1 of 49

Introductory Psychology

Module 15:

Therapy and Treatment

1

2 of 49

Affirmations

I choose to fully participate in this day
I must appreciate the journey to fully marvel at the accomplishments
People want to know the real me

2

3 of 49

Recall

How would you define a psychological disorder?
What is the diathesis-stress model?
Can you name 10 psychological disorders from the DSM?

3

4 of 49

Key Integrative Theme

Theme D: Psychology values diversity, promotes equity, and fosters inclusion in pursuit of a more just society.

4

5 of 49

Two Truths and a Lie

Which of these is the lie?

C. Dream analysis is a common type of therapy used today.

B. Unlike psychoanalysis, which focuses on past life events, cognitive behavioral therapy focuses on the “now”.

A. Advances in technology are relevant to psychotherapy.

5

6 of 49

Section 1 Learning Goals

1 Discuss the historical treatment of people with psychological disorders, and the eventual deinstitutionalization of mental health care

2 Describe how mental health services are delivered today, and the difference between voluntary and involuntary treatment

Deepen your understanding and form connections within these skills:

6

7 of 49

History of Mental Health Treatment

18th century – asylums (right) were created to house people with psychological disorders and keep them away from society. People were often mistreated.
1950s and 60s - antipsychotic medications introduced.
1963 – Deinstitutionalization closed large asylums with the goal of treating people in their communities.

7

8 of 49

How Common is Mental Illness?

19% of U.S. adults experienced mental illness in 2012
In 2008, 13.4% of adults received treatment for a mental health issue
People with mental illness are over-represented in homeless (a) and prison (b) populations

8

9 of 49

Where Do People Get Mental Health Treatment?

Primary care physician then referred to a mental health practitioner
Community mental health centers
Psychiatric hospitals
Schools
Prison

9

10 of 49

Why do people seek treatment?

Voluntary treatment: A person chooses to seek treatment in order to obtain relief from her symptoms
Involuntary treatment: A person is required by the courts or other systems to seek treatment

10

11 of 49

Types of Therapy

Psychotherapy is a psychological treatment that employs various methods to help someone overcome personal problems, or to attain personal growth

In modern practice, it has evolved into what is known as psychodynamic therapy, which will be discussed later.

Biomedical therapy involves medication and/or medical procedures to treat psychological disorders

11

12 of 49

Psychotherapy Techniques

Type	Description	Example
Psychodynamic psychotherapy	Talk therapy based on belief that the unconscious and childhood conflicts impact behavior	Patient talks about his past
Play therapy	Psychoanalytical therapy wherein interaction with toys is used in child therapy instead of talk	Patient (child) acts out family scenes with dolls
Behavior therapy	Principles of learning applied to change undesirable behaviors	Patient learns to overcome fear of elevators through several stages of relaxation techniques
Cognitive therapy	Awareness of cognitive process helps patients eliminate thought patterns that lead to distress	Patient learns not to overgeneralize failure based on single failure
Cognitive-behavioral therapy	Work to change cognitive distortions and self-defeating behaviors	Patient learns to identify self-defeating behaviors to overcome an eating disorder
Humanistic therapy	Increase self-awareness and acceptance through focus on conscious thoughts	Patient learns to articulate thoughts that keep her from achieving her goals

12

13 of 49

Evaluating Psychotherapy

According to the APA three factors work together to produce successful treatment

Use of evidence-based treatment that is deemed appropriate for your particular issue
Clinical expertise of the psychologist or therapist
Your own characteristics, values, preferences, and culture
No studies have found one psychotherapeutic approach more effective than another
One critical factor is the person’s relationship with the psychologist or therapist

13

14 of 49

Apply It

14

15 of 49

Section 2 Learning Goals

1 Describe psychoanalysis as a treatment approach

2 Describe cognitive and cognitive-behavioral therapy as treatment methods

3 Explain the basic process and uses of behavior therapy

4 Describe systematic desensitization

Deepen your understanding and form connections within these skills:

15

16 of 49

Psychoanalysis

Therapeutic orientation developed by Sigmund Freud (his couch is at right) that employs free association, dream analysis, and transference to uncover repressed feelings

16

17 of 49

Psychoanalysis

17

18 of 49

Behavioral Therapy

Uses principles of classical and operant conditioning to change behavior

Aversive conditioning
Exposure therapy

18

19 of 49

Behavioral Therapy

19

20 of 49

Cognitive Therapy

Cognitive therapists help their clients change dysfunctional thoughts in order to relieve distress
Emotional reactions are the result of your thoughts about the situation rather than the situation itself.
By changing your thoughts about the situation, you can improve your mental health.

