{"id":2654,"date":"2016-11-11T16:34:59","date_gmt":"2016-11-11T16:34:59","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/waymaker-psychology\/?post_type=chapter&#038;p=2654"},"modified":"2017-05-24T05:23:14","modified_gmt":"2017-05-24T05:23:14","slug":"introduction-to-treatment-modalities","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-fmcc-intropsych\/chapter\/introduction-to-treatment-modalities\/","title":{"raw":"Treatment Modalities","rendered":"Treatment Modalities"},"content":{"raw":"<h2>What you'll learn to do: explain and compare treatment modalities<\/h2>\r\n<a href=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2017\/04\/05204518\/chairs-58475_1280.jpg\"><img class=\"aligncenter wp-image-4162 size-full\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2017\/04\/05204518\/chairs-58475_1280.jpg\" alt=\"Colorful chairs set up in a circle for group therapy.\" width=\"1280\" height=\"719\" \/><\/a>\r\n\r\nThere are several modalities, or methods,\u00a0of treatment: individual therapy, group therapy, couples therapy, and family therapy are the most common. In an individual therapy session, a client works one-on-one with a trained therapist. In group therapy, usually 5\u201310 people meet with a trained group therapist to discuss a common issue (e.g., divorce, grief, eating disorders, substance abuse, or anger management). Couples therapy involves two people in an intimate relationship who are having difficulties and are trying to resolve them. The couple may be dating, partnered, engaged, or married. The therapist helps them resolve their problems as well as implement strategies that will lead to a healthier and happier relationship. Family therapy is a special form of group therapy. The therapy group is made up of one or more families. The goal of this approach is to enhance the growth of each individual family member and the family as a whole.\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li>Describe the types and benefits of different types of group therapies<\/li>\r\n \t<li>Explain why\u00a0the sociocultural model is important\u00a0in therapy and what type of cultural barriers prevent some people from receiving mental health services<\/li>\r\n<\/ul>\r\n<\/div>\r\n<div>\r\n\r\nOnce a person seeks treatment, whether voluntarily or involuntarily, he has an <strong>intake<\/strong> done to assess his clinical needs. An intake is the therapist\u2019s first meeting with the client. The therapist gathers specific information to address the client\u2019s immediate needs, such as the presenting problem, the client\u2019s support system, and insurance status. The therapist informs the client about confidentiality, fees, and what to expect in treatment. <strong>Confidentiality<\/strong> means the therapist cannot disclose confidential communications to any third party unless mandated or permitted by law to do so. During the intake, the therapist and client will work together to discuss treatment goals. Then a treatment plan will be formulated, usually with specific measurable objectives. Also, the therapist and client will discuss how treatment success will be measured and the estimated length of treatment. There are several different modalities of treatment (Figure 1): Individual therapy, family therapy, couples therapy, and group therapy are the most common.\r\n\r\n<\/div>\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"622\"]<img class=\"\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23225153\/CNX_Psych_16_03_OneonOne.jpg\" alt=\"Two photographs are shown. Photograph A depicts two people in conversation. Photograph B depicts a large group of people sitting in a circle on the beach.\" width=\"622\" height=\"226\" data-media-type=\"image\/jpeg\" \/> Figure 1. Therapy may occur (a) one-on-one between a therapist and client, or (b) in a group setting. (credit a: modification of work by Connor Ashleigh, AusAID\/Department of Foreign Affairs and Trade)[\/caption]\r\n\r\n<section data-depth=\"1\">\r\n<h2>Individual Therapy<\/h2>\r\nIn <strong>individual therapy<\/strong>, also known as individual psychotherapy or individual counseling, the client and clinician meet one-on-one (usually from 45 minutes to 1 hour). These meetings typically occur weekly or every other week, and sessions are conducted in a confidential and caring environment (Figure 2). The clinician will work with clients to help them explore their feelings, work through life challenges, identify aspects of themselves and their lives that they wish to change, and set goals to help them work towards these changes. A client might see a clinician for only a few sessions, or the client may attend individual therapy sessions for a year or longer. The amount of time spent in therapy depends on the needs of the client as well as her personal goals.\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/4742\r\n\r\n<\/div>\r\n<\/section>\r\n<h2>Group Therapy<\/h2>\r\n[caption id=\"\" align=\"alignright\" width=\"360\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23225156\/CNX_Psych_16_03_Groupn.jpg\" alt=\"A group of people arranged in a circle having a conversation is shown.\" width=\"360\" height=\"240\" data-media-type=\"image\/jpeg\" \/> Figure 2. In group therapy, usually 5\u201310 people meet with a trained therapist to discuss a common issue such as divorce, grief, an eating disorder, substance abuse, or anger management. (credit: Cory Zanker)[\/caption]\r\n\r\nIn <strong>group therapy<\/strong>, a clinician meets together with several clients with similar problems (Figure 2). When children are placed in group therapy, it is particularly important to match clients for age and problems. One benefit of group therapy is that it can help decrease a client\u2019s shame and isolation about a problem while offering needed support, both from the therapist and other members of the group (American Psychological Association, 2014). A nine-year-old sexual abuse victim, for example, may feel very embarrassed and ashamed. If he is placed in a group with other sexually abused boys, he will realize that he is not alone. A child struggling with poor social skills would likely benefit from a group with a specific curriculum to foster special skills. A woman suffering from post-partum depression could feel less guilty and more supported by being in a group with similar women.\r\n\r\nGroup therapy also has some specific limitations. Members of the group may be afraid to speak in front of other people because sharing secrets and problems with complete strangers can be stressful and overwhelming. There may be personality clashes and arguments among group members. There could also be concerns about confidentiality: Someone from the group might share what another participant said to people outside of the group.\r\n<figure><\/figure>\r\nAnother benefit of group therapy is that members can confront each other about their patterns. For those with some types of problems, such as sexual abusers, group therapy is the recommended treatment. Group treatment for this population is considered to have several benefits:\r\n<blockquote>Group treatment is more economical than individual, couples, or family therapy. Sexual abusers often feel more comfortable admitting and discussing their offenses in a treatment group where others are modeling openness. Clients often accept feedback about their behavior more willingly from other group members than from therapists. Finally, clients can practice social skills in group treatment settings. (McGrath, Cumming, Burchard, Zeoli, &amp; Ellerby, 2009)<\/blockquote>\r\nGroups that have a strong educational component are called psycho-educational groups. For example, a group for children whose parents have cancer might discuss in depth what cancer is, types of treatment for cancer, and the side effects of treatments, such as hair loss. Often, group therapy sessions with children take place in school. They are led by a school counselor, a school psychologist, or a school social worker. Groups might focus on test anxiety, social isolation, self-esteem, bullying, or school failure (Shechtman, 2002). Whether the group is held in school or in a clinician\u2019s office, group therapy has been found to be effective with children facing numerous kinds of challenges (Shechtman, 2002).