncover these unconscious conflicts. Psychodynamic therapy is an updated form of psychoanalysis; it incorporates many of Freud’s core themes, including the notion that personality characteristics and behavior problems often can be traced to unconscious conflicts. In psychodynamic therapy, therapists see clients once a week for several months rather than many times a week for years. And instead of sitting quietly off to the side, therapists and clients sit face-to-face and engage in a two-way dialogue.

1. a. behavior
2. anxiety hierarchy
3. b. aversion therapy
4. Answers will vary, but may be based on the following information. In behavior modification, one uses positive and negative reinforcement, as well as punishment, to help a child increase adaptive behaviors and reduce those that are maladaptive. For behaviors that resist modification, therapists might use successive approximations by reinforcing incremental changes. Some therapists will incorporate observational learning (that is, learning by imitating and watching others) to help clients change their behaviors.

1. cognitive therapy
2. d. Rational emotive behavior
3. Answers will vary, but may be based on the following information. Behavior therapies focus on behavioral change, with the belief that the key to resolving problems is not understanding their origins. Using the learning principles of classical conditioning, operant conditioning, and observational learning, behavior therapy aims to replace maladaptive behaviors with more adaptive behaviors. It incorporates a variety of techniques, including exposure therapy, aversion therapy, systematic desensitization, and behavior modification. Behavior therapy covers a broad range of treatment approaches, and focuses on observable behaviors in the present. Cognitive therapy is a type of therapy aimed at addressing the maladaptive thinking that leads to negative behaviors and feelings. The aim of cognitive therapy is to help clients recognize and resist their own cognitive distortions and illogical thoughts in short-term, action-oriented, and homework-intensive therapy sessions. The goal of both approaches is to change the way an individual works or functions in the world. One major difference is that behavioral therapy focuses on behaviors, whereas cognitive therapy focuses on thinking—the way an individual views the world, and views herself in the world.

1. group therapy
2. a. Self-help groups
3. Answers will vary (see TABLE 14.3). Group therapy would be inappropriate for an individual who is not comfortable talking or interacting with others and is unwilling to share his or her own thoughts, feelings, or problems. A group may fail if group members do not get along, are continually late for meetings, or drop out. The skills of the group therapist also play a role in the success of treatment (for example, empathy, facilitation skills, observation skills).

1. d. electroconvulsive therapy
2. b. antidepressants.
3. neurosurgery
4. Answers will vary. Biomedical therapies use physical interventions to treat psychological disorders. These therapies can be categorized according to the method by which they influence the brain’s functioning: chemical, electrical, or structural. Psychotherapy is a treatment approach in which a client works with a mental health professional to reduce psychological symptoms and increase his or her quality of life. These approaches share common features: The relationship between the client and the treatment provider is of utmost importance, as is a sense of hope that things will get better. And these approaches generally seek to reduce symptoms and increase the quality of life, whether a person is struggling with a psychological disorder or simply wants to be more fulfilled.

1. b. more; the same
2. licensing issues; privacy issues; limited empirical support
3. Answers will vary, but may be based on the following information. In general, therapy “works,” especially if it is long-term. All approaches to psychotherapy perform equally well across all disorders. But individuals whose insurance companies limit their choice of therapists and how long they can receive treatment do not experience the same improvement as those who are less restricted. In addition, people who start therapy but then decide to stop it experience less successful outcomes. The client’s cultural experience is important to keep in mind. Within any group, there is vast variation from one individual to the next, but it is still necessary for therapists to understand the cultural context in which they work. This includes being respectful of cultural norms and sensitive to the many forms of prejudice and discrimination that people can experience.

1. c. removed the inmates’ chains and listened to their complaints
2. c. insight therapy.
3. a. psychoanalysts
4. b. it is difficult to test through experimentation
5. d. person-centered therapy.
6. a. hierarchies
7. b. Getting fired once does not mean my career is over.
8. a. tends to work quickly.
9. d. Seeing others improve offers hope and inspiration.
10. d. family therapy
11. d. Humanistic
12. d. Psychopharmacology
13. b. limitations on choice of therapist as mandated by a health insurance policy
14. c. seizures
15. a. culture
16. Answers will vary, but may be based on the following information. Cognitive behavior therapy is an action-oriented type of therapy that requires clients to confront and resist their illogical thinking. Insight therapies aim to increase awareness of self and the environment. These approaches share common features: The relationship between the client and the treatment provider is of utmost importance, as is a sense of hope that things will get better. And these approaches generally seek to reduce symptoms and increase the quality of life, whether a person is struggling with a psychological disorder or simply wants to be more fulfilled.
17. Answers will vary (see TABLE 14.2).
18. Answers will vary, but may be based on the following information. Exposure is a therapeutic technique that brings a person into contact with a feared object or situation while in a safe environment, with the goal of extinguishing or eliminating the fear response. An anxiety hierarchy (a list of activities ordered from least to most anxiety-provoking) can be used to help with exposure. Aversion therapy is an approach that uses principles of classical conditioning to link problematic behaviors to unpleasant physical reactions.
19. Answers will vary, but may be based on the following information. One challenge of providing therapy is to meet the needs of clients from vastly different cultures. Within any group, there is great variation from one individual to the next, but it is still necessary for the therapist to keep in mind the client’s cultural experience. This includes being respectful of cultural norms and sensitive to the many forms of prejudice and discrimination that people can experience. Every client has a unique story and a singular set of psychological needs. Responding to those needs and determining which approach will be most effective are key to successful therapy.
20. Answers will vary, but may be based on the following information. As more people gain access to the Internet and as more therapists try to specialize and market their services, online therapies have multiplied. E-therapy can mean anything from e-mail communications between client and therapist to real-time sessions via a webcam. These digital tools are valuable for serving rural areas and providing treatment to those who would otherwise have no access. Videoconferencing is also useful for consultation and supervision. But online psychotherapy raises many concerns, including licensing and privacy issues, lack of nonverbal cues, and potential problems with developing therapeutic relationships.