20

21 of 49

Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) helps clients examine how their thoughts affect their behavior. It aims to change cognitive distortions and self-defeating behaviors.

Effective for depression, PTSD, anxiety disorders, eating disorders, bipolar disorder, and substance abuse.

Cognitive distortions include:

All-or-nothing thinking
Overgeneralization
Jumping to conclusions

21

22 of 49

Cognitive Behavioral Therapy

22

23 of 49

Cognitive Behavioral Therapy and RET

23

24 of 49

Question

1 Which type of psychotherapy is primarily focused on helping individuals recognize and change distorted thinking patterns that can lead to negative feelings and behaviors?

A) Psychoanalysis

B) Humanistic Therapy

C) Cognitive Behavioral Therapy (CBT)

D) Dialectical Behavior Therapy (DBT)

24

25 of 49

Apply It

25

Activity #2 from Instructor Resources:

Background

Before this activity, students should have already learned about the main categories of therapy, particularly CBT. This activity will have students think more about how research connects to the world of therapy. They will also watch a video about CBT and consider ways to change their thoughts.

Topic Alignment: Treatment Modalities
Learning Outcome: Describe how cognitive and cognitive-behavioral therapy are used as treatment methods
APA Learning Outcome:

A. Psychological science relies on empirical evidence and adapts as new data develop.
E. Our perceptions and biases filter our experiences of the world through an imperfect personal lens.
F. Applying psychological principles can change our lives, organizations, and communities in positive ways.

Source: Created by Patrick Carroll for Lumen Learning, CC-BY

Instructions

Handout worksheet: Activity Two Worksheet

We recommend stepping through the worksheet together as a class. Read through the first part and give students time to independently think through the questions.

Before getting into the Discussion section of the worksheet, show this video: Jake's Experience in Cognitive Behavioral Therapy for Suicide Prevention

In the video, Jake mentions a struggle to find a sense of purpose after returning home from active duty, and then experienced some events that caused added stress in his life. In what ways did Cognitive Behavioral Therapy (CBT) help him to find new meaning in his life?

How does a "Hope Box" work as a tool for suicide prevention? Can you think of any other practical strategies that might help someone who's struggling with suicidal thoughts?

Discuss

After watching the video, have students complete the worksheet by filling in the table about changing thoughts using the ABC method of REBT.

Here’s an example of something students might fill in to the worksheet:

Negative example (own scenario): You see a close friend hanging out with someone else and they didn't invite you. I must not be a good enough friend, they probably don't like me anymore. I'm always left out.

Positive twist (own scenario): You see a close friend hanging out with someone else and they didn't invite you. They must be catching up or discussing something personal. I know my friend values our friendship and this doesn't mean they don't want to spend time with me.

Discussion

After all the pairs have completed the worksheet and activity, have a class discussion asking students about what they wrote in the chart and ways that they can use tips from CBT or REBT in their own lives.

26 of 49

Section 3 Learning Goals

1 Describe humanistic therapy

2 Describe mindfulness, addiction treatments, and other emerging psychological treatments

3 Compare different biomedical therapies

Deepen your understanding and form connections within these skills:

26

27 of 49

Humanistic Therapy

Goal of humanistic therapy is to help people become more self-aware and accepting of themselves.

Focus on conscious thoughts and the patient’s present and future

Client-centered therapy:

Nondirective therapy
Active listening
Unconditional positive regard

27

28 of 49

Biomedical Therapy

Treatment that involves psychotropic medication and/or medical procedures to treat the symptoms of psychological disorders

If other treatments don’t work, electroconvulsive therapy (ECT) uses an electrical current to induce seizures in a person to help alleviate the effects of severe depression

28

29 of 49

Commonly Prescribed Psychotropic Medications

Type of Medication	Used to Treat	Example	How They Work	Side Effects
Antipsychotics (developed in the 1950s)	Schizophrenia and other types of severe thought disorders	Haldol, Mellaril, Prolixin, Thorazine	Treat positive psychotic symptoms such as auditory and visual hallucinations, delusions, and paranoia by blocking the neurotransmitter dopamine	Long-term use can lead to tardive dyskinesia, involuntary movements of the arms, legs, tongue and facial muscles, resulting in Parkinson’s-like tremors
Atypical Antipsychotics (developed in the late 1980s)	Schizophrenia and other types of severe thought disorders	Abilify, Risperdal, Clozaril	Treat the negative symptoms of schizophrenia, such as withdrawal and apathy, by targeting both dopamine and serotonin receptors; newer medications may treat both positive and negative symptoms	Can increase the risk of obesity and diabetes as well as elevate cholesterol levels; constipation, dry mouth, blurred vision, drowsiness, and dizziness