\r\n\r\nDuring a group session, the entire group could reflect on an individual\u2019s problem or difficulties, and others might disclose what they have done in that situation. When a clinician is facilitating a group, the focus is always on making sure that everyone benefits and participates in the group and that no one person is the focus of the entire session. Groups can be organized in various ways: some have an overarching theme or purpose, some are time-limited, some have open membership that allows people to come and go, and some are closed. Some groups are structured with planned activities and goals, while others are unstructured: There is no specific plan, and group members themselves decide how the group will spend its time and on what goals it will focus. This can become a complex and emotionally charged process, but it is also an opportunity for personal growth (Page &amp; Berkow, 1994).\r\n\r\n<section data-depth=\"1\">\r\n<h2>Couples Therapy<\/h2>\r\n<strong>Couples therapy<\/strong> involves two people in an intimate relationship who are having difficulties and are trying to resolve them (Figure 3). The couple may be dating, partnered, engaged, or married. The primary therapeutic orientation used in couples counseling is cognitive-behavioral therapy (Rathus &amp; Sanderson, 1999). Couples meet with a therapist to discuss conflicts and\/or aspects of their relationship that they want to change. The therapist helps them see how their individual backgrounds, beliefs, and actions are affecting their relationship. Often, a therapist tries to help the couple resolve these problems, as well as implement strategies that will lead to a healthier and happier relationship, such as how to listen, how to argue, and how to express feelings. However, sometimes, after working with a therapist, a couple will realize that they are too incompatible and will decide to separate. Some couples seek therapy to work out their problems, while others attend therapy to determine whether staying together is the best solution. Counseling couples in a high-conflict and volatile relationship can be difficult. In fact, psychologists Peter Pearson and Ellyn Bader, who founded the Couples Institute in Palo Alto, California, have compared the experience of the clinician in couples\u2019 therapy to be like \u201cpiloting a helicopter in a hurricane\u201d (Weil, 2012, para. 7).\r\n<figure>\r\n\r\n[caption id=\"\" align=\"alignright\" width=\"459\"]<img class=\"\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23225158\/CNX_Psych_16_03_Couple.jpg\" alt=\"A photograph shows two people talking to a third person.\" width=\"459\" height=\"306\" data-media-type=\"image\/jpeg\" \/> Figure 3. In couples counseling, a therapist helps people work on their relationship. (credit: Cory Zanker)[\/caption]<\/figure>\r\n<\/section><section data-depth=\"1\">\r\n<h2>Family Therapy<\/h2>\r\n<strong>Family therapy<\/strong> is a special form of group therapy, consisting of one or more families. Although there are many theoretical orientations in family therapy, one of the most predominant is the systems approach. The family is viewed as an organized system, and each individual within the family is a contributing member who creates and maintains processes within the system that shape behavior (Minuchin, 1985). Each member of the family influences and is influenced by the others. The goal of this approach is to enhance the growth of each family member as well as that of the family as a whole.\r\n\r\nOften, dysfunctional patterns of communication that develop between family members can lead to conflict. A family with this dynamic might wish to attend therapy together rather than individually. In many cases, one member of the family has problems that detrimentally affect everyone. For example, a mother\u2019s depression, teen daughter\u2019s eating disorder, or father\u2019s alcohol dependence could affect all members of the family. The therapist would work with all members of the family to help them cope with the issue, and to encourage resolution and growth in the case of the individual family member with the problem.\r\n\r\nWith family therapy, the nuclear family (i.e., parents and children) or the nuclear family plus whoever lives in the household (e.g., grandparent) come into treatment. Family therapists work with the whole family unit to heal the family. There are several different types of family therapy. In structural family therapy, the therapist examines and discusses the boundaries and structure of the family: who makes the rules, who sleeps in the bed with whom, how decisions are made, and what are the boundaries within the family. In some families, the parents do not work together to make rules, or one parent may undermine the other, leading the children to act out. The therapist helps them resolve these issues and learn to communicate more effectively.\r\n<div data-type=\"note\" data-label=\"Link to Learning\">\r\n<div class=\"textbox examples\">\r\n<h3>Link to Learning<\/h3>\r\nWatch this <a href=\"https:\/\/www.youtube.com\/watch?v=mPW0UZd9gQ4\">video<\/a> to get some more details view a structural family session.\r\n\r\n<\/div>\r\n<\/div>\r\nIn <strong>strategic family therapy<\/strong>, the goal is to address specific problems within the family that can be dealt with in a relatively short amount of time. Typically, the therapist would guide what happens in the therapy session and design a detailed approach to resolving each member\u2019s problem (Madanes, 1991).\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/4743\r\n\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/4744\r\n\r\n<\/div>\r\n<\/section><section data-depth=\"1\">\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Think It Over<\/h3>\r\n<section data-depth=\"1\">\r\n<div data-type=\"exercise\">\r\n<div data-type=\"problem\">\r\n<ul>\r\n \t<li>Your best friend tells you that she is concerned about her cousin. The cousin\u2014a teenage girl\u2014is constantly coming home after her curfew, and your friend suspects that she has been drinking. What treatment modality would you recommend to your friend and why?<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<\/section><section data-depth=\"1\"><\/section><\/div>\r\n<\/section>\r\n<div>\r\n<h2>Cultural Factors and Therapy<\/h2>\r\nThe sociocultural perspective looks at you, your behaviors, and your symptoms in the context of your culture and background. For example, Jos\u00e9 is an 18-year-old Hispanic male from a traditional family. Jos\u00e9 comes to treatment because of depression. During the intake session, he reveals that he is gay and is nervous about telling his family. He also discloses that he is concerned because his religious background has taught him that homosexuality is wrong. How does his religious and cultural background affect him? How might his cultural background affect how his family reacts if Jos\u00e9 were to tell them he is gay?\r\n\r\n<\/div>\r\nAs our society becomes increasingly multiethnic and multiracial, mental health professionals must develop <strong>cultural competence<\/strong> (Figure 4), which means they must understand and address issues of race, culture, and ethnicity. They must also develop strategies to effectively address the needs of various populations for which Eurocentric therapies have limited application (Sue, 2004). For example, a counselor whose treatment focuses on individual decision making may be ineffective at helping a Chinese client with a collectivist approach to problem solving (Sue, 2004).