ch15 - MORE on Schizophrenia Ch. 15: Treatments for...

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Unformatted text preview: MORE on Schizophrenia Ch. 15: Treatments for Schizophrenia and other SEVERE Mental Disorders LSD + genetics No drugs for me, thnx! I shouldve won an Oscar for this role A Random Side Note from Freud. Go see Inception , ja? Its about dreams and stuff get Einstein on zee phone, and ve can combine our forces to develop a quantum theory of how time progresses in YOUR SUBCONSCIOUS MIND, ja, and of course what all that has to do with sex or your mother. Topic Overview I nstitutional Care in the Past versus Today: A Turn for the Better Antipsychotic Dr ugs Psychother apy Community Approach Institutional Care in the Past States required by law to establish public mental institutions (state hospitals ) for patients who could not afford private ones Overcrowding and understaffing led to shift from humanitarian / good intentions to keeping order (using restraints, straightjackets and handcuffs) affected schizophrenics the most Advanced form of treatment lobotomy Schizophrenics worsened due to institutionalization process, itself Social breakdown syndrome extreme withdrawal, anger, physical aggressiveness, loss of interest in personal appearance / functioning Institutional Care Takes a Turn for the Better. 1950s helped improve personal care and self- image of patients, and problem areas that had been worsened by institutionalization 2 techniques Milieu Therapy The Token Economy Milieu Therapy Humanistic theorists I nstitutionalized patient deteriorate due to loss of independence, responsibility, positive self-regard, engagement in meaningful activities So, create a new milieu (social climate) that promotes productive activity, self-respect, and individual responsibility Widely used in institutions (West) Does lead to improvement (leave hospitals at higher rates than if no milieu treatment); but, some still need shelter / protection after release (halfway houses; etc. community programs) The Token Economy Started in the 1950s, by behaviorists I n institutions, only allowed to work with hopeless (i.e., schizophrenics) Use of operant conditioning Patients are rewarded when behave acceptably (e.g., making the bed, getting dressed, going to work program, speaking normally, following rules, showing self-control); not rewarded when behavior is unacceptable I mmediate reward : tokens; can be later exchanged for food, cigarettes, privileges, etc. Effectiveness and Limitations of Token Economies Reduces psychotic, related behaviors Study: after 4.5 yrs, 98% of schizophrenic patients involved in token economy were released Compare to deinstitutionalization of patients From milieu program : 75% Custodial care only: 45% Limitations to (most) research (except above) No control group (lack of care) for comparison Ethics: certain basic items should not be withheld (e.g., Ethics: certain basic items should not be withheld (e....
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ch15 - MORE on Schizophrenia Ch. 15: Treatments for...

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