29

30 of 49

Commonly Prescribed Psychotropic Medications

Type of Medication	Used to Treat	Example	How They Work	Side Effects
Anti-depressants	Depression and increasingly for anxiety	Prozac, Zoloft Tofranil and Elavil	Alter levels of neurotransmitters such as serotonin and norepinephrine	SSRIs: headache, nausea, weight gain, drowsiness, reduced sex drive Tricyclics: dry mouth, constipation, blurred vision, drowsiness, reduced sex drive, increased risk of suicide
Anti-anxiety agents	OCD, PTSD, panic disorder	Xanax, Valium, Ativan	Depress central nervous system activity	Drowsiness, dizziness, headache, fatigue, lightheadedness
Mood Stabilizers	Bipolar disorder	Lithium	Treat episodes of mania as well as depression	Excessive thirst, irregular heartbeat, itching/rash, swelling (face, mouth, and extremities), nausea, loss of appetite
Stimulants	ADHD	Adderall, Ritalin	Improve ability to focus on a task and maintain attention	Decreased appetite, difficulty sleeping, stomachache, headache

30

31 of 49

How is Addiction Treated?

Goal: to help an addicted person stop compulsive drug-seeking behaviors
Treatment usually includes behavioral therapy and/or medication, depending on the individual
About 40%–60% of individuals relapse, which means they return to abusing drugs and/or alcohol after a period of improvement

31

32 of 49

Effective Treatment for Addiction

3 months or more is best
Address communication, stress management, relationship issues, parenting, vocational concerns, and legal concerns
Group or family therapy to offer support, affiliation, identification, and even confrontation
Addresses other mental health disorders at the same time (Substance abusers are twice as likely to have a mood or anxiety disorder)

32

33 of 49

Section 4 Learning Goals

1 Explain memory consolidation and how it can be manipulated using concepts from conditioning

2 Describe how reconsolidation can be used to treat anxiety or PTSD

Deepen your understanding and form connections within these skills:

33

34 of 49

Question

1 What best defines memory reconsolidation as a treatment method?

A) The process of strengthening existing memories through repetitive recall and practice

B) The practice of eliminating all traumatic memories to cure disorders such as PTSD

C) The process of reactivating a consolidated memory to a flexible state, allowing it to be updated or modified

D) The technique of using medications to block the formation of new traumatic memories

34

35 of 49

Memory Reconsolidation

35

36 of 49

Section 5 Learning Goals

1 Define and give examples of individual therapy

2 Describe the various types of group therapy and their benefits

3 Explain why the sociocultural model is important in therapy and what type of cultural barriers prevent some people from receiving mental health services

Deepen your understanding and form connections within these skills:

36

37 of 49

Modalities of treatment:

Individual therapy
Group therapy
Couples therapy
Family therapy

37

38 of 49

Starting Therapy

Intake: therapist’s first meeting with the client in which the therapist gathers specific information about symptoms, support, and goals to address the client’s immediate needs

Confidentiality means the therapist cannot share what is said with any third party unless mandated or permitted by law to do so

38

39 of 49

Conducting an Intake Interview

39

Activity #3 from Instructor Resources��Background

The intake interview is a critical part of the counseling process, as it is where the counselor gathers information about the client's presenting problems, background, and goals for counseling. This activity is designed to provide students with an opportunity to practice their interviewing skills by conducting an intake interview with a simulated client. You could do it as an acting exercise as well where you as the instructor or someone else plays the role of someone presenting specific symptoms, and students ask intake styles questions to understand what the person is going through and what therapeutic interventions might be best. This activity will help students develop their communication skills, demonstrate empathy, and practice active listening.

Topic Alignment: Treatment Modalities

Learning Outcome: Explain and compare treatment modalities

APA Learning Outcome:

C. Psychological, biological, social, and cultural factors influence behavior and mental processes.

F. Applying psychological principles can change our lives, organizations, and communities in positive ways.

Source: Developed by Antonio Bedford and Lumen Learning, adapted from https://truecenterpublishing.com/tcp/intake.html, CC-BY-SA

Time Estimate: 40-60 minutes

Instructions

Conversation starter

Begin the activity by discussing the importance of intake interviews in the counseling process. Ask students to share their experiences with conducting or participating in intake interviews.

Handout: Activity Three Worksheet. This handout explains intake forms. Read the top portion of the document together.