\r\n\r\nMulticultural 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 balancs the importance of individualism and collectivism in the assessment, diagnosis, and treatment of client and client systems (Sue, 2001).\r\n\r\nThis therapeutic perspective integrates the impact of cultural and social norms, starting at the beginning of treatment. Therapists who use this perspective work with clients to obtain and integrate information about their cultural patterns into a unique treatment approach based on their particular situation (Stewart, Simmons, &amp; Habibpour, 2012). Sociocultural therapy can include individual, group, family, and couples treatment modalities.\r\n<figure>\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"975\"]<img src=\"https:\/\/textimgs.s3.amazonaws.com\/ospsych\/m49144\/CNX_Psych_16_05_Ethnic.jpg#fixme\" alt=\"A photo montage composed of eight photographs arranged in two parallel rows of four. From the top-left-hand-side, the photos are as follows: a person with a bicycle standing in a rice paddy, three children, three elderly people sitting along a rock wall, four cooks standing around a table, a classroom of students, a group of people seated at a covered outdoor table, two children wearing robes, and two people being held up by other people during a wedding ceremony.\" width=\"975\" height=\"328\" data-media-type=\"image\/jpeg\" \/> Figure 4. How do your cultural and religious beliefs affect your attitude toward mental health treatment? (credit \u201ctop-left\u201d: modification of work by Staffan Scherz; credit \u201ctop-left-middle\u201d: modification of work by Alejandra Quintero Sinisterra; credit \u201ctop-right-middle\u201d: modification of work by Pedro Ribeiro Sim\u00f5es; credit \u201ctop-right\u201d: modification of work by Agustin Ruiz; credit \u201cbottom-left\u201d: modification of work by Czech Provincial Reconstruction Team; credit \u201cbottom-left-middle\u201d: modification of work by Arian Zwegers; credit \u201cbottom-right-middle\u201d: modification of work by \u201cWonderlane\u201d\/Flickr; credit \u201cbottom-right\u201d: modification of work by Shiraz Chanawala)[\/caption]<\/figure>\r\n<div data-type=\"note\" data-label=\"Link to Learning\">\r\n<div class=\"textbox examples\">\r\n<h3>Link to Learning<\/h3>\r\nWatch this short <a href=\"https:\/\/www.youtube.com\/watch?v=MTh3pe8N3DQ\">video<\/a> to learn more about cultural competence and sociocultural treatments.\r\n\r\n<\/div>\r\n<\/div>\r\n<section data-depth=\"1\">\r\n<h2>Barriers to Treatment<\/h2>\r\nStatistically, ethnic minorities tend to utilize mental health services less frequently than White, middle-class Americans (Alegr\u00eda et al., 2008; Richman, Kohn-Wood, &amp; Williams, 2007). Why is this so? Perhaps the reason has to do with access and availability of mental health services. Ethnic minorities and individuals of low socioeconomic status (SES) report that barriers to services include lack of insurance, transportation, and time (Thomas &amp; Snowden, 2002). However, researchers have found that even when income levels and insurance variables are taken into account, ethnic minorities are far less likely to seek out and utilize mental health services. And when access to mental health services is comparable across ethnic and racial groups, differences in service utilization remain (Richman et al., 2007).\r\n\r\nIn a study involving thousands of women, it was found that the prevalence rate of anorexia was similar across different races, but that bulimia nervosa was more prevalent among Hispanic and African American women when compared with non-Hispanic whites (Marques et al., 2011). Although they have similar or higher rates of eating disorders, Hispanic and African American women with these disorders tend to seek and engage in treatment far less than Caucasian women. These findings suggest ethnic disparities in access to care, as well as clinical and referral practices that may prevent Hispanic and African American women from receiving care, which could include lack of bilingual treatment, stigma, fear of not being understood, family privacy, and lack of education about eating disorders.\r\n\r\nPerceptions and attitudes toward mental health services may also contribute to this imbalance. A recent study at King\u2019s College, London, found many complex reasons why people do not seek treatment: self-sufficiency and not seeing the need for help, not seeing therapy as effective, concerns about confidentiality, and the many effects of stigma and shame (Clement et al., 2014). And in another study, African Americans exhibiting depression were less willing to seek treatment due to fear of possible psychiatric hospitalization as well as fear of the treatment itself (Sussman, Robins, &amp; Earls, 1987). Instead of mental health treatment, many African Americans prefer to be self-reliant or use spiritual practices (Snowden, 2001; Belgrave &amp; Allison, 2010). For example, it has been found that the Black church plays a significant role as an alternative to mental health services by providing prevention and treatment-type programs designed to enhance the psychological and physical well-being of its members (Blank, Mahmood, Fox, &amp; Guterbock, 2002).\r\n\r\nAdditionally, people belonging to ethnic groups that already report concerns about prejudice and discrimination are less likely to seek services for a mental illness because they view it as an additional stigma (Gary, 2005; Townes, Cunningham, &amp; Chavez-Korell, 2009; Scott, McCoy, Munson, Snowden, &amp; McMillen, 2011). For example, in one recent study of 462 older Korean Americans (over the age of 60) many participants reported suffering from depressive symptoms. However, 71% indicated they thought depression was a sign of personal weakness, and 14% reported that having a mentally ill family member would bring shame to the family (Jang, Chiriboga, &amp; Okazaki, 2009).\r\n\r\nLanguage differences are a further barrier to treatment. In the previous study on Korean Americans\u2019 attitudes toward mental health services, it was found that there were no Korean-speaking mental health professionals where the study was conducted (Orlando and Tampa, Florida) (Jang et al., 2009). Because of the growing number of people from ethnically diverse backgrounds, there is a need for therapists and psychologists to develop knowledge and skills to become culturally competent (Ahmed, Wilson, Henriksen, &amp; Jones, 2011). Those providing therapy must approach the process from the context of the unique culture of each client (Sue &amp; Sue, 2007).\r\n<div data-type=\"note\" data-label=\"Dig Deeper\">\r\n<div data-type=\"title\">\r\n<div data-type=\"title\">\r\n<div class=\"textbox exercises\">\r\n<h3>Dig Deeper: Treatment Perceptions<\/h3>\r\nBy the time a child is a senior in high school, 20% of his classmates\u2014that is 1 in 5\u2014will have experienced a mental health problem (U.S. Department of Health and Human Services, 1999), and 8%\u2014about 1 in 12\u2014will have attempted suicide (Centers for Disease Control and Prevention, 2014). Of those classmates experiencing mental disorders, only 20% will receive professional help (U.S. Public Health Service, 2000). Why?\r\n\r\nIt seems that the public has a negative perception of children and teens with mental health disorders. According to researchers from Indiana University, the University of Virginia, and Columbia University, interviews with over 1,300 U.S. adults show that they believe children with depression are prone to violence and that if a child receives treatment for a psychological disorder, then that child is more likely to be rejected by peers at school.