Treatment of Psychological Disorders Jeff Qian and Taylor Whitehead

Treatment Approaches Insight into true nature of a disorder can be derived from examining the strategy that is most effective in treating the disorder.

Insight Therapies: Psychoanalytic and Humanistic Psychoanalytic approach to treatment of abnormal behavior is rooted in the concept of insight. Psychoanalysis (Psychoanalytic Therapy) ●Developed by Freud ●Focuses on probing past defense mechanisms of repression and rationalization to understand the unconscious cause of a problem ○ Free Association: patient reports any and all conscious thoughts and ideas ■ This hints to the nature of unconscious conflict ○ Dreams: images and occurrences in dreams are actually symbols representing the truly meaningful content of dreams ○ Transference: patient pushes thoughts and feelings about certain people or events onto therapist ■ Reveals nature of patient’s conflicts Risks *Countertransference*: occurs when therapist pushes his/her feelings onto patient Therapist strives to remain detached from the patient: resists emotional/personal involvement

Insight Therapies: Psychoanalytic and Humanistic (cont.) Instead of treating the person seeking help as a patient, the humanistic approach treats the individual. Humanistic Therapy Client-Centered Therapy ○ Invented by Carl Roger ○ Clients can only be understood in terms of their own reality ○ Focuses on client’s present perception of reality ○ Goal is to help client realize full potential through self-actualization ○ Therapist is open, honest, and expressive rather than being detached ○ Therapist provides unconditional positive regard to help client reach a state of unconditional self- worth ○ Final key to success is the therapist’s ability to view world from client’s eyes Gestalt Therapy ○ Developed by Fritz Perls ○ Combines both physical and mental therapies ○ Blend awareness of unconscious tensions with the belief that one must become aware of and deal with those tensions by taking personal responsibility ○ Physically act out conflicts ■ Empty Chair Technique

Behavioral Therapy ●Short-term process ●Treats symptoms (no deep underlying cause of problem) ●Abnormal behavior is the symptom and problem ○ Counterconditioning: technique where a response to a given stimulus is replaced by a different response ■ Aversion Therapy: aversive stimulus is repeatedly paired with the behavior the client wishes to stop ■ Systematic Desensitization: replace one response with another response Other Forms of Behavioral Therapy Extinction Procedure: weaken Maladaptive responses Flooding: exposing client to the stimulus that causes the undesirable response Implosion: Client imagines disruptive stimuli rather than confronting it Operant Conditioning: positive and negative reinforcement Behavioral Contracting: therapist and client draw up a contract that they both agree to abide by Modeling: clients watch someone act in a certain way and then receive a reward

Cognitive Therapy ●Changing the ways people think about situations in order to change behaviors ○ Rational-Emotive Behavior Therapy (REBT) ■ Developed by Albert Ellis ■ Confronted with situations, people will recite statements to themselves that express maladaptive thoughts ■ Goal is to change maladaptive thoughts and emotional response by confronting the irrational thoughts directly ○ Cognitive Therapy ■ Developed by Aaron Beck ■ Focus on maladaptive schemas ■ Goal is to eliminate or modify the individual’s maladaptive schemas

Biological Therapies ●Medical approaches to behavioral problems ●Used in conjunction with other forms of treatment ○ Electroconvulsive Therapy ■ High voltages of electricity are passed across a patient’s head ■ Successful in treatment of major depression, however only used if all other treatments for depression have failed ●Risks ○ Temporary Amnesia ○ More permanent memory loss ○ Can result in seizures ○ Psychosurgery ■ Most well-known form is the prefrontal lobotomy ■ Parts of frontal lobes are cut off from the rest of the brain ●Risks ○ Patients are left in catatonic state

Biological Therapies (cont.) ●Psychopharmacology ○ Treatment of psychological and behavioral maladaptives with drugs ■ Antipsychotics (Clozapine, Thorazine, Haldol) ●Reduce symptoms of Schizophrenia by blocking neural receptors of dopamine ○ Risks ■ Jerky movements ■ Tremors ■ Muscle Stiffness ●Clinician decides if disorder or side effects are worse ■ Antidepressant Drugs ●MAO Inhibitors (Eutron) ○ Increase serotonin and norepinephrine in the synaptic cleft ○ Produce increase by blocking monoamine oxidase which are responsible for the breakdown of many neurotransmitters ■ Risks ●Effective however toxic, require special dietary modifications

Biological Therapies (cont.) ●Tricyclics (Norpramin) ○ Used frequently ○ Amitriptyline and Imipramine (other drugs) increase amount of serotonin and norepinephrine ●Selective Reuptake Inhibitors (Prozac) ○ Increase amount of neurotransmitters at the synaptic cleft ○ Block the reuptake mechanism of the cell that released neurotransmitters ○ Indirect mechanism of action means fewer side effects ●Anxiolytics (Xanax) ○ Depress central nervous system and reduce anxiety while increasing feeling of well-being and reducing insomnia ■ Risks ●Include barbiturates which are rarely used because of their potential for addiction and danger when mixed with other drugs ●Benzodiazepines (Valium and Librium) ○ Cause muscle relaxation and feeling of tranquility ●Lithium Carbonate (A Salt) ○ Treats Bipolar Disorder ○ Mechanism of action is not known

Modes of Therapy ●Group Therapy ○ Clients meet together with a therapist as an interactive group ○ Group members learn from each other ○ Therapist is moderator ■ Advantages ●Less expensive ●Group dynamic is therapeutic in itself ■ Disadvantage ●Psychological effect is diluted because attention is focused on group rather than individual ○ Twelve Step Programs ■ Not moderated by professional psychotherapists ■ Combination of spirituality and group therapy ■ Focus on strong support system

Modes of Therapy (cont.) ●Couples or Family Therapy ○ Treatment arose out of simple observation that dysfunctional behavior affects the afflicted person’s loved ones ○ Help with communication and resolve conflicts ○ Focus on whole family instead of just “ill patient” ■ Couples Therapy ●Approach couple dyad as a system that involves complex interactions ■ Family Therapy ●Allows family members to express their feelings to each other and to therapist ●Encourages family members to listen to each other ●Therapy doesn’t minimize or get rid of stress but teaches family to overcome the stress

Vocabulary Manifest Content: images and occurrences Latent Content: truly meaningful, content of dreams Genuineness: Therapist is open, honest, and expressive Accurate Empathic Understanding: therapist’s ability to view the world from the eyes of the client Negative Triad: involves negative view of self, of the world, and of the future, these views are learned from experience Arbitrary Inference: person draws conclusion without evidence Dichotomous Thinking: involves all-or-none conceptions of situations