Introduce Intake Exercise
Explain to students that they will do a simulated intake where they will partner up and one person will play the part of a fictional character while the other student will play the role of the therapist conducting an intake interview. The purpose of the intake interview is to gather more information about a person’s background, current situation, and goals for counseling so that the counselor can develop an appropriate treatment plan.
*At this point of the activity, make it clear that this is a serious activity. Stress the importance of respect and empathy in the context of therapy, regardless of whether the characters are fictional. Encourage students to choose characters who could reasonably be expected to seek therapy, and make sure they understand the purpose is to simulate a professional therapeutic relationship.*
Pick a fictional client.
Provide students with the list of fictional characters and tell them they can use one that is listed or pick from from TV shows, movies, books, etc OR pick a case study from the included list.
Give students ample time to think about how their fictional character might respond to the intake questions.
Conduct the intake interview
With their partners, have each student fully act the part of the fictional character while the other, respectfully, conducts the intake interview. Tell students they do not have to ask or answer ALL of the provided questions but should ask at least 10 to get a feel for what the questions are like. Have the fictional character respond as their character would likely respond. Allot time to have the students switch roles.
Remind students of some best practices during intake interviews:

Establish a rapport with the client: Building a positive relationship with the client is essential for establishing trust and creating an environment where they feel comfortable sharing their thoughts and feelings.
Use open-ended questions: Ask questions that encourage the client to provide detailed answers, rather than simple yes or no responses. This can help you gather more information about their situation and goals for counseling.
Practice active listening: Listen attentively to what the client is saying and ask follow-up questions to clarify any points that are unclear. Reflect back to the client what you have heard to ensure that you have understood their perspective.
Show empathy: Demonstrate empathy by acknowledging the client's feelings and validating their experiences. This can help the client feel heard and understood, which can be an essential part of the healing process.
Maintain confidentiality: Ensure that the client understands that the information they share during the intake interview is confidential and will only be used for treatment purposes.
Be aware of cultural differences: Be mindful of cultural differences that may affect the client's perspective and approach to counseling. Respect their cultural values and beliefs and be open to learning more about their culture if necessary.
Clarify the goals for counseling: Ensure that you and the client are on the same page regarding the goals for counseling. This can help guide the development of a treatment plan that is tailored to the client's needs and goals.
Document the information gathered: Take detailed notes during the intake interview and document the information gathered in the client's file. This can help ensure that important information is not forgotten and can be used to guide treatment decisions.
Provide a potential diagnosis and treatment recommendations

Complete the questions at the end of the worksheet on developing a treatment plan. Have students consider what types of therapies might work best for the specific client, and why.

Discussion

After all the pairs have completed the intake interview, bring the class back together to discuss their experiences. Use the following questions to guide the discussion:

What were some of the challenges you faced during the intake interview?

What did you learn about the client's presenting problems, background, and goals for counseling?

How did you demonstrate empathy and active listening during the interview?

What are some best practices for conducting an effective intake interview?

How did your patient's cultural background might influence the way they experience and express symptoms? How might their cultural background impact their willingness to seek help or their views on mental health treatment?

How confident were you in your decisions and recommendations for the diagnosis and treatment? What challenges did you face during the interview?

What additional information would you have liked to have?

40 of 49

Risks and Benefits of Group Therapy

Benefits:

Can help decrease a client’s shame and isolation about a problem while offering needed support
Members can confront each other about their patterns.
Economical

Risks:

Members of the group may be afraid to speak in front of other people.
Personality clashes and arguments among group members.
Concerns about confidentiality

40

41 of 49

Couples Therapy

The couple may be dating, partnered, engaged, or married.
The primary therapeutic orientation used is cognitive-behavioral therapy
Some couples seek therapy to work out their problems, while others attend therapy to determine whether staying together is the best solution

41

42 of 49

Family Therapy

Systems approach
Structural family therapy
Strategic family therapy

42

43 of 49

Cultural Competence in Mental Health Treatment

Mental health professionals must understand and address issues of race, culture, and ethnicity. The sociocultural model integrates the impact of cultural and social norms into treatment.

43

(credit “top-left”: modification of work by Staffan Scherz; credit “top-left-middle”: modification of work by Alejandra Quintero Sinisterra; credit “top-right-middle”: modification of work by Pedro Ribeiro Simões; credit “top-right”: modification of work by Agustin Ruiz; credit “bottom-left”: modification of work by Czech Provincial Reconstruction Team; credit “bottom-left-middle”: modification of work by Arian Zwegers; credit “bottom-right-middle”: modification of work by “Wonderlane”/Flickr; credit “bottom-right”: modification of work by Shiraz Chanawala) in The Sociocultural Model and Therapy Utilization. Authored by: OpenStax College. Located at: http://cnx.org/contents/Sr8Ev5Og@5.52:T1PWqUy3@5/The-Sociocultural-Model-and-Th. License: CC BY: Attribution. License Terms: Download for free at http://cnx.org/content/col11629/latest/.