\r\n\r\nBernice Pescosolido, author of the study, asserts that this is a misconception. However, stigmatization of psychological disorders is one of the main reasons why young people do not get the help they need when they are having difficulties. Pescosolido and her colleagues caution that this stigma surrounding mental illness, based on misconceptions rather than facts, can be devastating to the emotional and social well-being of our nation\u2019s children.\r\n\r\nThis warning played out as a national tragedy in the 2012 shootings at Sandy Hook Elementary. In her blog, Suzy DeYoung (2013), co-founder of Sandy Hook Promise (the organization parents and concerned others set up in the wake of the school massacre) speaks to treatment perceptions and what happens when children do not receive the mental health treatment they desperately need.\r\n<p style=\"padding-left: 30px;\">I've become accustomed to the reaction when I tell people where I'm from. Eleven months later, it's as consistent as it was back in January. Just yesterday, inquiring as to the availability of a rental house this holiday season, the gentleman taking my information paused to ask, \u201cNewtown, CT? Isn't that where that...that <em data-effect=\"italics\">thing<\/em> happened?<\/p>\r\n<p style=\"padding-left: 30px;\">A recent encounter in the Massachusetts Berkshires, however, took me by surprise.<\/p>\r\n<p style=\"padding-left: 30px;\">It was in a small, charming art gallery. The proprietor, a woman who looked to be in her 60s, asked where we were from. My response usually depends on my present mood and readiness for the inevitable dialogue. Sometimes it's simply, Connecticut. This time, I replied, Newtown, CT. The woman's demeanor abruptly shifted from one of amiable graciousness to one of visible agitation.<\/p>\r\n<p style=\"padding-left: 30px;\">\u201cOh my god,\u201d she said wide eyed and open mouthed. \u201cDid you know her?\u201d<\/p>\r\n<p style=\"padding-left: 30px;\">. . . .<\/p>\r\n<p style=\"padding-left: 30px;\">\u201cHer?\u201d I inquired<\/p>\r\n<p style=\"padding-left: 30px;\">That woman,\u201d she replied with disdain, \u201cthat woman that raised that monster.\u201d<\/p>\r\n<p style=\"padding-left: 30px;\">\u201cThat woman's\u201d name was Nancy Lanza. Her son, Adam, killed her with a rifle blast to the head before heading out to kill 20 children and six educators at Sandy Hook Elementary School in Newtown, CT last December 14th.<\/p>\r\n<p style=\"padding-left: 30px;\">When Nelba Marquez Greene, whose beautiful 6-year-old daughter, Ana, was killed by Adam Lanza, was recently asked how she felt about \u201cthat woman,\u201d this was her reply:<\/p>\r\n<p style=\"padding-left: 30px;\">\u201cShe's a victim herself. And it's time in America that we start looking at mental illness with compassion, and helping people who need it.<\/p>\r\n<p style=\"padding-left: 30px;\">\u201cThis was a family that needed help, an individual that needed help and didn't get it. And what better can come of this, of this time in America, than if we can get help to people who really need it?\u201d (pars. 1\u20137, 10\u201315)<\/p>\r\nFortunately, we are starting to see campaigns related to the destigmatization of mental illness and an increase in public education and awareness. Join the effort by encouraging and supporting those around you to seek help if they need it. To learn more, visit the National Alliance on Mental Illness (NAMI) website (http:\/\/www.nami.org\/). The nation\u2019s largest nonprofit mental health advocacy and support organization is NAMI.\r\n\r\n<\/div>\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/4745\r\n\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/4746\r\n\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/4747\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/section><section data-depth=\"1\">\r\n<div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Think It Over<\/h3>\r\n<section data-depth=\"1\">\r\n<div data-type=\"exercise\">\r\n<div data-type=\"problem\">\r\n<ul>\r\n \t<li>What is your attitude toward mental health treatment? Would you seek treatment if you were experiencing symptoms or having trouble functioning in your life? Why or why not? In what ways do you think your cultural and\/or religious beliefs influence your attitude toward psychological intervention?<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<\/section><\/div>\r\n<\/div>\r\n<div><section>\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Glossary<\/h3>\r\n<div data-type=\"definition\"><strong>confidentiality:\u00a0<\/strong>therapist cannot disclose confidential communications to any third party, unless mandated or permitted by law<\/div>\r\n<div data-type=\"definition\">\r\n<div data-type=\"definition\"><strong>couples therapy:\u00a0<\/strong>two people in an intimate relationship, such as husband and wife, who are having difficulties and are trying to resolve them with therapy<\/div>\r\n<div data-type=\"definition\"><strong>cultural competence <\/strong>therapist\u2019s understanding and attention to issues of race, culture, and ethnicity in providing treatment<\/div>\r\n<\/div>\r\n<div data-type=\"definition\">\r\n<div data-type=\"definition\"><strong>family therapy:\u00a0<\/strong>special form of group therapy consisting of one or more families<\/div>\r\n<div data-type=\"definition\"><strong>group therapy:\u00a0<\/strong>treatment modality in which 5\u201310 people with the same issue or concern meet together with a trained clinician<\/div>\r\n<\/div>\r\n<div data-type=\"definition\"><strong>individual therapy:\u00a0<\/strong>treatment modality in which the client and clinician meet one-on-one<\/div>\r\n<div data-type=\"definition\"><strong>intake:\u00a0<\/strong>therapist\u2019s first meeting with the client in which the therapist gathers specific information to address the client\u2019s immediate needs<\/div>\r\n<div data-type=\"definition\"><strong>strategic family therapy:\u00a0<\/strong>therapist guides the therapy sessions and develops treatment plans for each family member for specific problems that can addressed in a short amount of time<\/div>\r\n<div data-type=\"definition\"><strong>structural family therapy:\u00a0<\/strong>therapist examines and discusses with the family the boundaries and structure of the family: who makes the rules, who sleeps in the bed with whom, how decisions are made, and what are the boundaries within the family<\/div>\r\n<\/div>\r\n<\/section><\/div>\r\n\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/4876","rendered":"<h2>What you&#8217;ll learn to do: explain and compare treatment modalities<\/h2>\n<p><a href=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2017\/04\/05204518\/chairs-58475_1280.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4162 size-full\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2017\/04\/05204518\/chairs-58475_1280.jpg\" alt=\"Colorful chairs set up in a circle for group therapy.\" width=\"1280\" height=\"719\" \/><\/a><\/p>\n<p>There are several modalities, or methods,\u00a0of treatment: individual therapy, group therapy, couples therapy, and family therapy are the most common. In an individual therapy session, a client works one-on-one with a trained therapist. In group therapy, usually 5\u201310 people meet with a trained group therapist to discuss a common issue (e.g., divorce, grief, eating disorders, substance abuse, or anger management). Couples therapy involves two people in an intimate relationship who are having difficulties and are trying to resolve them. The couple may be dating, partnered, engaged, or married. The therapist helps them resolve their problems as well as implement strategies that will lead to a healthier and happier relationship. Family therapy is a special form of group therapy. The therapy group is made up of one or more families. The goal of this approach is to enhance the growth of each individual family member and the family as a whole.