An unintended consequence of deinstitutionalization is today’s homeless population.
A substantial proportion of this group is thought to be made up of schizophrenic patients,
mostly off their medications and in serious need of care. Families and communities have
failed to meet the needs of these people.Treatment Approaches
No one approach for treating people with psychopathologies has been shown to be ideal.
Multiple approaches can often be more helpful than using one specific approach. For exam-
ple, a depressed patient might benefit from cognitive therapy, social skills training, and anti-
depressant drugs. Research is being conducted to determine the most effective (efficacious)
treatments for clients with different disorders. One method for evaluating outcome research
is meta-analysis. Meta-analysis, the systematic statistical method for synthesizing the
results of numerous research studies dealing with the same variables, indicates that clients
who receive psychotherapy are better off than most of those who receive no treatment.
Treatments that appear more effective than others for particular disorders are noted in the
following sections.Insight Therapies
Insight therapies include psychoanalysis, psychodynamic therapy, interpersonal psychotherapy;
humanistic client-centered; and Gestalt psychotherapy. They all agree that their goal is
to help clients develop insight about the cause of their problems, and that insight will lead
to behavior change; problems will decrease as self-awareness increases.Psychoanalysis
Sigmund Freud believed that abnormal behavior was the result of unconscious conflicts
from early childhood trauma experienced during the psychosexual stages of development.
He thought that the way to relieve the anxieties is to resolve the unconscious conflicts,
which are covered by layers of experience. Psychoanalysis involves going back to discover
the roots of problems, then changing one’s misunderstandings and emotions after identify-
ing the problem. His treatment plan to bring the conflict into the conscious mind, enabling
the client to gain insight and achieve personality change, includes the techniques of free
association and dream interpretation.
In traditional psychoanalysis, the client participates in several sessions every week for
2 or 3 years, during which the therapist sits behind the patient and asks him/her to say
whatever comes to mind, called free association. If clients do not censor what they say, key
thoughts will make unconscious conflicts accessible. Since threatening experiences and
feelings can be revealed when controls of the ego and superego are relaxed during sleep,
the analyst may ask the client to recall his or her dreams. The recalled dream—the surface
meaning—is called the manifest content. The therapist works with the client to find the
hidden, underlying meaning (the latent content), by analyzing symbols within the dream.
Hypnosis and Freudian slips, Freud’s “faulty actions,” for which his editor/translator
adopted the term parapraxes, may also reveal hidden conflicts. Resistance—blocking
of anxiety-provoking feelings and experiences, evidenced by behavior such as talking about
trivial issues or coming late for sessions—is a sign that the client has reached an important
issue that needs to be discovered. Although the analyst’s behavior is neutral, the client may
respond to the analyst as though he or she is a significant person in the client’s emotional
life. Known as transference, this behavior can allow the client to replay previous experi-
ences and reactions, enabling him or her to gain insight about current feelings and behav-
iors. Catharsis, the release of emotional tension after remembering or reliving an230 STEP 4. Review the Knowledge You Need to Score High
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