Deck 16: C: Therapies

Question 1

How and where people with serious mental illnesses are treated has changed a great deal since the 1800s.Describe how these changes occurred.Then describe the current approach to treating people with severe mental illness,including those who require serious long-term care.

Answer 1

From the 14^th century to the 19^th century,people with mental disorders were institutionalized;they would live in hospital-like settings with very little treatment.The goal of these 'asylums' was to protect the public,not to treat the ill.In the 1960s,perhaps as a result of the humanist movement and the development of medications to treat many mental afflictions,many began to argue for deinstitutionalization of the mentally ill.At present,people with mental illness who are not a threat to themselves or others live in private homes or group homes;most are treated with medications and/or talk therapies.The small fraction of individuals who cannot care for themselves or who are a threat to themselves or others because they are in an acute stage of illness or refuse to take their medication live in psychiatric wings of hospitals;there are relatively few free standing clinics for mental health (although there are still a few dozen left in Canada).Those who require long-term care are either housed in a psychiatric hospital or in a group home with supervision.The current approach is to give the person with the mental illness as much personal freedom as possible while ensuring that they receive the treatment they need to live safely.

Question 2

Many behavioural therapists view phobias and other anxiety disorders as the result of learning.Using the language of classical conditioning,describe a specific example of how this might occur.

Answer 2

To help people learn to handle fear-inducing situations,therapists may choose the behavioural technique known as systematic desensitization,in which gradual exposure to a feared stimulus or situation is coupled with relaxation training.This involves counter conditioning,pairing the feared stimulus (the CS)with a pleasant unconditioned stimulus (such as relaxation)that yields the unconditioned response of happiness.This will eventually cause the CS to elicit the unconditioned response (UR)as a conditioned response (CR).For example,a person who fears snakes may be taught to meditate (unconditioned stimulus (US)causing the UR of happiness)and then presented with snake pictures (a CS)and asked to meditate (the US)to a point where they are relaxed (UR).Once the snake picture elicits the CR of happiness from being paired with meditation,they can move to the next step which may involve using a model snake as the CS and pairing it with meditation until the CR of happiness is elicited.Successive approximations to a real snake will be made at levels that can reasonably be handled by the individual.At the end,the CS of a snake should not elicit the CR of fear but rather a CR of happiness.