Chapter 15
SLK 110
Elements Of the Treatment Process
● Sigmund Freud is widely credited with launching modern psychotherapy.
○ He discovered that a patient’s symptoms cleared up when she was
encouraged to talk about emotionally charged experiences from her past.
○ Talking things through had enabled the patient to release bottled-up
emotions that had caused her symptoms.
■ This insight led him to develop a new treatment procedure, which he
called psychoanalysis.
Treatments: How Many Types are there?
● Approaches to treatment can be classified into three major categories:
1. Insight Therapies:
● Is talk therapy in the tradition of Freud’s psychoanalysis.
● Clients engage in complex, often lengthy verbal interactions with their
therapist.
● The goal is to pursue increased insight regarding the nature of the
client’s difficulties and to sort through possible solutions.
2. Behaviour Therapies:
● Based on the principles of learning.
● Emphasising personal insights, behaviour therapists make direct
efforts to change problematic responses and maladaptive habits.
1
, 3. Biomedical Therapies:
● Involve intervention into a person’s biological functioning.
● Most widely used procedures are drug therapy and electroconvulsive
therapy.
● Biomedical therapies suggest these treatments are provided only by
doctors with a medical degree.
Clients: Who seeks therapy?
● People seeking mental health treatment represent the full range of human
problems:
○ Anxiety, depression, unsatisfactory interpersonal relations, troublesome
habits, poor self-control, low self-esteem, marital conflicts, self-doubt, a
sense of emptiness and feelings of personal stagnation.
● Mood and anxiety disorders were more common among women, and substance use
disorders were more common among men.
○ More than 17 million people in South Africa are dealing with depression,
substance abuse, anxiety, bipolar disorder or schizophrenia.
● The overburdened health system and the lack of mental resources in South Africa
mean that many people who require therapy do not receive it.
○ About 30% of South African adults meet the criteria for a mental disorder at
some stage in their life.
■ One of the most common reasons for not seeking support from
mental health services may be the individual’s perception relating to
the need for assistance.
2
, ■ The stigma surrounding receiving mental health treatment is a serious
barrier as many people equate seeking therapy with admitting
personal weakness or cultural deficiency.
Utilisation of Mental Health Services in South Africa
● Service delivery within a South African context is distributed across three levels:
○ Primary (consisting of clinics, healthcare centres and district hospitals).
○ Secondary (regional hospitals).
○ Tertiary (provincial hospitals) and quaternary (specialised hospitals).
● Psychological and psychiatric services are insufficient at all levels, and particularly at
primary and secondary levels.
○ The tertiary levels are overcrowded and under-resourced.
○ This poses a serious challenge to the accessibility of mental healthcare within
a community setting.
● Regional and district hospitals are ill-prepared to facilitate the increased demand for
psychiatric services on both a primary and secondary level.
○ Budget constraints and ineffective utilisation of resources contribute to
dissatisfaction with the implementation of the Mental Healthcare Act.
Mental Health Professionals Who Can Provide Professional Treatment
● It is not uncommon for people to seek help from friends, family members and
partners before seeking assistance from a psychiatrist or psychologist.
○ Friends and relatives may provide you with excellent advice about your
personal problems, but their assistance does not qualify as therapy.
3
, ○ A common source of confusion about psychotherapy is the variety of ‘helping
professions’ involved.
● Psychology and psychiatry are the main professions involved in the delivery of
psychotherapy, but treatment is also provided by other types of mental health
professionals.
Psychology:
● The professions within the field of psychology include the following fields of expertise:
○ Registered counsellor.
○ Psychometrist.
○ Clinical psychologist.
○ Counselling psychologist.
○ Educational psychologist.
○ Research psychologist.
○ Industrial psychologist.
● Those interested in majoring in psychology at a postgraduate level would need to complete an
undergraduate degree and Honours degree, and a Master’s programme at an accredited tertiary
academic institution.
● A Master’s programme in clinical, counselling, research and educational psychology includes
coursework, practical exposure and the completion of a mini dissertation.
○ This is conducted over a two-year period.
● Clinical psychologists and counselling psychologists specialise in the diagnosis and treatment of
psychological disorders and everyday behavioural problems.
