5 Steps to a 5 AP Psychology, 2010-2011 Edition (64 page)

• Developmental disorders include attention-deficit hyperactivity disorder, infantile autism, anorexia nervosa, and bulimia nervosa. Typically, they involve disturbances in learning, language, and motor or social skills showing up in infancy, childhood, or adolescence.

IN THIS CHAPTER

Summary:
If a close friend or family member were experiencing severe anxiety that interfered with his everyday life, what credentials would you want a therapist for him/her to have?

This chapter focuses on mental health practitioners, their theoretical approaches, and how they deliver their services.

Key Ideas

Mental health practitioners

Brief history of therapy

Insight therapies—psychoanalytic, psychodynamic, humanistic

Behavioral approache

Cognitive-behavioral approaches

Biological treatments

Modes of therapy

Community and preventive approaches

• A
psychiatrist
is a medical doctor (M.D.) and the only mental health professional who can prescribe medication (in most regions) or perform surgery. Psychiatrists generally take a biological approach to treating major disorders such as schizophrenia and depression. Their medical training includes an approved residency in a psychiatric section of a hospital. Psychiatrists are not required to take courses dealing with insight, psychoanalytic, behavioral, cognitive, or humanistic therapeutic approaches.

•
Clinical psychologists
must earn a doctoral degree (Ph.D. or a Psy.D.), which includes a supervised internship, then they must pass a licensing exam. Their training does emphasize different therapeutic approaches. Both psychiatrists and clinical psychologists see patients with similar disorders. Since many problems respond best to a combination of medication and supportive psychotherapy, clinical psychologists often work with psychiatrists.

•
Counseling psychologists
typically have one of a number of different advanced degrees (Ph.D., Ed.D., Psy.D., or M.A. in counseling) and tend to deal with less severe mental health problems in college settings, or in marital and family therapy practices. In the latter, they try not to assign blame but provide a supportive ear to all parties and help clarify the feelings of each individual to the others.

•
Psychoanalysts
may or may not be psychiatrists, but all follow the teaching of Freud and practice psychoanalysis or other psychodynamic therapies. They receive extensive training and self-analysis with a more experienced psychoanalyst before they begin their treatment of patients.

•
Clinical
or
psychiatric social workers
typically have earned a Master’s degree in social work (M.S.W.), which includes a supervised internship, and have taken a certification exam.

Other mental health care professionals include psychiatric nurse practitioners and pastoral counselors, who combine spiritual guidance with practical counseling.

While many medical insurance plans will pay for the services of psychiatrists, clinical psychologists, counseling psychologists, and clinical social workers, they will not pay for the services of unlicensed therapists. In most places, anyone can call himself/herself a therapist without having any training.

Archeological evidence and historical documents suggest that early humans believed people with mental health problems were possessed by evil spirits.
Trephining
, drilling holes in skulls, also indicates that early practitioners attempted to release these spirits.

Over 2,000 years ago, Greek physician Hippocrates proposed that psychological problems have physical causes for which he prescribed rest, controlled diets, and abstinence from sex and alcohol. More than 1,500 years ago, Greek physician Galen believed that medicine was needed to treat abnormal behavior, which he thought was a result of an imbalance in the four bodily humors, similar to today’s biomedical approach. Unfortunately, during the Medieval period, most societies returned to the belief that demons or Satan possessed people suffering from mental problems. Victims were punished with exorcisms or tested by drowning and burning.

The Enlightenment brought reformers: in the 18th century, Philippe Pinel of France and, in the 19th century, Dorthea Dix of the United States were champions of humane treatment for the mentally ill. Instead of treating those with mental health problems as sinners or criminals, they created separate institutions for them, and pioneered more individualized and kinder treatment strategies.

Deinstitutionalization

Serious overcrowding of most mental institutions became a problem by the 1950s. As a result, the needs of many patients were neglected. When better psychotropic drugs were created, a movement,
deinstitutionalization
, began to remove patients who were not considered a threat to themselves or the community from mental hospitals. Similar to the more humane goals of Pinel and Dix, the intent was that patients would improve more rapidly in familiar community settings. In the 1960s, Congress passed aid bills to establish community mental health facilities in neighborhoods across the United States.