44 of 49

Barriers to Treatment

Ethnic minorities and individuals of low socioeconomic status report that barriers to services include lack of insurance, transportation, and time
Even controlling for income levels and insurance, ethnic minorities are far less likely to use mental health services
Non-financial barriers include self-sufficiency and not seeing the need for help, not seeing therapy as effective, concerns about confidentiality, language differences, and the many effects of stigma and shame

44

45 of 49

Question

1 A friend is thinking about seeking therapy to get some tools for managing anxiety. What types of treatment should she consider? Why?

45

46 of 49

Apply It: Decolonizing Psychology

46

Activity #5 in the Instructor Resources

Background

This activity is designed to help students understand the importance of decolonizing Psychology

Topic Alignment: Cultural Factors and Therapy

Learning Outcome:

Explain why the sociocultural model is important in therapy

Examine decolonization

APA Learning Outcome: Integrative Theme D: Psychology values diversity, promotes equity, and fosters inclusion in pursuit of a more just society.

Sources: 2022 Decolonizing Introductory Psychology Resources

Time Estimate: 30 minutes

Instructions

Watch Ted Talk

Why we need to decolonize psychology | Thema Bryant | TEDxNashville

Complete Part 1 of the worksheet

Decolonizing Psychology

Introduce Indigenous psychology.
Read this Psychology Today article, either individually or as a class: https://www.psychologytoday.com/us/blog/moral-landscapes/201910/indigenous-psychologies-contrast-western-psychology
Divide students into groups and assign each group one of the Indigenous practices. Have them read the corresponding resource and look for at least one additional resource about the types of practices.
Māori Holistic Health Models (New Zealand)

The Whare Tapa Whā model emphasizes four dimensions: physical health (Taha Tinana), mental and emotional health (Taha Hinengaro), spiritual health (Taha Wairua), and family/social health (Taha Whānau).
https://www.openpolytechnic.ac.nz/current-students/wellbeing/new-te-whare-tapa-wha/
You can look for writings by Sir Mason Durie, who has done extensive work on Māori health.

Native American Healing Practices

Native American cultures often embrace a holistic approach to mental and physical well-being, integrating mind, body, spirit, and community.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913884/
Look for resources on the Medicine Wheel concept or practices involving nature, rituals, and ceremonies.

African Ubuntu Philosophy

Ubuntu translates to "I am because we are," and represents a sense of shared humanity and interconnectedness.
https://psycnet.apa.org/record/2004-17439-001

Aboriginal Dreaming and Well-Being (Australia)

The concept of Dreaming in Aboriginal cultures is a complex spiritual and philosophical system that connects people to land, ancestors, and each other.
https://wellcome.org/news/how-aboriginal-approach-mental-health-helping-farmers-deal-drought

Filipino Indigenous Psychology (Sikolohiyang Pilipino)

This approach emphasizes Filipino values, languages, and indigenous knowledge, rejecting Western psychological concepts that may not be applicable.
https://en.wikipedia.org/wiki/Filipino_psychology
Look for writings by Virgilio Enriquez, who pioneered this field in the Philippines.

Hawaiian Hō‘oponopono Practice

Hō‘oponopono is a traditional Hawaiian practice of reconciliation and forgiveness. It emphasizes harmony, balance, and taking responsibility for one's actions.
https://www.psychologytoday.com/us/blog/the-time-cure/202111/ho-oponopono-make-things-right

Share

Have groups summarize and share about the Indigenous practice they learned about.

Discussion

What is the potential harm of a one-size-fits-all approach in therapy?

47 of 49

Quick Review

How are mental health services delivered today?
What are psychoanalysis, play therapy and behavior therapy?
How are cognitive and cognitive-behavioral therapy used?
What are the characteristics of humanistic therapy?
Compare and evaluate various forms of psychotherapy
Explain and compare biomedical therapies

47

48 of 49

Quick Review

What are treatments for addictive disorders? What makes them effective? Consider the role of comorbid disorders.
What are the different modalities of therapy and what are the benefits of each?
Why is the sociocultural model is important in therapy and what type of cultural barriers prevent some people from receiving mental health services?

48

49 of 49

Attributions

Illustrations are from Storyset
Images from Pexels & Unsplash
Add additional attributions here……
Remember to add image alt text

49