4
SLK 110
Elements Of the Treatment Process
● Sigmund Freud is widely credited with launching modern psychotherapy.
○ He discovered that a patient’s symptoms cleared up when she was
encouraged to talk about emotionally charged experiences from her past.
○ Talking things through had enabled the patient to release bottled-up
emotions that had caused her symptoms.
■ This insight led him to develop a new treatment procedure, which he
called psychoanalysis.
Treatments: How Many Types are there?
● Approaches to treatment can be classified into three major categories:
1. Insight Therapies:
● Is talk therapy in the tradition of Freud’s psychoanalysis.
● Clients engage in complex, often lengthy verbal interactions with their
therapist.
● The goal is to pursue increased insight regarding the nature of the
client’s difficulties and to sort through possible solutions.
2. Behaviour Therapies:
● Based on the principles of learning.
● Emphasising personal insights, behaviour therapists make direct
efforts to change problematic responses and maladaptive habits.
1
, 3. Biomedical Therapies:
● Involve intervention into a person’s biological functioning.
● Most widely used procedures are drug therapy and electroconvulsive
therapy.
● Biomedical therapies suggest these treatments are provided only by
doctors with a medical degree.
Clients: Who seeks therapy?
● People seeking mental health treatment represent the full range of human
problems:
○ Anxiety, depression, unsatisfactory interpersonal relations, troublesome
habits, poor self-control, low self-esteem, marital conflicts, self-doubt, a
sense of emptiness and feelings of personal stagnation.
● Mood and anxiety disorders were more common among women, and substance use
disorders were more common among men.
○ More than 17 million people in South Africa are dealing with depression,
substance abuse, anxiety, bipolar disorder or schizophrenia.
● The overburdened health system and the lack of mental resources in South Africa
mean that many people who require therapy do not receive it.
○ About 30% of South African adults meet the criteria for a mental disorder at
some stage in their life.
■ One of the most common reasons for not seeking support from
mental health services may be the individual’s perception relating to
the need for assistance.
2
, ■ The stigma surrounding receiving mental health treatment is a serious
barrier as many people equate seeking therapy with admitting
personal weakness or cultural deficiency.
Utilisation of Mental Health Services in South Africa
● Service delivery within a South African context is distributed across three levels:
○ Primary (consisting of clinics, healthcare centres and district hospitals).
○ Secondary (regional hospitals).
○ Tertiary (provincial hospitals) and quaternary (specialised hospitals).
● Psychological and psychiatric services are insufficient at all levels, and particularly at
primary and secondary levels.
○ The tertiary levels are overcrowded and under-resourced.
○ This poses a serious challenge to the accessibility of mental healthcare within
a community setting.
● Regional and district hospitals are ill-prepared to facilitate the increased demand for
psychiatric services on both a primary and secondary level.
○ Budget constraints and ineffective utilisation of resources contribute to
dissatisfaction with the implementation of the Mental Healthcare Act.
Mental Health Professionals Who Can Provide Professional Treatment
● It is not uncommon for people to seek help from friends, family members and
partners before seeking assistance from a psychiatrist or psychologist.
○ Friends and relatives may provide you with excellent advice about your
personal problems, but their assistance does not qualify as therapy.
3
, ○ A common source of confusion about psychotherapy is the variety of ‘helping
professions’ involved.
● Psychology and psychiatry are the main professions involved in the delivery of
psychotherapy, but treatment is also provided by other types of mental health
professionals.
Psychology:
● The professions within the field of psychology include the following fields of expertise:
○ Registered counsellor.
○ Psychometrist.
○ Clinical psychologist.
○ Counselling psychologist.
○ Educational psychologist.
○ Research psychologist.
○ Industrial psychologist.
● Those interested in majoring in psychology at a postgraduate level would need to complete an
undergraduate degree and Honours degree, and a Master’s programme at an accredited tertiary
academic institution.
● A Master’s programme in clinical, counselling, research and educational psychology includes
coursework, practical exposure and the completion of a mini dissertation.
○ This is conducted over a two-year period.
● Clinical psychologists and counselling psychologists specialise in the diagnosis and treatment of
psychological disorders and everyday behavioural problems.
4
