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Intro to Psychology
Table of Contents
Unit 16 Overview: Therapy and Treatment
16.1 Mental Health Treatment: Past and Present
16.2 Types of Treatment
16.3 Treatment Modalities
16.4 Substance-Related and Addictive Disorders: A Special Case
16.5 The Sociocultural Model and Therapy Utilization

🥸intro to psychology review

16.1 Mental Health Treatment: Past and Present

Citation:

Mental health treatment has come a long way. From drilling holes in skulls to modern therapy, we've seen big changes. Today, there are many ways to get help, from talking to a therapist to using apps on your phone.

Getting mental health care can be voluntary or involuntary. Most people choose to get help, but sometimes it's required by law. This happens when someone is a danger to themselves or others because of mental illness.

Historical and Contemporary Mental Health Treatment

Treatment Approaches Evolution

  • Early treatment approaches
    • Trephination involved drilling holes in the skull believed to release evil spirits causing mental illness
    • Asylums were institutions that isolated individuals with mental illness from society often in inhumane conditions
    • Moral treatment emphasized humane care and social interaction aimed at restoring dignity and promoting recovery
  • Psychoanalytic era (early 20th century)
    • Freudian psychoanalysis focused on exploring unconscious conflicts and childhood experiences believed to underlie psychological distress
    • Psychodynamic therapy evolved from Freudian psychoanalysis emphasizing the role of unconscious thoughts and emotions in shaping behavior
  • Behavioral and cognitive approaches (mid-20th century)
    • Behaviorism emphasized observable behaviors and learning principles such as classical and operant conditioning (reinforcement, punishment)
    • Cognitive therapy focused on identifying and modifying maladaptive thoughts believed to contribute to emotional distress (negative self-talk, cognitive distortions)
    • Cognitive-behavioral therapy (CBT) combined behavioral techniques (exposure, relaxation) with cognitive strategies (thought challenging, cognitive restructuring)
  • Humanistic and existential therapies (mid-20th century)
    • Client-centered therapy emphasized empathy, unconditional positive regard, and genuineness in the therapeutic relationship to promote personal growth
    • Existential therapy focused on helping individuals find meaning and purpose in life while confronting existential concerns (freedom, responsibility, isolation, death)
  • Contemporary approaches (late 20th century to present)
    • Integrative and eclectic therapies combine elements from different therapeutic approaches tailored to individual client needs (psychodynamic, cognitive-behavioral, humanistic)
    • Evidence-based practices emphasize treatments supported by empirical research demonstrating their effectiveness for specific mental health conditions (cognitive-behavioral therapy for depression, exposure therapy for anxiety disorders)
    • Teletherapy and digital mental health services utilize technology (video conferencing, mobile apps) to deliver treatment remotely increasing access to care

Current Mental Health Service Delivery Methods

  • Outpatient therapy
    • Individual therapy involves one-on-one sessions with a mental health professional (psychologist, counselor, social worker) to address personal concerns and develop coping strategies
    • Group therapy involves sessions with multiple clients facing similar challenges (addiction, grief, social anxiety) facilitated by a mental health professional to provide support and promote interpersonal learning
    • Family and couples therapy addresses relationship and family dynamics (communication, conflict resolution) to improve functioning and well-being
  • Inpatient treatment
    • Psychiatric hospitals provide 24-hour care for individuals with severe mental illness requiring intensive treatment and stabilization (suicidal ideation, psychosis, severe substance abuse)
    • Residential treatment centers offer structured, long-term care in a home-like setting for individuals with chronic mental health conditions (personality disorders, eating disorders)
  • Community-based services
    • Community mental health centers provide accessible, affordable mental health care (therapy, medication management) to underserved populations
    • Assertive community treatment (ACT) delivers comprehensive, team-based care (psychiatrists, nurses, social workers) for individuals with severe mental illness (schizophrenia, bipolar disorder) to support community living
    • Supported housing and employment assist individuals with mental illness in developing daily living and vocational skills to promote independence and community integration
  • Integrated care
    • Collaborative care coordinates mental health treatment with primary care providers to address both physical and mental health needs (depression screening, medication management)
    • Behavioral health consultants are mental health professionals embedded in medical settings (primary care clinics, hospitals) to provide brief interventions and referrals
  • Technology-assisted services
    • Teletherapy conducts therapy sessions via video conferencing or phone to increase access to care for individuals in remote areas or with transportation barriers
    • Mobile apps offer self-help tools (mood tracking, relaxation exercises), symptom monitoring, and virtual support (chat rooms, peer support) to supplement traditional treatment
    • Online support groups connect individuals with shared experiences (chronic illness, bereavement) to provide emotional support and practical advice

