In this chapter, you will see that approaches to therapy include both psychological and biological interventions, all with the goal of alleviating distress. Because psychological problems can originate from various sources—biology, genetics, childhood experiences, conditioning, and sociocultural influences—psychologists have developed many different therapeutic techniques and approaches.
- 16.0: Prelude to Therapy and Treatment
- What comes to mind when you think about therapy for psychological problems? You might picture someone lying on a couch talking about his childhood while the therapist sits and takes notes, à la Sigmund Freud. But can you envision a therapy session in which someone is wearing virtual reality headgear to conquer a fear of snakes?
- 16.1: Mental Health Treatment - Past and Present
- Before we explore the various approaches to therapy used today, let’s begin our study of therapy by looking at how many people experience mental illness and how many receive treatment. According to the U.S. Department of Health and Human Services (2013), 19% of U.S. adults experienced mental illness in 2012. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2008, 13.4% of adults received treatment for a mental health issue.
- 16.2: Types of Treatment
- Two types of therapy are psychotherapy and biomedical therapy. Both types of treatment help people with psychological disorders, such as depression, anxiety, and schizophrenia. Psychotherapy is a psychological treatment that employs 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. Biomedical therapy involves medication and/or medical procedures to treat psychological disorders.
- 16.3: Treatment Modalities
- Once a person seeks treatment, whether voluntarily or involuntarily, he has an intake done to assess his clinical needs. An intake is the therapist’s first meeting with the client. The therapist gathers specific information to address the client’s immediate needs, such as the presenting problem, the client’s support system, and insurance status. The therapist informs the client about confidentiality, fees, and what to expect in treatment.
- 16.4: Substance Related and Addictive Disorders - A Special Case
- Addiction is often viewed as a chronic disease. The choice to use a substance is initially voluntary; however, because chronic substance use can permanently alter the neural structure in the prefrontal cortex, an area of the brain associated with decision-making and judgment, a person becomes driven to use drugs and/or alcohol. This helps explain why relapse rates tend to be high. About 40%–60% of individuals relapse, which means they return to abusing drugs and/or alcohol.
- 16.5: The Sociocultural Model and Therapy Utilization
- Multicultural counseling and therapy aims to offer both a helping role and process that uses modalities and defines goals consistent with the life experiences and cultural values of clients. It strives to recognize client identities to include individual, group, and universal dimensions, advocate the use of universal and culture-specific strategies and roles in the healing process, and balances the importance of individualism and collectivism in the assessment, diagnosis, and treatment.
Thumbnail: This is the famous couch in Freud’s consulting room. Patients were instructed to lie comfortably on the couch and to face away from Freud in order to feel less inhibited and to help them focus. Today, a psychotherapy patient is not likely to lie on a couch; instead he is more likely to sit facing the therapist (Prochaska & Norcross, 2010). (credit: Robert Huffstutter).