<\/p>\n<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li>Describe the types and benefits of different types of group therapies<\/li>\n<li>Explain why\u00a0the sociocultural model is important\u00a0in therapy and what type of cultural barriers prevent some people from receiving mental health services<\/li>\n<\/ul>\n<\/div>\n<div>\n<p>Once a person seeks treatment, whether voluntarily or involuntarily, he has an <strong>intake<\/strong> done to assess his clinical needs. An intake is the therapist\u2019s first meeting with the client. The therapist gathers specific information to address the client\u2019s immediate needs, such as the presenting problem, the client\u2019s support system, and insurance status. The therapist informs the client about confidentiality, fees, and what to expect in treatment. <strong>Confidentiality<\/strong> means the therapist cannot disclose confidential communications to any third party unless mandated or permitted by law to do so. During the intake, the therapist and client will work together to discuss treatment goals. Then a treatment plan will be formulated, usually with specific measurable objectives. Also, the therapist and client will discuss how treatment success will be measured and the estimated length of treatment. There are several different modalities of treatment (Figure 1): Individual therapy, family therapy, couples therapy, and group therapy are the most common.<\/p>\n<\/div>\n<div style=\"width: 632px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23225153\/CNX_Psych_16_03_OneonOne.jpg\" alt=\"Two photographs are shown. Photograph A depicts two people in conversation. Photograph B depicts a large group of people sitting in a circle on the beach.\" width=\"622\" height=\"226\" data-media-type=\"image\/jpeg\" \/><\/p>\n<p class=\"wp-caption-text\">Figure 1. Therapy may occur (a) one-on-one between a therapist and client, or (b) in a group setting. (credit a: modification of work by Connor Ashleigh, AusAID\/Department of Foreign Affairs and Trade)<\/p>\n<\/div>\n<section data-depth=\"1\">\n<h2>Individual Therapy<\/h2>\n<p>In <strong>individual therapy<\/strong>, also known as individual psychotherapy or individual counseling, the client and clinician meet one-on-one (usually from 45 minutes to 1 hour). These meetings typically occur weekly or every other week, and sessions are conducted in a confidential and caring environment (Figure 2). The clinician will work with clients to help them explore their feelings, work through life challenges, identify aspects of themselves and their lives that they wish to change, and set goals to help them work towards these changes. A client might see a clinician for only a few sessions, or the client may attend individual therapy sessions for a year or longer. The amount of time spent in therapy depends on the needs of the client as well as her personal goals.<\/p>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"lumen_assessment_4742\" class=\"resizable\" src=\"https:\/\/assessments.lumenlearning.com\/assessments\/load?assessment_id=4742&#38;embed=1&#38;external_user_id=&#38;external_context_id=&#38;iframe_resize_id=lumen_assessment_4742\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:400px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<\/section>\n<h2>Group Therapy<\/h2>\n<div style=\"width: 370px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23225156\/CNX_Psych_16_03_Groupn.jpg\" alt=\"A group of people arranged in a circle having a conversation is shown.\" width=\"360\" height=\"240\" data-media-type=\"image\/jpeg\" \/><\/p>\n<p class=\"wp-caption-text\">Figure 2. In group therapy, usually 5\u201310 people meet with a trained therapist to discuss a common issue such as divorce, grief, an eating disorder, substance abuse, or anger management. (credit: Cory Zanker)<\/p>\n<\/div>\n<p>In <strong>group therapy<\/strong>, a clinician meets together with several clients with similar problems (Figure 2). When children are placed in group therapy, it is particularly important to match clients for age and problems. One benefit of group therapy is that it can help decrease a client\u2019s shame and isolation about a problem while offering needed support, both from the therapist and other members of the group (American Psychological Association, 2014). A nine-year-old sexual abuse victim, for example, may feel very embarrassed and ashamed. If he is placed in a group with other sexually abused boys, he will realize that he is not alone. A child struggling with poor social skills would likely benefit from a group with a specific curriculum to foster special skills. A woman suffering from post-partum depression could feel less guilty and more supported by being in a group with similar women.<\/p>\n<p>Group therapy also has some specific limitations. Members of the group may be afraid to speak in front of other people because sharing secrets and problems with complete strangers can be stressful and overwhelming. There may be personality clashes and arguments among group members. There could also be concerns about confidentiality: Someone from the group might share what another participant said to people outside of the group.<\/p>\n<figure><\/figure>\n<p>Another benefit of group therapy is that members can confront each other about their patterns. For those with some types of problems, such as sexual abusers, group therapy is the recommended treatment. Group treatment for this population is considered to have several benefits:<\/p>\n<blockquote><p>Group treatment is more economical than individual, couples, or family therapy. Sexual abusers often feel more comfortable admitting and discussing their offenses in a treatment group where others are modeling openness. Clients often accept feedback about their behavior more willingly from other group members than from therapists. Finally, clients can practice social skills in group treatment settings. (McGrath, Cumming, Burchard, Zeoli, &amp; Ellerby, 2009)<\/p><\/blockquote>\n<p>Groups that have a strong educational component are called psycho-educational groups. For example, a group for children whose parents have cancer might discuss in depth what cancer is, types of treatment for cancer, and the side effects of treatments, such as hair loss. Often, group therapy sessions with children take place in school. They are led by a school counselor, a school psychologist, or a school social worker. Groups might focus on test anxiety, social isolation, self-esteem, bullying, or school failure (Shechtman, 2002). Whether the group is held in school or in a clinician\u2019s office, group therapy has been found to be effective with children facing numerous kinds of challenges (Shechtman, 2002).<\/p>\n<p>During a group session, the entire group could reflect on an individual\u2019s problem or difficulties, and others might disclose what they have done in that situation. When a clinician is facilitating a group, the focus is always on making sure that everyone benefits and participates in the group and that no one person is the focus of the entire session. Groups can be organized in various ways: some have an overarching theme or purpose, some are time-limited, some have open membership that allows people to come and go, and some are closed. Some groups are structured with planned activities and goals, while others are unstructured: There is no specific plan, and group members themselves decide how the group will spend its time and on what goals it will focus. This can become a complex and emotionally charged process, but it is also an opportunity for personal growth (Page &amp; Berkow, 1994).