Treatment of Psychological Disorders

Types of Therapy There are 3 Main Types of Therapies: 1. Insight Therapies Therapy achieved through verbal interaction 2. Behavioral Therapies Learning principles applied to change maladaptive behaviors 3. Biomedical Therapies Physiological intervention to reduce symptoms

Insight Therapies Psychoanalysis Recovery of unconscious conflicts & motives Free Association patients are invited to relate whatever comes into their minds during the analytic session, and not to censor their thoughts Dream Analysis the process of explaining the meaning of the way the unconscious thoughts and emotions are processed in the mind during sleep Interpretation Patient talks – therapist listens & interprets

Rorschach Inkblot Test subjects' perceptions of inkblots are recorded and then analyzed & interpreted Sometimes used to examine a person's personality characteristics and emotional functioning

Insight Therapies Dangers of Psychoanalysis Dangers? Resistance Occurs when patients patients block memories from conscious memory Transference unconscious redirection of feelings from one person to another person or object Projection ascribing internal feelings on to other things or people

Insight Therapies Person (Client) -Centered Therapy Cognitive Therapy Carl Rogers therapists create a comfortable, non-judgmental environment using a non-directive approach to aid patients in finding their own solutions to problems Cognitive Therapy Aaron Beck help the patient overcome difficulties by identifying and changing dysfunctional thinking, behavior, and emotional responses Group Therapy Simultaneous treatment of several clients 6 – 10 individuals meet face to face with a trained therapist

Behavioral Therapies Based on 2 Assumptions Types: 1. Behavior is a product of learning 2. What has been learned can be unlearned Types: Systematic Desensitization (Counter-conditioning) Aversion Therapy Social Skills Training

Systematic Desensitization Behavior therapy used to reduce phobic clients’ anxiety responses through counter-conditioning Steps 1. Build an Anxiety Hierarchy 2. Training in Deep Muscle Relaxtaion 3. Client tries to work through the hierarchy, learning to remain relaxed while imagining each stimulus 4. if possible, confront the real stimulus

Aversion Therapy Behavior therapy in which an aversive stimulus is paired with a stimulus that elicits an undesirable response Example: Emetic Drug, Electric Shock, etc.

Social Skills Training operant conditioning procedures for training social skills followed by modeling, coaching, and social cognitive techniques

Biomedical Therapies Psychopharmacotherapy Treatment of psychological disorders with medication Types of Medication: Anti-Anxiety Drugs Anti-Psychotic Drugs Anti-Depressant Drugs **Please remember that medication is usually a SHORT-TERM solution and does not treat the underlying cause of the disorder. Medication also comes with side effects & safety concerns. **

Anti-Anxiety Drugs relieve anxiety by slowing down the central nervous system to relax & calm you Can also be prescribed as sleeping pills and muscle relaxants Once you stop taking the drug, Anxiety symptoms return full force

Anti-Anxiety Drugs Side Effects Benzodiazapines/Tranquilizers Fast acting – take effect within 30 minutes Can be taken as needed Reduction in brain activity Metabolize slowly - can build up over time causing oversedation Side Effects Drowsiness, lack of energy Clumsiness, slow reflexes Slurred speech Confusion and disorientation Depression Dizziness, lightheadedness Impaired thinking and judgment Memory loss, forgetfulness Nausea, stomach upset Blurred or double vision Common Names Xanax (alprazolam) Klonopin (clonazepam) Valium (diazepam) Ativan (lorazepam)

Anti-Anxiety Drugs Anti-Depressant Drugs Buspirone (BuSpar) Preferred because dependency is less common Take a lot longer to work – up to 4 – 6 weeks Buspirone (BuSpar) Newer anti-anxiety medication that doesn’t impair memory & is not as addictive Slower acting – takes about 2 weeks Increases serotonin & decreases dopamine in the brain Beta Blockers Traditionally used to tread high blood pressure & heart problems Fight stress hormones like norepinephrine & controls physical symptoms of anxiety (heart rate, blood pressure, sweating, etc.)

