4.1 The nature and Function of treatments for Psychopathology
Treatments possess characteristics of:
o Relief from the distress cause by symptoms
o Provide the client with self-awareness and insight into the problem
o Enable the client to acquire coping and problem-solving skills to
prevent future problems
o Identify and resolve the causes of the psychopathology
Drug treatment have a palliative effect: the reduction of the severity of
symptoms and alleviation of distress
o No insight into problems
Other therapies provide ways of changing behavior but no insight
Treatment depends on
o The theoretical orientation and training of the therapist
Therapist must demonstrate continuing professional
development (CPD): regularly updating one’s knowledge
o The nature of psychopathology
National Institute for health and care excellence
(NICE): an independent UK organization responsible for
providing national evidence-based guidance on promoting
good health and preventing and treating ill health
Theoretical approaches to treatment
o Psychodynamic approaches
Reveal unconscious conflicts that developed early in life
Bring conflict into conscious awareness and develop
strategies for change
Psychoanalysis (Freud): understand source of conflict
Free association
Transference: target for emotional responses, behave
towards therapist as they would behave towards a
person in their life
Dream analysis
Interpretation: find conflict
Multiple sessions per week; takes 3-7 years until
benefits are realized
But limited effectiveness
o Behavior therapy
Interventions to change the client’s behavior
Conditioning – disorders resulting from faulty learning
Anxiety through classical conditioning
Behavior acquired through operant conditioning
o Behavior modification/behavior analysis –
unlearn a response
Therapies based on classical conditioning
Extinction (unlearning responses)
Flooding: a form of exposure therapy for the
treatment of phobias and related disorders in which the
, patient is repeatedly exposed to highly distressing
stimuli
Counterconditioning: a behavior therapy technique
designed to use conditioning techniques to establish a
response that is antagonistic to the psychopathology
Systematic desensitization: Treatment of phobias an
anxiety disorders during which the client overcomes
their fears through gradual and systematic exposure
Exposure therapy: treatment in which sufferers are
helped to confront and experience events and stimuli
relevant to their trauma/symptoms
Reciprocal inhibition: anxiety is eliminated not just
by extinguishing the relationship between the anxiety-
inducting cue and the threatening consequence but
also by attaching a response to the anxiety-inducing
cue which is compatible with anxiety
Also: addictive disorders, marital conflict, sexual dysfunction
Aversive therapy: attempts to condition an aversion to a
stimulus or event to which the individual in inappropriately
attracted (addictive behaviors)
Little evidence that aversive therapy alone has long-
term effects
o Therapies based of operant conditioning
Used in 3 specific ways
Understand what rewarding factors might be
maintaining challenging or aggressive behavior
Use reinforcers to establish new behavior
Used punishment to eliminate problematic behavior
Functional analysis: an observational method for
identifying the consistencies between problematic behaviors
and reinforcing consequences
Token economy
Response shaping: a reinforcing procedure that is used to
develop new behaviors (like withdrawal)
Behavioral self-control: the personal use of operant
conditioning principles to change or control one’s own
behavior
Behavioral self-control scheme to address obesity
Record time and quantity of food
Weighing before each meal and before bedtime
Removal of food from all places in the house (except
kitchen)
Pairing eating with no other activity
Setting a weight-loss goal of 1-2 pounds a week
Slowing down the pace of eating
Substituting other activities for between-meal eating
Cognitive therapies
, o Rational emotive therapy (RET): addresses how people construe
themselves, their life and the world (Albert Ellis)
People carry a set of implicit assumptions determining
perception
Change a set of core beliefs
o Cognitive therapy: based on the belief that psychological
problems are the products of faulty ways of thinking about the world
Replacing irrational beliefs
o Beck’s cognitive therapy: an intervention derived from Beck’s
view that depression is maintained by a “negative schema” that
leads depressed individuals to hold negative views about
themselves, their future and the world
Replace them with more rational schemas
Objective assessment of beliefs; provide evidence for them –
patients can perceive their existing schemas as biased
o Cognitive behavior therapy (CBT): an intervention for changing
both thoughts and behavior; an umbrella term for many different
therapies that share the common aim of changing both; possesses
characteristics of
the client keeps a diary of events, moods, thoughts
the client is urged to identify and challenge irrational
thoughts
homework in the form of “behavioral experiments” to see
whether thoughts are accurate
training of new ways of thinking, behaving and reacting in
specific situations
o “Waves” of CBT
New forms of CBT are known as “waves”
1st wave: behavioral techniques
2nd wave: cognitions and emotions
3rd wave: mindfulness and acceptance
Mindfulness-based cognitive therapy (MBCT):
treatments emphasize achieving a mental state characterized
by present-moment focus and non-judgmental awareness
Improve emotional well-being by increasing awareness
of how automatic cognitive and behavioral reactions to
thought, sensations and emotions cause distress
Focus on present and accept feelings → deal with life
stressors
Reduce depression and anxiety by countering
avoidance strategies
Acceptance and commitment therapy (ACT): a “third
wave” CBT intervention that adopts aspects of mindfulness,
but has developed more from Skinnerian approach to
understand behavior
Teaches patients to notice, accept and embrace
thoughts
Clarify and act on personal values and increase
psychological flexibility
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