Voluntary vs. Involuntary Treatment Options

  • Voluntary treatment
    • Informed consent requires clients to willingly agree to participate in treatment after being fully informed of the risks, benefits, and alternatives
    • Right to refuse treatment allows clients to discontinue treatment at any time for any reason without legal consequences
    • Collaborative decision-making involves clients and providers working together to develop individualized treatment plans based on client preferences and goals
  • Involuntary treatment
    • Civil commitment is a legal process that allows courts to order treatment for individuals deemed a danger to themselves or others due to mental illness
      • Inpatient commitment involves involuntary hospitalization for stabilization and treatment typically lasting several days to weeks
      • Outpatient commitment involves court-mandated community-based treatment (therapy, medication) with regular monitoring and reporting to the court
    • Emergency detention allows for short-term involuntary hospitalization (72 hours) for individuals experiencing a mental health crisis and posing an immediate safety risk
    • Guardianship grants legal authority to another person (family member, public guardian) to make treatment decisions on behalf of an individual deemed incapable of making informed choices due to mental illness or cognitive impairment
  • Criteria for involuntary treatment
    • Presence of a mental illness as diagnosed by a qualified mental health professional using established diagnostic criteria (DSM-5, ICD-11)
    • Danger to self or others includes suicidal ideation, self-harm, homicidal ideation, or violent behavior as a result of mental illness
    • Grave disability refers to the inability to meet basic needs (food, clothing, shelter) due to mental illness and requires immediate intervention to prevent harm
    • Lack of capacity to make informed treatment decisions involves the inability to understand the risks, benefits, and alternatives of treatment due to mental illness or cognitive impairment

Key Terms to Review (22)