Anti-Psychotic Drugs used to treat psychotic symptoms found in Schizophrenia (hallucinations, delusion, paranoia, etc.) Typical Atypical * Discovered in the 1950’s for Schizophrenia treatment only * Chlorpromazine (Thorazine) * Haloperidol (Haldol) * Perphenazine (generic only) * Fluphenazine (generic only) 1990’s – 2nd Generation Anti Psychotics * Risperidone (Risperdal) * Olanzapine (Zyprexa) * Quetiapine (Seroquel) * Ziprasidone (Geodon) * Aripiprazole (Abilify) * Paliperidone (Invega)

Anti-Psychotic Drugs Side Effects Most side effects go away after a few days and often can be managed successfully Drowsiness Dizziness when changing positions Blurred vision Rapid heartbeat Sensitivity to the sun Skin rashes Menstrual problems for women Tardive Dyskinesia (TD) Can get this from prolonged usage Uncontrollable muscle movement usually around the mouth Atypical Major weight gain Metabolic changes Risk of Diabetes & High Cholesterol Typical Rigidity Persistent muscle spasms Tremors Restlessness -

Anti-Depressant Drugs 5 Major Types SSRI’s SNRI’s Atypical Antidepressants Tricyclic & Tetracyclic MAOI’s Very popular treatment option for moderate to severe depression There are TONS available & often specific combinations are concocted by doctors based on individual cases

Anti-Depressant Drugs Selective Serotonin Reuptake Inhibitors (SSRI’s) most commonly prescribed antidepressants SSRIs block the reabsorption (reuptake) of the neurotransmitter serotonin in the brain seems to help brain cells send and receive chemical messages, which in turn boosts mood called selective because they seem to primarily affect serotonin, not other neurotransmitters Common FDA approved SSRI’s Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac, Prozac Weekly, Sarafem) Paroxetine (Paxil, Paxil CR, Pexeva) Sertraline (Zoloft)

Anti-Depressant Drugs Serotonin Norepinephrine Reuptake Inhibitors (SNRI’s) block the absorption (reuptake) of the neurotransmitters serotonin and norepinephrine called dual reuptake inhibitors Venlafaxine (Effexor XR) Desvenlafaxine (Pristiq) Duloxetine (Cymbalta) Atypical Antidepressants Called “Atypical” because they don’t really fit into any other category Mostly affect Dopamine, Serotonin & Norepinephrine Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL Trazodone (Oleptro Mirtazapine (Remeron, Remeron SolTab) Nefazodone

Anti-Depressant Drugs Tricyclic & Tetracyclics Older versions of antidepressants that have mostly been replaced Still an effective option for some patients Block reabsorption (reuptake) of Serotonin & Norepinephrine Names: Amitriptyline Desipramine (Norpramin) Nortriptyline (Pamelor) Protriptyline (Vivactil) Trimipramine (Surmontil) Monoamine Oxidase Inhibitors (MAOI’s) 1st type of antidepressant developed – now considered “last resort” Require strict dietary restrictions Can cause dangerous high blood pressure when combined with certain foods The enzyme monoamine oxidase is involved in removing norepinephrine, serotonin, and dopamine from the brain. MAOIs prevent this. Names: Isocarboxazid (Marplan) Phenelzine (Nardil) Selegiline (Emsam, Eldepryl, Zelapar) Tranylcypromine (Parnate)

Electroconvulsive Therapy electric currents are passed through the brain, deliberately triggering a brief seizure Used when other treatments are unsuccessful Stigma? based on past experimental treatments Media attention Electroconvulsive therapy is much safer today

New Trends in Therapy Eclecticism Positive Psychology Therapy that draws upon multiple theories, styles, or ideas to gain complementary insights into a subject, or application different theories in particular cases Individualized Psychology Positive Psychology Martin Seligman (1998) the scientific study of positive experiences, positive individual traits, and the institutions that facilitate their development concerned with well-being and optimal functioning, positive psychology aims to broaden the focus of clinical psychology beyond suffering and its direct alleviation

New Trends in Therapy Light Therapy Reverse Psychology The use of bright light to treat depression & circadian rhythm disorders Reverse Psychology a technique involving sharing a belief or behavior that is opposite to the one desired Hopefully will encourage what actually is desired: the opposite of what is suggested Mostly used on children & teens