<\/p>\n<section data-depth=\"1\">\n<h2>Couples Therapy<\/h2>\n<p><strong>Couples therapy<\/strong> involves two people in an intimate relationship who are having difficulties and are trying to resolve them (Figure 3). The couple may be dating, partnered, engaged, or married. The primary therapeutic orientation used in couples counseling is cognitive-behavioral therapy (Rathus &amp; Sanderson, 1999). Couples meet with a therapist to discuss conflicts and\/or aspects of their relationship that they want to change. The therapist helps them see how their individual backgrounds, beliefs, and actions are affecting their relationship. Often, a therapist tries to help the couple resolve these problems, as well as implement strategies that will lead to a healthier and happier relationship, such as how to listen, how to argue, and how to express feelings. However, sometimes, after working with a therapist, a couple will realize that they are too incompatible and will decide to separate. Some couples seek therapy to work out their problems, while others attend therapy to determine whether staying together is the best solution. Counseling couples in a high-conflict and volatile relationship can be difficult. In fact, psychologists Peter Pearson and Ellyn Bader, who founded the Couples Institute in Palo Alto, California, have compared the experience of the clinician in couples\u2019 therapy to be like \u201cpiloting a helicopter in a hurricane\u201d (Weil, 2012, para. 7).<\/p>\n<figure>\n<div style=\"width: 469px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23225158\/CNX_Psych_16_03_Couple.jpg\" alt=\"A photograph shows two people talking to a third person.\" width=\"459\" height=\"306\" data-media-type=\"image\/jpeg\" \/><\/p>\n<p class=\"wp-caption-text\">Figure 3. In couples counseling, a therapist helps people work on their relationship. (credit: Cory Zanker)<\/p>\n<\/div>\n<\/figure>\n<\/section>\n<section data-depth=\"1\">\n<h2>Family Therapy<\/h2>\n<p><strong>Family therapy<\/strong> is a special form of group therapy, consisting of one or more families. Although there are many theoretical orientations in family therapy, one of the most predominant is the systems approach. The family is viewed as an organized system, and each individual within the family is a contributing member who creates and maintains processes within the system that shape behavior (Minuchin, 1985). Each member of the family influences and is influenced by the others. The goal of this approach is to enhance the growth of each family member as well as that of the family as a whole.<\/p>\n<p>Often, dysfunctional patterns of communication that develop between family members can lead to conflict. A family with this dynamic might wish to attend therapy together rather than individually. In many cases, one member of the family has problems that detrimentally affect everyone. For example, a mother\u2019s depression, teen daughter\u2019s eating disorder, or father\u2019s alcohol dependence could affect all members of the family. The therapist would work with all members of the family to help them cope with the issue, and to encourage resolution and growth in the case of the individual family member with the problem.<\/p>\n<p>With family therapy, the nuclear family (i.e., parents and children) or the nuclear family plus whoever lives in the household (e.g., grandparent) come into treatment. Family therapists work with the whole family unit to heal the family. There are several different types of family therapy. In structural family therapy, the therapist examines and discusses the boundaries and structure of the family: who makes the rules, who sleeps in the bed with whom, how decisions are made, and what are the boundaries within the family. In some families, the parents do not work together to make rules, or one parent may undermine the other, leading the children to act out. The therapist helps them resolve these issues and learn to communicate more effectively.<\/p>\n<div data-type=\"note\" data-label=\"Link to Learning\">\n<div class=\"textbox examples\">\n<h3>Link to Learning<\/h3>\n<p>Watch this <a href=\"https:\/\/www.youtube.com\/watch?v=mPW0UZd9gQ4\">video<\/a> to get some more details view a structural family session.<\/p>\n<\/div>\n<\/div>\n<p>In <strong>strategic family therapy<\/strong>, the goal is to address specific problems within the family that can be dealt with in a relatively short amount of time. Typically, the therapist would guide what happens in the therapy session and design a detailed approach to resolving each member\u2019s problem (Madanes, 1991).<\/p>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"lumen_assessment_4743\" class=\"resizable\" src=\"https:\/\/assessments.lumenlearning.com\/assessments\/load?assessment_id=4743&#38;embed=1&#38;external_user_id=&#38;external_context_id=&#38;iframe_resize_id=lumen_assessment_4743\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:400px;\"><br \/>\n\t<\/iframe><\/p>\n<p>\t<iframe id=\"lumen_assessment_4744\" class=\"resizable\" src=\"https:\/\/assessments.lumenlearning.com\/assessments\/load?assessment_id=4744&#38;embed=1&#38;external_user_id=&#38;external_context_id=&#38;iframe_resize_id=lumen_assessment_4744\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:400px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<\/section>\n<section data-depth=\"1\">\n<div class=\"textbox learning-objectives\">\n<h3>Think It Over<\/h3>\n<section data-depth=\"1\">\n<div data-type=\"exercise\">\n<div data-type=\"problem\">\n<ul>\n<li>Your best friend tells you that she is concerned about her cousin. The cousin\u2014a teenage girl\u2014is constantly coming home after her curfew, and your friend suspects that she has been drinking. What treatment modality would you recommend to your friend and why?<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/section>\n<section data-depth=\"1\"><\/section>\n<\/div>\n<\/section>\n<div>\n<h2>Cultural Factors and Therapy<\/h2>\n<p>The sociocultural perspective looks at you, your behaviors, and your symptoms in the context of your culture and background. For example, Jos\u00e9 is an 18-year-old Hispanic male from a traditional family. Jos\u00e9 comes to treatment because of depression. During the intake session, he reveals that he is gay and is nervous about telling his family. He also discloses that he is concerned because his religious background has taught him that homosexuality is wrong. How does his religious and cultural background affect him? How might his cultural background affect how his family reacts if Jos\u00e9 were to tell them he is gay?<\/p>\n<\/div>\n<p>As our society becomes increasingly multiethnic and multiracial, mental health professionals must develop <strong>cultural competence<\/strong> (Figure 4), which means they must understand and address issues of race, culture, and ethnicity. They must also develop strategies to effectively address the needs of various populations for which Eurocentric therapies have limited application (Sue, 2004). For example, a counselor whose treatment focuses on individual decision making may be ineffective at helping a Chinese client with a collectivist approach to problem solving (Sue, 2004).<\/p>\n<p>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 balancs the importance of individualism and collectivism in the assessment, diagnosis, and treatment of client and client systems (Sue, 2001).<\/p>\n<p>This therapeutic perspective integrates the impact of cultural and social norms, starting at the beginning of treatment. Therapists who use this perspective work with clients to obtain and integrate information about their cultural patterns into a unique treatment approach based on their particular situation (Stewart, Simmons, &amp; Habibpour, 2012). Sociocultural therapy can include individual, group, family, and couples treatment modalities.<\/p>\n<figure>\n<div style=\"width: 985px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/textimgs.s3.amazonaws.com\/ospsych\/m49144\/CNX_Psych_16_05_Ethnic.jpg#fixme\" alt=\"A photo montage composed of eight photographs arranged in two parallel rows of four. From the top-left-hand-side, the photos are as follows: a person with a bicycle standing in a rice paddy, three children, three elderly people sitting along a rock wall, four cooks standing around a table, a classroom of students, a group of people seated at a covered outdoor table, two children wearing robes, and two people being held up by other people during a wedding ceremony.