Free Association: Free association is a technique used in psychotherapy, particularly in Freudian psychoanalysis, where the patient is encouraged to express their thoughts, feelings, and memories without censorship or inhibition. This process allows the unconscious mind to reveal itself, providing insights into the patient's inner world and potential sources of psychological distress.
Cognitive-Behavioral Therapy: Cognitive-behavioral therapy (CBT) is a type of psychotherapy that focuses on the interplay between an individual's thoughts, behaviors, and emotions. It aims to help people identify and change negative or maladaptive thought patterns and behaviors to improve their overall mental health and well-being.
Psychoanalytic Theory: Psychoanalytic theory is a comprehensive approach to understanding human behavior, personality, and the mind, developed by Sigmund Freud and his followers. It emphasizes the role of the unconscious mind, early childhood experiences, and the dynamic interplay between various psychological forces in shaping an individual's thoughts, emotions, and actions.
Sigmund Freud: Sigmund Freud was an Austrian neurologist and the founder of psychoanalysis, a clinical method for treating psychopathology through dialogue between a patient and a psychoanalyst. His ideas and theories had a profound impact on the development of psychology, particularly in the areas of personality, the unconscious mind, and the treatment of mental disorders.
Electroconvulsive Therapy: Electroconvulsive therapy (ECT) is a medical procedure in which a brief, controlled electric current is passed through the brain to induce a seizure, with the goal of improving severe mental health conditions like major depression, bipolar disorder, and schizophrenia. It is a treatment option for individuals who have not responded to other forms of therapy or medication.
Trephination: Trephination, also known as trepanation, is the surgical procedure of creating an opening in the skull. This practice has been used since prehistoric times and was often associated with various beliefs and practices related to mental health treatment.
Imipramine: Imipramine is a tricyclic antidepressant medication primarily used to treat depression, but it also has applications in the management of other mental health conditions. As a key term in the context of the 16.1 Mental Health Treatment: Past and Present chapter, imipramine represents an important development in the pharmacological approach to addressing mental illness.
Chlorpromazine: Chlorpromazine is a phenothiazine antipsychotic medication that was one of the first widely used drugs for the treatment of schizophrenia and other psychotic disorders. It has played a significant role in the history of mental health treatment, particularly in the transition from institutionalization to community-based care.
Philippe Pinel: Philippe Pinel was a French physician who is considered the father of modern psychiatry. He is known for his pioneering work in the humane treatment of mental illness and his efforts to reform the asylum system in 18th century France.
Mental Health Treatment: Past and Present: Mental health treatment refers to the various approaches and methods used throughout history to address mental health conditions and promote psychological well-being. This term encompasses the evolution of mental health care, from historical practices to modern evidence-based treatments, and how the understanding and management of mental health have progressed over time.
Telepsychiatry: Telepsychiatry is the delivery of psychiatric services using telecommunication technologies, such as videoconferencing, to provide remote access to mental health care. It allows patients to receive psychiatric evaluations, therapy, and medication management from licensed professionals located in different physical locations.
Assertive Community Treatment: Assertive Community Treatment (ACT) is an evidence-based, team-based approach to providing comprehensive, community-based mental health services for individuals with severe and persistent mental illnesses. It aims to help these individuals live independently in the community by providing intensive, around-the-clock support and services tailored to their unique needs.
Deinstitutionalization: Deinstitutionalization is the process of reducing the number of individuals residing in large, state-run mental health institutions and transitioning them to community-based care and independent living arrangements. This shift in approach to mental health treatment aims to provide more personalized and less restrictive care for individuals with mental illness or developmental disabilities.
Psychosocial Rehabilitation: Psychosocial rehabilitation is a holistic approach to helping individuals with mental health conditions or psychosocial disabilities regain their optimal level of independent functioning and improve their overall quality of life. It focuses on addressing the social, psychological, and environmental factors that impact an individual's mental well-being and reintegration into the community.
Psychopharmacology: Psychopharmacology is the scientific study of the effects of drugs on the mind and behavior. It encompasses the research, development, and clinical application of medications used to treat mental health conditions, such as depression, anxiety, and psychosis.
Moral Treatment: Moral treatment refers to a humane and compassionate approach to caring for individuals with mental health conditions, which emerged as a significant shift in the 19th century. It emphasized treating patients with respect, providing them with a therapeutic environment, and focusing on their psychological and social well-being, rather than solely relying on physical restraints or harsh punishments.
Biomedical Model: The biomedical model is a framework for understanding and treating mental health conditions. It views mental disorders as primarily biological in nature, caused by factors such as genetics, chemical imbalances, or physical abnormalities in the brain. This model emphasizes the importance of medical intervention, such as medication and other biological treatments, in addressing mental health issues.
Community Mental Health: Community mental health refers to the approach of providing comprehensive mental health services and support within a local community setting, rather than in isolated, institutional environments. This model aims to promote mental well-being, prevent mental illness, and provide accessible, integrated care for individuals with mental health needs.
William Tuke: William Tuke was a Quaker philanthropist and social reformer who played a pivotal role in the development of humane treatment for individuals with mental health conditions in the late 18th and early 19th centuries. His work was instrumental in shaping the transition from the harsh, inhumane asylum practices of the past towards a more compassionate, therapeutic approach to mental health treatment.
Civil Commitment: Civil commitment refers to the legal process by which individuals with mental illness or substance abuse issues can be involuntarily hospitalized or treated, typically when they are deemed a danger to themselves or others. It is a complex topic that intersects with the history of mental health treatment and evolving societal attitudes towards individual rights and public safety.
Recovery Model: The recovery model is a framework for mental health treatment that emphasizes the individual's personal journey towards wellness, empowerment, and the reclamation of a meaningful life, rather than focusing solely on symptom reduction or management. It is a holistic approach that recognizes the unique needs and strengths of each person, promoting self-determination, hope, and active engagement in the recovery process.
Managed Care: Managed care is a system of healthcare delivery that aims to control costs and improve the quality of care by actively managing the utilization and provision of healthcare services. It involves the coordination and integration of various healthcare services and resources to ensure efficient and effective patient care.