Therapy

• Trephination


  An early therapy for mental disorders that involved cutting a hole in the skull (to allow demons to release through an exit)
• Early "therapies" for psychological disorders


  • Based on the idea that psychological disorders were caused by evil spirits

  
• Beginning in the sixteenth century, "hospitals for the insane" were established throughout Europe
• Conditions in early "hospitals for the insane"

  Barbaric, chaotic, and patients were sometimes displayed to the public for a fee
• General paresis was discovered to be a consequence of syphilis

  1897
• This paved the way for antibiotics and a medical perspective regarding psychological disorders
• Sigmund Freud's "talking cure"


  The first psychological therapy that drew attention to environmental and social dimensions
• Contemporary therapy providers primarily offering psychological therapies

  • Clinical psychologist
  • Marriage, family, and child counselor
  • Mental health counselor
  • Clinical social worker
  • School psychologist and vocational counselor
• Contemporary therapy providers providing primarily biological therapy

  • Psychiatrist
  • General medical practitioner
  • Neurologist
  • Psychiatric nurse
• Administration of biological therapies always requires a license
• There is active debate on who should be allowed to prescribe medication to treat psychological disorders
• Providers of psychological therapy can claim the title of "counselor" or "therapist" without any special license
• Neither professional credentials nor years of experience strongly predict a person's success in providing psychological therapies
• There are clear advantages to receiving therapy from a trained professional
• Subsyndromal disorders


  Versions of psychological disorders that don't meet the DSM-5 criteria for diagnosis but may cause significant problems
• Barriers that prevent people from obtaining therapy

  • Lack of physical access to treatment
  • Lack of financial access to treatment
  • Failure to recognize a psychological disorder as a treatable condition
  • Stigma
• Between 5–10 percent get worse as a result of therapy
• Rapport


  A patient's sense of trust in, respect for, and comfort with the treatment provider
• Cultural competence


  An understanding of how patients' cultural backgrounds shape their beliefs, values, and expectations for therapy
• Culturally appropriate therapy


  Therapy that is conducted in a manner that is sensitive to the patient's cultural background and expectations
• The long-term clinical outcome for people with schizophrenia is better in some developing countries than in Europe and the United States
• Hysteria


  An older term for a group of presumably psychogenic disorders that included a wide variety of physical and psychological symptoms; the term used today is conversion disorder
• Psychogenic


  Resulting from a psychological cause rather than from organic damage to the nervous system
• Free association


  A therapeutic method in which the patient says anything that comes to mind, no matter how apparently trivial, embarrassing, or disagreeable
• Resistance


  In psychoanalysis, a patient's self-censorship or avoidance of certain topics
• Psychoanalysis

  A method of therapy, developed by Sigmund Freud, asserting that clinical symptoms arise from unconscious conflicts rooted in childhood
• Interpretations


  In psychoanalysis, explanations of how various thoughts, feelings, and behaviors are linked to prior experiences
• Transference


  The tendency of patients to respond to an analyst or therapist in ways that recreate patient's responses to major figures in their own lives
• Ego psychology


  A school of psychodynamic thought that emphasizes the skills and adaptive capacities of the ego
• Object relations


  A school of psychodynamic thought that emphasizes the real (as opposed to fantasized) relationships an individual has with important others
• Contemporary psychodynamic therapists


  • Use techniques that bear Freud's imprint, but have modified the treatment in various ways to include the adaptive capacities of the ego and the importance of real relationships
• Interpersonal therapy (IPT)


  A form of therapy focused on helping patients understand how they interact with others and then learn better ways of interacting and communicating
• Humanistic approach


  An approach to therapy centered around the idea that people must take responsibility for their lives and actions
• Client-centered therapy (person-centered therapy)


  A form of humanistic therapy in which the therapist's genuineness, unconditional positive regard, and empathic understanding are crucial to therapeutic success; also known as person-centered therapy
• Non-directive therapy


  A specific kind of person-centered therapy in which the therapist allows patients to simply express themselves, rather than giving any direct advice or feedback
• Motivational interviewing


  A brief, nonconfrontational, client-centered therapy designed to change specific problematic behaviors such as alcohol or drug use
• Gestalt therapy


  A form of humanistic therapy that aims to help patients integrate inconsistent aspects of themselves into a coherent whole by increasing self-awareness and self-acceptance
• Experiential therapy


  The collective term for modern humanistic therapies
• Behavioral approaches


  • A family of therapeutic approaches based on the idea that problematic behaviors are the result of learning
• Exposure techniques


  Behavioral techniques designed to remove the anxiety connected to a feared stimulus through repeated approach toward the feared stimulus