\" width=\"975\" height=\"328\" data-media-type=\"image\/jpeg\" \/><\/p>\n<p class=\"wp-caption-text\">Figure 4. How do your cultural and religious beliefs affect your attitude toward mental health treatment? (credit \u201ctop-left\u201d: modification of work by Staffan Scherz; credit \u201ctop-left-middle\u201d: modification of work by Alejandra Quintero Sinisterra; credit \u201ctop-right-middle\u201d: modification of work by Pedro Ribeiro Sim\u00f5es; credit \u201ctop-right\u201d: modification of work by Agustin Ruiz; credit \u201cbottom-left\u201d: modification of work by Czech Provincial Reconstruction Team; credit \u201cbottom-left-middle\u201d: modification of work by Arian Zwegers; credit \u201cbottom-right-middle\u201d: modification of work by \u201cWonderlane\u201d\/Flickr; credit \u201cbottom-right\u201d: modification of work by Shiraz Chanawala)<\/p>\n<\/div>\n<\/figure>\n<div data-type=\"note\" data-label=\"Link to Learning\">\n<div class=\"textbox examples\">\n<h3>Link to Learning<\/h3>\n<p>Watch this short <a href=\"https:\/\/www.youtube.com\/watch?v=MTh3pe8N3DQ\">video<\/a> to learn more about cultural competence and sociocultural treatments.<\/p>\n<\/div>\n<\/div>\n<section data-depth=\"1\">\n<h2>Barriers to Treatment<\/h2>\n<p>Statistically, ethnic minorities tend to utilize mental health services less frequently than White, middle-class Americans (Alegr\u00eda et al., 2008; Richman, Kohn-Wood, &amp; Williams, 2007). Why is this so? Perhaps the reason has to do with access and availability of mental health services. Ethnic minorities and individuals of low socioeconomic status (SES) report that barriers to services include lack of insurance, transportation, and time (Thomas &amp; Snowden, 2002). However, researchers have found that even when income levels and insurance variables are taken into account, ethnic minorities are far less likely to seek out and utilize mental health services. And when access to mental health services is comparable across ethnic and racial groups, differences in service utilization remain (Richman et al., 2007).<\/p>\n<p>In a study involving thousands of women, it was found that the prevalence rate of anorexia was similar across different races, but that bulimia nervosa was more prevalent among Hispanic and African American women when compared with non-Hispanic whites (Marques et al., 2011). Although they have similar or higher rates of eating disorders, Hispanic and African American women with these disorders tend to seek and engage in treatment far less than Caucasian women. These findings suggest ethnic disparities in access to care, as well as clinical and referral practices that may prevent Hispanic and African American women from receiving care, which could include lack of bilingual treatment, stigma, fear of not being understood, family privacy, and lack of education about eating disorders.<\/p>\n<p>Perceptions and attitudes toward mental health services may also contribute to this imbalance. A recent study at King\u2019s College, London, found many complex reasons why people do not seek treatment: self-sufficiency and not seeing the need for help, not seeing therapy as effective, concerns about confidentiality, and the many effects of stigma and shame (Clement et al., 2014). And in another study, African Americans exhibiting depression were less willing to seek treatment due to fear of possible psychiatric hospitalization as well as fear of the treatment itself (Sussman, Robins, &amp; Earls, 1987). Instead of mental health treatment, many African Americans prefer to be self-reliant or use spiritual practices (Snowden, 2001; Belgrave &amp; Allison, 2010). For example, it has been found that the Black church plays a significant role as an alternative to mental health services by providing prevention and treatment-type programs designed to enhance the psychological and physical well-being of its members (Blank, Mahmood, Fox, &amp; Guterbock, 2002).<\/p>\n<p>Additionally, people belonging to ethnic groups that already report concerns about prejudice and discrimination are less likely to seek services for a mental illness because they view it as an additional stigma (Gary, 2005; Townes, Cunningham, &amp; Chavez-Korell, 2009; Scott, McCoy, Munson, Snowden, &amp; McMillen, 2011). For example, in one recent study of 462 older Korean Americans (over the age of 60) many participants reported suffering from depressive symptoms. However, 71% indicated they thought depression was a sign of personal weakness, and 14% reported that having a mentally ill family member would bring shame to the family (Jang, Chiriboga, &amp; Okazaki, 2009).<\/p>\n<p>Language differences are a further barrier to treatment. In the previous study on Korean Americans\u2019 attitudes toward mental health services, it was found that there were no Korean-speaking mental health professionals where the study was conducted (Orlando and Tampa, Florida) (Jang et al., 2009). Because of the growing number of people from ethnically diverse backgrounds, there is a need for therapists and psychologists to develop knowledge and skills to become culturally competent (Ahmed, Wilson, Henriksen, &amp; Jones, 2011). Those providing therapy must approach the process from the context of the unique culture of each client (Sue &amp; Sue, 2007).<\/p>\n<div data-type=\"note\" data-label=\"Dig Deeper\">\n<div data-type=\"title\">\n<div data-type=\"title\">\n<div class=\"textbox exercises\">\n<h3>Dig Deeper: Treatment Perceptions<\/h3>\n<p>By the time a child is a senior in high school, 20% of his classmates\u2014that is 1 in 5\u2014will have experienced a mental health problem (U.S. Department of Health and Human Services, 1999), and 8%\u2014about 1 in 12\u2014will have attempted suicide (Centers for Disease Control and Prevention, 2014). Of those classmates experiencing mental disorders, only 20% will receive professional help (U.S. Public Health Service, 2000). Why?<\/p>\n<p>It seems that the public has a negative perception of children and teens with mental health disorders. According to researchers from Indiana University, the University of Virginia, and Columbia University, interviews with over 1,300 U.S. adults show that they believe children with depression are prone to violence and that if a child receives treatment for a psychological disorder, then that child is more likely to be rejected by peers at school.<\/p>\n<p>Bernice Pescosolido, author of the study, asserts that this is a misconception. However, stigmatization of psychological disorders is one of the main reasons why young people do not get the help they need when they are having difficulties. Pescosolido and her colleagues caution that this stigma surrounding mental illness, based on misconceptions rather than facts, can be devastating to the emotional and social well-being of our nation\u2019s children.<\/p>\n<p>This warning played out as a national tragedy in the 2012 shootings at Sandy Hook Elementary. In her blog, Suzy DeYoung (2013), co-founder of Sandy Hook Promise (the organization parents and concerned others set up in the wake of the school massacre) speaks to treatment perceptions and what happens when children do not receive the mental health treatment they desperately need.<\/p>\n<p style=\"padding-left: 30px;\">I&#8217;ve become accustomed to the reaction when I tell people where I&#8217;m from. Eleven months later, it&#8217;s as consistent as it was back in January. Just yesterday, inquiring as to the availability of a rental house this holiday season, the gentleman taking my information paused to ask, \u201cNewtown, CT? Isn&#8217;t that where that&#8230;that <em data-effect=\"italics\">thing<\/em> happened?<\/p>\n<p style=\"padding-left: 30px;\">A recent encounter in the Massachusetts Berkshires, however, took me by surprise.<\/p>\n<p style=\"padding-left: 30px;\">It was in a small, charming art gallery. The proprietor, a woman who looked to be in her 60s, asked where we were from. My response usually depends on my present mood and readiness for the inevitable dialogue. Sometimes it&#8217;s simply, Connecticut. This time, I replied, Newtown, CT. The woman&#8217;s demeanor abruptly shifted from one of amiable graciousness to one of visible agitation.<\/p>\n<p style=\"padding-left: 30px;\">\u201cOh my god,\u201d she said wide eyed and open mouthed. \u201cDid you know her?\u201d<\/p>\n<p style=\"padding-left: 30px;\">. . . .<\/p>\n<p style=\"padding-left: 30px;\">\u201cHer?\u201d I inquired<\/p>\n<p style=\"padding-left: 30px;\">That woman,\u201d she replied with disdain, \u201cthat woman that raised that monster.\u201d<\/p>\n<p style=\"padding-left: 30px;\">\u201cThat woman&#8217;s\u201d name was Nancy Lanza. Her son, Adam, killed her with a rifle blast to the head before heading out to kill 20 children and six educators at Sandy Hook Elementary School in Newtown, CT last December 14th.<\/p>\n<p style=\"padding-left: 30px;\">When Nelba Marquez Greene, whose beautiful 6-year-old daughter, Ana, was killed by Adam Lanza, was recently asked how she felt about \u201cthat woman,\u201d this was her reply:<\/p>\n<p style=\"padding-left: 30px;\">\u201cShe&#8217;s a victim herself. And it&#8217;s time in America that we start looking at mental illness with compassion, and helping people who need it.<\/p>\n<p style=\"padding-left: 30px;\">\u201cThis was a family that needed help, an individual that needed help and didn&#8217;t get it. And what better can come of this, of this time in America, than if we can get help to people who really need it?\u201d (pars. 1\u20137, 10\u201315)<\/p>\n<p>Fortunately, we are starting to see campaigns related to the destigmatization of mental illness and an increase in public education and awareness. Join the effort by encouraging and supporting those around you to seek help if they need it. To learn more, visit the National Alliance on Mental Illness (NAMI) website (http:\/\/www.nami.org\/). The nation\u2019s largest nonprofit mental health advocacy and support organization is NAMI.<\/p>\n<\/div>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"lumen_assessment_4745\" class=\"resizable\" src=\"https:\/\/assessments.lumenlearning.com\/assessments\/load?assessment_id=4745&#38;embed=1&#38;external_user_id=&#38;external_context_id=&#38;iframe_resize_id=lumen_assessment_4745\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:400px;\"><br \/>\n\t<\/iframe><\/p>\n<p>\t<iframe id=\"lumen_assessment_4746\" class=\"resizable\" src=\"https:\/\/assessments.lumenlearning.com\/assessments\/load?assessment_id=4746&#38;embed=1&#38;external_user_id=&#38;external_context_id=&#38;iframe_resize_id=lumen_assessment_4746\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:400px;\"><br \/>\n\t<\/iframe><\/p>\n<p>\t<iframe id=\"lumen_assessment_4747\" class=\"resizable\" src=\"https:\/\/assessments.lumenlearning.com\/assessments\/load?assessment_id=4747&#38;embed=1&#38;external_user_id=&#38;external_context_id=&#38;iframe_resize_id=lumen_assessment_4747\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:400px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<section data-depth=\"1\">\n<div>\n<div class=\"textbox learning-objectives\">\n<h3>Think It Over<\/h3>\n<section data-depth=\"1\">\n<div data-type=\"exercise\">\n<div data-type=\"problem\">\n<ul>\n<li>What is your attitude toward mental health treatment? Would you seek treatment if you were experiencing symptoms or having trouble functioning in your life? Why or why not? In what ways do you think your cultural and\/or religious beliefs influence your attitude toward psychological intervention?<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<\/div>\n<div>\n<section>\n<div class=\"textbox key-takeaways\">\n<h3>Glossary<\/h3>\n<div data-type=\"definition\"><strong>confidentiality:\u00a0<\/strong>therapist cannot disclose confidential communications to any third party, unless mandated or permitted by law<\/div>\n<div data-type=\"definition\">\n<div data-type=\"definition\"><strong>couples therapy:\u00a0<\/strong>two people in an intimate relationship, such as husband and wife, who are having difficulties and are trying to resolve them with therapy<\/div>\n<div data-type=\"definition\"><strong>cultural competence <\/strong>therapist\u2019s understanding and attention to issues of race, culture, and ethnicity in providing treatment<\/div>\n<\/div>\n<div data-type=\"definition\">\n<div data-type=\"definition\"><strong>family therapy:\u00a0<\/strong>special form of group therapy consisting of one or more families<\/div>\n<div data-type=\"definition\"><strong>group therapy:\u00a0<\/strong>treatment modality in which 5\u201310 people with the same issue or concern meet together with a trained clinician<\/div>\n<\/div>\n<div data-type=\"definition\"><strong>individual therapy:\u00a0<\/strong>treatment modality in which the client and clinician meet one-on-one<\/div>\n<div data-type=\"definition\"><strong>intake:\u00a0<\/strong>therapist\u2019s first meeting with the client in which the therapist gathers specific information to address the client\u2019s immediate needs<\/div>\n<div data-type=\"definition\"><strong>strategic family therapy:\u00a0<\/strong>therapist guides the therapy sessions and develops treatment plans for each family member for specific problems that can addressed in a short amount of time<\/div>\n<div data-type=\"definition\"><strong>structural family therapy:\u00a0<\/strong>therapist examines and discusses with the family the boundaries and structure of the family: who makes the rules, who sleeps in the bed with whom, how decisions are made, and what are the boundaries within the family<\/div>\n<\/div>\n<\/section>\n<\/div>\n<p>\t<iframe id=\"lumen_assessment_4876\" class=\"resizable\" src=\"https:\/\/assessments.lumenlearning.com\/assessments\/load?assessment_id=4876&#38;embed=1&#38;external_user_id=&#38;external_context_id=&#38;iframe_resize_id=lumen_assessment_4876\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:400px;\"><br \/>\n\t<\/iframe><\/section>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-2654\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Modification, adaptation, and original content. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Treatment Modalities. <strong>Authored by<\/strong>: OpenStax College. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:CVPTyhFg@6\/Treatment-Modalities\">http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:CVPTyhFg@6\/Treatment-Modalities<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em>. <strong>License Terms<\/strong>: Download for free at http:\/\/cnx.org\/contents\/4abf04bf-93a0-45c3-9cbc-2cefd46e68cc@5.48<\/li><li>Image of chairs. <strong>Authored by<\/strong>: wollyvonwollery. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/pixabay.com\/en\/chairs-chair-circle-therapy-58475\/\">https:\/\/pixabay.com\/en\/chairs-chair-circle-therapy-58475\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/cc0\">CC0: No Rights Reserved<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section>","protected":false},"author":29,"menu_order":6,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Treatment Modalities\",\"author\":\"OpenStax College\",\"organization\":\"\",\"url\":\"http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:CVPTyhFg@6\/Treatment-Modalities\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"Download for free at http:\/\/cnx.org\/contents\/4abf04bf-93a0-45c3-9cbc-2cefd46e68cc@5.48\"},{\"type\":\"original\",\"description\":\"Modification, adaptation, and original content\",\"author\":\"\",\"organization\":\"Lumen 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